Why Am I Tired All The Time
Feeling exhausted is so common that it has its own acronym, TATT, which stands for “tired all the time”.
We all feel tired from time to time. The reasons are usually obvious and include:
- too many late nights
- long hours spent at work
- a baby keeping you up at night
But tiredness or exhaustion that goes on for a long time is not normal. It can affect your ability to get on and enjoy your life.
Unexplained tiredness is one of the most common reasons for people to see their GP.
Is It A Myth
Thereâs no science to back it up. The Endocrine Society, the world’s largest organization of endocrinologists , flatly says that adrenal fatigue is not a real disease. And it says the symptoms of adrenal fatigue are so general, they can apply to many diseases or conditions or stem from everyday life.
And the society says some of the treatments can be dangerous. Improving your diet will probably make you feel better, no matter what ailment you have, but taking unidentified supplements to help your body produce extra cortisol if you don’t need them may cause your adrenal glands to stop working, it warns.
Warning Signs You Have Adrenal Fatigue And How To Beat It Forever
The easy, relaxed lifestyle experienced by our ancestors no longer exists, and we’re not even aware of how much stress we’re under. The problem? “Our lifestyles have changed, but our bodies haven’t,” Dr. James Wilson said in his November lecture at the First Arizona Choices Exposition in Tucson, Ariz. A large portion of our population is feeling tired and stressed out, and we want to know why.
The adrenal glands sit over the kidneys, where they play a significant role in the body, secreting more than 50 hormones necessary for life, including epinephrine , cortisol, dehydroepiandrosterone , progesterone and testosterone. Since they produce so many essential hormones, the adrenal glands are responsible for many of the functions we need to stay alive and healthy, including:
- Energy production – carbohydrate, protein and fat conversion to blood glucose for energy
- Fluid and electrolyte balance
- Fat storage
One hormone in particular, cortisol, is extremely important for keeping our body systems in balance, as well as protecting our cells. For example:
- It controls the strength of the immune system: Too much cortisol weakens the immune system, setting the motions for increased susceptibility to infections and cancer, while too little leads to an overactive immune system and autoimmune disease.
- It normalizes blood sugar.
- It regulates blood pressure.
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Fatigue Insomnia And The Brain
We know that fatigue is a symptom of insomnia but the type of insomnia can also influence the fatigue experienced.4 People with psycho-sociological insomnia have been shown to have higher fatigue scores than other types of insomnia.1
Psycho-sociological insomnia is where a person focuses on their sleep and worries about not getting enough sleep. They then go to bed worrying about how their lack of sleep is going to affect them the following day and then struggle to sleep due to this heightened anxiety.
Sleep studies that record brainwaves during sleep can reveal that a personâs perception of how theyâre sleeping does not reflect how theyâre actually sleeping. For example, someone with insomnia may believe that theyâre getting very little sleep.
A sleep study may show a person is getting a lot of sleep but not good quality, restorative sleep. We often think that the way to improve our daytime symptoms is to get more sleep but this isnât always the solution.
While we know that sleep duration may not predict the level of fatigue, we do know that the more severe the insomnia, the more severe the fatigue.
Knowing that fatigue is not necessarily caused by lack of sleep, several researchers have put forward the idea that it may be at least in part caused by perception of sleep.67 What this means is that if you believe that your sleep is particularly bad, then you may be at higher risk of fatigue.
Fatigue Caused By Burnout: An Exhausted Tired Feeling
A deficit of several chemical substances in the brain makes it so that you lose your will to live, become fatigued and no longer feel rested. Sometimes you even start having problems sleeping, so the exhaustion builds up. You seem to lose your self-control and constantly feel tired and empty. An excess of adrenaline or stress hormone causes your mind and body to work more than they should, so you become literally and figuratively exhausted. You cannot go on and do not understand why. You feel tired and fatigued, irritable and difficult. Also, you suffer from many small complaints like heart palpitations, an aching back, tiredness, sleeplessness, apathy, nagging, and being unpleasant, brusque or even aggressive toward others. Your exhaustion increases.
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When Should You Worry About Fatigue
Q.I have been quite fatigued over the past two weeks. How long should I wait before seeing a doctor?
A. We all go through periods of low energy. Even a week of feeling more tired than usual is not uncommon.
Yet most people can tell when their fatigue feels like something more serious. If that’s the case, or your fatigue gets worse or lasts longer than a week or two, it’s time to see your doctor. Your fatigue might be related to an underlying illness or infection, especially if it’s accompanied by symptoms, such as a low-grade fever, shortness of breath, or loss of appetite.
Other reasons to see your doctor about fatigue are if you often wake up exhausted despite sleeping well, do not feel motivated to begin the day, or struggle to do activities that are ordinarily easy. These could be symptoms of a sleep disorder or depression.
