Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
We all feel exhausted sometimes, but most of us bounce back after a good night’s sleep. But for many, tiredness doesn’t go away.
TATT – Tired All The Time – is one of the commonest medical complaints I see, and a little detective work is often needed to work out the cause. Tiredness is a symptom, not a condition in itself, but fortunately, many of the causes of tiredness can be treated.
Expect to be asked how long you’ve had the symptoms, how your mood is, if you’ve had other symptoms such as losing weight, change in bowel habit, how heavy and long your periods are, if anything happened around the time you became tired (like major stress, another illness etc), and how the tiredness is affecting your life. Physical causes your GP will want to rule out include:
Underactive thyroid Your thyroid gland produces a hormone, thyroxine, that tells your body how fast to tick over. If you don’t produce enough, everything slows down. Along with tiredness, you may be constipated and cold all the time, find it hard to concentrate, put on weight and have dry skin and hair. Anaemia Without enough red blood cells to carry vital oxygen to your organs, you can feel breathless, dizzy and tired. Iron deficiency from heavy periods is a common cause. Poor diet and other conditions such as chronic kidney problems and rheumatoid arthritis can also cause anaemia. Gut conditions like coeliac or Crohn’s disease or internal bleeding can also result in anaemia.
IT MAY SEEM STRANGE, BUT REGULAR EXERCISE IS A REMARKABLY EFFECTIVE WAY TO REDUCE TIREDNESS FROM A VARIETY OF CAUSES
Diabetes Type 1 diabetes tends to cause dramatic symptoms including severe tiredness, thirst and weight loss. The more common type of diabetes, type 2, often causes similar but less severe symptoms, which you may put down to being stressed.
Heart failure If your heart can’t pump fluid round the body efficiently enough, you can develop ankle swelling, shortness of breath and tiredness.
Poor sleep Whether it’s stress, depression or bladder problems which wake you frequently, lack of sleep can have a knock-on effect on energy levels as well as concentration and mood. In obstructive sleep apnoea, your airways close up for a few seconds while you’re sleeping. Loud snoring can make your sleep less restful resulting in chronic tiredness.
Chronic fatigue syndrome Sometimes called ME, chronic fatigue is debilitating, a severe cause of exhaustion. It may follow from a virus infection (as glandular fever, another cause of tiredness, does). The tiredness isn’t made better with rest and gets much worse if you overdo things. Medication Many drugs affect your sleep: some anti-depressants, beta blockers and painkillers are the most common culprits.
But while your GP will probably arrange blood tests, in most cases no physical cause is found for tiredness. Instead, it’s often your body’s way of making you slow down. One of the most common symptoms of depression is tiredness. Stress and anxiety can affect your sleep and being anxious all the time keeps your adrenaline levels high, which is exhausting.
Since tiredness isn’t a medical condition in itself, treatment will depend on the underlying cause. Looking after yourself helps, so eat healthily and keep stress to a minimum. Next week: Let’s talk about sex
IF YOU STRUGGLE WITH INSOMNIA, HAVING A REGULAR ROUTINE, INCLUDING GETTING UP AT THE SAME TIME AND NOT CATNAPPING, CAN HELP
LACK OF SLEEP CAN HAVE A KNOCK-ON EFFECT ON ENERGY LEVELS, CONCENTRATION AND MOOD