Fatigue Causes Internal Disorders

Almost every illness can make you tired. The body signals that it needs rest and help. In some diseases, however, fatigue is particularly common.

Fatigue often indicates first of all that something is wrong in the body, that it has to defend itself against an incipient infection, a creeping dysfunction. As a general disease symptom, fatigue feelings accompany very different health problems.


In some diseases, however, those affected suffer more than usual fatigue. This is often the case with…

Acute as well as chronic infections, inflammation
Low blood pressure, high blood pressure
Heart disease
Lung disease
Kidney and liver damage
Hormonal and metabolic disorders
Certain autoimmune diseases

Here you will find a brief overview of important clinical pictures with the typical symptoms. For most diseases there are detailed guides on our pages (see related links) for more information.

Infections, inflammation: fatigue is one of them

– Cold flu

A common cold is usually transmitted by viruses. First symptoms are frequent itching in the nose and in the throat area, tiredness, pressure feeling or pain in the head area, shivering. Then follow the typical symptoms such as hoarseness, sore throat, runny nose, cough. In addition, there are often headache and body aches, fatigue, sometimes fever.

When influenza (influenza), the symptoms are often sudden and violent. Characteristic are severe headache and body aches, chills, fever, cough, runny nose, fatigue, tiredness, photophobia. If the symptoms indicate a flu, a doctor should clarify the infection.

– Pfeiffer’s glandular fever (mononucleosis)

These infectious diseases triggered by the Eppstein-Barr virus are often reported by physicians in connection with the symptom of fatigue. In childhood, the disease can go unnoticed. In adults, flu-like symptoms usually occur.

Symptoms: Fever, sore throat, tiredness, fatigue and swollen, but not or only slightly painful lymph nodes, especially on the neck and neck. After surviving infection, fatigue sometimes lasts for weeks.

At times, doctors also suspect a past mononucleosis as a cause of chronic fatigue syndrome.

– Chronic sinusitis

Permanent inflamed mucous membranes in the sinuses can cause frequent colds, allergies or constant external stimuli. Occasionally anatomical features such as a crooked nasal septum favor chronic inflammation. For chronic inflammation in the nasal cavity, the ear, nose and throat doctor are in demand.

Symptoms: Headache, nasal forehead pressure, tiredness, chronic runny nose are typical symptoms. Often the secretion does not drain from the nose, but inwards. Hoarseness, free-hacking, coughing is therefore common.

– Facial rose (herpes zoster infection)

After a chickenpox infection, which usually has passed through childhood, the responsible varicella-zoster virus remains in the nerve nodes without being noticeable. Under certain conditions, however, it can become active again, for example if the immune system is temporarily weakened. If it affects nerves in the face, it causes a facial rose. Other possible disease zones include the ears, eyes, back and abdomen.

The main symptoms of a facial rose are initially tiredness and severe facial pain, shortly thereafter skin rashes with the typical blisters, tingling and numbness, fatigue. A herpes zoster infection generally weakens very much, and those affected often feel tired even after the symptoms have died down.

Anemia: Often associated with fatigue

In the blood, the red blood cells (erythrocytes) transport the oxygen with their dye hemoglobin. If the blood contains too few erythrocytes or hemoglobin, the organs and tissues of the body are less well supplied with oxygen. There are several forms of anemia. Important triggers may be an iron, folic acid or vitamin B12 deficiency. In particular, women are more likely to suffer from iron deficiency anemia, such as increased iron needs during pregnancy and lactation, or heavy menstrual bleeding. In addition, various diseases sometimes cause anemia, such as kidney disorders, bone marrow diseases or chronic bleeding, for example, in gastric ulcers. Other possible causes include infectious diseases such as malaria, blood disorders such as leukemia (“blood cancer”), tumors, lymphoma or side effects of some drugs.

Symptoms: The classic symptoms of anemia include pale skin and mucous membranes (especially in iron deficiency anemia and vitamin B12 deficiency), fatigue (especially in vitamin B12 deficiency, here, the skin may also be yellow), poor performance, dizziness , Sensitivity to cold. The other symptoms depend on the particular form of anemia and affect different bodily functions. These may be skin changes, gastrointestinal disorders, heart problems.

Diagnosis and Therapy: The medical history, blood tests and possibly further investigations consolidate the diagnosis. The therapy depends on the particular cause.

Blood pressure changes and tiredness

– Low blood pressure

People with low blood pressure (blood pressure levels below 105 to 60 mmHg) are more likely to complain of discomfort than those who are overweight. Physical inactivity promotes low blood pressure levels. Especially with a pronounced feeling of fatigue it is often indistinguishable whether ultimately the lack of physical activity is responsible for it. Sometimes also drugs such as antihypertensives as a trigger in question. The affected person should talk to their doctor about this. Although low blood pressure can be annoying, but rarely has disease value.

