"I'm So Tired"

Feeling tired is the most common complaint physicians hear. Diagnosing the cause can be challenging, as there are a number of possible contributing factors.

Rae Lee Cooper is a registered nurse. She and her husband, Lowell, have two adult married children and three adorable grandchildren. She
spent most of her childhood in the Far East and then worked as a missionary with her husband in India for 16 years. She enjoys music, creative
arts, cooking, and reading.

WHEN I SAW MY FRIEND SHERRY* arrive at our church-operated community service food bank that morning, I knew something was not right. She looked pale, exhausted, and withdrawn. Even her voice sounded tired as she answered, “I’m OK” upon my inquiry.

It’s normal to feel exhausted at the end of a busy day, after a good exercise workout, after helping with a strenuous project, or even as a result of jet lag. Ongoing episodes of fatigue, however, can lower functionality and decrease quality of life.

Feeling tired is the most common complaint physicians hear. Diagnosing the cause can be challenging, as there are a number of possible contributing factors. A good medical history, a physical examination, and possible additional tests performed by medical personnel will likely be recommended in order to pinpoint the cause and initiate
treatment. One thing is for sure, though: feeling tired most of the time is not normal, and a doctor’s visit may help get your life back on track.

1. You are not getting enough sleep. 

Many people are too stressed and too busy, which makes it difficult to slow down and get enough sleep. Adults need up to eight hours of sleep per night. Routinely getting less than that can result in a buildup of sleep debt. Symptoms of sleep debt can include chronic fatigue, lack of motivation and concentration, memory loss, increased anxiety, and depression. Look for ways to help yourself get your best rest, such as regular hours for sleep, getting some exercise every day, eating only light foods in the evening, having a comfortable sleeping environment, resisting checking e-mail or social media accounts just before bedtime, and
making adequate, restful sleep a top priority.

2. It could be sleep apnea. 

Loud snoring, pauses in breathing, or shallow breathing lasting anywhere from a few seconds to a minute while a person is sleeping are symptoms of sleep apnea. Breathing usually disruption to good sleep. Other symptoms of sleep apnea can be tiredness, morning headaches, memory problems, poor concentration, irritability, depression, and a sore throat upon waking. Your doctor will recommend a sleep study to analyze the presence and severity of sleep apnea and then advise helpful treatment. Untreated sleep apnea can lead to heart disease, stroke, or even sudden death.

3. Your environment is cluttered.
Disorganization and clutter, whether at work or at home, can be mentally exhausting. The mere sight of it can restrict your ability to focus on any one task. On the other hand, an organized, neat space will give you the feeling of efficiency, decrease your stress, and help you keep your energy level steady.

4. You may be anemic.
A simple blood test at your doctor’s office will show if you are suffering from anemia. With anemia your body has fewer red blood cells, which means there isn’t enough hemoglobin, the substance that gives blood cells their red color. Red blood cells carry oxygen to all parts of the body. Too little hemoglobin, or a low red blood cell count,
translates to less oxygen available for the body, resulting in symptoms of fatigue, shortness of breath, dizziness, and headaches.

5. Your thyroid is slowing down.
Anyone can have problems with their thyroid gland, but most people (especially women) find their thyroid function decreasing with age. Hypothyroidism (a slow thyroid) is a condition in which the thyroid gland does not produce enough of the hormone needed to maintain the body’s normal metabolism needs. When thyroid hormone levels are low the metabolism can slow down, resulting in various symptoms that can include tiredness, weight gain, and feeling cold. Hypothyroidism can be diagnosed by a simple blood test, followed by recommended treatment.

6. You might be depressed.
Symptoms of depression can include feeling sad and empty, a loss of interest in activities once enjoyed, tiredness, changes in appetite, a lack of motivation, feelings of worthlessness or guilt, difficulty sleeping, and even thoughts of death or suicide. If you feel like you may be depressed, speak with your doctor. Some routine blood tests may be ordered, including a thyroid test. One symptom of hypothyroidism can be feelings of depression. Your doctor may also recommend that you see a professional therapist who can guide you in working through your feelings.

