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Prof. Jean-Robert Rapin : "we do not treat fatigue but a tired patient "

image : What advice should be given to doctors who receive "tired" patients?

Pr. J.-R. Rapin is a pharmacologist at the University of Dijon, specializing in brain metabolism.
Pr. J.-R. Rapin is a pharmacologist at the University of Dijon, specializing in brain metabolism.

Jean-Robert Rapin: Fatigue is a very frequent reason for consultation. The first thing to do when you see a patient who complains of fatigue is to determine the cause of the fatigue. It can be physical fatigue, chronic fatigue, stress-related fatigue... In reality, fatigue is not an illness in itself but always a symptom of another pathology. To be able to treat fatigue, it is first necessary to identify what causes fatigue. If the cause is not removed, fatigue will always return. This can be the result, for example, of a thyroid problem, a cardiovascular disease, a psychological problem... In fact, it is not fatigue that is treated but a patient, and there are as many treatments as there are patients.

How to proceed in case of fatigue?

First, the patient is asked to determine what the pathology could be that causes fatigue. One of the first things to do is to analyze your diet to identify any deficiencies. An unbalanced diet that does not provide all the necessary elements can cause states of fatigue.

What are the most common deficiencies?

There are many of them, so you can see, for example, that the patient is not consuming enough magnesium, which can cause stress that causes fatigue. Or if the patient eats few vegetables, he may lack folates, which increases the risk of heart disease and leads to fatigue. A patient who claims never to eat fish is likely to be deficient in omega-3. If a patient rarely eats meat, iron deficiency can be suspected, as anemia is a major cause of fatigue. Sometimes also fatigue can be linked to vitamin B6 deficiency caused by excessive alcohol consumption.

What do you do after identifying these imbalances?

In all cases, after having identified these dietary imbalances, blood tests are carried out to check these deficiencies. If they are proven, supplementation can be implemented to correct them. Of course we give advice to the patient so that he corrects his diet to stop creating these imbalances.

What advice could you give to someone who complains of being tired?

I would tell him to go to a doctor who is particularly aware of the importance of nutrition in order to have a personalized treatment. Advising a general treatment of fatigue that would suit everyone is impossible, fatigue is not in itself an illness and there are as many possible treatments as there are tired people. There is no recipe.