Symptoms: Some sufferers may feel less well-off, unfocused, fast-tired and need longer to get well in the mornings. Sleep disorders, cold hands and cold feet, depressive moods are also often associated with arterial hypotension (arterial hypotension).

– High blood pressure

High blood pressure levels (from 140 to 90 mmHg) increase the risk of vasoconstriction, heart disease and strokes. However, the increased pressure in the blood vessels initially hardly noticeable by complaints. The exact causes of hypertension are mostly unknown. However, there are a number of risk factors such as obesity, smoking, stress, lack of exercise. In addition, certain diseases can lead to hypertension, such as kidney disease, hormonal imbalances, a sleep apnea syndrome or some medications.

Symptoms: Headache, nervousness, dizziness when bending or getting up, palpitations, shortness of breath during exercise, nosebleeds, sleep disturbances and tiredness can sometimes be the first signs.

Regular blood pressure checks, for example, once a year help to detect a high pressure early and to get a grip. Also, in many pharmacies it is possible to measure the blood pressure.

Heart disease: often associated with fatigue

– Heart failure

Fatigue is a common cause of many heart diseases. Above all, feelings of fatigue and weakness occur in heart failure. Because of the insufficient cardiac output many organ functions are impaired and various damages arise, increased tiredness is multiple reasons. Depending on which heart chamber and which organ systems are affected by the insufficiency, different symptoms are in the foreground.

Symptoms: Left heart failure manifests itself mainly in respiratory distress on exertion and then also at rest, nocturnal cough, asthmatic complaints.

In case of right heart failure, feet and legs swell, veins jam on the neck. Those affected gain weight, despite loss of appetite, and often have indigestion. Other typical symptoms of both forms of heart failure include frequent nocturnal urination, cardiac arrhythmia, wet, cold skin, insomnia, anxiety.

– Cardiac arrhythmias

As bradycardia doctors refer to a cardiac arrhythmia in which the heartbeat is too slow and can occasionally suspend short term.

Symptoms: Fatigue, followed by fainting or even brief fainting, may be indicative of bradycardia. Sweats, shortness of breath, chest tightness appear as possible further signs.

Among the triggers of a slow heartbeat is the so-called AV block.

Symptoms: Here too, depending on the stage of the AV block, physical weakness, fainting, shortness of breath and / or chronic fatigue may occur.

– Heart muscle inflammation

Triggers are once infections by viruses, bacteria or fungi, on the other autoimmune diseases. Inflammation of the heart muscle may also occur as a result of radiation or as overreaction to certain drugs. Sometimes the muscle also ignites without apparent cause. The disease can be without discomfort but can also take on life-threatening forms.

Symptoms: Infectious myocarditis is often characterized by fatigue, poor performance, shortness of breath, cardiac arrhythmia, muscle, heart and chest pain.

Lung diseases as a cause of constant tiredness

– Pulmonary hypertension (pulmonary hypertension)

If vessels in the lungs narrow, lose elasticity, or if vascular occlusions reduce the pulmonary circulation, hypertension may develop in the lungs. The most common causes are chronic diseases of the heart as well as connective tissue diseases (collagenoses) of the lung with oxygen deficiency and certain medicines or drugs.

Symptoms: In the early stage usually, no typical symptoms occur. In the further course usually, complaints of the triggering basic illness dominate. Often, the right half of the heart is under increased pressure. This leads to faster fatigue, accelerated heartbeat and shortness of breath during exercise, dizziness and swelling legs.

– Exogenous allergic alveolitis

Difficult breathing makes you tired because the oxygen supply is disturbed. Many pulmonary dysfunctions such as chronic bronchitis or chronic obstructive pulmonary disease (COPD) can therefore generally lead to fatigue and fatigue. Irritants and inflammatory processes in the lungs increase fatigue symptoms. An example of this is exogenous allergic alveolitis. In this lung disease, those affected breathe regularly, mostly for work, regularly organic, allergenic substances and micro particles. This can happen, among other things, in agriculture, livestock, chemical or metalworking companies. The consequences are allergic reactions in the alveoli and their environment.

Symptoms: Acute symptoms include shortness of breath, coughing, watery eyes, fever, headache and body aches. For chronic forms, ongoing fatigue, poor performance, coughing and shortness of breath are in the foreground. Also weight loss is possible.

Diagnosis and therapy: The health and professional history, detailed physical examinations, imaging procedures as well as lung tests and possibly histologic examinations are informative for the physician.

Patients must avoid contact with the disease-causing substances, which often means a career change. In the acute case, cortisone may be effective.

Kidney diseases that cause tiredness

In kidney disease, fatigue can be a stressful symptom alongside other key symptoms. This often occurs in chronic kidney inflammation and chronic kidney failure (renal insufficiency).

