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What is Fatigue?

Fatigue is a persistent feeling of extreme tiredness or exhaustion that makes it difficult for you to get out of bed in the morning and make it through the day to fulfill work tasks and personal obligations. 

Severe fatigue is different from the temporary tiredness you experience after a long day at work or too much exercise, which is relieved by rest and sleep. 

Fatigue symptoms can manifest as tiredness or physical exhaustion, weakness, decreased activity, low energy, needing extra effort to do physical tasks, decreased physical endurance, slowness, sluggishness, heaviness, sleepiness, and nonrestorative sleep. It can also manifest as decreased brain function, causing problems with thinking and memory.

Many different things, including lifestyle habits and acute and chronic health conditions, can make you feel tired all the time. You may be able to stop feeling tired by making lifestyle changes or getting treatment for an underlying health condition that is causing your fatigue.

Medical Conditions Linked to Fatigue

Chronic Fatigue Syndrome or Myalgic Encephalomyelitis

Myalgic encephalomyelitis, also called chronic fatigue syndrome (CFS), is a condition in which there is extreme fatigue lasting six months or longer due to unknown causes. A diagnosis of CFS is made when blood tests, urine tests, and other diagnostic tools don’t reveal any other apparent causes for severe fatigue. Symptoms of CFS don’t typically improve with sleep and rest and may include:

• Extreme exhaustion following any type of mental or physical activity.

• Trouble with thinking and memory.

• Muscle pain and joint pain.

• Dizziness that is worse when going from a sitting or lying position to standing.

Other symptoms may include sore throat, headaches, and swollen lymph nodes. Some people with chronic fatigue syndrome have increased sensitivity to stimuli (lights, sounds, and smells), medications, or foods.

Obstructive Sleep Apnea and Other Sleep Disorders

Obstructive sleep apnea (OSA) is a sleep-related breathing condition in which there are repeated episodes of stopped breathing during sleep due to blocking of the airway. Symptoms of OSA include waking up, gasping during the night, loud snoring, dry mouth, sore throat, morning headaches, daytime sleepiness, and fatigue.

Other common sleep disorders that can cause fatigue due to disrupted sleep and sleep deprivation include: 

• Insomnia: a common condition in which there is trouble falling asleep or trouble sleeping through the night, leading to daytime fatigue.

• Shift work sleep disorder: where changes in sleep schedule disrupt sleep and the body’s natural circadian rhythm or wake-sleep cycle.

• Narcolepsy: a sleep disorder that causes you to fall asleep suddenly during the daytime hours.

Anemia

Anemia is a condition in which there isn’t enough hemoglobin, a protein in red blood cells, that transports oxygen and delivers it to tissues throughout the body. A common cause is iron deficiency. Fatigue is a common symptom of anemia. Other symptoms include weakness, dizziness, headaches, pale skin, cold hands and feet, irregular heartbeat, and shortness of breath.

Hypothyroidism

Hypothyroidism, also called underactive thyroid, is a condition in which the thyroid gland doesn’t make enough thyroid hormone. Symptoms of hypothyroidism include feeling fatigued, muscle weakness, muscle aches, muscle stiffness, increased sensitivity to cold, dry skin, constipation, weight gain, slowed heart rate, memory problems, and depression.

Read next: “What Does Hypothyroid Brain Fog Feel Like?”

Diabetes

Fatigue symptoms are common in people with high blood sugar levels due to both type 1 and type 2 diabetes mellitus. People with diabetes often continue to feel tired even after their blood glucose levels are under control. Experts believe diabetes and fatigue have a two-way relationship where one worsens the other and vice versa. Some of the causes of fatigue in people with diabetes include lack of exercise, poor sleep habits, excessive caloric intake, variations in blood glucose levels, repeated episodes of hypoglycemia (low blood sugar), and complications of diabetes such as kidney disease. 