During your exam, your doctor will try to rule out issues like medication side effects. He or she also may order blood tests to determine if the fatigue is related to a specific problem, such as anemia, an underactive thyroid , or liver inflammation . However, don’t be surprised if your doctor does not find a cause. I have found that in most cases people bounce back from fatigue after some rest and a good night’s sleep.
by Howard LeWine, M.D.
Your Doctor May Also:
- take your sleep history, including how much sleep you get each night, what the quality of your sleep is like, and whether you snore, wake or stop breathing in the night
- do a physical examination to check for signs of illness or disease
- carry out tests to rule out physical causes, such as blood and urine tests.
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How Is Fatigue Treated
To find out what is causing your fatigue, your doctor will ask you about any other symptoms and do a full examination. They may also order some blood tests or imaging tests, depending on what they think your condition might be.
Treatment will depend on the condition that is causing your fatigue. Sometimes, after treatment, you will feel better almost straight away. However, it might also take several weeks for your fatigue to lessen.
Non-medical treatments that have been shown to be effective for some people include mindfulness, meditation, yoga and cognitive behavioural therapy.
How Can I Feel Less Tired
Some changes to your lifestyle can make you feel less tired. Here are some suggestions:
- Keep a fatigue diary to help you find patterns throughout the day when you feel more or less tired.
- Exercise regularly. Almost anyone, at any age, can do some type of physical activity. If you have concerns about starting an exercise program, ask your doctor if there are any activities you should avoid. Moderate exercise may improve your appetite, energy, and outlook. Some people find that exercises combining balance and breathing improve their energy.
- Try to avoid long naps late in the day. Long naps can leave you feeling groggy and may make it harder to fall asleep at night. Read A Good Nights Sleep for tips on getting better rest at night.
- Stop smoking.Smoking is linked to many diseases and disorders, such as cancer, heart disease, and breathing problems, which can drain your energy.
- Ask for help if you feel swamped. Some people have so much to do that just thinking about their schedules can make them feel tired. Working with others may help a job go faster and be more fun.
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Can We Measure Fatigue
Just as fatigue is hard to define, thereâs also a lack of consensus on how to measure it. Many different questionnaires have been developed to try to give a number or level to the fatigue that someone is experiencing. These are often used in research settings and by doctors.
The most commonly used is a scale known as the Fatigue Severity Scale . This is calculated using a short, nine-question questionnaire in which answers are scored as a number, where one=strongly disagree and seven=strongly agree.
The final score for the nine questions is then used to give a measure of how fatigued the person is. The lowest score possible is seven and the highest is 63. Higher scores indicate higher levels of fatigue. People with fatigue usually score more than 36.
More often, itâs the average of the nine questions thatâs used, which gives a score between one and seven. Healthy people tend to have a score around 2.3, while those experiencing fatigue record scores of four or above.
This scale was originally created to measure fatigue in two autoimmune disorders: multiple sclerosis and lupus.3 It was found to be highly accurate in both groups and has since been used successfully to measure fatigue associated with many different illnesses and disorders.
Psychological Causes Of Tiredness
Psychological tiredness is much more common than tiredness caused by a physical problem. Both anxiety and depression can make you feel very tired. Eating disorders can make you feel tired, particularly if you are underweight or overweight. Any cause of a sleep problem will also cause tiredness during the day.
Stress is a common cause of tiredness, either because it interferes with sleep, or because of the effect of having a worry on your mind all the time.
Other possible causes include:
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Long Term Exhaustion For No Reason
How Do I Know If I Have Chronic Fatigue? Symptom 4
Sometimes the body simply goes through a short period of adjustment to its sleep cycle and you can feel exhausted no matter what you do for two or three days. This isnt Chronic Fatigue Syndrome. Medical professionals only begin to look at CFS when these symptoms of dramatic exhaustion, mental fatigue, depression and aches & pains last for six weeks or more.
If youve had a period of six continuous weeks where youve had all of these symptoms, then you may have Chronic Fatigue Syndrome. Consult with a medical practitioner if this is the case with you. After a physical exam, they will run a series of tests on your blood for fatigue to rule out other, potential causes of your symptoms. CFS can only be diagnosed by ruling out other conditions.
Cognitive Behavioural Therapy Is Highly Effective For Treating Fatigue
Fatigue cannot be treated with medication. To treat the problem, you need to get to its root cause. Thereâs a wealth of literature showing that cognitive behavioural therapy can help to diminish fatigue in a range of different illnesses, diseases and conditions.
CBT works by focussing on the personâs attitudes and beliefs, in order to try to change or challenge those behaviours and thoughts that are causing problems and to build healthier connections to equip the person with better tools to deal with emotional issues.
As weâve discussed above, level of fatigue is often related more to how the person thinks theyâre sleeping, as opposed to how much sleep theyâre actually achieving. If CBT can help the person to improve their perception of sleep, then their fatigue levels will consequentially decrease.
When it comes to reducing fatigue related to sleep disorders, the gold standard is undoubtedly cognitive behavioural therapy for insomnia .
In fact, thereâs extensive literature that shows that CBTi is effective at treating insomnia-related fatigue in a whole host of different illnesses and disorders, such as depression, multiple sclerosis, chronic fatigue syndrome, lupus and during/following cancer treatment.1011121314
CBTi is the technique that Sleepstation is built upon and we have almost a decade of experience using it to treat insomnia. You can find out more about Sleepstation and how CBTi works here.
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How Do I Know If I Have Me
Whats ME?
The International Consensus Criteria defines Myalgic Encephalomyelitis as an acquired neurological disease with complex global dysfunctions.
Myalgic Encephalomyelitis is sometimes referred to as Chronic Fatigue Syndrome. However, this is gradually yet persistently changing, as many patient advocates and medical specialists find that this term to be inadequate and inaccurate. Some people use the term ME/CFS.
Do I Have ME?
Many of our readers report that they had a lightbulb moment when they first read the The International Consensus Criteria for Myalgic Encephalomyelitis. This report was prepared by a panel medical clinicians and research scientists from around the world. Below you can find excerpts about assessment and diagnosis, plus links to the full text.
An increasing number of people with long COVID are now being diagnosed with ME.
Whats Post-Exertional Neuroimmune Exhaustion?
There are four categories listed below. The first is called Post-Exertional Neuroimmune Exhaustion
This is a confusing-sounding term which basically means: Your symptoms get worse after you do things.
You may start to feel worse immediately afterwards. Or several days later. You may feel worse for a short time. Or a long time. Or indefinitely.
Some people experience worsened symptoms after heavy activity and some people experience symptoms after light activity or mental activity .
Take This Quiz To See If You Might Have Cfs Or Fibromyalgia
Wonder if you have CFS or fibromyalgia? If you have had severe fatigue or widespread pain lasting over three months without an obvious cause, and if you also have insomnia, then you might have chronic fatigue syndrome and/or fibromyalgia. The checklist below can help you assess the possibility of this. If your score indicates you might, then you should consult a physician to find out for sure.
The Checklist uses two sets of criteria to evaluate your posibility of having CFS or fibromyalgia. Questions 1-5 are based on criteria established by the CDC for evaluating a person’s possibility of having CFS. Questions 6-10 are based on criteria established by the ACR for evaluating a person’s possibility of having fibromyalgia.
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And What Isnt Fatigue
Itâs probably useful to clarify exactly what is not fatigue â¦and whatâs commonly mistaken for it. Firstly, as mentioned above, feeling tired isnât fatigue. If you feel tired or sleepy but feel better after a good sleep, then youâre not experiencing fatigue.
Daytime sleepiness is often reported alongside fatigue, especially in people with sleep problems, but the two should not be confused. Daytime sleepiness is exactly as it sounds: you feel sleepy. With fatigue you are worn out but not sleepy.
Sleepiness differs from fatigue in that the sensation of being sleepy generally builds up over the day and is relieved by sleep. Fatigue is not relieved by sleep.
If your symptoms come and go often and donât interfere with your daily life, then theyâre most likely due to other causes. Some short-duration fatigue is completely normal: you can experience muscle fatigue after exercising or mental fatigue after a day of revising for an important exam.
But both of these types of activities result in acute forms of fatigue and the feeling passes relatively swiftly, usually after sleeping.
Any short-term sensation of low energy, low mood or inability to get things done does not necessarily signify fatigue. When these sensations persist over the longer term and interfere with your daily life then itâs worth talking to your healthcare provider.
How Can You Combat Fatigue
Happily, there are numerous approaches you can take to reduce fatigue. Firstly, itâs important to rule out underlying medical conditions. Sleep problems are only some of the causes of fatigue and there are several medical reasons that can cause it.
A first step would be to chat to your healthcare provider to rule out any underlying causes. If a sleep disorder is suspected, then there are several factors that can put you at higher risk of fatigue, including:
Itâs clear from this short list that some of these factors can be addressed by health and lifestyle changes. Quitting smoking, maintaining a healthy weight, optimising sleep and looking after your mental wellbeing could all lead to a reduction in the levels of perceived fatigue.
Ensuring good sleep hygiene is another way to combat fatigue, so itâs a good idea to think about your sleep habits and sleep environment if you feel like youâre suffering from daytime fatigue.
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Pots: A Little Known Cause Of Extreme Fatigue
Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.
While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.
