3 Common Reasons for Fatigue

If you feel tired for a day or two, it may be because you’re stressed or physically exhausted or didn’t get enough sleep. 

“If you continue feeling this way for a week or more despite eating well, sleeping and resting, you may be fatigued,” explains Dr. Kartikeya Kohli, Associate Consultant, Internal Medicine at Sitaram Bhartia Institute of Science and Research.

Fatigue can dampen your spirits, concentration and cause mood swings. 

Very often we tend to brush it off as inconsequential, thinking that it may be linked to continuous cycles of chasing after children, tasks that keep piling up, stress at work or even increasing age. 

If this sounds familiar and you can recall many moments in the recent past where you’ve thought about how tired you were, it’s time to dig a little deeper. 

There are quite a few medical conditions that may make you feel constantly tired. Here are three common conditions:

  1. Depression

    It can make you feel drained of energy apart from causing feelings of helplessness and sadness. You may feel this way for weeks or months. It may make you wake up early or cause trouble sleeping at night, leading to exhaustion during the day.

    According to the National Mental Health Survey 2015-16, one in twenty Indians suffer from depression.

    Ajay Jain, a banking professional, was finding it hard to focus on work. Assignments that used to usually take him half an hour to finish seemed to drag on for hours because he felt unusually tired and disoriented at times. At the insistence of a close friend, he finally came for a check up.

    “When we discussed Ajay’s routine, appetite, sleep schedule and his thoughts, we asked him to take a depression screen,” says Dr Kartikeya.

    “The test strengthened our suspicions. We listened to him and counselled him about the matters on his mind.”

    “After a few sessions, he seemed to be in a better frame of mind, as if he was slowly letting go of a heavy load.”

    Ajay recounts his sessions, “I was advised to take antidepressants and to exercise. I was skeptical of how going for a walk every day would have any positive effect and thought it would instead increase my fatigue. But I felt a dramatic difference within 10 days.”

    “I felt..recharged! It’s hard to explain..I didn’t imagine that my fatigue would be linked to depression but now I see how my emotions, disturbed sleep cycle and concentration were all interlinked and made me feel weary all the time.”

    If you’ve been feeling low and are dealing with concerns related to your career, family or health, you should remember that it’s okay to ask for help. Try speaking to a medical professional who will hear you out and can provide guidance about how you can manage your situation better.


  2. Hypothyroidism

    It could also cause constant exhaustion. In this condition, the thyroid gland is producing less thyroxine (T4), one of the main thyroid hormones in the blood. The thyroid gland usually produces hormones triiodothyronine T3 and T4 which aid in regulating body functions. Since the thyroid gland is underactive meaning it doesn’t produce enough of T3 and T4, the body functions tend to slow down, causing you to feel incessantly tired.

    Lata Madan, 45, felt exactly this way. She had trouble waking up in the morning to get her kids ready for school. She also observed that she had gained weight despite watching her diet.

    Sensing that she should get herself checked, she came in for a consultation.The doctor examined her thyroid gland, asked her about hair loss, dry skin and aches and pains.

    Based on the details she provided, she was asked to get a blood test to assess her thyroid profile. Her reports indicated high TSH and low T4 levels confirming hypothyroidism.

    “The doctors explained to me how medication would help control my TSH levels and that I would have to get them checked every 12 weeks,” says Lata.

    “I was very particular about my doses and was relieved to see my symptoms dissipate within a few weeks!”

    Like Lata, you too should take note of the visible signs that help identify an underlying condition.

  3. Sleep apnea

    Unlike hypothyroidism, however, this condition presents with symptoms that may not always be evident.

    Vijay Sharma, a 58 year old overweight man found that he would often nod off in business meetings. He had to make an effort to pay attention, and felt frustrated especially since he woke up with a headache each morning.

    During an annual preventive health check up, when Vijay was asked about his daily routine and how well he slept, he mentioned his drowsiness, constant tiredness and irritability. 

