Why Am I So Tired All The Time?

Occasional tiredness is normal, and affects everyone from time to time, but increasing numbers of people admit to feeling tired all the time.

Some researchers estimate it affects as many as one in three people at any one time and that the most common cause is stress. Interestingly, more women than men are affected, perhaps because women are more likely to juggle different aspects of their life – looking after the home, working, raising children, organising meals – and have less time to sit down, put up their feet and look after their own health.

Why are you so tired all the time?

Feeling tired all the time tends up creep up on you so you feel increasingly washed out. The following pointers will help you work out why you are so exhausted, and what you can do about it.

Are you getting enough sleep?

Although it may seem obvious, lack of sleep will quickly lead to tiredness. Try going to bed earlier, ensuring your bedroom is quiet and dark. Supplements such as valerian or 5-HTP will help you sleep, while  magnesium is helpful for relaxation, sleep and improving energy levels. If you don’t wake feeling refreshed, you may have poor quality of sleep due to snoring or even sleep apnoea in which the airway partially collapses to restrict airflow. If lack of sleep is an issue, see my tips on how to sleep better naturally.

Do you regularly skip meals?

Skipping meals will lower blood glucose levels and leave you feeling tired with difficulty concentrating. Always find time to eat, especially breakfast – even if it’s just a quick granola bar, banana and juice. I like Belvita breakfast biscuits as these have a high content of slowly digestible starch which slowly releases energy for around four hours.

Do you get your 5-a-day fruit and veg?     

Fruit and vegetables are important sources of vitamins, minerals and co-enzymes needed to generate energy in the body. If you don’t eat the recommended amount, then a lack of vitamins and minerals can lead to tiredness all the time. While diet should always come first, a multivitamin and mineral supplement will help to correct any deficiencies and improve your energy levels over a few months. Click here for my tips on selecting a multivitamin supplement.

Do you drink sufficient fluids?    

Dehydration is a common cause of tiredness and fatigue. By the time you feel thirsty you are already significantly dehydrated so don’t rely on thirst to tell you when to drink fluids. Ensure you get at least 2 to 3 litres of fluid per day from drinks and foods such as juicy fruits and soups. Keep water with you to sip regularly throughout the day – coconut water provides additional minerals and is particularly refreshing. In fact, researchers have found that coconut water is more hydrating after exercise-induced dehydration than pure water. It tastes better, too!

Do you drink more than three caffeinated drinks a day?

In small doses, caffeine perks you up, but too much is an energy drainer and can lead to restlessness, insomnia, headache, anxiety and fatigue. This is because caffeine is a stimulant that blocks adenosine receptors in the brain. While this increases alertness, your brain adapts to a regular caffeine intake so that the number of adenosine receptors increases to produce a tolerance effect known as caffeine dependence syndrome. The number of brain receptors that respond to other stimulant neurotransmitters may also decrease so that, if you suddenly stop having caffeine, your adenosine receptors are deprived of their usual  ‘fix’, and your other coping mechanisms are unable to adapt quickly enough to prevent withdrawal symptoms such as headache, irritability, fatigue and lethargy. It’s therefore important to cut back slowly to avoid caffeine withdrawal symptoms.

Are you working too hard?

A high work load and long hours can lead to physical and emotional stress which are common causes of tiredness. Take a well-deserved holiday and use relaxation techniques such as meditation to help you recover. Korean ginseng is a traditional remedy used to help you adapt during times of physical and emotional stress.

Is pregnancy a possibility?

Overwhelming tiredness in women of reproductive age is often one of the first signs of pregnancy. If your period is late (even by just one day) take a pregnancy test. Tiredness is usually gone by the 16th week of pregnancy – if it persists, tell your doctor or midwife.

Do you feel anxious?

The effects of stress hormones can drain your energy levels through what is popularly known as ‘adrenal fatigue’. If there is no obvious cause for your anxiety, you could have a generalised anxiety disorder which is associated with feelings of apprehension, panic, dread and even impending doom. Surveys suggest that as many as one in six people have experienced feelings of anxiety within the previous week, and that one in ten people will have a disabling anxiety disorder at some time during their life.

Generalised anxiety disorder (GAD) is diagnosed when you spend at least six months worrying excessively about everyday problems. You are always anticipating disaster and are unable to relax through worry about health, finances, family, career – or just the thought of having to get through the day. If there is an identifiable cause, try to resolve this so it doesn’t keep coming back. There is an ongoing debate about whether anxiety disorders are the result of biological changes in the brain, and therefore likely to respond to drug treatment, or whether they are psychological in nature and more likely to improve with cognitive behaviour therapy. It seems that both physical and psychological processes are at work, so that combined therapy is often an effective approach. Your doctor can refer you to local services.

Rhodiola is a traditional herbal remedy for anxiety and stress that also has an energising action and can help to lift both anxiety and fatigue.

Have you noticed paleness, faintness, shortness of breath, palpitations or rapid pulse?

If yes, you could have anaemia which may be due to lack of dietary nutrients (iron, vitamin B12 or folic acid), excessive blood loss (eg heavy periods, bleeding stomach ulcer), reduced production of red blood cells (eg bone marrow or kidney problems) or to increased destruction of red blood cells (some immune conditions). See your doctor for a check-up before you start taking supplements which may mask the underlying cause.

Are you unusually sensitive to heat or cold?

