10 Possible Causes of Fatigue
When it’s time to see a doctor about your exhaustion — and what to try first.
By Gina Shaw
Reviewed by Laura J. Martin, MD
Do you feel tired all the time? Lots of people do. It’s a sign of our overbooked times.
Getting your energy back could be simpler than you think. Start by seeing if you can relate to the top three reasons for feeling drained.
Top 3 Reasons
The most common reasons for feeling tired are about daily habits.
1. What you eat. Reaching for caffeine and sugar can backfire, leaving you more fatigued as your blood sugar levels fluctuate wildly. Instead, go for a balanced, healthy diet replete with fruits, vegetables, and lean protein. «Most people feel like they’re less tired if they eat a healthy diet,» says J. Fred Ralston Jr., MD, past president of the American College of Physicians. «Eating healthy also means you’ll carry less weight, and obesity is a big contributor to fatigue.
2. How much you sleep. You saw this one coming, right? Many people don’t get enough sleep. If you’re one of them, avoid caffeine and alcohol in the hours just before bedtime, turn off the TV before bed, and keep your bedroom quiet and restful.
3. How much you exercise. This is the biggie, Ralston says. His favorite prescription for plain old tiredness is regular, vigorous exercise. Finish at least three hours before bedtime, so you have time to wind down.
If you think that exercise would just make you more tired, there’s good news: Exercise breeds energy. Almost all the studies that have looked at this question have found the same thing: Sedentary people who start exercising feel much less fatigue than those who stay idle. It’s one of those surprising truths: move more and you’ll get more energy.
Ralston recommends getting 40 minutes of exercise at least four days a week, to get you going.
Do that, and a month from now, you should notice some improvement. Keep with it for three to six months more, and you should feel much better.
If you follow your exercise prescription for at least a month — and you’re also making enough time for sleep — and you’re still feeling lousy, look into other causes, Ralston advises.
Could It Be Something Else?
The most common reasons for feeling so tired all the time are those we’ve just discussed. Don’t start thinking that you’ve got a medical condition until you’ve tried those strategies and really given them a chance.
If you still feel exhausted, you’ll need to check with your health care provider to look into it. Chronic tiredness is linked to many different medical conditions, such as:
4. Anemia. «This is a very common cause of fatigue and very easy to check with a simple blood test,» says Sandra Fryhofer, MD, an Emory University clinical associate professor of medicine. «It’s particularly a problem for women, especially those who are having heavy menstrual periods.» You can remedy anemia with an iron-rich diet, heavy in meats and dark, leafy greens, or supplements if you have a chronic iron deficiency.
Could It Be Something Else? continued…
5. Deficiencies in key nutrients, such as potassium. Again, this is easily checked with blood testing.
6. Thyroid problems. Over- and under-active thyroids both can cause fatigue, Fryhofer says. A blood test for your level of thyroid-stimulating hormone can help evaluate your thyroid function.
7. Diabetes. People who have uncontrolled diabetes «just plain don’t feel good,» Fryhofer says. «If you feel draggy and you’re also having blurred vision or lots of urination, you should get that checked with a blood test.»
8. Depression. If your feelings of exhaustion are accompanied by sadness and loss of appetite, and you just can’t find any pleasure in things you once enjoyed, you may be depressed. Don’t keep that to yourself. Your doctor, or a therapist, can start you on the path back to feeling better.
9. Sleep problems. If you never feel rested, and nothing seems to fix that, you might look into visiting a sleep lab, especially if you snore. Snoring can be part of obstructive sleep apnea, in which people briefly stop breathing several times a night. There are treatments for that.
10. Undiagnosed heart disease. Tiredness can be a sign of heart trouble, particularly in women, Ralston says. «If you have trouble with exercise you used to do easily, or if you start feeling worse when you exercise, this could be a red flag for heart trouble. If you have any doubts, see your doctor.»
But again, start with the basics: your sleep, your diet, and your activity level. Sometimes the simplest fixes are all it takes.