“I’m soooo TIRED!!” A phrase I hear regularly from my busy clients. Tiredness can be for a number of reasons from too many late nights, candles burning both ends of the day, reading too late into the night or just tooooo much of something. You may think you know why you are tired, but there are more causes than you might think. We all get tired from time to time, but if it is persisting then you might find something here as to what’s behind it. Any long term fatigue or sleep issues need to be referred to your doctor for investigation.

Cause No. 1: Not enough sleep

It may seem obvious but you could be getting too little sleep. That can negatively affect your concentration and health. Adults should get seven to eight hours every night.

Help: Make sleep a priority and keep a regular schedule. Ban laptops, cell phones, and televisions from your bedroom. Still having trouble then consult your doctor to eliminate if you have a sleep disorder.

Cause No. 2: Sleep apnoea

Some people think they’re sleeping enough, but sleep apnoea gets in the way. It briefly stops your breathing throughout the night. Each interruption wakes you for a moment, but you may not be aware of it. The result? You’re sleep-deprived despite spending eight hours in bed. Your doctor may order a sleep study to check for this.

Help: Lose weight if you’re overweight, quit smoking, and you may need a CPAP device to help keep your airway passages open while you sleep.

Cause No. 3: Not enough benefits from your diet

Eating too little causes fatigue, but eating the wrong foods can also be a problem. Eating a balanced diet helps keep your blood sugar in a normal range and prevents that sluggish feeling when your blood sugar drops.

Help: Always eat breakfast and try to include protein and complex carbohydrates in every meal. For example, eat eggs with whole-grain toast or spinach. Also eat small meals and snacks throughout the day for sustained energy.

Cause No. 4: Anaemia

This can be one of the leading causes of fatigue in women. Menstrual blood loss can cause an iron deficiency, putting women at risk. Red blood cells are needed because they carry oxygen to your tissues and organs. It is also an issue at menopause if you do not have an iron-rich diet.

Help: For anaemia caused by an iron deficiency eating iron-rich foods, such as lean meat, liver, shellfish, beans, and enriched cereal, can help. Get your doctor to perform a full blood count if you are concerned about your iron levels.

Cause No. 5: Depression

You may think of depression as an emotional disorder, but it contributes to many physical symptoms, as well. Fatigue, headaches, and loss of appetite are among the most common symptoms. If you feel tired and “down” for more than a few weeks, see your doctor.

Help: Depression responds well to talk therapy and a combined progesterone and oestrogen hormone cream can also be effective.

Cause No. 6: Hypothyroidism

The thyroid controls your metabolism (the speed at which your body converts fuel into energy). When the thyroid gland is underactive, your metabolism performs slowly so you may feel sluggish and put on weight.

Help: If a blood test confirms your thyroid hormones are low, then your doctor may prescribe a drug like Thyroxine, but bioidentical progesterone can also help.

Cause No. 7: Caffeine overload

Ahhhh, yes… my go to. Caffeine can improve alertness and concentration in moderate doses, but too much can increase heart rate, blood pressure, and jitteriness. And research indicates too much actually causes fatigue in some people.

Help: Gradually cut back on coffee, tea, chocolate, soft drinks, and any medications that contain caffeine. Stopping suddenly can cause caffeine withdrawal and more fatigue.

Cause No. 8: Hidden UTI

If you’ve ever had a urinary tract infection (UTI), you’re probably familiar with the burning pain and sense of urgency. But the infection does not always announce itself with such obvious symptoms. In some cases, fatigue may be the only sign. A urine test can quickly confirm a UTI.

Help: Antibiotics may be necessary if severe, but first try paracetamol and place a hot water bottle on your tummy, back or between your thighs. Drinking unsweetened cranberry juice is one of the most well-known natural remedies for urinary tract infections. Cranberries work by preventing bacteria from adhering to the urinary tract, thus preventing infection.

Cause No. 9: Diabetes

In people with diabetes, abnormally high levels of sugar remain in the bloodstream instead of entering the body’s cells, where it would be converted into energy. The result is a body that runs out of steam despite having enough to eat. If you have persistent, unexplained fatigue, ask your doctor about being tested for diabetes.

Help: Treatments for diabetes may include lifestyle changes such as diet and exercise, insulin therapy, and medications to help the body process sugar.

Cause No. 10: Dehydration

Your fatigue can be a sign of dehydration. Your body needs water to work well and keep cool. If you’re thirsty, you’re already dehydrated.

Help: Drink water throughout the day so your urine is light-coloured, the darker it is the more you need to drink. Keep a water bottle with or near you and take regular drinks. Have at least two cups of water an hour or more before a planned physical activity and afterwards drink another two cups.

Cause No. 11: Heart disease

When fatigue strikes during everyday activities, such as cleaning the house or weeding the garden, it can be a sign that your heart is no longer up to the job. If you notice it’s becoming increasingly difficult to finish tasks that were once easy, talk to your doctor about heart disease.

Help: Lifestyle changes such as diet and exercise, medication, can get heart disease under control and restore your energy. This is one of my key areas. Talk to me if you have concerns.

Cause No. 12: Shift work sleep disorder

Working nights or rotating shifts can disrupt your internal clock. You may feel tired when you need to be awake, and you may have trouble sleeping during the day.

Help: Limit your exposure to daylight when you need to rest. Make your room dark, quiet, and cool. If you’re still having sleep issues, talk with your doctor and some natural sleep aid supplements and routine changes can help.

Cause No. 13: Food allergies

Some doctors believe hidden food allergies can make you sleepy. If your fatigue intensifies after meals, you could have a mild intolerance to something you’re eating – not enough to cause itching or a specific reaction, just enough to make you tired.

Help: Try eliminating foods one at a time to see if your fatigue improves. You can also ask your doctor about a food allergy test.

Cause No. 14: CFS and fibromyalgia

If your fatigue lasts more than six months and is so severe that you can’t manage your daily activities, chronic fatigue syndrome or fibromyalgia are a possibility. Both can have various symptoms, but persistent, unexplained exhaustion is a main one.

Help: While there’s no quick fix for CFS or fibromyalgia, patients often benefit from changing their daily schedule, learning better sleep habits, and starting a gentle exercise program.

Other helpful information

Fatigue can have many causes but certainly sleep and thyroid issues are up there so if that is the case for you, consider that progesterone could help. Check out my previous progesterone blog.

Also worth considering: If you have mild fatigue that isn’t linked to any medical condition, the solution may be exercise. Research suggests healthy but tired adults can get a significant energy boost from a modest workout programme. In one study, participants rode a stationary bike for 20 minutes at a mild pace. Doing this just three times a week was enough to fight fatigue.

Tiredness can have many causes, so do speak to your doctor if concerned. Low progesterone levels can also be a contributory factor so check if you have signs oestrogen dominance which can start in your thirties, become strong in your mid forties and hang around into your fifties! Talk to me about hormone balance, eating wholefoods, getting regular exercise or lifting weights.

I’m off for a nap…