Repost:FATIGUE AFFECTING PEOPLE WITH LIVER DISEASE

liver411

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.