Doctors say a silent 'mini-stroke' may explain your constant fatigue
Also known as a transient ischemic attack, they occur due to a brief blockage of blood flow to the brain and can last for up to a day.
More than 240,000 Americans and about 45,000 Brits experience one every year but only one in 30 realize they have had one.
That's because the symptoms can be easily dismissed: muscle weakness, headaches and vision changes.
A group of Danish researchers have now found that these mini-strokes can have much longer lasting effects, leaving sufferers feeling fatigued for up to a year.
TIA's can cause fatigue due to several factors including the brain's need to compensate for the temporary disruption in blood flow.
The brain has to work harder to complete tasks after a TIA and this effort can lead to increased energy consumption and persistent fatigue.
Dr Boris Modrau, a neurology professor at the Aalborg University Hospital in Denmark and lead author of the study said: 'People with a transient ischemic attack can have symptoms such as face drooping, arm weakness or slurred speech and these resolve within a day.
'However, some have reported continued challenges including reduced quality of life, thinking problems, depression, anxiety and fatigue.'
The study followed 354 people with an average age of 70 who had a mini-stroke for a year.
Participants were asked to complete questionnaires about their level of fatigue in the first two weeks after a mini-stroke and again at three, six and 12 months later.
Researchers looked at how many participants experienced fatigue by defining it as a score of 12 or higher. Those being analyzed also underwent had brain scans to check for blood clots.
The experts discovered that 61 percent of those surveyed experienced increases in their fatigue scores two weeks after the mini-stroke.
Half reported fatigue at the three, six and 12 month mark.
The scientists also found that participants who reported feeling fatigued were twice as likely to have a history of anxiety and/or depression.
The team said that the study was observational and cannot prove that the mini-strokes were behind the persistent fatigue.
Dr Modrau said: 'Long-term fatigue was common in our group of study participants, and we found if people experience fatigue within two weeks after leaving the hospital, it is likely they will continue to have fatigue for up to a year.'
He also advised that experts need to focus on whether mini-stroke patients are showing signs of fatigue and provide adequate care.
'For future studies, people diagnosed with a transient ischemic attack should be followed in the weeks and months that follow to be assessed for lingering fatigue.
'This could help us better understand who might struggle with fatigue long-term and require further care,' he concluded.
The study has been published today in Neurology, the medical journal of the American Academy of Neurology.
While not as extensively as a complete stroke, a mini stroke can cause a certain degree of brain damage when it occurs.
This damage can leave a person with muscle weakness, difficulty with coordination and a general sense of weariness - which are all signs of fatigue.
Fatigue is medically described as the persistent and excessive feeling of tiredness or lack of energy which interferes with daily activities, even after adequate rest.
Particularly, physical fatigue can include muscle weakness, aches, pain, gastrointestinal issues and headaches.
While mental fatigue entails difficulty concentrating, learning new tasks, slowed reflexes and impaired decision-making.
Brain damage due to a mini-stroke can also change sleeping patterns, emotional distress and memory, all of which can contribute to ongoing tiredness.
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