Ask the Doctor: Extreme Fatigue; Brain Protection; Fasting for Tests

Q: I’m in my late 60s and I’ve been extremely tired lately. I’m having trouble concentrating and doing even light exercise. Is this just a function of getting older?

A: Endurance can decline somewhat with age, and you may not be able to move as quickly as when you were younger, but feeling overly fatigued could be related to a medical condition or lifestyle issue. If this fatigue has hit you suddenly or becomes more frequent, you should consult with your physician. There are several health issues that can cause excessive tiredness. The following are a few of the more common conditions that can deplete energy.

Anemia occurs when there is a low red blood cell count, which can result in a drop of energy. Heart disease can cause the heart to pump less efficiently, leading to less oxygen flowing to your lungs and making it more difficult to breathe and be physically active. Hypothyroidism is a condition in which your thyroid gland isn’t producing enough thyroid hormone, which can result in fatigue, weight gain, and dry skin. Also, certain medications can make you tired, such as blood pressure drugs, antidepressants and antihistamines. Check with your doctor, especially if you’re taking a new medication. If medical issues or medications don’t seem to be the problem, you can boost energy with a brisk 30-minute walk, which can increase circulation and energy. A cup of caffeinated coffee or tea in the morning can help, as can a short 20- to 30-minute nap. Avoid napping for longer because it can make you groggy. Also, don’t nap too late in the day, as it can ruin nighttime sleep.

Q: I know there are brain-related changes with age. What are the best things I can do to protect my brain?

A: Studies suggest that even healthy older adults can experience some brain atrophy, or shrinkage in brain volume. But not everyone experiences this problem and researchers are studying them to find out why. New brain cells replace injured and dying ones in a process called neurogenesis. Researchers have linked several activities that can help maintain or increase neurogenesis in older age. One study from Harvard compared meditators and non-meditators, and found that those who meditated had more gray matter volume. Meditation requires focus and concentration. The brain is a muscle, and cognitive activity involved with meditation is good for brain health.

Regular physical activity, at least 30 minutes per day most days of the week, has been shown to slow down age-related declines in the brain. The brain has an extensive capillary network, and exercise helps increase blood circulation throughout the body, including the brain, providing a supply of oxygen-rich blood to feed brain cells. Other lifestyle strategies that can boost brain health include getting seven to eight hours of sleep each night, eating a Mediterranean-style diet that is rich in fresh fruits and veggies and low in saturated fats, and seeking treatment for mood disorders, such as depression and anxiety. Treatments for these mood disorders may work in part by stimulating neurogenesis in the brain.

Q: I’m scheduled for an early morning blood test and was told to fast. Does that mean no coffee? I don’t like missing my morning cup.

A: Blood glucose levels are constantly changing throughout the day, depending on what you eat or drink. Your physician ordered a fasting plasma glucose test because it is the most reliable way to measure your blood glucose level. It’s best to follow the request to fully fast. If you snack on something before your blood is drawn, it will affect the results of the test. While coffee may seem harmless, it can elevate blood sugar levels, even if you drink it without cream or sugar. These tests are typically scheduled for the morning, so you don’t have to wait too long before eating. If you are thirsty, plain water is the best choice.

—Editor-in-Chief Jonathan Wanagut, MD, PhD

The post Ask the Doctor: Extreme Fatigue; Brain Protection; Fasting for Tests appeared first on University Health News.

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