globulins

Fatigue is a feeling of weariness, tiredness, or lack of energy. It can interfere with your usual daily activities. Fatigue can be a normal response to physical activity, emotional stress, boredom, or lack of sleep. But sometimes it can be a sign of a mental or physical condition. If you have been feeling tired for weeks, contact your health care provider. They can help you find out what's causing your fatigue and recommend ways to relieve it.

Fatigue itself is not a disease; it's a symptom. It can have many different causes, including pregnancy and various medical problems, treatments, and lifestyle habits such as:

• Medical problems:
  • Chronic (long-lasting) diseases such as diabetes, COPD (chronic obstructive pulmonary disease), and heart, liver, kidney and thyroid diseases
  • Untreated pain and diseases like fibromyalgia
  • Anemia
  • Infections
  • Parkinson's disease
  • Sleep apnea and other sleep disorders
  • Recent stroke
  • Mental disorders such as depression and anxiety
• Treatments:
  • Cancer treatments such as chemotherapy, radiation, and bone marrow transplants
  • Recovering from major surgery
  • Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
• Lifestyle habits:
  • Not getting enough sleep
  • Staying up too late
  • Drinking too much alcohol
  • Substance use
  • Having too much caffeine (which can keep you from getting a good night's sleep)
  • Getting too little or too much exercise

Overwhelming fatigue is part of a disorder called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The fatigue caused by this disorder is different from a tired feeling that goes away after you rest. Instead, the fatigue in ME/CFS lasts a long time, does not get better with rest, and limits your ability to do ordinary daily activities.

If you've had fatigue that does not get better after several weeks, call your provider. They will ask questions about your sleep, daily activities, appetite, and exercise. They will likely do a physical exam and order lab tests. Once they decide on a diagnosis, they can tell you what treatments might help.

You can also make some lifestyle changes to feel less tired:

• Get regular physical activity
• Improve your sleep habits
• Stop smoking (if you smoke), since smoking is linked to many diseases that can cause fatigue
• Manage stress
• Eat a healthy diet and avoid alcohol

It also may be helpful for you to keep a fatigue diary. This can help you find patterns throughout the day, such as when you feel more tired and when you have more energy. It can also help you plan for activities that may give you more energy.

NIH: National Institute on Aging

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.

Hepatitis B is a type of viral hepatitis. It can cause an acute (short-term) or chronic (long-term) infection. People with an acute infection usually get better on their own without treatment. Some people with chronic hepatitis B will need treatment.

Thanks to a vaccine, hepatitis B is not very common in the United States. It is more common in certain parts of the world, such as sub-Saharan Africa and parts of Asia.

Hepatitis B is caused by the hepatitis B virus. The virus spreads through contact with blood, semen, or other body fluids from a person who has the virus.

Anyone can get hepatitis B, but the risk is higher in:

• Infants born to mothers who have hepatitis B
• People who inject drugs or share needles, syringes, and other types of drug equipment
• Sex partners of people with hepatitis B, especially if they are not using latex or polyurethane condoms during sex
• Men who have sex with men
• People who live with someone who has hepatitis B, especially if they use the same razor, toothbrush, or nail clippers
• Health care and public-safety workers who are exposed to blood on the job
• Hemodialysis patients
• People who have lived in or traveled often to parts of the world where hepatitis B is common
• Have diabetes, hepatitis C, or HIV

Often, people with hepatitis B don't have symptoms. Adults and children over 5 are more likely to have symptoms than younger children.

Some people with acute hepatitis B have symptoms 2 to 5 months after infection. These symptoms can include:

• Dark yellow urine
• Diarrhea
• Fatigue
• Fever
• Gray- or clay-colored stools
• Joint pain
• Loss of appetite
• Nausea and/or vomiting
• Abdominal pain
• Yellowish eyes and skin, called jaundice

If you have chronic hepatitis B, you may not have symptoms until complications develop. This could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms. Screening means that you are tested for a disease even though you don't have symptoms. If you are at high risk, your health care provider may suggest screening.

In rare cases, acute hepatitis B can cause liver failure.

Chronic hepatitis B can develop into a serious disease that causes long-term health problems such as cirrhosis (scarring of the liver), liver cancer, and liver failure.

If you have ever had hepatitis B, the virus may become active again, or reactivated, later in life. This could start to damage the liver and cause symptoms.

To diagnose hepatitis B, your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam
• Blood tests, including tests for viral hepatitis

If you have acute hepatitis B, you probably don't need treatment. Some people with chronic hepatitis B don't need treatment. But if you have a chronic infection and blood tests show that hepatitis B could be damaging your liver, you may need to take antiviral medicines.

The best way to prevent hepatitis B is to get the hepatitis B vaccine.

You can also reduce your chance of hepatitis B infection by:

• Not sharing drug needles or other drug materials
• Wearing gloves if you have to touch another person's blood or open sores
• Making sure your tattoo artist or body piercer uses sterile tools
• Not sharing personal items, such as toothbrushes, razors, or nail clippers
• Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.

