<s>[INST] I am 40 years old, 150 pounds, 5 10 .For the past ten years I have been to a doctor a couple of times a year to no avail. I am exhausted. So exhausted I can t take it anymore. I work 40 hours a week standing on my feet but i am certain this has nothing to do with it. Sometimes I am fine. I am in good physical shape and eat healthy. But suddenly I will be exhausted. For days. Sometimes weeks. Can barely get out of bed exhausted. I have had blood work done every year and nothing shows up. I drag myself through it all and most people wouldn t even know what I am going through. I go home and go to bed early every night just so I can work. I sleep all weekend. The only other symptoms I have are a permanently red chest (like sunburn, not itchy, not raised). Have had for 15 years or so. And dyshridosis on my left hand. Please help. I can t keep doing this. All I ever hear is CFS. [/INST] HiMost of the time fatigue can be traced to one or more of your habits or routines, particularly lack of exercise. It's also commonly related to depression. On occasion, fatigue is a symptom of other underlying conditions that require medical treatment.Lifestyle factorsTaking an honest inventory of things that might be responsible for your fatigue is often the first step toward relief. Fatigue may be related to:Use of alcohol or drugsExcess physical activityJet lag disorderLack of physical activityLack of sleepMedications, such as antihistamines, cough medicinesUnhealthy eating habitsConditionsUnrelenting exhaustion may be a sign of a condition or an effect of the drugs or therapies used to treat it, such as:Acute liver failureAnemiaAnxietyCancerChronic fatigue syndromeChronic infection or inflammationChronic kidney diseaseConcussionCOPD (chronic obstructive pulmonary disease)Depression (major depressive disorder)DiabetesEmphysemaFibromyalgiaGriefHeart diseaseHyperthyroidism (overactive thyroid)Hypothyroidism (underactive thyroid)Inflammatory bowel disease (IBD)Medications and treatments, such as chemotherapy, radiation therapy, pain drugs, heart drugs and antidepressantsMultiple sclerosisObesityPain that's persistentSleep apneaStressTraumatic brain injuryCauses shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.Since fatigue is a symptom of an underlying condition, the treatment depends upon the condition that is causing the fatigue, regardless of whether it is physical, psychological or a combination of the two.There may be a lag time between when the illness has been treated and the intensity of fatigue symptoms; some symptoms may resolve as soon as the underlying condition is treated. For example, individuals who are anemic feel much better as soon as their red blood cell count increases, while those recovering from infectious mononucleosis may require weeks to have their energy levels return to normalFatigue as a symptom can occur as the result of many causes and therefore, prevention is not an issue. More importantly, the early recognition of fatigue will allow a person to seek medical care and potentially have an earlier diagnosis of the underlying cause made.Sometimes, symptoms like fatigue arise gradually and it is difficult for the person to realize that there is a problem. It may take an outside perspective from a friend or family member to appreciate a difference in function. Self-awareness of gradual decline in body performance is often difficult as a person makes repeated small accommodations to complete daily activities.RegardsDR DE </s>