What Is Malaise?

If you've ever felt "off", but couldn't figure out what was wrong, you might have experienced malaise. Malaise is not a condition, but it can appear as a symptom of many other health conditions. It is characterized by weakness, tiredness, discomfort, or generally feeling unwell. Sometimes, malaise is confused with fatigue, which can co-occur with malaise, but fatigue is a distinct condition characterized by exhaustion that does not improve with rest. 

Something that differentiates malaise from pain is that it's more generalized. Typically people feeling malaise have whole-body discomfort, not an ache or pain that only affects a portion of the body.

What Causes Malaise?

Malaise is a general feeling of being unwell that may be a symptom of multiple health conditions, reactions to medications, or other causes.

Research says that inflammatory proteins called cytokines, which deploy when your immune system activates or doesn’t work properly, may be partly responsible for malaise. Malaise may also occur if the cells in your body don’t have enough energy.  

Malaise may also be the result of a medical condition or medication. Here are some conditions and medications known to cause malaise.

Medical Conditions

Malaise can be a symptom of multiple infectious and non-infectious diseases and conditions:

• Respiratory infections: Diseases including pneumonia, tuberculosis, the common cold, influenza, bronchitis, and pneumonia cause malaise, even in the absence of fever.
• Other infections: Lyme disease, mononucleosis, AIDS, hepatitis, and other parasitic infections can cause malaise. 
• Organ failure or disease: Congestive heart failure, chronic obstructive pulmonary disorder, kidney disease, and liver disease are life-threatening conditions that can cause malaise. 
• Connective tissue diseases: Rheumatoid arthritis, sarcoidosis, and systemic lupus erythematosus can cause malaise.
• Metabolic disease: Adrenal gland dysfunction, diabetes, and thyroid disease can cause malaise and fatigue.
• Cancers: Leukemia, lymphoma, colon and other cancers are also known to cause malaise and fatigue. The cancer cells siphon off your body’s energy so that they can grow.
• Blood disorders: Anemia occurs when the blood isn’t able to transport enough oxygen to the body’s tissues and organs. This energy deficit can cause malaise.
• Psychiatric conditions: Depression, anxiety, and dysthymia (persistent depressive disorder) are associated with higher levels of inflammation leading to malaise.
• Long COVID: Malaise is a commonly reported symptom in people with long COVID (those who are experiencing long-lasting symptoms after contracting COVID-19).

Many people recovering from COVID-19 and those with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may also experience post-exertional malaise. This occurs when minor mental or physical activity has a drastic impact on the body’s metabolism. As a result, it leads to malaise, fatigue, and a worsening of other symptoms.  

Medications

Malaise is an unwanted, but common, side effect of different types of medications:

• Anticonvulsants (anti-seizure medication): In rare cases, malaise can be a warning sign of serious liver side effects.
• Antihistamine (allergy medication): These drugs affect the levels of the neurotransmitter acetylcholine. This affects your brain’s attention and arousal, which can cause you to feel malaise, fatigue, and drowsiness.
• Beta-blockers: These drugs are used to lower blood pressure or treat heart disease, and can lower the amount of oxygen transported to the rest of the body. Since your cells are receiving less fuel, this can lead to malaise. 
• Psychiatric medications: Malaise is a warning sign of more serious side effects for antipsychotic medications. Taking or tapering off of antidepressants can also cause malaise.

Symptoms of Malaise

There isn’t a lot of peer-reviewed research focused solely on malaise. However, there are still clear symptoms that allow healthcare providers to make a diagnosis:

• A sense of general discomfort
• Feeling weak, unwell, or ill 
• Vague bodily discomfort
• Low hunger levels

How to Treat Malaise

The treatments for malaise depend on the underlying cause. Sometimes the cause isn’t apparent and requires further diagnostic tests. 

A healthcare professional might ask for your family history as well as any new medications you might be taking. If they believe your malaise is linked to a drug reaction, they may suggest switching to another medication. If the underlying cause is still unknown, they may request different tests to diagnose the source of the symptoms. 

These tests include:

• Blood tests to look for signs of anemia, cancer, metabolic diseases, and inflammation.
• Screenings for mental illnesses like anxiety or depression.
• A physical exam to assess your overall health.
• X-rays and other diagnostic imaging for cancer and other abnormalities.

The causes of malaise aren’t always clear-cut and can be difficult to diagnose. For the majority of cases, these tests can clear up the source of malaise. For example, if the blood test shows low iron levels suggesting anemia, this might be the source of your malaise. Your healthcare practitioner would then recommend iron supplements to treat the anemia.

When to See a Healthcare Provider

If malaise lasts longer than one week or co-occurs with other symptoms, you should contact your healthcare provider. It's essential to address the root issue and, if necessary, seek medical advice to ensure a proper diagnosis and treatment.

In addition to medical treatments, your healthcare provider may recommend certain lifestyle changes to help treat the malaise or underlying conditions. These may include:

• Ensure you get adequate rest and sleep. Malaise can worsen due to fatigue, so getting enough sleep can help your body recover.
• Stay well-hydrated by drinking water, herbal teas, and clear broths. Dehydration can contribute to feelings of malaise.
• Eat a balanced diet with plenty of fruits and vegetables, and other nutrient-rich foods.
• Wear loose, comfortable clothing and keep the room temperature moderate to avoid excessive heat or cold.
• Relaxation techniques like deep breathing, meditation, or gentle yoga can help alleviate stress and anxiety, which can contribute to malaise.
• Keep track of your symptoms and their severity. This can help your healthcare provider identify any factors contributing to your malaise.

A Quick Review 

Malaise is a term used to describe a general feeling of discomfort, unease, or a sense of not being well. It's a non-specific feeling of being "off" or not quite right, often without specific or easily identifiable symptoms.

Malaise can be associated with various physical and psychological conditions, such as illness, infection, fatigue, stress, or even depression. It's a subjective feeling and can vary in intensity from mild to severe.

If you are experiencing malaise, you may feel sluggish or tired. You may not be able to pinpoint a specific cause or symptom. It can be a sign that something is wrong with your body or mind and can serve as an early warning sign of a more significant health issue.

If accompanied by other symptoms or the malaise lasts at least a week, you should speak with your healthcare provider. They can help diagnose and treat the underlying cause of malaise.