Feeling tired all the time can be incredibly frustrating, especially when it starts to impact your daily life. Fatigue is a common complaint and can be caused by a range of underlying factors, from lifestyle habits to more serious health conditions. Here, we’ll explore eight potential causes of constant tiredness and provide guidance on how to investigate these issues to find a solution.

1. Poor Sleep Quality

Even if you’re getting the recommended seven to nine hours of sleep per night, poor sleep quality can leave you feeling exhausted. Common culprits include sleep disorders like insomnia, sleep apnoea, restless legs syndrome, or simply an uncomfortable sleep environment.

How to Investigate:

• Keep a Sleep Diary: Track your sleep patterns, including bedtime, wake-up time, and any night-time awakenings.
• Consider a Sleep Study: If you suspect a sleep disorder, your GP may recommend a sleep study (polysomnography) to monitor your sleep cycles and diagnose conditions like sleep apnoea.
• Evaluate Your Sleep Environment: Ensure your bedroom is conducive to sleep – it should be dark, quiet, and cool. Assess your mattress and pillow to see if they might be contributing to discomfort.

2. Chronic Stress

Stress is a major contributor to fatigue. When you are constantly stressed, your body remains in a heightened state of alertness, which can lead to adrenal fatigue, anxiety, and sleep disturbances.

How to Investigate:

• Stress Assessment: Reflect on your lifestyle to identify sources of stress, whether they are related to work, personal relationships, or financial concerns.
• Cortisol Levels Test: A blood or saliva test can measure cortisol levels, which may indicate if your body is under chronic stress.
• Seek Professional Help: A psychologist or counsellor can help you develop stress management techniques, including mindfulness, meditation, and cognitive behavioural therapy (CBT).

3. Nutritional Deficiencies

Lack of essential nutrients can result in persistent tiredness. Deficiencies in iron, vitamin D, vitamin B12, and magnesium are particularly notorious for causing fatigue.

How to Investigate:

• Blood Tests: Your GP or our private GP can order blood tests to check for deficiencies. The most common tests include a full blood count (FBC), ferritin levels (for iron), and serum levels of vitamin D, B12, and magnesium. At CLNQ, we offer vitamin D and B12 injections.
• Dietary Review: Consider seeing a dietitian who can assess your diet for any gaps in nutrition and suggest foods or supplements to correct deficiencies.

4. Thyroid Issues

An underactive thyroid (hypothyroidism) can slow down your metabolism, leading to feelings of lethargy, weight gain, and depression. This condition is more common in women, particularly those over 50.

How to Investigate:

• Thyroid Function Test: A blood test measuring Thyroid Stimulating Hormone (TSH) and Thyroxine (T4) levels can help diagnose thyroid dysfunction. High TSH and low T4 levels indicate hypothyroidism.
• Monitor Symptoms: Alongside fatigue, look for other symptoms of hypothyroidism, such as dry skin, hair loss, cold intolerance, and constipation.
• Consult an Endocrinologist: If diagnosed, a specialist can guide you through treatment, usually involving thyroid hormone replacement therapy.

5. Mental Health Conditions

Conditions such as depression and anxiety can manifest as physical symptoms, with fatigue being one of the most prominent. The overwhelming sense of tiredness may stem from the mental and emotional exhaustion these conditions bring.

How to Investigate:

• Mental Health Screening: Your GP or a mental health professional can perform a screening to assess your mental well-being. Tools like the Patient Health Questionnaire (PHQ-9) for depression or the Generalised Anxiety Disorder (GAD-7) scale are often used.
• Discuss Symptoms: Be open about your emotional state, any changes in your sleep patterns, appetite, and daily interests. This information is crucial for an accurate diagnosis.
• Treatment Options: Depending on the diagnosis, treatment may include psychotherapy, medication (like antidepressants), or lifestyle modifications to improve mental health.

6. Chronic Fatigue Syndrome (CFS)

Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis (ME), is characterised by extreme, persistent fatigue that doesn’t improve with rest and is not directly caused by other conditions.

How to Investigate:

• Medical Evaluation: CFS is a diagnosis of exclusion, meaning other potential causes of fatigue must be ruled out first. This usually involves a thorough medical history, physical examination, and possibly a range of blood tests to exclude other illnesses.
• Symptom Tracking: Keep a detailed record of your symptoms, including their severity and frequency, to help your healthcare provider understand your condition.
• Specialist Referral: If CFS is suspected, a referral to a specialist in ME/CFS or a rheumatologist may be recommended for further evaluation and management.

7. Anaemia

Anaemia, particularly iron-deficiency anaemia, is a common cause of fatigue, especially in women of childbearing age. It occurs when your body doesn’t have enough healthy red blood cells to carry adequate oxygen to your tissues.

How to Investigate:

• Full Blood Count (FBC): This is the primary blood test used to diagnose anaemia. It measures the levels of haemoglobin and the number of red blood cells. We can perform this at CLNQ as part of a screening profile.
• Iron Studies: If anaemia is suspected, further tests to measure iron levels, ferritin (iron stores), and transferrin saturation can help determine if iron deficiency is the cause.
• Treatment Options: Treatment often involves iron supplements or dietary changes to increase iron intake, and in more severe cases, intravenous iron therapy may be necessary.

8. Diabetes

Fatigue is a common symptom of both type 1 and type 2 diabetes, caused by high blood sugar levels that can lead to a range of complications, including dehydration and disrupted sleep.

How to Investigate:

• Blood Glucose Test: A fasting blood glucose test or HbA1c test can indicate if your blood sugar levels are too high, which might suggest diabetes or prediabetes.
• Symptom Monitoring: In addition to fatigue, be on the lookout for other symptoms of diabetes such as excessive thirst, frequent urination, and unexplained weight loss.
• Diabetes Management: If diagnosed, diabetes can be managed through a combination of medication, lifestyle changes (diet and exercise), and regular monitoring of blood sugar levels.

Conclusion

Constant fatigue can be a sign of a wide variety of underlying issues, ranging from lifestyle factors to more serious health conditions. It’s important to listen to your body and seek medical advice if you find yourself feeling tired all the time. Your GP or our private GPs at CLNQ can help guide you through the necessary investigations and treatment options to get to the root of the problem and help restore your energy levels.