What Is Malaise?

It's about more than feeling tired

a senior man sleeping on sofa with newspaper

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In This Article

Malaise is a term used to describe a general feeling of discomfort, lack of well-being, or illness that can develop slowly or quickly and accompany almost any health condition.

Malaise should not be confused with fatigue, the term used to describe 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 may often be the first sign of an undiagnosed condition or one that persists with a chronic illness.

Causes

Malaise is about more than feeling "blah." It is a significant symptom that doctors use when making a diagnosis or describing your response to a treatment or chronic illness. It even has its own ICD code (R53; Malaise and Fatigue) used for reporting by doctors, health insurers, and public health officials.

There are many theories as to why malaise occurs. Some suggest that it is the body's subtle response to proteins known as cytokines that regulate how the body responds to disease. Although there is a multitude of cytokines produced by the body, 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 that 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.

Types

There are different categories of malaise that doctors sometimes use when describing an illness. When malaise occurs as part of a diagnosed illness or condition, the doctor will typically record it "general malaise.".

If the cause of malaise is unknown, it may be classified as isolated general malaise (IGM). Although the term is less commonly used today, IGM is not meant to suggest that the symptom is "all in your head." Rather, it describes an episode of malaise, either short-lived or persistent, with no known etiology (cause).

Another form is known as post-exertional malaise (PEM), an imprecise term used to describe a feeling of unwellness after physical activity. As with IGM, there are no tests by which to make a diagnosis.

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. Further evaluation may reveal an underlying cause, ranging 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, or systemic diseases. Diseases, health conditions and medications associated with malaise include:

Even jet lag or a hangover can cause short-term malaise.

When to Call a Doctor

You should call your doctor if malaise persists for more than a week with or without accompanying symptoms

During the appointment, your doctor will review your symptoms and medical history to help pinpoint the underlying cause. There may also be a physical exam and blood tests to check if there are any 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.

You can make the most of your appointment by taking the time to anticipate some of the questions your doctor is likely to ask, including:

  • How long have you had malaise?
  • What are your 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?

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 a diagnosis and treatment plan can be delivered.

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Article Sources

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