    His wife highlighted that he snored loudly and woke up multiple times through the night. Upon probing, she revealed that at times it felt as if Vijay was struggling to breathe. 

     “Vijay’s wife shared an important piece of information which made us suspect a sleeping disorder,” says Dr Kartikeya. 

    A sleep study and a few other tests confirmed a diagnosis of sleep apnea.

    Sleep apnea is a condition in which people have trouble breathing while sleeping at night. When we normally breathe, the air that is inhaled passes through the mouth and nose to the lungs. With sleep apnea, the air is unable to pass through as the muscles may relax during sleep causing the tissues at the back of the throat to collapse and narrow the passageway.

    Being overweight, male and middle aged may increase your chances of developing the disorder. 

    “When you have breathing trouble at night, you may wake up frequently and end up feeling more tired during the day, as was the case with Vijay.”

    After a thorough consultation about the diagnosis and the treatment options available, Vijay decided to opt for a ‘mask’ that would provide sufficient air pressure and eliminate breathing difficulty and snoring.

    “I didn’t realize that my sleepiness and fatigue could be cured. I’m so glad that my wife and I discussed it with the doctor. I can finally sleep tension free! As my night time sleeping improves, my daytime sleepiness reduces and I’m able to be more alert at work,” says Vijay. 

    Other reasons for fatigue

    A few other conditions may make you feel worn out such as:

    Anemia, or an iron deficiency: This is common in pregnant women or women with heavy periods. If this is suspected, you may be advised a full blood count to assess the number of red blood cells. If the count is low, you may be suggested iron tablets apart from which you should eat leafy green vegetables, pulses, iron fortified cereals and reduce your intake of milk, dairy, tea and coffee.

    Fibromyalgia, which is a chronic condition that causes musculoskeletal pain in multiple parts of the body and is more common in women. It has symptoms that resemble other medical problems and so may be wrongly diagnosed. It can cause fatigue, sleep disturbances, headaches, depression and anxiety. 

    Chronic fatigue syndrome (CFS) also causes extreme fatigue that is not caused by a hidden medical problem. There are no tests that check for CFS. It is usually diagnosed based on your symptoms as per the diagnostic criteria for the condition and if you are unable to perform routine chores for atleast six months. It is common in women between 40-50 years of age.

Ill Effects of Fatigue

Untreated fatigue can lead to several complications including a loss of appetite, headaches, mood swings and can completely diminish motivation and concentration. 

Like Ajay, Lata and Vijay, you should take action to overcome your weariness.

Tips to Keep in Mind Before Seeking Medical Advice

If you’re unsure whether your fatigue is a sign of an underlying condition, try making changes to your lifestyle by 

  • Prioritizing actions: Finishing tasks that are time sensitive or require coordination with other people.
  • Following a sleeping schedule: Try to set a specific time to sleep and to wake up. This not only impacts your body’s internal clock, but can also help curb irritability that may be due to fatigue.
  • Eating different coloured fresh fruits such as red cherries that contain antioxidants, oranges and sweet lime for vitamin C and yellow bananas for vitamin B6.  Studies have shown that fatigue and depression are sometimes associated with a vitamin C deficiency.
  • Increasing your step count: Walk around the house for 30 minutes if you’d like to avoid public parks at this time. Exercise helps release endorphins and feel good hormones, which can help restore your energy levels. 

It can also be helpful to maintain a diary where you record your episodes of tiredness, especially if they come and go. Write down how you felt, any particular thoughts and how it may have impacted your day.

If none of these changes reduce your tiredness, you should see a doctor. 

What You Can Expect in a Consultation

Your doctor will ask about any medications you have been taking that may be causing fatigue as a side effect. He will also ask about your medical history, lifestyle, your exercise and eating patterns and any other areas of concern.

Depending on your symptoms, you may be asked to get some tests to check for TSH, iron levels or vitamin deficiencies. 

“Make sure to get all your previous reports and prescriptions, and tell us how you honestly feel because the key to a proper diagnosis often lies in the details,” finishes Dr Kartikeya. 

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