7. Your heart may be the problem.
Heart failure can cause you to feel tired, especially with physical exertion. When the heart is not working normally, it is less effective in pumping that important oxygenated blood throughout the body to muscles and other important tissues. Daily activities such as walking, cleaning the house, keeping up with work at the office, and carrying
groceries to the car can become challenging. Other symptoms of heart disease can include chest pain, palpitations, dizziness, fainting, and shortness of breath. Since heart
symptoms can differ between women and men, fatigue may be the primary symptom instead of chest pain for women. In order to receive the best treatment possible, it’s
very important to talk to your doctor sooner rather than later about all your symptoms, including a history of your family’s past medical conditions.

8. You may have chronic fatigue syndrome.
Fatigue that does not improve with rest and may even worsen with physical or mental exertion is known as chronic fatigue syndrome. Other symptoms can include short-term memory impairment, lack of concentration, muscle and joint pain, headaches, tender lymph nodes, and frequent sore throat. Although the causes of chronic fatigue syndrome are under ongoing scientific study, it is important to see your doctor, who can suggest some helpful treatments.

9. You’ve been skipping your workout sessions.
Failing to exercise on a regular basis can lead to symptoms of fatigue, low energy, and sluggishness. About 20 to 30 minutes a day of heartpumping physical activity is a good way to boost your energy levels and get those feel-good endorphins working for you. Choose activities you enjoy and make exercise a daily routine. Your body
will run more efficiently, and you may not feel so tired as often. However, do not work out just before bedtime, as this has the  potential to disrupt and delay restful sleep. And be sure to check with your doctor first about what exercises will be best for you.

10. You are not drinking enough water.
Dehydration causes the heart to pump blood less efficiently, which decreases oxygen and nutrient flow throughout the body. It’s a sure recipe for fatigue and lack of energy. Make sure to get those eight-plus glasses of water daily (or the amount your doctor recommends).

11. Your eating habits are working against you.
Skipping breakfast and snacking on empty calories are two eating habits that can sabotage your energy level and overall general health. Give your body the fuel it needs at the beginning of the day to get you through the morning. Making sure to get good nutrition at the start of the day will decrease the temptation to snack on junk foods later on, which can cause blood sugar to spike and then crash, leaving you really tired. If you must snack, reach instead for nutritious fiber-rich foods such as fruit or veggie  fingerfoods, which can help keep you on track until your next nutritious meal. Skip the sugar-loaded sodas and fruit juices too, and keep that water bottle nearby for handy use.

12. You may be too sweet.
Diabetes can cause fatigue when sugar levels run too high or too low. An enormous portion of the population worldwide is affected by type 2 diabetes, which is a condition related to lifestyle and heredity. Many individuals with elevated blood sugars are unaware that they are either diabetic or pre-diabetic. The cause of type 2 diabetes is the body’s failure to use insulin effectively, or maybe not at all. Sugar then remains in the bloodstream instead of entering the cells, where it could have been used as an energy
source for the body. The result is tiredness and sluggishness. Your doctor will help you determine if you have a sugar-related problem, and then advise you regarding diet, exercise, and appropriate medications as needed.

13. You are just bored.
Our mental attitude has a direct effect on our physiological response. Feeling tired can be caused by dissatisfaction, lack of challenge, or a lack of interest in what we are doing. Take time to analyze yourself. Is it the job that is boring? If so, think of creative ways to improve your situation. How can you make what you do more enjoyable, more productive, more satisfying? How can you improve your skills? There’s no guarantee your wages will increase, and you may not be promoted, but the result can be less
fatigue, much more zest for life, and increased satisfaction for you!

The causes of fatigue listed here are fairly common. Numerous medical conditions can cause fatigue. My friend Sherry (mentioned previously) suffers from a chronic, slowly
debilitating disease, which periodically seriously affects her gastrointestinal tract. During those episodes she is unable to sleep more than a couple hours at night. A trip to
the emergency department of a local hospital provides her with the medical help she needs.

If you feel your tiredness is out of the ordinary and you aren’t just missing out on the sleep you need to feel rested, make an appointment to see your doctor. Finding a
reason for your fatigue could result not only in an improved outcome but also help detect conditions that should be diagnosed for other reasons as well.


*Name changed



Rae Lee Cooper is a registered nurse. She and her husband, Lowell, have two adult married children and three adorable grandchildren. She
spent most of her childhood in the Far East and then worked as a missionary with her husband in India for 16 years. She enjoys music, creative
arts, cooking, and reading.