By Jillian Kubala, MS, RD and Franziska Spritzler — Medically reviewed by Maya Feller, MS, RD, CDN, Nutrition — Updated on December 9, 2021
If you’re feeling overly tired or have little energy, you’re not alone.
Fatigue may be caused by simple factors like a lack of sleep or coming down with a cold or the flu. However, it can also be caused by underlying health conditions.
Even though everyone feels tired from time to time, chronic fatigue can harm your quality of life and prevent you from doing things you enjoy.
In most cases, fatigue can be remedied by lifestyle or dietary modifications, correcting a nutrient deficiency, or treating an underlying medical condition. Still, to improve fatigue, you need to get to the bottom of what’s causing it.
Here are 12 potential reasons why you’re always tired.
Getting enough sleep is essential for overall health. Unfortunately, many of us don’t get enough, which may lead to fatigue.
During sleep, your body performs a number of critical processes, including releasing important growth hormones and repairing and regenerating cells. This is why most people wake up feeling refreshed, alert, and energized after a night of high quality sleep (1, 2, 3).
Importantly, sleep should be restful and uninterrupted to allow your brain to go through three stages of non-rapid eye movement (NREM) sleep and one stage of rapid eye movement (REM) sleep — the stage in which you dream (1).
Even though sleep time should be individualized, the American Academy of Sleep Medicine and Sleep Research Society recommends that adults get at least 7 hours of sleep per night for optimal health (2, 3).
Even though you may know the importance of getting enough sleep, falling and staying asleep can be a struggle.
Insomnia is a term for any condition that causes difficulty falling or staying asleep. It can be caused by several factors, including menopause, medical conditions, psychological stress, poor sleeping environments, and excessive mental stimulation (1, 4).
Insomnia is very common. In fact, one review noted that up to 40% of adults in the United States experience insomnia at some point in a given year (5).
Short-term insomnia, which lasts less than 3 months, is more common and affects 9.5% of the U.S. population. Yet, 1 in 5 cases of short-term insomnia turns into chronic insomnia, which occurs 3 or more times per week and lasts longer than 3 months (5).
If you’re experiencing insomnia, treatments like natural supplements, medications, and the management of underlying medical conditions may help. Visit your doctor to get the appropriate care and treatment.
SummaryInadequate or poor quality sleep is a common cause of fatigue. Stress, medical conditions, and poor sleeping environments may negatively affect sleep and trigger insomnia. If you’re experiencing insomnia, consult your doctor for advice.
Nutrient deficiencies may lead you to feel exhausted on a daily basis, even if you’re getting more than 7 hours of sleep.
Deficiencies in the following nutrients have been linked to fatigue (6, 7):
Deficiencies in many of these nutrients are quite common.
Anemia affects 25% of the world’s population. Iron deficiency anemia is the most common type, responsible for 50% of all anemia. Fatigue is one of the most common symptoms of this condition, but it typically improves once iron stores are restored (8).
Furthermore, studies suggest that up to 20% of people in the United States and United Kingdom ages 60 and over are deficient in vitamin B12. This deficiency is especially common in older adults because the body’s ability to absorb B12 declines with age (9).
B12 is critical for oxygen delivery and energy production, so low levels can cause extreme fatigue.
Additionally, a vitamin D deficiency may cause fatigue. Over half of the world’s population has inadequate vitamin D levels (10).
Because these deficiencies are quite common, it’s important to have your levels tested if you’re experiencing unexplained fatigue.
Typically, fatigue related to a deficiency in one or more nutrients improves once your nutrient levels normalize.
SummaryDeficiencies in certain nutrients — such as iron and vitamins B12 and D — may cause fatigue. Your doctor can test for nutrient deficiencies and suggest appropriate treatment.
Although some stress is normal, chronic stress is linked to fatigue (11, 12, 13).
In fact, chronic stress may lead to stress-related exhaustion disorder (ED), a medical condition characterized by psychological and physical symptoms of exhaustion (14).
Furthermore, chronic stress may cause structural and functional changes in your brain and lead to chronic inflammation, which may contribute to symptoms like fatigue (14, 15).
