Tiredness can be a challenging presentation because there are just SO many reasons why someone could be experiencing tiredness, and to do it justice in a 10-15 minute GP consult can be a stretch. I am hoping this article will be useful to go through some of the very common causes of tiredness, many of which can be addressed at home, or with changes in lifestyle or diet but also some will need a doctors visit. It is important to stress that any information in my blogs is generalised. No two humans are the same and if you have health concerns it is important you see your family doctor.
Tell me your story
As with anything in medicine history is key. I try and encourage patients to tell me the story of their problem. For example with tiredness how long have you had it for and what other symptoms you have. If you have periods have they become heavier? Are you at a stage in your life when your hormones may be changing. Are you loosing weight unintentionally, seeing blood in your stools or other concerning symptoms? By honing in on new symptoms I can try and get to the root of your problem.
- Are you sleeping well?
- Recent life stressors?
- Are you eating well?
- Any new or concerning symptoms (we call these red flags)
- Have you previously had other medical conditions that can be recurring?
- The list goes on!
Do I need a blood test?
The quickest and easiest thing can often be to run a panel of bloods and this is often appropriate when someone is feeling more tired than usual. A low iron level, B12, vitamin D or abnormal thyroid function can be easy to treat and make a huge difference. If eating well it should be possible to get most if not all of your micro and macronutrients through your diet, but ruling out deficiencies is often useful and reassuring.
Common causes of tiredness
- Sleep, sleep, sleep and SLEEP! This may seem really obvious but the proportion of people not getting enough good quality of sleep or relying on ‘sleeping tablets’ is quite terrifying. If you can crack sleep then so much else falls into place. It isn’t a quick fix but is one that is really worth working on. I need to write a blog on this topic alone, but in the meantime I will recommend if you are struggling to get enough sleep to make you feel refreshed you read Matthew Walker ‘why we sleep’ it’s a brilliant in depth book which covers all you need to know to get a great nights slumber. If you haven’t got time for a book then check out this link from the ministry of health website: Sleep tips for adults | Ministry of Health NZ. It is very important to know that there is no such thing as a sleeping tablet, just a sedative, eg Zopiclone, benzodiazepines. These do not give you a good quality sleep and they are addictive. Some people may benefit from a course of Melatonin in addition to sleep hygiene measures.
- Eating foods which do not work for your body. I dislike the term ‘bad foods’ or the phrase ‘poor diet’. I think it more productive to think about what works and doesn’t work for your body and to try and ingest a mainly plant based diet and foods that look like food. Reducing or stopping processed foods can have huge effect on energy levels. Processed food refers to any food item that has undergone significant modifications from its original form through various industrial processes. See my recent blog on this topic for more information. What are Processed Foods and How to Avoid Them (butlerplasticsurgery.co.nz),
- Exercise: Too little or too much! Its so confusing isn’t it, and I don’t think you will find a consensus on the ‘right ’amount of exercise, but as a general rule, over 150 minutes of moderate intensity exercise per week is shown to have benefit to health. My top tips for exercise are just do what you love, move every day, try not to make it a chore and try and include it into your daily routine, eg as part of your commute or as a group social activity, you are more likely to keep it up that way. If you are a women entering the perimenopause, weights or resistance training is essential to promote bone and muscle strength, which have a host of health benefits.
- Reducing stress: This is a part of our lives that is so often overlooked in the racing modern world. Stress reduction enhances all aspects of our lives from our immune systems and sleep to relationships, productivity, mental health and even controlling our weight. Adding in a daily meditation practice, even for a few minutes can be so beneficial. I love the headspace app for this, insight timer and smiling mind are free alternatives.
- Medical conditions: such as anaemia, thyroid disorders, diabetes, infections, chronic fatigue, sleep apnoea, heart or lung conditions, muscular or connective tissue disorders, the list could go on and on, and to diagnose some of these blood tests or other investigations are often needed.
- Mood disorders: Depression and anxiety can often manifest in tiredness, which along with poor sleep can result in a cycle of worsening symptoms. If you are experiencing low mood or anxiety it is important to seek help, links at the bottom of the page.
- Substances: drugs (prescribed and recreational) and alcohol are also all too commonly causes of tiredness. If all other avenues have been explored and no cause found for your tiredness, it could be worth cutting down or stopping alcohol, reviewing your prescribed medications, and stopping recreational drugs if these are part of your lifestyle and you want to feel better.
So there you have it. There are many many causes of tiredness and if you are experiencing this more than is usual for you it is a good idea to see your family doctor. I hope this article is a useful to discuss some of the other causative factors that may not be discussed at your medical appointment.