What it Means If You Feel Tired All the Time (and What to Do About It)

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We live in a culture where being under-slept, overworked and over-committed is a sign of success. But what if there's more going on than a too-packed schedule and too little shut eye?

Chronic Fatigue Syndrome, or tiredness lasting more than 24 hours and not improved by bed rest, affects millions of people in the U.S.—so many, in fact, that the numbers are disputed. But there could also be a number of other things contributing to your endless weariness—and some of these causes can be serious.

Is your exhaustion trying to tell you something? Is your sudden surprising lack of energy for working out a sign that something is going on with your health? Here's what to look for.

When your thyroid gland doesn't produce sufficient triiodothyroidine (T3) and thyroxine (T4)—hormones responsible for all aspects of metabolism—you may experience symptoms including fatigue, weight gain, dry skin, thinning hair, muscle aches, and sensitivity to cold and blood pressure. If the hormones aren't regulated, your body may not use fats and carbohydrates properly, and because these are your body's preferred sources of fuel, you may feel lethargic. If you're experiencing any of the above symptoms, talk to your health care provider. A simple blood test can show any deregulation of your thyroid hormone levels.

Adrenal imbalance
Your adrenal glands sit atop your kidneys and regulate stress hormones in the body, primarily cortisol and adrenaline. External factors like job stress, relationships, lack of sleep, over-exercising, dieting and emotional distress can upset the balance and timing of when these hormones are released, causing unusual exhaustion.

Fatigue in this case might feel like a strange combination of "tired and wired." You might feel unmotivated or notice your endurance is suffering. If this is the case, take stock of your daily responsibilities, your self-care and, yes, your caffeine consumption. Removing some stress (or taking care of your body and mind when possible) might help with the fatigue. You may also wish to speak to a naturopath about holistic remedies to calm the body and restore energy.

Anxiety and depression
Anxiety can cause fatigue due to the ever-shifting levels of adrenaline and cortisol pulsing through the body. Meanwhile, depression often interrupts the healthy habits that prevent fatigue—proper sleep, eating well, exercising, socializing—and can contribute to prolonged tiredness. Being unmotivated to move around slows metabolism, telling your body it doesn't need to generate and use energy as normal. Working with a mental health professional to adjust lifestyle, schedule, thought processes and sometimes medication can be helpful in reducing fatigue.

Overactive immune system
That feeling of intense exhaustion you get just before a cold comes on isn't coincidental. That's your body redirecting its energy and resources to fight off bacteria. If this feeling persists for a long time—and you're not experiencing noticeable symptoms of a cold or flu—your body might be fighting off another virus altogether. Consider drinking more fluids and resting more to help your body fight off invaders. If you're concerned it's something more serious, consult a medical practitioner.

Red blood cells contain hemoglobin, a protein that transports oxygen to all the cells in the body. A lack of red blood cells, often caused by an iron deficiency, is called anemia. This is the most common type of anemia, but it can also be caused by a genetic inheritance; pregnancy; blood loss; or an iron deficiency caused by a digestive condition, autoimmune condition, or a nutrient-devoid diet. Anemia can lead to excessive fatigue because your heart has to work extra hard to send oxygen to your cells, and an overworked heart and under-oxygenated cells are a perfect combination for low energy.

A blood test can easily show if you're anemic, and small shifts in diet can make a big difference. Plant-based foods like dark leafy green veggies, legumes, dried apricots, raisins, molasses, and fortified breads, cereals and pasta provide non-heme iron. Heme iron comes from animal sources (think oysters, red meat and dark meat poultry). A combination of both in the diet can be effective at replenishing iron stores, as can a food-based supplement.

Sleep apnea or other sleep disorders
Unsurprisingly, not getting enough sleep (or enough good quality sleep) can contribute to chronic fatigue. Aim to get at least eight hours of shut-eye each night. If you suspect you have a sleep disorder, like sleepwalking, night terrors or sleep apnea, you may wish to speak with a sleep professional affiliated with the American Sleep Association. An overnight stay in a facility may show you that you're awake more often than you think during the night, or that you're missing out on substantial restorative REM sleep.

Unstable blood sugar
You know that crash you experience after a carb-heavy lunch, the kind of crash that makes it tough to stay awake at your desk? If you're experiencing something similar frequently throughout the day, your blood sugar may be out of whack (and perhaps the culprit behind your sleepiness).

When blood sugar levels fall too low, energy supply to your tissues, especially the brain, is impaired. When blood sugar spikes too high, energy can be diverted to your pancreas and digestive tract to help address the influx of glucose, taking it away from other processes like mental function and muscle contraction. Aim for a balanced diet with ample fiber and protein that's also low in sugar and refined carbohydrates. Also reconsider the timing of your meals to find the best regulatory schedule for your body. You may also wish to do a fasting blood glucose test with a doctor to see if you're at risk for diabetes or hypoglycemia.

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