Feeling tired all the time can occur with both an overactive and an underactive thyroid gland. If tiredness persists, it is important to rule these out – especially if thyroid problems run in your family. See your doctor for a check-up.

Do you regularly drink more than two units of alcohol per day?

Tiredness can result from drinking alcohol. Avoid alcohol for a few weeks to see if symptoms improve – most people quickly notice they sleep better. Milk thistle and globe artichoke supplements can help to support your liver if your intake has been high. If you have difficulty avoiding alcohol, seek medical advice.

Do you feel depressed?

Have you noticed a low mood, tearfulness, reduced sex drive, recurrent headaches and general loss of interest in what’s going on around you? If so, you may have a depressive illness which will make you feel tired and run down. Seek medical advice as, like anxiety, depression can respond to talking therapies and, in some cases, antidepressant drugs are needed. If depression is not severe, your doctor may be willing for you to try options such as St John’s Wort or 5-HTP (don’t take these two treatments together) to lift mild to moderate depression. Check with a pharmacist if you are already taking any prescribed medications in case of drug interactions.

Are you recovering from a viral illness such as influenza or glandular fever?

You may experience persistent tiredness for several months after a viral illness. If you have persistent fatigue, seek medical advice. Research suggests that taking high dose vitamin B group supplements may help. Essential fatty acids have also been shown to produce significant beneficial effects in up to 80% of people suffering from chronic fatigue. Omega-3 fish oils, magnesium and co-enzyme Q10 can also help. See my posts on the best magnesium supplements and the best co-enzyme Q10 supplements.

Are you inactive or overweight?

Carrying excess fat can leave you feeling tired through effects on your metabolism and liver function. If you tend to avoid regular exercise, a sedentary lifestyle will also lower your stamina, leaving you unfit and feeling tired after exertion. Start a gentle exercise programme and steadily increase the amount of effort you put in. Try to exercise every day for at least 30 to 60 minutes – brisk walking is ideal. Invest in a pedometer or fitness tracker and slowly increase your goal steps until you can manage at least 7,000 steps per day easily – and preferably 10,000!

Are you unusually thirsty, pass lots of urine or prone to infections such as thrush or boils?

Tiredness and fatigue can accompany both type 1 and type 2 diabetes. It tiredness persists, it’s important to see your doctor for a diabetes screen, especially if you are overweight, are losing weight unexpectedly, are experiencing visual changes, or if diabetes runs in your family.

Are you taking any medication?

Tiredness is a possible side effect of many prescribed drugs – especially statins and other medicines prescribed to treat conditions such as high blood pressure. Check the Patient Information Leaflet supplied with your medication to see if tiredness is listed as a recognised adverse effect. If so, talk to your doctor about other treatments that may suit you better.

Are you breathing correctly?

Poor breathing habits such as deep sighs, gasps, breath-holding or taking rapid, shallow breaths are common, and can lead to tiredness. In contrast, breathing properly can help to relieve stress, lower anxiety and improve energy levels by ensuring optimum oxygen perfusion of your tissues. In the long-term this can even reduce your risk of a number of health conditions, including high blood pressure, heart attack and stroke. It may also help you sleep better, lift your mood and reduce pain perception.

Products to boost your oxygen intake are increasingly popular, too, especially those scented with essential oils.

Essential oils can help

Inhaling certain essential oils can have profound effects on the brain, to clear your thoughts, lift your mood and boost your energy levels. Essential oils used to treat physical and emotional tiredness include Angelic, Benzoin, Black Pepper, Cardamom, Lemon, Orange, Peppermint, Pint, Rosemary, Rosewood and Sandalwood. Others, such as lavender, geranium, Grapefruit, Jasmine, Neroli and Ylang Ylang oils are used to promote relaxation and aid sleep. Using these to scent a room can help to overcome feelings of being tired all the time.

Is it carbon monoxide poisoning?

The possibility of carbon monoxide poisoning is worth considering if fatigue is accompanied by headache, and symptoms rapidly clear on breathing fresh air. Carbon monoxide is a colourless, odourless, tasteless, non-irritant and therefore undetectable gas. It leaks from old motors and poorly maintained gas-powered tools, heaters and cooking equipment and can kill. Have chimneys and flues cleaned and checked regularly, and gas appliances and heating systems professionally inspected every year to ensure they are safe. You should also invest in carbon monoxide detectors for your home which will give you a warning if carbon monoxide occurs. Choose one that emits a noise if carbon monoxide is present, rather than one that changes colour as you might not notice this.

Seek advice

If tiredness persists, seek medical advice. Occasionally, persistent tiredness is linked with illnesses such as hidden infections, diabetes, irregular heartbeat, autoimmune conditions, liver or kidney problems, or even cancer, and your doctor will want to investigate to find out the cause. Persistent tiredness is not a symptom you should ignore.

I hope you found this helpful. If you have any questions or product recommendations, please use the comment form below. Thanks.

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About Dr Sarah Brewer

QUORA EXPERT - TOP WRITER 2018 Dr Sarah Brewer MSc (Nutr Med), MA (Cantab), MB, BChir, RNutr, MBANT, CNHC qualified from Cambridge University with degrees in Natural Sciences, Medicine and Surgery. After working in general practice, she gained a master's degree in nutritional medicine from the University of Surrey. Sarah is a registered Medical Doctor, a registered Nutritionist and a registered Nutritional Therapist. She is an award winning author of over 60 popular self-help books and a columnist for Prima magazine.

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