Arthritis Symptoms What Is Malaise? By Carol Eustice facebook Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. Learn about our editorial process Carol Eustice Medically reviewed by Medically reviewed by David Ozeri, MD on May 03, 2020 linkedin David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies. Learn about our Medical Review Board David Ozeri, MD on May 03, 2020 Print Table of Contents View All Types of Malaise Associated Conditions Causes When to Call a Doctor Malaise is a term used to describe a general feeling of discomfort, lack of well-being, or illness that can come on quickly or develop slowly and accompany almost any health condition. It should not be confused with fatigue, which is extreme tiredness and a lack of energy or motivation. Although fatigue commonly accompanies malaise, malaise is a non-specific symptom in which you simply feel that "something is not right." The uneasiness often is an early sign of an undiagnosed condition. Jose Luis Pelaez Inc. / Getty Images Types of Malaise Malaise is more than feeling "blah." It is a significant symptom that doctors use when making a diagnosis or describing a response to a treatment or chronic illness. It even has its own International Classification of Diseases (ICD) code (R53; Malaise and Fatigue) used for reporting by doctors, health insurers, and public health officials. When malaise occurs as part of a diagnosed illness or condition, a doctor typically will record it "general malaise." Aside from that, there are two other types of malaise: Isolated general malaise (IGM): An episode of malaise, either short-lived or persistent, with no known etiology (cause). IGM is not meant to suggest a symptom is "all in your head" and is rarely used. Post-exertional malaise (PEM): An imprecise term used to describe a feeling of unwellness after physical activity. Post-exertional malaise is characterized by symptoms that tend to worsen 12 to 48 hours after physical activity and persist for days or even weeks. PEM is a characteristic of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) but can occur on its own without any clear etiology. Underlying causes range from subclinical hypothyroidism and obstructive sleep apnea to polymyalgia rheumatica and bipolar depression. Associated Conditions Malaise is a non-specific symptom associated with nearly all infectious, metabolic, and systemic diseases and may also be a side effect of certain medications: Acute infections, including influenza, Lyme disease, and pneumoniaAutoimmune diseases, including rheumatoid arthritis and systemic lupus erythematosusBlood abnormalities, including anemia and neutropeniaCancers, including colon cancer, lymphoma, and leukemiaChronic infection, including HIV (especially if untreated) and chronic hepatitis CEndocrine or metabolic diseases, including diabetes and thyroid diseaseHeart and lung diseases, including congestive heart failure and chronic obstructive pulmonary disease (COPD)Medications, including antihistamines, beta-blockers, antidepressants, and antipsychoticsMalnutrition or malabsorption disorders like celiac diseaseUntreated depression Even jet lag or a hangover can cause short-term malaise. Causes There are many theories for why malaise occurs. One is that it is the body's subtle response to proteins known as cytokines that regulate how the body reacts to disease. Although the body produces a multitude of cytokines, their function remains the same: to coordinate cells to repair tissues, maintain tissues, and fight infection or disease. When cytokines are produced in response to disease, it is believed they affect a structure deep in the brain called the basal ganglia, making it less receptive to the "feel-good" hormone dopamine. The deprivation of dopamine in the brain can result in anhedonia (the inability to feel pleasure) and psychomotor slowing (sluggish thoughts and movements). Malaise often serves as an early warning sign of an acute illness that is subclinical (with few notable symptoms). It may also be the consequence of increased cytokine activity in people with a chronic illness. When to Call a Doctor You should see your doctor if malaise persists for more than a week with or without accompanying symptoms. During your appointment, they will review your symptoms and medical history to help pinpoint the underlying cause. It can be helpful to have ready answers to some of the questions you may be asked, such as: How long have you had malaise?What other symptoms do you have?Do you have any chronic health conditions?Does the malaise come and go, or is it constant?What prescription or over-the-counter medications do you take?Have you taken a trip overseas lately? You also will likely have a physical exam to check for signs of infection (such as swollen glands) or evidence of anemia (pale skin, brittle nails, or cold hands or feet). Additional tests may be ordered based on these preliminary findings. Although it may take time to pinpoint the cause, try to be patient and honest with your doctor. The more information you can give, the sooner they can pin down what's causing your malaise and how to treat it. Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hughes C. ICD-10 coding for the undiagnosed problem. Fam Pract. 2014 May-June;21(3):17-20. De Portugal Alvarez J, Rivera Berrio L, González San Martín F, Sánchez Rodríguez A, De portugal E, Del Rivero F. Etiology of isolated general malaise. An Med Interna. 1996;13(10):471-5. Centers for Disease Control and Prevention. Post-exertional malaise. Updated November 19, 2019. Felger JC, Miller AH. Cytokine effects on the basal ganglia and dopamine function: the subcortical source of inflammatory malaise. Front Neuroendocrinol. 2012;33(3):315-27. doi:10.1016/j.yfrne.2012.09.003 Argyropoulos SV, Nutt DJ. Anhedonia revisited: is there a role for dopamine-targeting drugs for depression?. J Psychopharmacol (Oxford). 2013;27(10):869-77. doi:10.1177/0269881113494104