hen the holidays are looming, feeling tired is the status quo for many people. Yet just because fatigue is common doesn't mean it's normal, or something that has to be endured.

The first step to eliminating the problem is to determine whether what you're feeling is fatigue or weakness, both of which are symptoms, not diseases in and of themselves. Fatigue is defined as a lack of energy, and the feeling that you require an extra effort to perform daily activities. It's usually caused by overwork, too little sleep or poor quality of sleep, lack of exercise, stress, depression and even boredom. Temporary illnesses like colds and the flu also are characterized by fatigue which disappears once you get well.

Weakness, meanwhile, usually occurs after you've overexerted yourself, such as following a day of heavy Christmas shopping or an unusually hard workout. The resulting weakness and muscle soreness usually disappears within a few days.

Both fatigue and weakness, however, can be caused by different health problems, some serious, so it's important that you be evaluated by your doctor. If you have fatigue that lasts longer than one or two weeks — especially if you're getting enough sleep — it's an indicator that you may have a significant health problem. Ditto if you're experiencing fatigue in combination with breathing difficulties, abnormal bleeding, difficulty performing everyday tasks, pain or unexplained weight loss or weight gain. If you experience any major muscle weakness, meanwhile, get checked right away.

Causes of Fatigue

• Heart disease, especially coronary artery disease.
  
• Type 2 diabetes and other metabolic disorders.
  
• Depression, anxiety and extreme stress
  
• Side effects of prescription and nonprescription medications.
  
• Abuse of alcohol, caffeine or illegal drugs.
  
• Sleep apnea
  
• Nasal allergies or hay fever
  
• Food allergies
  
• Rheumatoid arthritis
  
• Anemia
  
• Chronic fatigue syndrome.
  
• Fibromyalgia
  

Causes of Weakness

• Low thyroid (hypothyroidism) or high thyroid (hyperthyroidism)
  
• Electrolyte imbalance, caused by deficiencies of potassium or sodium.
  
• Myasthenia gravis, a chronic disorder that causes rapid muscle fatigue and weakness.
  
• Guillain-Barre syndrome, a rare nerve disorder that causes weakness and can progress to paralysis.
  

If your muscle weakness comes on very suddenly, and is accompanied by difficulty speaking, seeing, or weakness on one side of the body, it can indicate the onset of a stroke, a TIA (transient ischemic attack or "mini-strike") or a spinal cord problem. If you experience any of these symptoms, go to the emergency room immediately.

eeping your teeth and gums healthy isn't just about avoiding bad breath. Good oral hygiene helps keep your entire body healthy, while gum disease is a strong risk factor for serious health problems, including heart disease and diabetes.

With that in mind, there are some general guidelines for selecting the best toothbrush to keep your teeth clean:

• Pick the right size, one with a head that allows you easy access to all surfaces of your teeth.
  
• Select a brush with soft bristles. This is the most comfortable and safest choice for most people. Medium- and hard-bristled models can actually damage protective tooth enamel.
  
• Be sure the brush you select, whether electric or manual, carries the American Dental Association seal of approval.
  

Studies have found no significant difference between electric or manual toothbrushes. The lone exception is the rotation oscillation brush, in which the bristles move both round and round and back and forth. Recent evidence suggests they may perform better than manual brushes. Other factors to consider:

• Cost. Obviously electronic models are considerably more expensive than manual.
  
• Personal preference. Most people prefer one type of brush over the other. Electric models also can be more comfortable for people with arthritis since it may be easier to grip.
  
• Safety. An electric toothbrush is gentler on the gums and teeth. However, some research suggests electric toothbrushes may increase the amount of bacteria in a person's bloodstream more than a manual brush. This may pose a risk in people with heart disease or weakened immune systems.
  

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