TIREDNESS


Tiredness is probably one of the most common symptoms in general practice, and can be due to a huge range of underlying causes!


Fatigue is a constant feeling of being tired - not just due to a big day or lots of exercise, but unrelenting overwhelming exhaustion


Lifestyle medicine gives a great framework for exploring and identifying causes for tiredness - so if you struggle with fatigue, this post is for you ❤️


If you are tired all the time, the first step is to talk to your doctor about blood tests, and ruling out serious causes


These tests should include :


▪️iron studies (aim for a ferritin between 40-200 micrograms/L if female, and 50-300 if male. Ferritin can also be elevated if inflammation is present, so I also do a CRP level to check for this)


▪️ B12 (aim over 250)


▪️thyroid levels (ie normal TSH and T4)


▪️autoimmune tests (if associated symptoms, talk to your doctor about these)


▪️blood count


▪️blood sugar (Hba1c, looking for diabetes or prediabetes. Even an hba1c in the high normal range can indicate underlying insulin resistance

C peptide levels can check this)


▪️kidney and liver function


If blood tests are normal, then looking at other potential causes is next


The most common reasons include:


▪️lack of sleep (less than 7h of sleep /night)


▪️diet high in refined carbs and sugar and lacking adequate healthy protein (this causes blood sugar spikes, fatigue, and sugar craving)


▪️lack of exercise (seems ironic, but often exercise actually helps energy production!)


▪️chronic stress (constant low grade stress leads to fatigue and 'burnout', where often tiredness is the first symptom)


▪️depression (often with other symptoms ie lack of enjoyment, no motivation, feeling constantly flat, poor appetite or overeating)


▪️medications (pain medication, antihistamines, chemo, and beta blockers are all common causes)


▪️perimenopause (often associated with hot flushes, night sweats, brain fog)


▪️dietary intolerance (ie gluten or lactose intolerance)


▪️ chronic fatigue and fibromyalgia


Serious causes such as cancer are actually fairly rare, especially if blood tests normal


It's a complex topic, but a structured approach can really help ❤️

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