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Tell a friend you’re struggling with fatigue, and you’ll probably be met with some seriously sympathetic vibes. After all, wondering why you're always so freaking tired is a common question in this stressful, busy life. But how do you know when feeling tired all the time is a sign of a bigger prob?
Sure, there’s an obvious link between feeling extremely fatigued and binge-watching a Netflix show late at night, or struggling to get out of bed in the morning because you've been training your butt off for a virtual race. But other times, the reason why you always feel tired isn't obvious.
Turns out, there are a lot of health issues that can cause you to feel tired all the time—and they're treatable. These are some of the most common reasons why you might be dealing with extremely low energy and extreme exhaustion, plus how to fix each one (because a girl can only put up with feeling wiped for so long!).
1. Your allergies are acting up.
There are classic symptoms of seasonal allergies, like sneezing and having watery eyes. Then there are lesser-known symptoms, like low energy and fatigue. “If left untreated, seasonal allergies can cause fatigue,” says Purvi Parikh, MD, an allergist and immunologist with Allergy & Asthma Network. Why? Your body is working hard to fend off the allergen, and that requires extra energy. That’s true whether you have allergies to stuff outside, like ragweed or pollen, or have issues with indoor allergens like dust mites, Dr. Parikh says.
It’s not just the allergens that can trigger fatigue issues—allergy medications can, too. “Some of the over-the-counter allergy pills like antihistamine unfortunately cause fatigue as well,” Dr. Parikh says.
How to fix it: Struggling with being tired due to allergies is a sign that your current treatment plan isn’t working for you, Dr. Parikh notes. So, check in with your doctor about your options. They’ll likely recommend medication (or a different medication) to help get things under control. Running a HEPA air purifier in your home can also help get rid of allergens at your place, Dr. Parikh adds.
2. You’ve been more sedentary than usual.
While going hard during your at-home workouts can wear you out, the opposite is true too. “The human body gets more tired with progressive sedentary habits due to generalized deconditioning of the body and, ultimately, muscle loss,” says Sobia Khan, MD, assistant professor of general internal medicine and Director of Women's Center for Comprehensive Care at Baylor College of Medicine.
Basically, your body takes a “use it or lose it” approach to fitness. And, if you don’t exercise regularly, you’re going to feel more tired when you actually do start moving, and during the time when you're not expending energy.
How to fix it: This solution is pretty simple—get moving more. Just a reminder, the general physical activity recommendation is that you get 150 minutes of moderate-intensity exercise each week, along with two or more days a week of muscle-strengthening activity. Once you start moving again, it’ll be easier to get through your day-to-day stuff without being a zombie.
3. You’re overdoing it on sugar and refined carbs.
When you eat things that are sugary or high in refined carbs (think: white bread, pasta, pastries), it causes your blood sugar to spike, explains Jessica Cording, MS, RD, author of The Little Book of Game-Changers. In the moment, that can make you feel kinda hyper. But, unfortunately, all of that sugar and carbs will lead to an inevitable crash. “That can leave you feeling tired,” Cording says.
If you continue overloading on a ton of sugar and refined carbs, you can also cause something known as insulin resistance in your body, Dr. Khan adds, which is when your body can’t use glucose (a.k.a. sugar) as well as it should. The result: You feel tired a lot.
How to fix it: Try to cut back on how much sugar and refined carbs you’re having on a regular basis, Cording says. FWIW, the Centers for Disease Control and Prevention (CDC) recommends limiting your intake of added sugars to less than 10 percent of your total daily calories. (So, if you eat a 2,000-calorie diet, no more than 200 of those calories should come from added sugars.)
When you’re going to have sugary or carb-filled foods, try to balance out the meal with some protein and fat, like adding nut butter atop your crackers. This can help lower the odds you’ll have an energy crash afterward, Cording notes.
4. You’re stressed out big time.
Stress isn’t just a mental thing—it can impact you physically as well. “Your mind and body are closely linked and are in constant communication with one another,” says Monifa Seawell, MD, a board-certified psychiatrist in Atlanta, Georgia. “When there is a shift in your emotional state, be it positive or negative, it is not at all uncommon for that change to also show up in some physical way in your body.”
Stress can show up in your body in a lot of different ways, like in the form of headaches, an upset stomach, and, yep, fatigue, Dr. Seawell says.
How to fix it: When it comes to stress, you really need to try to address the root issue, Dr. Seawell says. While there’s some stress that’s unavoidable (hey, pandemic life), doing your best to limit stress that you can do something about can be helpful.
Dr. Seawell also recommends trying to get 20 to 30 minutes of exercise a day. That “can oftentimes help boost your energy levels” when you can’t completely obliterate your stress levels, she says. And, if you’re still struggling, she recommends talking to a licensed mental health professional. They “can help you process your emotions and learn healthy coping skills,” Dr. Seawell says.
5. You’re skimping on sleep.
According to the National Sleep Foundation, you should be getting between seven to nine hours of sleep a night. Definitely getting less? Enter the fatigue.
“Minimum seven hours of sleep is required for effective rejuvenation of the body and restfulness of the brain,” Dr. Khan says. Here’s the thing: Even one night of bad sleep can mess with your circadian rhythm (your sleep-wake cycle) and throw you off for a few days, she says.
How to fix it: At baseline, the solution is simply to get more sleep. But, of course, sometimes that’s easier said than done. You need to first figure out what’s screwing up your sleep—stress? Netflix? Crappy sleep hygiene?—and then address the reason for your lack of sleep. If you’re still struggling, talk to your doctor about your options. You may need an intervention such as cognitive behavioral therapy to treat insomnia, for example.
