Whether you’re a high-achieving professional or someone trying to manage the daily grind, feeling consistently drained can be debilitating. While fatigue may have many causes, it’s essential to identify the root of the problem and address it effectively.
This blog is written from information taken from the Wealth of Health podcast episode ‘5 Reasons You Are Always Tired’.
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Hormonal Imbalances
Hormones play a pivotal role in regulating energy levels, and imbalances in thyroid function, cortisol production, or sex hormones can significantly contribute to fatigue. Let’s break this down:
- Thyroid Function: The thyroid gland produces hormones that control metabolism. Hypothyroidism—or underactive thyroid—is a well-known cause of fatigue. Symptoms include weight gain, cold sensitivity, and low energy. However, even if thyroid function falls within the “normal” range, borderline low levels can still impact your vitality. Many patients find relief with thyroid hormone supplementation, even when their test results aren’t classified as abnormal.
- Cortisol Levels: Often misunderstood, the idea of “adrenal fatigue” has been debunked by many medical professionals. Instead, what’s more accurate is adrenal insufficiency, where the adrenal glands don’t produce enough cortisol, a hormone crucial for energy regulation. Low cortisol levels can cause profound fatigue, and in some cases, supplementing with cortisol can help, but this should always be done under medical supervision.
- Sex Hormones: Low levels of testosterone, especially in men, or imbalances in oestrogen and progesterone in women can also contribute to tiredness. Optimising these hormones can often restore energy levels.
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Post-Viral Fatigue and Chronic Fatigue Syndrome
Post-viral fatigue is a condition that often follows viral infections like COVID-19, the flu, or Epstein-Barr virus. It’s a subset of Chronic Fatigue Syndrome (CFS), which is increasingly recognised as a genuine medical condition.
- Symptoms: The hallmark of post-viral fatigue is overwhelming tiredness that doesn’t improve with rest. Patients describe it as feeling like “the plug has been pulled out.” Other symptoms include brain fog, joint and muscle pain, and unrefreshing sleep.
- Patient Profile: High-achieving individuals—those with demanding jobs, busy schedules, or rigorous exercise routines—are often the most affected. Women are disproportionately affected, making up about 70% of cases.
- Diagnosis: Diagnosing post-viral fatigue involves ruling out other conditions such as thyroid disorders, anaemia, or autoimmune diseases. A detailed history is critical, as is checking for deficiencies in vitamins like Vitamin D and B12.
- Treatment: Treatment requires a multi-pronged approach. Patients need to:
- Accept the condition: Understanding that this is a real illness, not weakness or laziness, is vital for recovery.
- Reduce energy expenditure: This means scaling back on physical, cognitive, and emotional stress.
- Gradually rehabilitate: Recovery is slow and requires pacing activities. It’s a “two steps forward, one step back” process.
- Consider new therapies: Hyperbaric oxygen therapy has shown promise in some studies, especially for long COVID. This involves sitting in a pressurised chamber and breathing oxygen-rich air, which can help the body repair itself more effectively.
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Vitamin Deficiencies
Vitamin deficiencies are an often-overlooked cause of fatigue, but they’re relatively easy to diagnose and treat. Here are the most common culprits:
- Vitamin D: Most patients with chronic fatigue have low Vitamin D levels. Given how easy it is to test and supplement this vitamin, it’s an essential first step in addressing fatigue.
- Vitamin B12 and Folic Acid: These vitamins are crucial for energy production and proper nerve function. Deficiencies can lead to lethargy, brain fog, and even anaemia. Supplementation can make a noticeable difference in energy levels.
Addressing these deficiencies often leads to significant improvement in fatigue, making it a low-hanging fruit in terms of treatment.
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Poor Sleep Quality
Sleep is the foundation of health and energy, yet many people struggle with sleep disorders that exacerbate fatigue. Whether you have difficulty falling asleep, staying asleep, or waking up unrefreshed, poor sleep quality can leave you feeling drained no matter how long you’ve been in bed.
- Causes of Poor Sleep: Stress, anxiety, and poor sleep hygiene are common contributors. Conditions like sleep apnoea, where breathing repeatedly stops and starts during sleep, can also play a role.
- Management Tips:
- Establish a consistent sleep schedule.
- Create a relaxing bedtime routine, such as reading or meditating.
- Address underlying issues, such as anxiety or medical conditions, with professional help if needed.
Improving sleep often has a profound impact on energy levels and overall well-being.
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Lifestyle Factors: Stress and Overexertion
High stress levels and overexertion—whether physical, emotional, or cognitive—can deplete your energy reserves over time. This is particularly relevant for high achievers who are used to pushing through exhaustion without realising the long-term impact on their health.
- Emotional Stress: Emotional stress drains energy faster than almost any other factor. Learning to manage stress is crucial for recovery.
- Overtraining Syndrome: While exercise is beneficial, overdoing it can have the opposite effect, leaving you constantly fatigued. Post-exertional malaise is a key feature of post-viral fatigue, where even mild exercise can leave patients feeling wiped out for days.
- Strategies to Manage Stress:
- Incorporate mindfulness practices, such as yoga or meditation, into your daily routine.
- Set realistic goals for yourself and allow time for recovery.
- Seek support from friends, family, or professionals if you’re struggling to manage stress on your own.
Recovery is Possible: A Step-by-Step Approach
While chronic fatigue can feel insurmountable, recovery is possible with the right approach. Here’s a summary of the key steps:
- Get a thorough medical evaluation: Rule out conditions like thyroid disorders, anaemia, and autoimmune diseases.
- Adopt a balanced lifestyle: Reduce energy expenditure and pace yourself to avoid overexertion.
- Optimise hormones: Work with your doctor to ensure your thyroid, cortisol, and sex hormones are functioning at optimal levels.
- Consider innovative therapies: For conditions like post-viral fatigue, treatments like hyperbaric oxygen therapy may offer additional support.
- Be patient: Recovery takes time. Focus on gradual progress rather than quick fixes.
Fatigue is a complex issue with multiple potential causes, but understanding its root can empower you to take the right steps toward recovery. From addressing vitamin deficiencies to managing stress and considering advanced therapies, there are actionable solutions for almost everyone. If you’ve been struggling with fatigue, consult a healthcare professional to develop a tailored plan that works for you.
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Further Reading on Fatigue
https://www.mayoclinic.org/symptoms/fatigue/basics/causes/sym-20050894
https://www.nhs.uk/conditions/tiredness-and-fatigue/
https://my.clevelandclinic.org/health/symptoms/21206-fatigue