Poorly controlled diabetes can lead to chronic kidney disease (CKD), which can cause chronic fatigue due to electrolyte imbalances and excess fluid. Not to mention, CKD patients often have anemia as their kidneys are not adequately producing a hormone needed for red blood cell production. 

Gastrointestinal Conditions

A food allergy or celiac disease can cause fatigue due to poor absorption of nutrients that are necessary for energy metabolism.

Heart Disease

Constant fatigue may be a symptom of heart failure, a condition in which the heart is unable to pump blood effectively. Less commonly, fatigue can be a symptom of coronary heart disease.

Depression and Anxiety

People with depression and anxiety disorders often report fatigue. Also, chronic fatigue can lead to depression and anxiety. Because of this bidirectional relationship, the cycle can be hard to break. Doctors who treat patients with depression report that fatigue is one of the most common presenting symptoms and also one of the symptoms that tend to linger after treatment with antidepressant drugs. 

Medication Side Effects

Certain over-the-counter and prescription medications can cause fatigue and weakness as side effects. These fatigue symptoms are usually temporary and go away once your body adjusts to the medicine. The fatigue also resolves when you stop treatment with the medication. Examples of medications that can cause fatigue and weakness include anti-anxiety and antidepressant medicines, allergy medicines, blood pressure medications, cholesterol-lowering drugs, GERD medicines, muscle relaxants, antibiotics, and others.

Lifestyle Factors Contributing to Fatigue

How Much Sleep Should You Be Getting? 

The recommended amount for adults (age 18 and older) is 7 or more hours of sleep per night. As mentioned, the quality of sleep is as important as the quantity.

Poor Sleep Quality and Quantity

Not getting enough sleep or having disrupted sleep can lead to both mental and physical fatigue. In fact, feeling extremely tired during the daytime hours is a hallmark symptom of sleep deprivation. In other words, getting enough high quality sleep every night is essential to feeling rested during the day. Many things can affect sleep quality and quantity, such as distractions from electronics or too much caffeine. 

The terms sleepiness and fatigue are sometimes used interchangeably, but they are different. Sleepiness is a strong desire to fall asleep. It is relieved by sleeping. Fatigue is tiredness and lack of energy that makes it difficult to complete daily tasks. It is not relieved by sleeping. Lack of sleep can cause both sleepiness and fatigue.

Unhealthy Diet

An unhealthy diet consists of fried, fatty, and low-fiber foods that are hard to digest. It can affect your body’s ability to derive energy from food, leaving you feeling tired all the time.

In contrast, a healthy diet can help you feel energetic and lessen the effects of fatigue from other causes. Fresh fruits and vegetables, whole grains, lean meats and plant-based proteins, and healthy fats are components of a balanced diet that can give you maximum nutrition and energy. Eating iron rich foods can help prevent anemia, which is a common cause of fatigue.

Learn more: “Feeling Tired After Eating? Learn Why It Happens.”

Dehydration

Dehydration is not having enough fluids in your body. This can make it hard for cells in your body to function properly. As a result, dehydration can make you feel tired and cause other symptoms, such as dizziness and headaches. Drinking enough water is essential not only for more energy but also to prevent serious health complications such as heat exhaustion. 

Remember that the recommended daily fluid intake may vary among people, especially those with certain health conditions such as heart failure, liver problems, or kidney disease. If you have any of these health conditions or stay on fluid restrictions, talk to your healthcare providers to determine how much fluid you should consume daily. 

Lack of Exercise

People with fatigue due to an underlying medical condition often find it difficult to exercise. However, lack of exercise can cause further fatigue, low energy, excess weight, and deconditioning, which can make it harder to exercise as time goes on. That’s why it’s important to exercise regularly even if you have chronic fatigue. 

Excessive Caffeine or Alcohol Consumption

Caffeine is a stimulant that prevents you from feeling sleepy. Consumption of excessive caffeine, especially in the second half of the day, can lead to poor sleep, which in turn, can lead to daytime fatigue. 

