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Mar 18, 2018 Features / Columnists
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Tiredness, or fatigue, means having less energy than usual. You feel exhausted, either mentally, physically, or both. It is a normal part of life, but if it persists, it may suggest a medical problem. Today I will try to explain when tiredness may be as a result of a medical condition instead of you doing too much.
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WHAT ARE THE CAUSES OF TIREDNESS?
Physical causes of tiredness
Tiredness may be due to a wide range of physical illnesses. Common examples include:
• A tendency to be lacking in iron (anemia).
• An underactive thyroid gland (hypothyroidism).
• Diabetes.
• Heart failure or a blockage in your heart that will soon cause a heart attack
• Chest illnesses (including asthma and chronic obstructive pulmonary disease).
• Addison’s disease.
• Bowel problems (for example, coeliac disease).
• Carbon monoxide poisoning.
• Having to get up in the night a lot to pass urine, due to problems such as an overactive bladder or an enlarged prostate gland.
• Breathing problems at night interfering with sleep (obstructive sleep apnea).
• Pregnancy.
• Pain from other medical conditions keeping you awake at night.
• Infections that constantly depletes you
Most physical causes of tiredness will cause other symptoms. Some causes of tiredness (such as anemia and hypothyroidism) may not cause any other symptoms apart from tiredness.
Psychological causes of tiredness
Psychological tiredness is much more common than tiredness caused by a physical problem. Both anxiety and depression can make you feel very tired. Eating disorders can make you feel tired, particularly if you are underweight or overweight. Any cause of a sleep problem will also cause tiredness during the day.
Stress is a common cause of tiredness, either because it interferes with sleep, or because of the effect of having a worry on your mind all the time.
Lifestyle causes of tiredness
Tiredness can be caused by lifestyle. We often try to cram too much into our lives and as they become more and more busy we can get tired. Lifestyle causes of tiredness include:
• Drinking too much alcohol.
• Having an unhealthy, unbalanced diet.
• Taking recreational drugs.
• Excessive exercise or total lack of exercise.
• Working night shifts, which may lead to a poor sleep pattern and result in tiredness.
• Big life events such as getting married or moving house.
In many cases no specific cause for tiredness is found and doctors will test to make sure there aren’t any medical condition(s) causing it.
WHAT TESTS ARE THERE FOR TIREDNESS?
If your tiredness is persisting, or if you are unwell in any other way, or if it is having an effect on your life, see your doctor. In order to try to find the cause, your doctor will need to ask you some questions. He/she may need to examine you and they may arrange some blood tests.
Blood tests
Your doctor may feel you should have some blood tests to rule out physical causes for tiredness. In most cases these turn out to be normal. This might include tests to rule out:
• Low iron levels (anemia).
• Low thyroid hormone levels (hypothyroidism).
• Diabetes.
• Vitamin deficiencies such as B12 or vitamin D.
• Coeliac disease.
• Any inflammation in your system.
• Any problems with the function of your liver or kidneys.
• Tests for specific infections.
• Testing your heart to ensure its working well
WHAT CAN I DO TO HELP MY TIREDNESS?
• Eat often to beat tiredness- a good way to keep up your energy through the day is to eat regular meals and healthy snacks every 3 to 4 hours, rather than a large meal less often.
• Get moving- you might feel that exercise is the last thing on your mind. But, in fact, regular exercise will make you feel less tired in the long run, so you’ll have more energy.
• Lose weight to gain energy – if your body is carrying excess weight, it can be exhausting. It also puts extra strain on your heart, which can make you tired. Lose weight and you’ll feel much more energetic.
• Sleep well – many people don’t get the sleep they need to stay alert through the day.
• Reduce stress to boost energy – stress uses up a lot of energy. Try to introduce relaxing activities into your day to beat the tiredness.
• Cut out caffeine – using caffeine to keep alert will cause you to slowly wear your body down over time.
• Avoid alcohol – although alcohol may help you fall asleep, you sleep less deeply after drinking alcohol. The next day you’ll be tired, even if you sleep a full 8 hours.
• Drink more water for better energy – sometimes you feel tired simply because you’re mildly dehydrated. A glass of water will do the trick, especially after exercise.
DO I NEED TO SEE A DOCTOR?
If you can figure out the reason for feeling tired yourself, and do something about it, then no. If the tiredness is getting in the way of your life, or making you feel unhappy, or you feel unwell, then yes, you should visit your doctor. You should definitely see a doctor if you feel tired and have lost weight without trying to. Also see a doctor if you have other symptoms as well as being tired, such as coughing up blood, a change in the way your guts are working, heavy periods or a lump somewhere it shouldn’t be.
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