– Kidney (tissue) inflammation (interstitial nephritis, glomerulonephritis)

Acute and chronic kidney infections have many causes. These can be infectious diseases, such as streptococcal infections (more common in children). Also, in question are poisoning or drug abuse, for example analgesic abuse. Glomerulonephritis sometimes develops in the context of systemic diseases such as connective tissue diseases (collagenoses) or vascular inflammations as well as cancers.

Symptoms: A kidney infection may initially be without symptoms. In the advanced stage, the amount and quality of the urine and the composition of the blood often change. Tiredness and fatigue, headache and body aches are common symptoms, as well as fluid retention (edema) on the face, eyes, hands and feet.

– Chronic renal insufficiency

Different kidney diseases, such as diabetic nephropathy or various forms of glomerulonephritis, can eventually lead to a loss of function of the kidneys. In chronic renal failure this gradually develops. Therefore, the doctors distinguish several stages.

Symptoms: Initial symptoms include increased urination, swelling of legs, feet and eyelids, pain in the kidney area. In the course of the disease, fatigue, poor performance and paleness due to anemia. Other symptoms include blurred vision, itching, loss of appetite, nausea, drowsiness, heart failure, a typical halitosis.

Tired due to liver disease

The liver regulates the metabolism, disposes of harmful substances, produces hormones, bile and much more. Suffering from this versatile organ, this is often announced by constant fatigue and other complaints. The causes of liver damage include viral infections that lead to liver inflammation (hepatitis A, B, C, D, E), excessive alcohol consumption (alcohol hepatitis, alcoholic fatty liver, liver cirrhosis), metabolic disorders, obesity (so-called fatty liver hepatitis), autoimmune diseases, long-standing heart failure as well as medications and toxins.

Symptoms: In addition to tiredness, at first there is a lack of drive and loss of appetite. The stomach is often bloated with nausea and a feeling of pressure in the right upper abdomen. Also, a very light or very dark colored stool, dark urine, yellowish discoloration of the skin or eyeballs – signs of jaundice – or frequent nosebleeds may be evidence of a diseased liver.

A familial jaundice is the “Meulengracht” disease, which is most often noticeable in younger men around the age of 20 years. Fatigue, headaches, indigestion and depressive moods are often the only symptoms. The disorder usually has no serious effects.

Gastrointestinal disorders also often cause fatigue

Different disorders in the digestive tract cause the food components in the stomach can be insufficiently split, recycled and absorbed. This results in deficiency states (malasimilation syndrome), which can cause increased fatigue along with other symptoms such as abdominal pain and diarrhea. In diarrheal diseases, for example, it is a potassium deficiency that makes you tired.

Gastric ulcers, small intestine diverticula or chronic inflammatory bowel diseases such as Crohn’s disease, for example, often result in anemia. The associated vitamin B12 and folic acid deficiency causes prolonged tiredness. Constant inflammatory processes also contribute to this. Similarly, people with food intolerances or autoimmune-related celiac disease feel increasingly sluggish and underachieving.

An irritable stomach syndrome or an irritable bowel disturbs the function of the digestive organs concerned. For this, previous infection may play a triggering role. In addition, an overly sensitive stomach and intestine, familial predispositions, as well as mental stress, come into play here. Fatigue therefore accompanies these two complex disorders in many ways.

Hormone disorders: fatigue as a striking symptom

A number of hormones affect alertness, fatigue and sleep. Imbalances in the hormone balance often have far-reaching consequences. Sustained tiredness may therefore prevail over other typical symptoms in some hormonal diseases.


If the thyroid gland produces too few thyroid hormones, this leads to disorders in many areas of the body. Thyroid hormones affect, among other things, brain functions, the cardiovascular system, digestion, many metabolic processes, the musculature, the psyche.

Symptoms: Signs of hypofunction include low blood pressure, fatigue, decreased performance, constipation, weight gain despite lack of appetite, sensitivity to cold, depressive moods.

– Parathyroid hyperfunction

The four parathyroid glands are located at the upper and lower ends of the thyroid (see picture). They are approximately lense-sized and form the parathyroid hormone. This affects the calcium level in the blood and thus the electrolyte balance. Too much parathyroid hormone can cause kidney stones, bone damage and digestive problems, as well as affect nerves and psyche. Causes of overproduction are once diseases of the parathyroid glands themselves such as tumors, on the other parent disorders such as chronic renal failure, a diseased nutrient absorption via the intestine with the result of a lack of calcium, vitamin D deficiency, and cirrhosis.

Symptoms: Significant symptoms include frequent urination, increased thirst, renal colic, nausea, constipation, limb and back pain, weight loss, loss of appetite, muscle weakness, fatigue and depressed mood.

Diagnosis and therapy: The doctor determines the disease with blood tests and imaging procedures. The therapy depends on the cause and the individual symptoms.

