Fatigue Affecting People with Liver Disease
Why do patients with liver disease become fatigued and what can
they do about it?
One of the most common and debilitating symptoms among
individuals with liver disease is fatigue. It is universal to all
varieties of liver disease from Primary Biliary Cirrhosis to
Chronic Hepatitis C. In some patients, fatigue begins several years
after the diagnosis of liver disease is made. In others, it was the
primary reason for seeking medical attention. In such individuals
multiple visits are made to a variety of physicians in search of a
cause of their extreme lassitude. Some patients even seek
psychiatric evaluation, as an accompanying symptom is often
depression.
Fatigue may occur at any time of day but is most common in the
morning about an hour after awakening. By 9 a.m. one may already
feel the exhaustion of a full workday. Others describe weakness and
a lack of energy throughout the entire day. Their usual "pep" is
now gone. Even little tasks become more trying and around 4 p.m.,
they simply must lie down to take a nap.
The treatment of fatigue can be challenging. First, a search for
all other potential causes should be made, as some are easily
treated. Thyroid disease and anemias commonly coexist with liver
disease and can worsen any existing lethargy. Nutritional
deficiencies as well as disturbances in fluid balance also
contribute to exhaustion. Primary depression from causes other than
liver disease lead to fatigue and may require pharmacological
control. Finally, all medications that the patient is taking must
be reviewed and the unnecessary ones eliminated.
If all of the above conditions are corrected, and fatigue
continues to persist, there are a few simple measures that may be
of help. A healthy, low fat, well balanced diet, cessation of
smoking, alcohol intake in moderation, and a daily exercise routine
are all essential lifestyle adjustments. Any excess weight should
be eliminated with a sound weight reducing diet. The demands of a
hectic job or home life may need to be modified, as an overworked,
overwhelmed person even without liver disease may suffer from
fatigue. If possible, a 30-45 minute daytime nap can help to
rejuvenate the patient, and may need to be incorporated into a
schedule. Finally, one must remember that the treatment for fatigue
does not come in a bottle as many medications, whether
over-the-counter or prescription,may adversely affect the liver (as
well as the wallet). One must always consult with the hepatologist
prior to trying any new fad products that promise to cure
fatigue.
Copyright 1997 by Melissa Palmer, M.D.
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