Malaise (Sick Feeling) Meaning, Causes and Symptoms

We have all experienced it at some time in life or the other but probably did not know the medical term for this feeling. It is probably best remembered as the drained and ‘miserable’ sensation we feel just prior to the onset of the flu symptoms which continues through the flu. However, it is not only restricted to the flu or other viral conditions. Malaise may be either acute or chronic and arise with a host of different diseases.

What is Malaise?

Malaise is best described as a feeling of being unwell. There may be general discomfort but not actual pain. There may be a lack of well-being, where a person knows that they are not well but cannot specify the exact sensation they are experiencing. It is often accompanied by fatigue and many people may feel a need to sleep and recuperate. However, malaise is not a consequence of insufficient sleep specifically.

Thus far the focus of malaise has been in the context of it being a prelude to a disease, like the feeling we experience about 24 hours before the flu symptoms arise. However, malaise continues through the disease and may sometimes persist even after other disease symptoms have cleared.  For some people with certain diseases, malaise can be a continuous feeling lasting weeks, months or even years.

Reasons for Malaise

The exact reason why malaise occurs is unclear. It is a non-specific symptom and subjective to some degree. There are many theories as to why a person experiences this sensation. From immune activity, to nutritional demands, alterations if blood pressure and blood glucose levels, fever and inadequate oxygen perfusion. However, while all of these factors may contribute to it, there is no specific reason that can be attributed to the onset and persistence of malaise.

Malaise may serve as a warning by the body of an impending illness. It may also signal that the body is under stress and by its very nature compel a person to rest in order to recuperate. However, it can occur in some people despite the obvious lack of any illness. Irrespective of the exact pathophysiological mechanism behind the sensation, what is apparent is that the body is not functioning at its peak or is facing bombardment of some sort. Therefore many people describe malaise as a ‘sick feeling’ or that ‘something is not right’ with the body without being able to specify the exact problem.

Other Signs and Symptoms

Malaise is a symptom that is highly subjective. It cannot be measured or monitored independently beyond what a person reports. Many patients may mistaken fatigue for malaise and vice versa. While fatigue is a part of malaise, it is important to note that it is a separate symptom that is often eased with adequate rest. Malaise is not as easily remedied with rest and usually requires the disease to resolve in order for it to subside.

Depending on the underlying cause, malaise may b accompanied by:

  • Fever
  • Profuse perspiration
  • Nausea
  • Loss of appetite
  • Sleepiness
  • Weakness

Specific symptoms like a runny nose, cough, difficult breathing, diarrhea, vomiting and so on may arise with certain diseases that is the underlying cause of malaise and the host of other symptoms.

Causes of Malaise

Although malaise can occur with just about any disease, particularly systemic diseases, it tends to be a common feature of the conditions below. Malaise may sometimes be considered as a symptom that does not warrant medical attention on its own since it is non-specific. However, early medical assessment may help to identify an underlying cause and treat it before complications arise.


Malaise can occur with both short term infections like the seasonal flu (influenza) and long term infections such as HIV/AIDS. It is common in viral infections but may also arise with bacterial diseases. Acute bronchitis, pneumonia, Lyme disease and infectious mononucleosis (mono) are some of the short term infections diseases where malaise is prominent. Tuberculosis, viral hepatitis and parasitic diseases usually present with malaise as well.

Cardiac and Respiratory

Malaise is also seen with conditions like heart failure and chronic obstructive pulmonary disease. In heart failure the heart’s ability to pump blood is impaired. Depending on the underlying problem, heart failure can persist for months or years. In chronic obstructive pulmonary disease (COPD), the flow of air to and from the lungs is impeded. The two main conditions are emphysema and chronic bronchitis, which are associated with long term cigarette smoking.


Malaise is often seen in severe anemia, where there is insufficient hemoglobin in the bloodstream. Since hemoglobin is required for transporting oxygen throughout the system, malaise in these cases may be associated with the low oxygen levels.

Autoimmune Conditions

Malaise is reported in many autoimmune conditions particularly those with a systemic effect. Rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus (SLE)  are some of the autoimmune conditions where malaise features prominently. These disease are a consequence of the immune system attacking the body’s own tissues.

Endocrine Diseases

Endocrine disease are conditions involving the glands of the body and specifically the disturbance of the hormones released by these glands. Hypothyroidism, diabetes and adrenal gland dysfunction are some of the main conditions where malaise is prominent.

Organ Failure

Apart from heart failure, malaise is also seen with kidney failure and liver failure. These organs play a crucial role in maintaining oxygen and nutrient supply to all parts of the body, regulating metabolic changes and removing wastes from the system. Therefore malaise may be associated with these specific biochemical disturbances.


Malaise may occur with any type of cancer, be it a solid mass like with lung cancer or colon cancer, or systemic like leukemia. It is also a major symptoms of chemotherapy and radiation therapy for the treatment of cancer.

Other Conditions

Malaise is also reported in psychiatric conditions like depression. It may therefore be linked to disturbances in brain hormones such as serotonin. Several drugs are known to cause malaise usually as a side effect. This means it does not occur in every person. These drugs include anticonvulsant medicines, antihistamines, beta blockers and certain
psychiatric drugs.



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