Alcohol has sedative effects and makes you feel drowsy. However, drinking alcohol can disrupt sleep and cause nighttime awakenings. Alcohol can also contribute to sleep apnea. Disrupted sleep can lead to daytime fatigue and lethargy after a night of drinking.

How to Combat Tiredness and Fatigue

Natural Treatments For Tiredness or Fatigue

• Get enough high-quality sleep (7-9 hours of sleep per night is recommended for most adults). High-quality sleep typically means falling asleep within 30 minutes of getting into bed and staying asleep all through the night. If you do wake up during the night, you are likely to fall back asleep within 20 minutes. High-quality sleep will result in you feeling well-rested. 

• Eat a healthy, balanced diet.

• Stay well hydrated.

• Get regular exercise and maintain a healthy weight. Make lifestyle changes to lose weight if you are overweight or obese.

• Avoid excessive caffeine and alcohol intake.

• Manage stress levels to keep your energy levels up.

Tips For Better Sleep And Reducing Fatigue

• Create an environment in your bedroom that promotes restful sleep. This includes: 

  • Blocking out light 

  • Minimizing noise

  • Ensuring a comfortable room temperature between 65 and 68 degrees Fahrenheit

  • Removing electronic distractions. (Tip: Set a sleep timer on your TV so you don’t fall asleep with it on, and implement phone-free time before bed.)

• Maintain a regular sleep schedule. Go to bed and get up at the same time every day, including weekends and holidays.

• Get at least 30 minutes of natural light exposure and 20-30 minutes of exercise every day. 

• Limit caffeine after 2 p.m. and limit alcohol intake in the 3-4 hours before bedtime.

• Avoid taking a daytime nap for more than 20 minutes.

• Eat your last meal of the day at least 2-3 hours before bedtime.

• Keep a sleep diary to identify unhealthy sleep patterns that may be contributing to your feeling tired all the time.

When Should I See My Doctor About Fatigue?

You should see your doctor about any fatigue that lingers for more than a few weeks or is severe enough to affect your ability to function and do your daily tasks. Your provider will obtain a medical history, perform a physical exam, and order tests to find out the underlying cause of your fatigue. Many chronic illnesses can cause tiredness, and treating these conditions may provide relief from fatigue symptoms. For example, a blood test may reveal an underactive thyroid, and taking thyroid hormone supplements may relieve fatigue.

Find out “The Best Medications to Fight Fatigue.”

FAQs About Fatigue

Why Am I So Tired And Have No Energy?

You may be tired and have no energy due to lifestyle factors such as not getting enough sleep or being dehydrated. Or you may have an underlying health condition that is causing you to feel tired all the time. Talk to your doctor if you have low energy or fatigue lasting more than a couple of weeks with no obvious cause.

Why Am I So Tired Even When I Sleep Enough?

Certain health conditions can leave you feeling tired and run down even when you sleep enough. Common causes include mental health conditions such as depression and anxiety, as well as medical conditions such as anemia, hypothyroidism, and chronic diseases like diabetes and heart disease.

What Is Being Very Tired A Symptom Of?

Being very tired can be a symptom of acute illnesses such as the flu or COVID-19. It can also be a symptom of chronic diseases such as thyroid disorders, heart disease, diabetes, kidney disease, rheumatoid arthritis, multiple sclerosis, and cancer. Unrelenting fatigue and low energy levels can also be due to lifestyle factors such as lack of exercise, dehydration, or not getting enough sleep (if you stay awake several nights in a row, for example, the fatigue from sleep deprivation can be persistent).

Why Do I Feel So Sleepy Even After Sleeping 8 Hours?

You may feel sleepy even after sleeping 8 hours because of poor quality sleep, for example, due to frequent nighttime awakenings or difficulty falling back asleep after waking up during the night. If your sleepiness continues, your primary care doctor may refer you to a sleep specialist who can diagnose common sleep disorders that can cause unrestful sleep.