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Table 1 Possible mechanisms involved in fatigue

From: Fatigue in chronic inflammation - a link to pain pathways

Endocrine system Dysregulation of HPA axis and resistance to glucocorticoids
Thyroid insufficiency
Central nervous system Decrease or polymorphism of neurotransmitters
Peripheral nervous system Alteration of autonomic system
Stimulation of vagus nerve via microbiota or inflammation
Anemia Decrease of tissue oxygenation
Inflammation Increase of levels of pro-inflammatory cytokines (IL-1, IL-6, IL-8 and TNF)
Proliferation of immune cells
Oxidative stress Excess formation of free radicals
Treatments Possible side effects
  1. HPA hypothalamic-pituitary-adrenal, IL interleukin; TNF tumor necrosis factor