EpistemisExtreme physical exhaustion
Specialty: General.
Why it occurs
- Strenuous physical overexertion or overtraining syndrome (massive muscle microstructural damage with total depletion of glycogen stores and dysfunction of the central nervous system)
- Severe chronic sleep deprivation (accumulation of adenosine in the extracellular space of the brain and impaired clearance of toxins by the glymphatic system)
- Professional burnout or severe burnout syndrome (chronic emotional and physical exhaustion mediated by adrenal axis dysfunction)
- Post-operative recovery from complex major surgeries or prolonged transfers in fragile patients (high metabolic cost of healing and immobilization)
- Acute subclinical post-hemorrhagic anemia (loss of erythrocyte volume due to occult digestive or abundant gynecological bleeding).
Initial workup
Complete blood count with erythrocyte indices, serum ferritin levels, liver and kidney profile, fasting blood glucose, venous blood gases, serum electrolytes (sodium, potassium, chloride), and electrocardiogram.
red flags
Mental confusion that prevents coherent communication, bradycardia or severe tachycardia at rest, syncope or severe postural arterial hypotension, oppressive chest pain, manifest oliguria with concentrated urine with a strong odor.
Standard management
- Oral supplementation with rehydration salts to restore blood volume and peripheral electrolyte balance
- B complex with vitamin B12 — 1000 mcg orally per day as a metabolic coenzyme to facilitate obtaining energy from nutrients
- Paracetamol (500 mg orally in case exhaustion is accompanied by myalgia due to overexertion, to facilitate night rest).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- General
- Listed causes
- 5
- Treatment options
- 3