If you think you have been in contact with the hepatitis B virus, see your health care provider right away. Your provider may give you a dose of the hepatitis B vaccine to prevent infection. In some cases, your provider may also give you a medicine called hepatitis B immune globulin (HBIG). You need to get the vaccine and the HBIG (if needed) as soon as possible after coming into contact with the virus. It is best if you can get them within 24 hours.

National Institute of Diabetes and Digestive and Kidney Diseases

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.

Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors - diabetes, high blood pressure, heart disease, or a family history of kidney failure.

Specific kidney tests include:

• Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
• Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
• Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
• Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
• Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons.

There are many kinds of liver diseases:

• Diseases caused by viruses, such as hepatitis A, hepatitis B, and hepatitis C
• Diseases caused by drugs, poisons, or too much alcohol. Examples include fatty liver disease and cirrhosis.
• Liver cancer
• Inherited diseases, such as hemochromatosis and Wilson disease

Symptoms of liver disease can vary, but they often include swelling of the abdomen and legs, bruising easily, changes in the color of your stool and urine, and jaundice, or yellowing of the skin and eyes. Sometimes there are no symptoms. Tests such as imaging tests and liver function tests can check for liver damage and help to diagnose liver diseases.

Lupus is a chronic (long-lasting) type of autoimmune disease.Autoimmune diseases happen when your immune system attacks healthy cells and tissues by mistake. This attack causes inflammation. It can also damage many parts of the body, including the joints, skin, kidneys, heart, lungs, and brain.

There are several types of lupus:

• Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
• Cutaneous lupus affects the skin. It causes a rash or sores, usually after your skin is exposed to sunlight. The two major types of cutaneous lupus are discoid lupus and subacute cutaneous lupus.
• Drug-induced lupus is caused by a reaction to some medicines. The symptoms may start 3 to 6 months after starting the medicine. The symptoms usually go away when you stop taking the medicine.
• Neonatal lupus, which is rare, affects newborns. It is caused by certain antibodies that are passed from the pregnant parent to the baby.

The cause of lupus is unknown. Researchers are studying what might cause or trigger the disease, such as:

• Genetics
• Environmental factors, such as viral infections, sunlight, certain medicines, and smoking
• Problems with the immune system

Anyone can get lupus, but women get it much more often than men.

Lupus is more common in African Americans than in White people. It is also more common in people of American Indian and Asian descent. African American and Hispanic women are more likely to have severe forms of lupus.

Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are:

• Arthritis, causing painful and swollen joints and morning stiffness
• Fever
• Fatigue or feeling tired often
• Red rashes, most often on the face (also called the "butterfly rash")
• Chest pain when taking a deep breath
• Hair loss
• Pale or purple fingers or toes, from cold and stress (Raynaud's disease)
• Sensitivity to the sun
• Swelling in legs or around eyes
• Mouth ulcers
• Swollen glands
• Headache and dizziness
• Confusion and memory problems

Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time.

Lupus causes inflammation throughout your body. This can cause problems in your organs, including:

• Kidney damage (lupus nephritis).
• Heart problems, including inflammation in the heart (myocarditis), heart valves, or lining of the heart muscle (pericarditis).
• Inflammation of blood vessels (vasculitis).
• Blood clots
• Inflammation of the tissue that surrounds the lungs (pleurisy). This can make it painful to breathe.

Some people with lupus may be more likely to develop other conditions, such as coronary artery disease (CAD) and atherosclerosis.

There is no specific test for lupus, and it's often mistaken for other diseases that cause similar symptoms. So it may take a while to get a diagnosis. To find out if you have lupus, your health care provider:

• Will ask about your symptoms, medical history, and family health history
• Will do a complete physical exam
• May order blood tests, such as ANA (antinuclear antibody), antibodies, complete blood count, and complement tests
• May order other tests, such as urine tests
• May do biopsies:
  • Skin biopsy (looking at skin samples under a microscope)
  • Kidney biopsy (looking at tissue from your kidney under a microscope)

There is no cure for lupus, but medicines and lifestyle changes can help control it.

People with lupus often need to see different providers. You will most likely have a primary care provider and a rheumatologist (a doctor who specializes in diseases of the joints and muscles). Which other specialists you will depend on how lupus affects your body. For example, if lupus is damaging your heart or blood vessels, you would see a cardiologist (a doctor who specializes in heart diseases).

Your primary care provider should coordinate care between all of your other providers and treat other problems as they come up. You and your primary care provider will develop a treatment plan to fit your needs. You will both review the plan often to make sure that it is working. You should report new symptoms to your provider right away so that your treatment plan can be changed, if needed.

The goals of a treatment plan are to:

• Prevent flares
• Treat flares when they occur
• Reduce organ damage and other problems
• Improve your quality of life

Treatments may include drugs to:

• Reduce fever, swelling, and pain
• Reduce inflammation in your body
• Prevent or reduce flares
• Reduce or prevent damage to joints
• Suppress (lower) the activity of your immune system

Besides taking medicines for lupus, you may need to take medicines for problems that are related to lupus such as high cholesterol, high blood pressure, or infection.