6. You’re dealing with depression.
Depression can cause a range of symptoms, but decreased energy or fatigue is definitely one of them, according to the National Institute of Mental Health (NIMH). “Whenever I am screening a patient for depression, feelings of fatigue and loss of energy is one of the symptoms I always inquire about,” Dr. Seawell says.
These are the symptoms of depression to be familiar with, according to the NIMH:
Persistently feeling sad, anxious, or "empty"
Feelings of hopelessness, or pessimism
Feelings of guilt, worthlessness, or helplessness
No longer feeling pleasure in your hobbies and activities
Low energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping or oversleeping
Appetite and/or weight changes
Ideation about death or suicide
Pain, aches, headaches, cramps, or digestive problems that don't have a clear cause or get better with treatment
Worth noting: Not everyone with depression experiences every symptom, according to the NIMH. So, it’s entirely possible for you to feel tired on the regular and not even realize that it’s due to depression.
How to fix it: This is another issue where you have to fix the problem that’s causing your fatigue before you’ll feel better. Depression can be treated with psychotherapy, medication, or a combination of the two. If you suspect that your fatigue is linked to depression, though, it’s best to talk to your doctor about getting evaluated and next steps for treatment.
7. You have a thyroid issue.
Your thyroid is a small butterfly-shaped gland in the front of your throat that produces hormones that control the way your body uses energy. When it doesn't produce enough thyroid hormone, it causes a condition known as hypothyroidism, which can mess with or slow down many of your body's functions, according to Medline Plus.
“Thyroid hormones have receptors on essentially every organ of human body and their deficiency can cause fatigue by excessively slowing the metabolic pathways,” Dr. Khan says.
How to fix it: The treatment for hypothyroidism is medication to replace the hormone that your own thyroid can no longer make. Just know this: It could take a little while for you to feel better. As a result, your doctor may need to adjust your medication until you reach the optimal level.
8. You’re getting over an infection.
Just because you’re on the mend from, say, a virus doesn’t mean you should expect to automatically bounce back energy-wise. Recovery can take time. "A viral or bacterial infection can cause dehydration, generalized inflammation, and immense fatigue," Dr. Khan says.
How to fix it: Dr. Khan recommends simply giving yourself time to recoup. Drink plenty of water and just take it easy, and you should feel less tired and more like yourself in a week or two.
9. You have anemia.
Anemia is a condition where your blood has a lower-than-normal amount of red blood cells or hemoglobin, the National Heart, Lung, and Blood Institute (NHLBI) explains. Hemoglobin is an iron-rich protein that helps red blood cells carry oxygen from the lungs to the rest of the body. And, if you have anemia, your body does not get enough oxygen-rich blood, per the NHLBI. So if you have the condition, you can struggle with “fatigue and excessive tiredness,” Dr. Khan says.
How to fix it: It depends on the type of anemia you have. For some types of mild to moderate anemia, your doctor may simply recommend that you take OTC or prescription iron supplements. But you also may need to take certain vitamins, do IV therapy, or take medicines that make your body produce more red blood cells, according to the NHLBI. Your doctor may also recommend that you make dietary changes to get more iron-rich foods in your body. Basically, you really need to see your doctor for this one.
10. You have an issue with gluten.
In case you’re not familiar with it, gluten is a protein found in wheat, barley, and rye. In some people, gluten damages the small intestine and causes symptoms like bloating, diarrhea, constipation, gas, nausea, stomach pain, vomiting, and yep, fatigue, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Celiac disease can also cause long-term digestive issues and keep you from getting the nutrients you need, and in turn, cause ongoing fatigue.
How to fix it: Celiac disease can be a tricky one to diagnose, but after doing a physical exam, your doctor may recommend you take a blood test and undergo an intestinal biopsy to look for inflammation in your small intestine. If you are diagnosed with Celiac disease, you’ll need to avoid foods containing gluten in the future.
11. You have multiple sclerosis (MS).
This is an less-likely diagnosis, but it’s still worth mentioning. MS is a disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body, according to the National Multiple Sclerosis Society (NMSS).
Fatigue is a very common symptom in people with MS—about 80 percent of patients struggle with it, according to the NMSS. The fatigue can get so bad that it can significantly interfere with a person’s ability to function, even if they feel good otherwise. The fatigue can be caused by treatable medical side effects of medication, or other causes, per the NMSS.
How to fix it: There are specific treatments to help people with MS manage fatigue, including occupational therapy to simplify tasks at home, physical therapy to learn energy-saving ways of walking and doing other tasks, a regular exercise program, sleep regulation, psychological interventions, and heat management strategies, per the NMSS.
12. Cancer can also be a cause of tiredness and low energy.
Another one to add to the category of “unlikely, but worth knowing.” Cancer-related fatigue is incredibly common: At least 80 percent of people diagnosed with cancer experience it, according to the American Cancer Society (ACS). While people can experience fatigue from cancer treatments, they can also feel wiped out from the cancer itself. Cancer leads to fatigue by various mechanisms, explains Dr. Khan. It overtakes almost all the metabolic pathways and sabotages the mitochondrial energy of the body, she says.
How to fix it: Don't freak out that you have a serious health issue. But know that getting a proper diagnosis is important and, from there, proper treatment is needed to target the health issue, including a specific type of cancer. That's why seeing your doctor to rule out a serious issue is key if you haven't been able to shake your tiredness for a prolonged period.
Here's when low energy and tiredness warrants a visit to your doctor.
Feeling tired here and there is pretty normal—but experiencing constant fatigue isn’t. If you’re struggling, Dr. Khan recommends seeing your doctor. They’ll likely want to do a bunch of tests, including a physical exam and blood work, to try to figure out what’s happening.
The upside: The sooner you seek help, the sooner you can get answers—and start down the road to recovery and back to your energetic self.
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