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 ❤️