The term asthenia indicates to extreme muscle weakness and lack of energy. The asthenia is described as unusual fatigue without or before any effort. In some studies are said that it is frequent cause occurring in almost 30% of ambulatory settings. 0.2 – 0.7% of these cases belong to the CFS (chronic fatigue syndrome) or SEID (systemic exercise intolerance disease) . CFS is a serious debilitating disorder which may seriously affect the quality of person’s life and it can cause long – term illness.
You should keep active physical life as much as you can, so in this way, you will reduce your risk for asthenia to minimal. Also, you should spend at least thirty minutes outdoor on daily basis, so your risk for asthenia will be reduced as much as possible.
The most common signs and symptoms of asthenia include :
- Sudden loss of consciousness
- Restless sleep
- Excruciating pain
- Deteriorating attentiveness
- Pain in joints
- Wobbly sensation
- Episodes of tremors
- Absence or loss of muscle strength
- Muscle cramps
- Loss or lack of energy
If you have some of the above mentioned symptoms of the asthenia, then you should see your doctor as soon as possible. Your doctor will tell you the proper diagnosis and the evaluation of your condition, so your doctor can see if there is any underlying cause for the asthenia. Your doctor will make blood tests. He or she will check for the complete blood count, including ferritin levels, folate and Vitamin B12.
Also, your doctor will see for inflammatory markers, such as CRP and ESR to rule out the underlying chronic inflammatory disease. Also, your doctor will make you urine test, so your doctor will see if diabetes, renal or liver disease or pregnancy are causes for the asthenia.
There are different factors which can lead to asthenia, such as:
- Vitamin deficiencies: The lack of vitamins in the body can make the person to feel dizzy, tired and unable to do the daily activities. 
- Chemotherapy or radiation therapy: There are some chemotherapy drugs which can affect the overall health and the mobility of the person. Some of them are next: Cisplatin and carboplatin (they affect the vestibular system of the inner ear) and high dose of cytosine arabinoside and fluorouracil can affect the cerebellum which is leading to imbalances. 
- Drug – induced myopathies: They are very common complications of drug therapy. The most common symptoms include electromyographic changes, increased muscle enzyme levels and proximal muscle weakness. For example, a combination of a fibrate and a statin or cyclosporine and colchicine can induce severe myopathies. 
- Pregnancy: In many cases, pregnancy is associated with low energy levels and fatigue and it is most common during the third trimester. The reduction in the energy levels is due to the altered progesterone levels. 
- Chronic diseases: Some diseases, like myasthenia gravis can lead to rapid and generalized weakness. Also, some chronic conditions, like cancer, chronic kidney disease, diabetes and insomnia can affect the quality of the life. 
- Infections: The prolonged infection in the body, such as infective endocarditis, hepatitis or tuberculosis can cause this condition and have a debilitating effect on muscles.
- Aging: As you are getting older, there is a reduction in the ability of cells and tissues in the body to maintain homeostasis and particularly when the person is under the stress, symptoms of asthenia are seen more often. 
- Sedentary life: The World Health Organization has said that about 60 – 85% of people in the world are lack of physical activity in their life . The state of sedentary life makes their muscles weaker.
- Anxiety or depression: It is noticed that the main cause of fatigue and almost half of the cases of asthenia is anxiety or depression. But, in the most cases, it goes undiagnosed and unrecognized. Mostly, it is experienced by people who suffer from life – limiting illness. It is interfering with the person’s functional status and the quality of life. 
 Young P, Finn BC, Bruetman J, et al. The chronic asthenia syndrome: a clinical approach. Medicina (B Aires). 2010;70(3):284-92.
 Craig HR, White PD. Etiology and symptoms of neuro-circulatory asthenia: Analysis of one hundred cases, with comments on prognosis and treatment. Archives of Internal Medicine. 1934;53(5):633-48. doi:10.1001/archinte.1934.00160110002001
 Plevin D, Galletly C. The neuropsychiatric effects of vitamin C deficiency: a systematic review. BMC Psychiatry. 2020;20.
 Bruera E, MacDonald N. Asthenia in patients with advanced cancer. Journal of Pain and Symptom Management. 1988;3(1):9-14.
 Lega JC, Reynaud Q, Belot A, et al. Idiopathic inflammatory myopathies and the lung. European Respiratory Review. 2015;24:216-31. doi:10.1183/16000617.00002015
 Mortazavi F, Borzoee F. Fatigue in pregnancy: The validity and reliability of the Farsi multidimensional assessment of fatigue scale. Sultan Qaboos University Medical Journal. 2019;19(1):e44–e50. doi:10.18295/squmj.2019.19.01.009
 Hjollund NH, Andersen JH, Bech P. Assessment of fatigue in chronic disease: a bibliographic study of fatigue measurement scales. Health and Quality of Life Outcomes . 2007;5.
 Avin KG, Frey Law LA. Age-related differences in muscle fatigue vary by contraction type: A meta-analysis. Physical Therapy. 2011;91(8):1153–65. doi:10.2522/ptj.20100333
 World Health Organization. Physical inactivity a leading cause of disease and disability, warns WHO. 2002. Retrieved from www.who.int/news/item/04-04-2002-physical-inactivity-a-leading-cause-of-disease-and-disability-warns-who
 Ruzhenkova VV, Ruzhenkov VA, Lukyantseva IS, Anisimova NA. Academic stress and its effect on medical students’ mental
health status. Drug Invention Today. 2018;10(7):1171-4.