Malaise is a general feeling of physical discomfort or uneasiness.
What is going on in the body?
Malaise is often the first sign of an infection or other disease. Many people can "feel" an infection or disease starting because they develop the feeling of malaise. The causes of malaise can range from working out or studying too hard to cancer.
What are the signs and symptoms of the condition?
A doctor may want to know several things when a person complains of malaise, such as:
Other symptoms may be important in determining the cause of the malaise. For instance, the doctor may want to know about fever, weight loss, or pain.
- how long the person has had the feeling
- whether it occurs every day or only some days
- whether it is getting worse, better, or staying the same
- whether the malaise seems more mental or physical in origin
- whether the feeling came on slowly or happened suddenly
- whether the person has been or currently feels sick
- the number of hours of sleep the person gets every night
- the amount of stress in the person's life
- the amount of activity or exercise a person engages in
- what the person's diet is like
What are the causes and risks of the condition?
Almost any sudden illness and many chronic illnesses can cause malaise. The more common causes include:
Other causes of malaise are also possible. Sometimes, the cause is unknown.
- lack of sleep or sleep disorders
- infections, such as acute bronchitis, a common cold, the flu, or infectious mononucleosis
- a low blood count, called anaemia
- hormone imbalances, such as a low thyroid hormone level, called hypothyroidism. Another example is low adrenal hormone levels, called hypoadrenalism.
- depression or other psychological disorders
- autoimmune disorders, which are conditions in which a person's immune system attacks his or her own body for no apparent reason. Examples of autoimmune diseases include systemic lupus erythematosus and rheumatoid arthritis.
- toxin or chemical exposure, such as carbon monoxide or lead poisoning
- medications, such as antihistamines, cancer chemotherapy, or certain medications used to treat depression and high blood pressure. Examples include atenolol, paroxetine, and diphenhydramine.
- systemic disorders, such as heart, liver, lung, or kidney disorders
- uncontrolled diabetes
- tumours or cancer, such as lung cancer or a blood cancer called leukaemia
- salt imbalances, such as a low sodium level or a high potassium level
- chronic fatigue syndrome and fibromyalgia, two poorly understood conditions with no known cause. These conditions commonly cause malaise and make people feel weak and tired.
What can be done to prevent the condition?
Prevention is related to the cause. Avoidance of stress and overexertion, getting enough sleep, and eating a healthy diet can prevent some cases of malaise. Taking medications as prescribed can prevent some cases due to diabetes and allergies.
How is the condition diagnosed?
The role of the doctor is to help figure out the cause of malaise. This may be possible after a complete history and physical examination. In other cases, further tests must be done. This often involves blood tests, such as a full blood count or FBC, which can help detect anaemia or an infection. Blood hormone levels, such as thyroid function tests, can help diagnose hormone imbalances. Salt, or electrolyte, levels can also be checked with a chem-7 blood test. A blood glucose test can help detect diabetes.
Other tests may be advised based on the suspected condition. For instance, a chest x-ray may be done if lung or heart disease is thought to be the cause. An x-ray test called a chest CT scan may be used if lung cancer is suspected.
What are the long-term effects of the condition?
Malaise can limit a person's ability to work or go to school. Other long-term effects depend on the cause. For instance, cancer may result in death. An infection often goes away and results in no long-term effects.
What are the risks to others?
Malaise itself is not contagious and poses no risk to others. However, malaise may be caused by an infection that is contagious.
What are the treatments for the condition?
In general, recommendations for treatment of malaise include:
More specific treatment is directed at the cause. For instance, a person may need antibiotics for infection. Thyroid hormone medication may be needed for low thyroid levels. In other people, control of diabetes or another systemic disorder may be needed. Those with depression often need medication to treat their condition. Those with cancer may need surgery, chemotherapy, or radiation therapy.
- regular exercise without overdoing it
- getting enough sleep
- eating a healthy diet
- decreasing stress
What are the side effects of the treatments?
Side effects depend on the treatments used. Medication side effects can include allergic reactions, stomach upset, and headache. Surgery carries a risk of bleeding, infection, and allergic reaction to the anaesthesia.
What happens after treatment for the condition?
If the malaise goes away, a person may or may not need further treatment. For instance, an individual with diabetes needs lifelong treatment. Someone who was "overdoing it" may need no further treatment once he or she gets some rest. Someone with cancer may die if treatment is not successful.
How is the condition monitored?
A person can often monitor his or her symptoms at home. Any new or worsening symptoms should be reported to the doctor. Other monitoring is related to the cause. For instance, someone with diabetes needs to monitor blood sugars regularly.
Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 19/02/2005
Potential conflict of interest information for reviewers available on request