– Adrenal cortical hypofunction (adrenocortical insufficiency)

The adrenals are glands that sit on top of the kidneys like hoods. They produce in their outer part, the bark, important hormones such as cortisol and aldosterone, in the inner part stress hormones such as adrenaline and norepinephrine. Cortisol has important functions for many metabolic processes and also promotes alertness. Aldosterone regulates the salt and fluid balance as well as the blood pressure. A hypofunction of the adrenal cortex and thus a lack of these two hormones triggers characteristic complaints. This is especially the case with the primary form called Addison’s disease. The cause is autoimmune processes that attack and gradually destroy the adrenal cortex. Other causes may include infectious diseases, tumors and cancer metastases.

In the secondary form disorders in certain areas of the brain or long-term treatment with cortisone are possible as possible triggers. However, aldosterone production is often not that limited.

Symptoms of Addison’s disease: Tiredness and feelings of weakness are among the leading symptoms. Those affected tire quickly, lose weight and dry out due to the impaired fluid balance. The skin turns brownish, especially in the area of ​​scars, on the palms and mucous membranes, the blood pressure drops. These include abdominal pain, nausea, indigestion and muscle weakness possible.

The deficiency symptoms can culminate acutely in an Addison crisis, which can develop to coma only at low temperature, then with fever, vomiting, hypotension and shock.

Diagnosis and therapy: Different blood tests and imaging procedures such as ultrasound confirm the diagnosis. For the treatment of Addison’s disease, the hormone deficiency is compensated with cortisone drugs.

Diabetes Mellitus: Fatigue often burdened

Fatigue is one of the common nonspecific symptoms that can occur again and again in the course of diabetes.

Symptoms: Fatigue, decreased performance, increased thirst, sweating, nocturnal leg cramps are common early symptoms that are more common in type 1 diabetes, and often only gradually in type 2 diabetes. Increased tiredness, sweating, weakness sometimes indicate morning low sugar.

Kidney damage, which can occur as a possible consequence of illness (diabetic nephropathy), often causes no special symptoms for a long time. Symptoms of creeping renal failure with frequent urination, swelling of the legs and feet, fatigue, loss of performance, blurred vision, itching of the skin are possible. Therefore, it is always important to ensure a good blood sugar control and to follow the regular check-ups.

Systemic and autoimmune diseases that trigger fatigue

Certain autoimmune diseases are often associated with fatigue and fatigue. There are several reasons for this. Autoimmune disease means that the body’s own defense system is not directed against pathogens and pathogenic substances from the outside, but against the body itself. The result is excessive inflammatory reactions that can seize and damage many areas of the organism. Increased immune defense and inflammatory processes often cause fatigue. Diseases in which fatigue is more prominent than the cardinal symptoms include rheumatoid arthritis, Sjögren syndrome and systemic lupus erythematosus.

– Rheumatoid arthritis

This chronic inflammatory joint disease is characterized by characteristic symptoms, often including fatigue.

Symptoms: It comes – initially often in batches – on both sides to swelling on hands and fingers, but also on other small joints. Joint effusions are also possible. Pain often occurs at night, while at rest, but also during certain movements. Especially in the morning, hands and fingers are weak and stiff. Fatigue, fatigue, mild fever, loss of appetite can often be initial symptoms, even before the joint symptoms start.

In the course of the disease, further inflammation of vessels and organs may develop, such as pericarditis. Mobility in everyday life is often difficult. That’s also why those affected often feel tired and exhausted.

– Sjögren syndrome

The second most common rheumatic disease leads to chronic inflammation of the lacrimal and salivary glands and other mucous membranes, such as the nose or bronchi. Even vessels and internal organs can get sick.

Symptoms: The effects of the disease include pronounced dry mouth and dry, burning eyes. Difficulty in swallowing and breathing, coughing, hoarseness indicate that the mucous membranes of the lower respiratory tract are also inflamed. In addition, those affected find the often sudden onset of extreme fatigue and poor performance as a burden.

– Systemic lupus erythematosus

The autoimmune disease affects the skin as well as vessels and many organs.

Symptoms: Severe fatigue, weakness, fever and difficulty in breathing are often the first and only signs of the onset of illness. Other symptoms include painful swelling of the fingers and hands as well as morning stiffness. Characteristic are butterfly-shaped, red rashes on the face, as well as rashes on the hands and other parts of the body. Sun as well as stress and mental stress intensify the complaints.

Allergies and fatigue

In some people, the immune system is hypersensitive to certain substances, allergens. The consequences are different, often violent physical reactions.

Symptoms: These include runny nose, cough, asthma or rash. Itching, swelling, nausea, vomiting, diarrhea, circulatory problems are also typical. Fatigue can be a common side effect.

Read more about allergies in the special “Allergy: When the bodyguard plays crazy.” There you will also find links to the various types of allergies.

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