We all feel worn out from time to time, but when exhaustion becomes a constant companion, it could be a sign of something more serious than just a busy lifestyle. Distinguishing between normal tiredness and a chronic health issue is crucial for getting the right help.
When Tiredness Becomes a Medical Concern
According to Dr Angela Rai, a GP at The London General Practice, fatigue is an extremely common symptom in general practice. While feeling tired is a normal part of life, it can also be a key indicator of underlying illness, especially during high-pressure periods like the festive season.
She notes that the vague symptoms of being 'tired all the time' (TATT) can be difficult to manage alone. However, consulting a doctor is a vital step to rule out more serious conditions. The term 'chronic fatigue' is typically used for Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME).
Unlike everyday exhaustion, ME/CFS involves persistent fatigue accompanied by sleep problems, cognitive issues like 'brain fog', and memory struggles. Dr Rai adds that sufferers may also experience flu-like symptoms, fever, headaches, and aching joints or muscles.
Eight Common Causes of Persistent Fatigue
Dr Rai advises that essential investigations, starting with a simple blood test, can identify most causes of ongoing tiredness. She highlights several frequent culprits:
Anaemia: Iron deficiency anaemia is one of the most common reasons for feeling constantly run down. Women with heavy periods are particularly at risk. Treatment usually involves iron supplements or, in severe cases, iron infusions.
Stress: If no physical cause is found, the issue may be psychological. Stress raises cortisol levels, which can disrupt sleep patterns and leave you feeling unrefreshed.
Hypothyroidism: An underactive thyroid gland fails to produce enough hormones, slowing the metabolism. Symptoms include tiredness, weight gain, feeling cold, and constipation, all diagnosable via a blood test.
Diabetes: This metabolic disorder leads to high blood sugar over time, causing fatigue, excessive thirst, and frequent urination. Untreated diabetes can lead to serious heart and kidney complications.
Glandular Fever: A common viral illness in teens and young adults, it causes fever, sore throat, and swollen glands. While most recover in weeks, tiredness can linger for months.
Obstructive Sleep Apnoea (OSA): This sleep disorder involves throat muscles relaxing and blocking breathing. Signs include loud snoring, waking up gasping, and daytime sleepiness, often treated with sleep therapy.
Vitamin B12 and Folate Deficiency: These vitamins are crucial for nervous system health. Low levels can cause extreme fatigue, mouth ulcers, pins and needles, and a sore, red tongue.
Depression and Anxiety: Mood disorders can profoundly disrupt sleep and energy levels. Feeling drained is a common symptom, and cognitive behavioural therapy (CBT) can be an effective treatment if these conditions are diagnosed.
Taking Action on Exhaustion
The key message from medical professionals is clear: persistent fatigue should not be dismissed. While lifestyle factors like poor sleep and dehydration are common contributors, a medical assessment is essential to identify or rule out underlying conditions.
Starting the conversation with your GP can provide a clear path forward, whether it requires simple dietary changes, treatment for a specific condition, or support for mental wellbeing. Listening to your body's signals is the first step towards reclaiming your energy.
