Plus how to differentiate tiredness from chronic fatigue.
Reviewed by Dietitian Jessica Ball, M.S., RD
If you feel like your feet—or brain cells—are dragging far more often than they used to, you're not alone. A whopping 3 in 4 American adults surveyed in 2020 by OnePoll admit that daytime tiredness negatively impacts their productivity.
One solution sounds easy in theory, but is challenging in practice: get enough sleep. But what if you're scoring your recommended seven to nine hours most nights and are still lacking a pep in your step?
You might be dealing with an underlying mental or physical health condition, and if this is the case, it's vital to listen to your body's signs of exhaustion and seek professional help. (We'll explain more below.) Alternatively, you could simply be living amid an environment that's zapping all your energy stores.
"Paying attention to your own personality needs can be one more tool to keep tiredness at bay," says Patricia Bannan, M.S., RDN, a dietitian based in Los Angeles and the author of From Burnout to Balance.
Ahead, we'll explain what tiredness feels like, reveal some of the under-the-radar reasons you might experience those sensations, then we'll explain how to determine if it's time to check in with your doc.
What Is "Tiredness," Exactly?
Feeling tired can be the result of physical or mental processes in the body—or often, a combo platter of both, confirms William W. Li, M.D., a Boston-based internal medicine physician and author of Eat to Beat Disease: The New Science of How Your Body Can Heal Itself.
On the physical side, it could be related to:
Exhaustion from lack of sleep. (We're not covering this topic here, but if you'd like to learn more, start with this #1 habit you should break for better sleep).
Muscle fatigue after strenuous exercise. "The buildup of metabolites and lactic acid literally makes you feel achy and worn down," says Li.
Depleted energy stores. Inadequate nutrition and hydration can result in sensations of being low on fuel. Micronutrient deficiencies can also leave you feeling gassed.
Hormonal shifts. These can affect your body's natural melatonin production, which impacts the circadian rhythm.
Within the psychological space, tiredness may manifest due to:
A disruption in normal neurotransmitter activity.
A mental health disorder that dampens mood, and as a result, energy.
Excessive stress. Who has time to have physical energy when you're trying to put out so many psychological fires?
Emotionally draining environments or situations.
The time of day may play a role as well, Bannan explains.
"As energy is used, there is a buildup of adenosine. Adenosine plays an important role in sleep-wake homeostasis. An increase in adenosine leads to increased feelings of tiredness due to an increased sleep drive," she says, referencing a 2022 study in the Journal of Sleep Research. "When you are experiencing tiredness, you have little left in your tank when it comes to your mental, emotional and physical capacity."
And this can be the case even if you slept well last night.
8 Sneaky Reasons You're Tired That Have Nothing to Do with Sleep
If you feel tuckered out more often than you'd predict based on your snooze patterns, one of these factors might be the cause.
Among Li's clients who have very full schedules and frequently feel tired without a clear reason, he says dehydration is among the most common diagnoses.
"Busy people can sometimes forget to drink enough water during the day. When you're dehydrated, your blood pressure can fall. This means less blood is pumped to your brain and muscles, leading to a sense of fatigue," Li says.
Related: How Much Water Should You Drink, By The Numbers
2. Energy and Nutrient Imbalances
Even though it's now marketed as a "lifestyle change," diet-culture messages are still swirling around loud and clear. That means that calorie counting and under-eating are fairly common among many humans—especially those who identify as females, Bannan says.
"Unbalanced eating patterns are running rampant, and many people aren't consuming enough—or the right—calories to meet their daily energy needs," she explains. As a result, "low levels of iron, vitamin D and vitamin B12 can make you feel tired, anxious and weak," as can a general underconsumption of calories.
Just think: If your gas tank is empty, your car isn't going far.
The Solution: Focus on balance, Bannan advises. "The best approach to eating for steady energy is to include a mix of complex carbs, healthy fats and lean proteins at every meal. Choose foods that will fill you up and keep you fueled, and provide nutrients that prevent fatigue—which commonly happens when you're short on essential vitamins and/or minerals," she says.
