Fatigue

Fatigue is a feeling of extreme physical and/or mental tiredness, and at any given time, one in five people in the UK feel unusually tired and one in 10 have prolonged fatigue.

We all know that overdoing it can cause tiredness, but sleep problems, shift work, stress and long working hours can be draining in the longer term and make you feel tired all the time.

Underlying medical conditions including anaemia, thyroid disease, chronic fatigue syndrome, arthritis, vitamin deficiencies, drug side effects and cancer that can sap your energy, too – so fatigue that persists shouldn't be ignored.

Causes

Everyone can feel tired occasionally, but 10 to 18 per cent of people in the UK report fatigue lasting one month or longer.

Sleep problems, such as insomnia and sleep apnoea, a condition that affects breathing during sleep, can leave you feeling exhausted.Anxiety, stress and depression can also be draining. Feeling tired and low in winter can be a symptom of seasonal affective disorder (SAD), a form of winter depression that affects one in 15 people in the UK.

Iron deficiency anaemia, where iron deficiency leads to a reduction in the number of red blood cells, is one of the main reasons why you may be feeling run down and tired. The National Diet and Nutrition Survey revealed 46 per cent of girls and almost one in four women have low iron intakes.

Other serious illnesses such as underactive thyroid, where you have too little of the hormone thyroxine needed for energy metabolism and coeliac disease, an autoimmune disease where the body’s immune system reacts to gluten can also be causes of fatigue. Glandular fever, a viral infection that affects young adults; rheumatoid arthritis, a painful autoimmune condition where antibodies attack the joints; and any chronic (long term) illness, can cause fatigue too.

People with cancer may feel fatigued from the disease, treatments, or both.If you’re experiencing severe tiredness particularly if accompanied by symptoms of weight loss and bleeding, get it checked out with your GP.

When fatigue persists for more than four months, and isn’t due to an underlying medical condition, it may be chronic fatigue syndrome, which causes long term debilitating exhaustion that affects your everyday life.

Symptoms

The symptoms of fatigue will vary depending on the cause. Common symptoms include an overwhelming sense of tiredness, lack of energy and physical or mental exhaustion.

You may also have aching and sore muscles, feel breathless and/or dizziness after minimal exertion, have difficulty concentrating and been irritable.

Diagnosis

Your doctor may diagnose fatigue from your symptoms, and they may ask about your sleep, rest, exercise, diet and lifestyle.

Initial investigations for fatigue include blood tests, kidney and liver function tests, an ESR, which detects inflammation associated with infections and cancer, and tests to check your thyroid as well as for coeliac disease.Your doctor may even review your medication, as side effects can cause fatigue.

Who gets fatigue?

It’s estimated 10 per cent of people worldwide suffer with persistent tiredness and more women than men are affected.

Treatments

Firstly, the underlying condition will need to be treated if it’s known, for instance with iron deficiency anaemia it will usually involve taking a supplement and/or making dietary changes.

Treatments for persistent unexplained fatigue vary. It’s also important to identify and address lifestyle factors that may be causing fatigue, such as stress, workload and personal relationships. For improving sleep, the Royal College of Psychiatrists advises going to bed and getting up at the same time every day, limiting daytime naps, avoiding stimulants and having a hot bath to wind down before bed.

Regular physical exercise may help to reduce feelings of depression and stress while improving mood and wellbeing. Eating a balanced diet is important because nutritious foods (particularly those containing iron and B vitamins) will give you energy. Incorporating relaxation such as yoga or meditation into your daily routine can also help.

Talking therapies, such as counselling or cognitive behavioural therapy (CBT) can help fight fatigue. In fact, research by the Medical Research Council found that CBT and exercise was the most effective way in treating chronic fatigue.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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