Doctors cast off fatigue in older man due to aging

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FOR RELEASE WEEK OF JUNE 26, 2023 (COL. 2)

BYLINE: By Keith Roach, M.D.

TITLE: Doctors cast off fatigue in older man due to aging

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DEAR DR. ROACH: I'm writing in regarding my 92-year-old father. He has always been active, still plays golf and had played softball up until the age of 88. My father has a history of blood clots, so he is on blood thinners. Nowadays, my father is constantly fatigued; walking out to the garage leaves him drained, and attempting to play nine holes of golf leaves him drained. He sleeps a lot during the day. All the doctors say is: "Hey, your dad is 92 years old." So, my question is, is this a normal part of aging? -- J.N.

ANSWER: While it is true that we all slow down a little bit as we get older, and 92 is certainly a very respectable age, I would not rush to blame this on his age, especially if these changes are relatively sudden. I certainly would not diagnose this as normal aging without, at least, a careful history and physical examination, as well as some judicious laboratory studies.

Fatigue is a very nonspecific symptom that can be caused by abnormalities of virtually all your major organs, especially the heart, liver, kidney, lungs and bone marrow. Thyroid problems are another common issue, and depression is a frequently overlooked possibility, especially in older men.

DEAR DR. ROACH: What is your recommendation for weight gain supplements? -- H.B.

ANSWER: I don't recommend weight gain supplements, except under unusual circumstances. Most people do better eating food than using supplements such as protein powders, food replacement drinks, vitamins, minerals, herbal supplements or other over-the-counter medications purported to help people gain weight.

There are clearly some exceptions to my lack of enthusiasm for these products. Many medical conditions can cause poor absorption of nutrients, and people may be prescribed supplements by their physician, which may be completely appropriate for them. One example is in people with very severe lung disease, such as emphysema, who often lose a great deal of weight.

Increasing one's healthy fat intake can help improve weight as well as reduce demand on the lungs. Consuming protein and energy supplements almost never has a benefit compared to when healthy people eat well.

DEAR DR. ROACH: I just read your recent column regarding Raynaud's, and I'm a bit confused. My fingers and toes tend to get cold, so I always wear socks in the winter, even though I live in Southern California. Sometimes I will put on two pairs of socks.

This past winter, I noticed that my toes would sometimes be red when I took the socks off. There didn't seem to be any rhyme or reason as to when it happened. My doctor then diagnosed me with Raynaud's. You stated that with Raynaud's, toes can turn either white or blue. Is there some other medical condition that would cause them to turn red? -- M.F.

ANSWER: The classical progression in an attack of Raynaud's is the affected fingers or toes will turn white, then blue, then red. However, not everybody has the classical color change, and you might be missing the white or blue color change, since your feet are in your socks (I recommend wool) and shoes.

Your doctor's diagnosis seems likely to me; though, of course, I can't be sure there isn't something else. Blockages in the circulation to your toes are worth considering.

Some people are so sensitive that the temperature doesn't need to be very cold at all to cause an attack. While warmer footwear will help, keeping your entire body warm is important in preventing Raynaud's attacks. That may mean you having to wear warmer clothes than other people, even when the weather feels warm to others.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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