The six reasons you can’t stop feeling tired DR XAND’S MUST-READ GUIDE

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eir 40s, r Xand. gling to to start looking and the condition is diagnosed via a blood test. It’s very treatable with a daily hormone tablet to raise thyroxine levels.” Many of us aren’t drinking enough, especially if we’re stuck at a desk all day.

Dr Xand says: “As we get older, we tend to feel less thirsty and we can get used to running pretty dehydrated – if we’re busy we can go for hours without drinking. When I worked in A&E I wouldn’t pee sometimes for 12 hours!

“There are loads of myths about how much water you should drink, such as the ‘eight glasses of water a day’ stuff. That figure came from a study on how much water a kidney needs to function. The truth is, you also get fluid from foods such as lettuce and cucumber, as well as from cups of coffee, soup and so on.

“Salt consumption is an important factor – if you’re eating ready meals and fast food twice a day, you’ll need to drink a lot more. To stay hydrated and boost energy, reduce sodium intake by eating better, treat yourself like a five-year-old and never leave home without a water bottle, stay active to keep fluid moving around your body and make sure you’re peeing clear and regularly.” Having high levels of the stress hormone cortisol is an energy zapper and can make you ill, says Dr Xand.

“What we know about stress is that if you feel in control over your destiny, your stress levels are lower. In a work situation that can be hard to achieve, but it’s important to find one source of meaningful joy in your life. Food is a joy for me, but that’s not meaningful, so doesn’t count!

“We don’t think of fulfilling relationships and hobbies as medical interventions, but they’re vital to wellbeing. Mindfulness techniques like mediation work well for some people and volunteering can be immensely rewarding. If you feel useful and have a source of meaning in your life, it’ll reduce your stress levels.” Feeling extremely tired is a symptom of Type 2 diabetes where the body doesn’t produce enough insulin or cells don’t react to insulin, so glucose stays in the blood and isn’t used as fuel.

“Central abdominal fat drives diabetes, so your waist measurement is key,” says Dr Xand. “If you’re a woman, lose weight if it’s 30.5 inches or more and for men the figure is 37 inches.

“If you have Type 2, you’re also likely to have disordered cholesterol and high blood pressure along with raised blood sugar. It’s a package of problems that raise risks of heart attack, stroke, dementia and kidney failure.

“Losing weight and doing exercise will not only help you to control Type 2 diabetes if you have it, but also help prevent it if you’re at risk.” Says Dr Xand: “Many people think of health as black and white – you’re either well or you’re ill.

“But you’re the one who determines how well you feel and your risk of getting ill in the future. The health service will help if you’re sick, but the prevention bit is largely down to you.

“There are lots of tools that make it easy t take control of your health – iphones have built-in pedometers to count your daily step and there are plenty of apps and online resources to help with diet and weight loss. “If you don’t have obvious symptoms but want to find out if you need to make lifestyle tweaks, then you can go a step further and have preventive blood tests to check for thin such as high cholesterol, iron deficiency and raised blood sugar (check out blood test service werlabs.co.uk).

“This helps you to take charge, and knowi your blood values is useful.

“If your iron levels are on the low side for example, it’s easy to fix yourself with iron supplements and diet.”