At the same time, pay attention to what foods and qualities might deplete your energy, such as sugar, alcohol and caffeine. "You don't have to cut these out entirely, but you should scale back if you're struggling with energy levels and notice they have a large impact," Bannan adds.
Check out our guide to calories and how many you might need. For even more personalized advice, consult with a registered dietitian.
3. Stress and Anxiety
Even though we tend to think of excess stress and anxiety (high energy) as the opposite of depression (low or no energy), that's not exactly the case, Bannan says.
"While anxiety might manifest as a 'wound up' feeling or circular thoughts, that zaps energy and can lead to feelings of tiredness, too. An anxious mind struggles to rest. It's like leaving your car idling at night instead of turning off the engine," she explains.
The Solution: Find steady ground by focusing on your breath, which can help you re-center. "Optimal breathing is inhaling deep into the belly. When you're stressed or anxious, the breath often stays shallow and in your chest, requiring more energy and delivering less oxygen," Bannan says.
Breathing from the belly, also known as diaphragmatic breathing, can help regulate the nervous system and reduce your body's physiological stress response. The next time you feel stress or anxiety zapping your energy, place a hand on your belly and focus on deepening your breath to that region.
Related: Halle Berry Says This 10-Minute Meditation Practice Helps Her Reconnect with Herself
It stands to reason that the aforementioned low/no energy state, depression, may lead to sensations of tiredness. And it's quite common: more than 8% of Americans have experienced at least one major depressive episode, according to estimates from the National Institutes of Health. Many more individuals are likely experiencing some symptoms of depression without an official diagnosis, too. (As a quick refresher, major depression involves a depressed mood or loss of interest in activities you used to enjoy for two weeks or more, the National Institute of Mental Health explains.)
"Someone who is depressed is likely to feel tired, unmotivated and worn out," Li says.
The Solution: The best way to address fatigue associated with depression is to treat the depression itself, Li advises. "This can be done using a combination of methods, including therapy, taking antidepressant medications, improving diet and lifestyle choices and getting help to remove triggers for depression."
See your doctor to dial in your personal treatment plan and to get a referral to a psychologist, psychiatrist, therapist or counselor.
5. Your Social Environment
Just like too much stimulation can make you feel like tapping out, lack of social stimulation, loneliness and boredom can snowball into feelings of tiredness, Li says.
On the opposite end of the spectrum, many humans soak up societal pressures to take care of everyone else's needs first, Bannan continues, which means that there's very little left over to take care of themselves.
"When you continuously push your self-care further down the list, it will eventually take a toll on your energy and well-being, and can lead to burnout. The internal and external expectations from society are a heavy load to carry," Bannan says. "Women in particular are often expected to be the perfect parent, the perfect partner, the perfect employee and the perfect child. It's exhausting!"
Beyond that, not aligning work and personal life with your personality can take a toll as well. Keep in mind that extroverts, introverts and ambiverts all prefer to recharge in different ways.
Extroverts thrive around other people, and being active and social recharges extroverts' batteries.
Introverts are the opposite; they feel exhausted by big groups or social events. Being in a large group often depletes introverts' energy.
Ambiverts have both extrovert and introvert qualities, and likely prefer a mix of both group time and solo time to power up.
The Solution: The key here is to focus on self-care, connection and intuition. Start small, say, with a few minutes of quiet time just for you. Ask yourself: When have I felt most refreshed, and what was involved in the activities that led up to that sensation? Were you alone or with others? And what had you done that day/week?
Your preferred version of self-care may involve listening to a podcast or watching your favorite TV show while lying on your couch, calling or texting a friend or family member for support, taking a warm bath, going for a walk, journaling, reading a good book, taking a group workout class, dining out with your inner circle; whatever feels rejuvenating to you is the best Rx, Bannan says.
Related: 5 Ways to Make Healthier Decisions When You're Exhausted
6. Pregnancy or Other Hormonal Shifts
Fatigue is one of the most common symptoms of a hormonal imbalance, Bannan shares. Low progesterone can interfere with your sleep, while high levels can cause fatigue. The estrogen shifts that come along with menopause can also wreak havoc on sleep and energy.
