Why am I always tired?

Are you tired of feeing tired? It could be a sign that you’re a bit run down, you’re iron deficient or you’ve got an underlying sleep disorder. In fact, it could be a symptom of hundreds of different illnesses and conditions – both physical and psychological

CREDIT: This is an edited version of an article that originally appeared on Huffington Post

We’re leading increasingly busy lives, to the point where some of us are forced to schedule in free time;. We work long hours, we’re staying up late scrolling on our ‘phones – so it’s no surprise tiredness is rife. The issue even has its own acronym TATT, which stands for ‘tired all the time’. Sound familiar?

The Royal College of Psychiatrists suggests that, at any given time, one-in-five of us feel unusually tired, and one-in-10 have prolonged fatigue – with women more impacted than men. But when is your tiredness cause for concern, or signal of a more serious health issue, and at what point does day-to-day tiredness progress into full-on fatigue? Here’s when it might be worth seeking help.

Tiredness is one of the most common symptoms people present with to doctors, says Dr Jeff Foster, a private GP specialising in men’s health. It’s medically described as a lack of (or decreased) energy, and physical or mental exhaustion. Between 10-18% of people in the UK report tiredness lasting one month or longer, according to NICE – the organisation which provides evidence-based guidance to the NHS – and it can impact everything from your work and family life to romantic relationships and socialising.

When it comes to ‘curing’ tiredness, sometimes it’s as simple as looking at a person’s lifestyle and suggesting tweaks. “Many people have unrealistic expectations about what they can achieve, or have poor diets, or poor sleep, or do no exercise,” says Dr Foster. Tiredness can also be a side effect of some types of medication – ask your GP or pharmacist if you are unsure on this.

In a small number of people tiredness can be a sign of an underlying condition or something more serious. “The key is to look at other symptoms or signs when a patient presents as tired to see if it matches an underlying medical problem,” Dr Foster says.

Lifestyle-based causes?

In his experience the most common causes of tiredness among patients are lifestyle-based – typically the result of sleep deprivation, diet or chronic alcohol use. However, they can also be psychological – for example, as a result of mental health problems like depression and anxiety – and pathological, which refers to a range of underlying conditions such as diabetes, infections like glandular fever, anaemia, sleep apnoea, underactive thyroid, menopause in women and low testosterone in men.

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“Tiredness becomes a worry when either it impacts your ability to maintain your activities of daily living, or it becomes associated with other symptoms such as night sweats, increased thirst or weight changes,” Dr Foster explains.

Other red flags, as suggested by NICE, include coughing up blood, struggling to swallow food or drink, or not being able to swallow at all, rectal bleeding, finding a breast lump, or postmenopausal bleeding. If you experience any of these symptoms alongside tiredness you should speak to your GP urgently.

Rarer causes of tiredness can include chronic headaches or other forms of chronic pain syndrome such as fibromyalgia, renal or liver disease, heart failure or cancer; this group of illnesses shouldn’t go untreated.

“Tiredness, in most cases, is normal and related to doing too much activity or not sleeping properly,” Martin Ledwick, Cancer Research UK’s head information nurse explains. “However, like all health problems, it should be investigated if it is persistent, can’t be easily explained or is combined with other, persistent health problems that are unusual for you.”

Meaningful changes

Where tiredness is simply a result of your lifestyle there are meaningful changes you can make. “It is very common that we simply expect too much of our bodies and devote too little time to looking after ourselves,” says Dr Foster. He advises spending less time on mobile ‘phones, and screens in general.

“People need to log off from work when they hit the evening,” he says – as well as getting at least six-to-seven hours of good quality sleep, and eating properly and frequently. “This means three meals a day,” he continues. “It seems obvious but, on closer questioning, it is so often missed.”

Exercise is obviously crucial for boosting energy levels. “Most people spend their day in front of a screen sitting still,” he adds. “The human body does not like this; exercise helps us sleep, produces endorphins, regulates hormones and metabolism and prevents tiredness.”

Dr Foster’s last prescription might come as a surprise to some, but is crucial too. “We need to socialise and get out of the office,” he says. “This provides essential de-stressing and helps us unwind.

“The body feels less tired when our brain is not wound up and stressed.”

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