Nov. 26, 1999 (Atlanta) -- Frequent fatigue, often assumed to be just a fact of life in the '90s, may have dire consequences for millions of baby boomers reluctant to seek treatment. But doctors say some of its underlying causes can raise the risk of a heart attack if left untreated.
"Fatigue can be a wake-up call for manageable conditions like thyroid disease, sleep apnea, or mild depression," says Sandra Fryhofer, MD, an internist in Atlanta and president-elect of the American College of Physicians and American Society of Internal Medicine. "But if left undiagnosed and untreated, these disorders can lead to heart disease in later life," she says. Yet many adults are reluctant to discuss fatigue with their physicians.
"Fatigue is so common that many doctors treat it like background noise," says Benjamin Natelson, MD, a neuroscience expert at the University of Medicine and Dentistry in New Jersey and author of Facing and Fighting Fatigue. "Still, it's a mistake to assume that fatigue is normal." Natelson tells WebMD that "fatigue is most likely to have an underlying illness when it comes on suddenly for no apparent reason, persists for weeks, and is unrelieved with sleep."
Fryhofer says thyroid disease is often the culprit in women. "Hypothyroidism occurs when the thyroid gland, located at the base of the throat, fails to produce enough hormone. This causes the metabolism to slow down and energy to wane." Because the disease affects more than 11 million people, internists now recommend routine testing of thyroid stimulating hormone (TSH) for all women over the age of 50. Unfortunately, it may take a while for managed care plans to catch up.
"The American Association of Health Plans relies on a panel of government-appointed experts to establish standards for minimum coverage," says spokesperson Susan Pisano. "And routine blood screening for thyroid disease is not recommended for asymptomatic adults. Of course, the task force considers peer-reviewed research in support of new guidelines periodically." For the millions of Americans over 40, that may not be soon enough.
"We want to encourage baby boomers to plan for their retirement health, just as they plan for their retirement income," says Fryhofer. "And fatigued adults should see an internist before it's too late."