Alternative and complementary therapies are therapies that are not part of standard treatments. Some people try alternative and complementary therapies to improve their lupus symptoms. But research has not clearly shown whether these treatments may help or treat lupus. Talk to your provider before trying any new treatments.

It is important to take an active role in your treatment. It helps to learn more about lupus - being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.

It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Lymphoma is a cancer of a part of the immune system called the lymph system. There are many types of lymphoma. One type is Hodgkin disease. The rest are called non-Hodgkin lymphomas.

Non-Hodgkin lymphomas begin when a type of white blood cell, called a T cell or B cell, becomes abnormal. The cell divides again and again, making more and more abnormal cells. These abnormal cells can spread to almost any other part of the body. Most of the time, doctors don't know why a person gets non-Hodgkin lymphoma. You are at increased risk if you have a weakened immune system or have certain types of infections.

Non-Hodgkin lymphoma can cause many symptoms, such as :

• Swollen, painless lymph nodes in the neck, armpits or groin
• Unexplained weight loss
• Fever
• Soaking night sweats
• Coughing, trouble breathing or chest pain
• Weakness and tiredness that don't go away
• Pain, swelling or a feeling of fullness in the abdomen

Your doctor will diagnose lymphoma with a physical exam, blood tests, a chest x-ray, and a biopsy. Treatments include chemotherapy, radiation therapy, targeted therapy, biological therapy, or therapy to remove proteins from the blood. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells. Biologic therapy boosts your body's own ability to fight cancer. If you don't have symptoms, you may not need treatment right away. This is called watchful waiting.

NIH: National Cancer Institute

Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of your immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bones.

No one knows the exact causes of multiple myeloma, but it is more common in older people and African Americans. It can run in families. Common symptoms may include:

• Bone pain, often in the back or ribs
• Fractures (broken bones)
• Weakness or fatigue
• Weight loss
• Frequent infections and fevers
• Feeling very thirsty
• Frequent urination

Doctors diagnose multiple myeloma using lab tests, imaging tests, and a bone marrow biopsy. Your treatment depends on how advanced the disease is and whether you have symptoms. If you have no symptoms, you may not need treatment right away. If you have symptoms, you may have chemotherapy, stem cell transplantation, radiation, or targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Your newborn infant has screening tests before leaving the hospital. There may be different tests depending on the state where you live. They include:

• Tests on a few drops of blood from pricking the baby's heel. The tests look for inherited disorders. All states test for at least 30 of these conditions.
• A hearing test that measures the baby's response to sound
• A skin test that measures the level of oxygen in the blood. This can tell if the baby has a congenital heart defect.

These tests look for serious medical conditions. If not treated, some of these conditions can cause lifelong health problems. Others can cause early death. With early diagnosis, treatment can begin right away, before serious problems can occur or become permanent.

If a screening shows that your baby might have a condition, the health care provider or the state health department will call you. It is important to follow up quickly. Further testing can verify whether your baby has the condition. If so, treatment should start right away.

NIH: National Institute of Child Health and Human Development

There are four major blood types: A, B, O, and AB. The types are based on substances on the surface of the blood cells. Another blood type is called Rh. Rh factor is a protein on red blood cells. Most people are Rh-positive; they have Rh factor. Rh-negative people don't have it. Rh factor is inherited through genes.

When you're pregnant, blood from your baby can cross into your bloodstream, especially during delivery. If you're Rh-negative and your baby is Rh-positive, your body will react to the baby's blood as a foreign substance. It will create antibodies (proteins) against the baby's blood. These antibodies usually don't cause problems during a first pregnancy.

But Rh incompatibility may cause problems in later pregnancies, if the baby is Rh-positive. This is because the antibodies stay in your body once they have formed. The antibodies can cross the placenta and attack the baby's red blood cells. The baby could get Rh disease, a serious condition that can cause a serious type of anemia.

Blood tests can tell whether you have Rh factor and whether your body has made antibodies. Injections of a medicine called Rh immune globulin can keep your body from making Rh antibodies. It helps prevent the problems of Rh incompatibility. If treatment is needed for the baby, it can include supplements to help the body to make red blood cells and blood transfusions.

NIH: National Heart, Lung, and Blood Institute

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in your joints. It can affect any joint but is common in the wrist and fingers.

More women than men get rheumatoid arthritis. It often starts in middle age and is most common in older people. You might have the disease for only a short time, or symptoms might come and go. The severe form can last a lifetime.

Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. RA can affect body parts besides joints, such as your eyes, mouth and lungs. RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body's own tissues.

No one knows what causes rheumatoid arthritis. Genes, environment, and hormones might contribute. Treatments include medicine, lifestyle changes, and surgery. These can slow or stop joint damage and reduce pain and swelling.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases