Tiredness and fatigue
Tiredness and fatigue

Feeling exhausted is so common that it has its own acronym, TATT, which stands for ‘tired all the time’.

Tiredness is one of the most common complaints GPs see in their surgery. Many patients complain of feeling exhausted, even though they’re sleeping well. Often it goes on for several months.

At any given time, one in five people feels unusually tired, and one in 10 have prolonged fatigue, according to the Royal College of Psychiatrists. Women tend to feel tired more than men.

It’s unusual to find anything physically wrong. Most of the time, fatigue is linked with mood and the accumulation of lots of little stresses in life.

A blood test  is often taken from patients complaining of tiredness to rule out a medical cause, such as anaemia or an underactive thyroid gland.

There’s more chance of a medical reason for tiredness if there are other symptoms as well, such as heavy periods, weight loss, a change in bowel habits, hair loss, and extreme thirst.

If you want to work out how you became tired in the first place, it can help to think about:

  • parts of your life, such as work and family, that might be particularly tiring
  • any events that may have triggered your tiredness, for instance, a bereavement or relationship break-up
  • how your lifestyle may be making you tired.

Physical causes of tiredness

There are lots of health complaints that can make you feel tired. Not just the well-recognised ones like anaemia and thyroid problems, but also more surprising ailments, such as diabetes and food intolerance and a sleep disorder called sleep apnoea.

Read more about the medical causes of tiredness below.

Being overweight or underweight can cause tiredness. That’s because your body has to work harder than normal to do everyday activities. If you’re underweight, you have less muscle strength, and you may feel tired more quickly.

Pregnancy, especially in the first 12 weeks, can also sap your energy.

Psychological causes of tiredness

Psychological tiredness is far more common than tiredness that's caused by a physical problem.

One key reason is anxiety, which can cause insomnia and in turn lead to persistent fatigue. A survey by the Mental Health Foundation found that nearly a third of the population are severely sleep-deprived, often because of job and money worries. The Foundation’s report, Sleep Matters, suggests a link between insomnia and low energy levels.

The worries and strains of daily life can be exhausting, even positive events, such as moving house or getting married. And emotional shock, such as bad news, bereavement or the break-up of a relationship, can make you feel drained.

Mental health problems such as depression or anxiety can make you feel more tired. They can also prevent you from getting a proper night's sleep.

Lifestyle causes of tiredness

Tiredness can often be attributed to lifestyle factors, such as drinking too much alcohol, or having a bad diet. If you drink alcohol in the evening, it tends to wake you in the middle of the night. And if you drink a lot regularly, it can make you depressed and affect your sleep.

If you have a disturbed sleep pattern – for instance if you work night shifts, sleep in the day or look after young children – it can be difficult to get a good night’s sleep, and you’ll feel tired during the day.

How to tackle tiredness

It may be common to feel tired all the time but it isn’t normal. If you’re worried, see your doctor for advice and reassurance and to rule out anything serious that might be causing tiredness.

10 medical reasons for feeling tired

Any serious illness, especially painful ones, can make you tired. But some quite minor illnesses can also leave you feeling washed out. Here are 10 health conditions that are known to cause fatigue.

1. Coeliac disease

This is a type of food intolerance, where your body reacts badly when you eat gluten, a substance found in bread, cakes and cereals. One in 100 people in the UK are affected, but research suggests that up to 90% of them don’t know they have the condition, according to patient group Coeliac UK. Other symptoms of coeliac disease, apart from tiredness, are diarrhoea, anaemia and weight loss. Your GP can check if you have coeliac disease through a blood test.

Read more about coeliac disease.

2. Anaemia

One of the most common medical reasons for feeling constantly run down is iron deficiency anaemia. It affects around one in 20 men and post-menopausal women, but may be even more common in women who are still having periods.

Typically, you’ll feel you can’t be bothered to do anything, your muscles will feel heavy and you’ll get tired very quickly. Women with heavy periods and pregnant women are especially prone to anaemia.

Read more about iron deficiency anaemia.

3. Chronic fatigue syndrome

Chronic fatigue syndrome (also called myalgic encephalomyelitis or ME) is a severe and disabling tiredness that goes on for at least six months. There are usually other symptoms, such as a sore throat, muscle or joint pain and headache.

Read more about chronic fatigue syndrome.

4. Sleep apnoea

Sleep apnoea is a condition where your throat narrows or closes during sleep and repeatedly interrupts your breathing. This results in bad snoring and a drop in your blood's oxygen levels. The difficulty in breathing means that you wake up often in the night, and feel exhausted the next day.

It’s most common in overweight, middle-aged men. Drinking alcohol and smoking makes it worse.

Read more about sleep apnoea.

5. Underactive thyroid

An underactive thyroid gland means that you have too little thyroid hormone (thyroxine) in your body. This makes you feel tired. You’re also likely to put on weight and have aching muscles. It’s most common in women, and it happens more often as you get older.

Your GP can diagnose underactive thyroid by taking a simple blood test.

Read more about underactive thyroid.

6. Diabetes

One of the main symptoms of diabetes, a long-term condition caused by too much sugar in the blood, is feeling very tired. The other key symptoms are feeling very thirsty, going to the toilet a lot, and weight loss. Your GP can diagnose diabetes with a blood test.

Read more about diabetes.

Find your local diabetes support services.

7. Glandular fever

Glandular fever is a common viral infection that causes fatigue along with fever, sore throat and swollen glands. Most cases happen in teenagers and young adults. Usually, glandular fever symptoms clear up within four to six weeks, but the fatigue can linger for several more months.

Read more about glandular fever.

8. Depression

As well as making you feel very sad, depression can also make you feel drained of energy. And it can stop you dropping off to sleep or cause you to wake up early in the morning, which makes you feel more tired during the day.

Read more about depression.

Find your local depression support services and self help groups.

9. Restless legs

This is when you get uncomfortable sensations in your legs, which keep you awake at night. You might have an overwhelming urge to keep moving your legs, or a deep ache in your legs, or your legs might jerk spontaneously through the night. Whatever your symptoms, your sleep will be disrupted and of poor quality, so you’ll feel very tired through the day.

Read more about restless legs.

10. Anxiety

Feeling anxious is sometimes perfectly normal. However, some people have constant, uncontrollable feelings of anxiety, which are so strong that they affect their daily life. Doctors call this generalised anxiety disorder (GAD). It affects around around one in 20 people in the UK. As well as feeling worried and irritable, people with GAD often feel tired.

Read more about anxiety.

Find your local anxiety support services.

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How the weather can affect you

Winter tiredness

Do you find it harder to roll out of bed every morning when the temperature drops and the mornings are darker? If so, you’re not alone. Many people feel tired and sluggish during winter. Here are six energy-giving solutions.

What is winter tiredness?

If you find yourself longing for your warm, cozy bed more than usual during winter, blame the lack of sunlight.

As the days become shorter, your sleep and waking cycles become disrupted, leading to fatigue. Less sunlight means that your brain produces more of a hormone called melatonin, which makes you sleepy.

Because the release of this sleep hormone is linked to light and dark, when the sun sets earlier your body also wants to go to bed earlier – hence you may feel sleepy in the early evening.

While it’s normal for all of us to slow down generally over winter, sometimes lethargy can be a sign of more serious winter depression. This health condition, known medically as seasonal affective disorder, affects around one in 15 of us but can be treated.  If your tiredness is severe and year-round, you could have chronic fatigue syndrome.

Try these tactics to boost your vitality during the winter months.

Sunlight is good for winter tiredness

Open your blinds or curtains as soon as you get up to let more sunlight into your home. And get outdoors in natural daylight as much as possible, even a brief lunchtime walk can be beneficial. Make your work and home environment as light and airy as possible.

Fight fatigue with vitamin D

The wane in sunshine over the winter months can mean you don’t get enough vitamin D, and that can make you feel tired.

The main source of vitamin D is sunlight, but here in the UK we can't make any vitamin D from winter daylight between November and March so it’s especially important to get vitamin D from your diet.

Good food sources of vitamin D are oily fish (for example salmon, mackerel and sardines), eggs and meat. Vitamin D is also added to all margarine, and to some breakfast cereals, soya products, dairy products and low-fat spreads.

Even with a healthy, balanced diet it’s possible to become vitamin D deficient.

The latest National Diet and Nutrition Survey found evidence of vitamin D deficiency in all ages especially toddlers, 11-18 year old girls and men and women over the age of 65.

The government recommends that people at risk of vitamin D deficiency – including everyone 65 or over – should take a daily supplement.

Read more about how to get enough vitamin D and whether you may need a supplement.

Get a good night's sleep

When winter hits it’s tempting to go into hibernation mode, but that sleepy feeling you get in winter doesn’t mean you should snooze for longer. In fact if you do, chances are you’ll feel even more sluggish during the day.

We don’t technically need any more sleep in winter than in summer. Aim for about eight hours of shuteye a night and try to stick to a reliable sleep schedule. Go to bed and get up at the same time every day. And make sure your bedroom is conducive to sleep – clear the clutter, have comfortable and warm bedlinen and turn off the TV.

Read about how to get a good night’s sleep.

Fight winter tiredness with regular exercise

Exercise may be the last thing you feel like doing on dark winter evenings, but you’ll feel more energetic if you get involved in some kind of physical activity every day, ideally so you reach the recommended goal of 150 minutes of exercise a week. Exercise in the late afternoon may help to reduce early evening fatigue, and also improve your sleep.

Winter is a great time to experiment with new and different kinds of activity. For instance, if you’re not used to doing exercise, book a session at one of the many open-air skating rinks that open during the winter. Skating is a good all-round exercise for beginners and aficionados alike. There are also many dry ski slopes and indoor snow centres in the UK, which will offer courses for beginners.

If you’re more active, go for a game of badminton at your local sports centre, or a game of 5-a-side football or tennis under the floodlights.

If you find it hard to get motivated to exercise in the chillier, darker months, focus on the positives – you’ll not only feel more energetic but stave off winter weight gain.

Read about exercising.

Learn to relax

Feeling time-squeezed to get everything done in the shorter daylight hours? It may be contributing to your tiredness. Stress has been shown to make you feel fatigued.

There’s no quick-fire cure for stress but there are some simple things you can do to alleviate it. So, if you feel under pressure for any reason, calm down with meditation, yoga, exercise and breathing exercises.

Find out more about beating stress.

Eat the right foods

Once the summer ends, there’s a temptation to ditch the salads and fill up on starchy foods such as pasta, potatoes and bread. You’ll have more energy, though, if you include plenty of fruit and vegetables in your comfort meals.

Winter vegetables such as carrots, parsnips, swede and turnips can be roasted, mashed or made into soup for a warming winter meal for the whole family. And classic stews and casseroles are great options if they’re made with lean meat and plenty of veg.

You may find your sweet tooth going into overdrive in the winter months, but try to avoid foods containing lots of sugar – it gives you a rush of energy but one that wears off quickly.

See below for more information or find out more about healthy eating in general.

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The best way to eat if you want to banish tirednessis to have a healthy, balanced diet that contains foods from the four main food groups in the right proportions. The four food groups are:

  • potatoes, bread, rice, pasta and other starchy foods
  • fruit and vegetables
  • milk and dairy foods
  • meat, fish, eggs, beans and other non-dairy sources of protein

Eat at regular intervals

If you eat at regular times, your body knows when your next meal is coming and learns to manage feelings of hunger and sustain your energy levels. Try to eat three meals a day and limit snacks – especially high-fat ones – between meals.

Breakfast boosts your energy

Breakfast gives you the energy you need to face the day. Despite this, up to one third of us regularly skip breakfast, according to the British Dietetic Association.

Go for healthier options, such as porridge with fruit; vegetable omelette or wholemeal toast with a scraping of low-fat spread or jam.

If you can’t face eating as soon as you get up, take a high-fibre snack to eat on the run, rather than snacking on high-sugar or high-fat foods.

Aim for 5 a day for more vitality

Most people in the UK eat too much fat, sugar and salt, and not enough fruit and vegetables.

Fruit and vegetables are good sources of vitamins, minerals and fibre – essential nutrients that your body needs to work properly. Try to incorporate at least five portions of a variety of fruit and veg into your daily diet. They can be fresh, frozen, tinned, dried or juiced.

Read more about how to get your 5 a day.

Slow-burning starches give sustained energy

Starchy foods (also called carbohydrates) such as potatoes, bread, cereals and pasta are an important part of a healthy diet. They’re a good source of energy and the main source of a range of nutrients.

Starchy foods should make up about a third of everything you eat. There are different types of starch. Where possible, go for slow-burning wholegrain or wholemeal varieties, as they release energy gradually.

Sugar steals your stamina

Adults and children in the UK eat too much sugar. Sugar is not only bad for your teeth, it can also be bad for your waistline. It gives you a rush of energy, but one that wears off quickly.

Cutting out all sugar is virtually impossible. There are natural sugars in lots of foods, including fruit and veg, and you don’t need to avoid these. However, it’s a good idea to cut down on foods with lots of added sugar, such as sweets, cakes, biscuits, non-diet fizzy drinks and chocolates.

Read about swapping sugar in your diet..

Iron-rich foods prevent fatigue

One in four (40%) girls and women aged 16-24 and almost half (44%) of girls aged 11-15 have low iron stores, according to the National Diet and Nutrition Survey. Being low on iron can make you feel tired, faint and look pale.

While red meats, green vegetables and fortified foods such as breakfast cereals are good sources of iron, the important thing is to eat a range of foods, to get enough iron.

Here's more advice on good sources of iron.

Non-alcoholic drinks boost zest levels

Watch your alcohol intake. It can dehydrate you, which will make you feel tired.

Make sure you stay hydrated by drinking on average six to 10 small glasses of fluid, such as water or milk, a day.

The European Food Safety Authority recommends that women should drink about 1.6 litres of fluid and men should drink about 2.0 litres of fluid per day. That's about eight glasses of 200ml each for a woman, and 10 glasses of 200ml each for a man.

Eat enough to pack a punch

Make sure you eat the right amount for your activity level. The average man needs around 2,500 calories a day, and the average woman needs 2,000 calories. Remember, we all overestimate how active we are.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 02/06/2015 12:11:26