From 50-70 percent of patients with sarcoidosis are estimated to experience fatigue, which can have a severe impact on their quality of life.

Causes of fatigue in sarcoidosis

Sarcoidosis is an inflammatory condition that causes abnormal deposits of immune cells, known as granulomas, to build up in different parts of the body such as the lungs, eyes, lymph nodes, and skin.

The condition is characterized by an overwhelming amount of inflammatory chemicals such as tumor necrosis factor (TNF)-α, interleukin-6, and interferon-γ present in the blood. Studies suggest that high levels of these chemicals may cause patients to feel extremely tired.

Fatigue may also be a symptom of other conditions associated with sarcoidosis such as anxiety, depression, poor sleep, and hypothyroidism, or low levels of thyroid hormone. It can also be a side effect of corticosteroid treatment.

Symptoms of fatigue

People are often affected differently by fatigue and may experience changes in the degree of fatigue over hours, days, or months.

Usual symptoms of fatigue can include difficulty concentrating, intense tiredness despite minimal activity, heavy limbs, waking up tired even after a good night’s sleep, and vision and balance problems.

Symptoms that last more than six months may indicate a patient has developed chronic fatigue. Other symptoms that may accompany chronic fatigue are anxiety, depression, body aches, difficulty concentrating and remembering things, weakness, and illness after exertion.

Diagnosing fatigue

Fatigue can be difficult to diagnose. Several rating scales, like the fatigue assessment scale, may be used by healthcare providers to assess fatigue, although these are usually not conclusive.

Managing fatigue in sarcoidosis

Treating sarcoidosis-related fatigue can be challenging. Often, fatigue may remain even when all other symptoms of sarcoidosis have disappeared.

Medications that may be used to manage fatigue include neuro stimulants such as methylphenidate, modafinil, and armodafinil, and TNF-α (tumor necrosis factor-alpha) inhibitors such as Humira (adalimumab). Patients may also benefit from cognitive behavioral therapy.

Lifestyle changes such as increasing the amount of physical exercise, eating a balanced diet, cutting down on alcohol, stopping smoking, and taking steps to get a good night’s sleep may be helpful in managing fatigue in sarcoidosis.

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