"Pregnancy, breastfeeding, the postpartum period, fertility treatments and your menstrual cycle are all roller coasters for your hormones, causing your energy levels to peak and plummet; often without notice," Bannan says.
The Solution: Your best plan of attack is to talk to your primary care doctor or OB/GYN, explains Phillip J. Cozzi, M.D., medical director of the Elmhurst Hospital Sleep Center and medical director of critical care at Elmhurst Hospital in Elmhurst, Illinois. If necessary, they can take a blood test and personalize your next steps to get your hormone—and energy—levels back on track.
Related: Hormones and Our Health: How What We Eat May Affect How They Work
You probably won't feel physically out of breath more than usual if you're anemic, but when you don't have enough hemoglobin (the part of your red blood cells that carry oxygen around your body), your brain and muscles are left gasping for air.
"With less oxygen internally, you feel more tired. Anemia can be caused by bleeding, including heavy menstrual bleeding, kidney disease, chronic diseases like cancer and iron deficiency," Li says.
Anemia is particularly common among premenopausal women (who are recommended to get twice as much iron as men each day); those with digestive disorders such as Crohn's disease or celiac disease, which may affect iron absorption; plant-based eaters and anyone who doesn't eat enough of the best food sources of iron. An estimated 5.6% of Americans meet the criteria for anemia, according to a November 2016 PLoS One study.
The Solution: The treatment for fatigue linked to anemia lies in addressing the causes of anemia itself, which often ties back to iron. A doctor can help you home in on the exact cause. A simple blood test can diagnose anemia. Your doc can then recommend iron supplements, if they're a fit, or you may be able to eat your way back with our anemia diet plan to help boost iron levels.
8. Heart Disease or Other Chronic Conditions
There are also a slew of medical conditions such as heart failure, cancer, chronic obstructive pulmonary disease (COPD), fibromyalgia, autoimmune conditions, thyroid diseases, kidney disease, liver disease and more that can cause chronic fatigue.
The Solution: It's vital to receive personalized treatment for your particular condition, both to treat that disorder and the related fatigue. Again, your medical care team comes in clutch.
How to Tell If You Might Have Chronic Fatigue
Tiredness tends to be a fairly temporary, subjective condition, and can often be minimized with certain behavioral changes such as sleep, eating patterns and integrating strategies to shift more towards work-life balance, Bannan says.
This is very different from chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis (ME), which lasts longer than six months and does not resolve with bed rest or reducing daily activities to less than 50%, Cozzi explains.
In addition to feeling extreme fatigue, people suffering from CFS often experience muscle and joint pain, brain fog, difficulty with concentration, impaired memory, rapid heartbeat and dizziness," Li says.
Chronic fatigue is more likely among:
People with impaired immune systems
Individuals with long COVID
Those who identify as women, especially during middle age
"CFS is a serious condition that requires thorough medical evaluation for underlying causes. There is no definitive treatment, and a multimodal approach with different types of specialists including infectious disease, neurology, cardiology, and physical and rehabilitation medicine may be required," Li adds.
Treatments need to be tailored to each individual, and may involve medications, physical therapy, dietary modifications and psychotherapy or counseling, according to Li.
The Bottom Line
The majority of Americans are walking around daily feeling tuckered out, and the solution isn't always found by sleeping more. Stress, anxiety, depression, nutrition, hydration, hormones, your environment and underlying health conditions can all increase feelings of tiredness.
"If your fatigue persists for more than a couple of weeks despite a good night's rest and you can't clearly identify a cause, or if your symptoms are interfering with your quality of life or ability to work, then it's time to see your doctor to find out what's going on," Li advises.
They will likely ask questions about what is going on in your life, conduct a physical exam and perform blood tests as part of the detective work to find out if there is anything "off" that could result in your fatigue.
If feelings of tiredness appear every so often—or you know there is a direct reason for the exhaustion that you feel in control of—you may decide professional help isn't needed at that time and you can consider our solution suggestions above.
"If there's a noticeable change in your relationships, mood, performance and self-worth, it's definitely worth seeking help from a medical professional," Bannan says, rather than suffering in silence … and in fatigue.
Read the original article on Eating Well.