While you may be unable to avoid stressful situations, especially those related to work or family obligations, managing your stress may help prevent complete exhaustion.
For example, you can set aside time to decompress by taking a bath, meditating, or going for a walk (16).
A therapist may also help you develop strategies to reduce stress. Many health insurance plans cover mental health counseling, and virtual therapy is also an option.
SummaryExcessive stress may cause fatigue and reduce your quality of life. Prioritizing time for yourself and going to therapy may help you manage stress.
If you’re experiencing unexplained, chronic fatigue, you should visit your doctor and discuss your symptoms.
They may recommend testing to rule out certain health conditions that cause fatigue, such as sleep apnea, hypothyroidism, cancer, chronic fatigue syndrome, multiple sclerosis, anxiety disorders, kidney disease, depression, diabetes, and fibromyalgia (17, 18, 19).
It’s important to know that it’s abnormal to feel exhausted all the time. If you experience frequent fatigue, there’s likely one or more causes.
Getting proper treatment for an underlying medical condition can help you feel better and improve other areas of health as well.
SummaryNumerous medical conditions are linked to fatigue. If you’re chronically tired, it’s important to visit your healthcare professional to undergo appropriate testing.
Your diet significantly affects the way you feel.
To maintain energy and get the nutrients your body needs to perform critical processes, it’s important to consume a balanced diet high in nutrient-dense foods.
Undereating — or eating ultra-processed foods low in essential nutrients — may lead to calorie and nutrient deficiencies, which can cause exhaustion.
When you don’t obtain enough calories and nutrients like protein, your body starts breaking down fat and muscle to meet energy demands.
This leads to a loss of body fat and muscle mass, which may trigger fatigue (20).
Older adults are especially at risk of malnutrition and nutrient deficiencies due to factors like age-related changes in appetite and reductions in physical activity (20).
Additionally, diets high in ultra-processed foods impair energy levels. For example, a diet high in added sugar may harm sleep and lead to chronically high blood sugar and insulin levels, which can result in fatigue (20).
In a 28-day study in 82 people, a diet high in refined sugars and highly processed grains resulted in 38% and 26% higher scores for depressive symptoms and fatigue, respectively, than a low glycemic load diet high in whole grains and legumes but low in added sugar (21).
What’s more, a review including over 53,000 postmenopausal women associated diets high in added sugars and refined grains with a greater risk of insomnia — and diets high in fruits, vegetables, and whole grains with a lower risk of insomnia (22).
Following a diet low in ultra-processed food and added sugar but rich in nutrient-dense foods like fruits, veggies, legumes, and protein sources like fish and eggs may help reduce fatigue and support healthy sleep while providing your body with optimal nutrition.
SummaryA diet high in ultra-processed foods may hamper your energy levels, so transitioning to a nutrient-dense diet loaded with whole, nourishing foods like fruits, vegetables, and legumes may reduce fatigue.
Although caffeinated beverages like coffee and energy drinks give you a temporary boost of energy, over-reliance on them may make you more tired the next day. That’s because too much caffeine can harm sleep, which may cause fatigue.
Research shows that feeling tired in the morning leads people to consume large amounts of caffeine, which impairs your sleep cycle. In turn, you may overuse coffee or other caffeinated drinks for energy, which continues the cycle of poor sleep followed by too much caffeine (23).
Drinking too much caffeine is linked to increased nighttime worrying, sleeplessness, increased nighttime awakenings, decreased total sleep time, and daytime sleepiness (24).
A study in 462 women linked high calorie coffee and energy drink intake to poor sleep quality and sleep disturbance. Those who didn’t drink these beverages reported better sleep quality (25).
Still, caffeine tolerance varies, and some people are more sensitive to caffeine’s effects on sleep than others (26).
While coffee and caffeinated beverages like green tea may benefit health when consumed in moderation, energy drinks are extremely high in stimulants and added sugar. Thus, you should avoid them whenever possible (27).
If you’re currently experiencing sleep issues and frequently drink caffeinated beverages, try cutting back to see whether it helps improve your sleep and energy levels.
SummaryRelying too heavily on caffeinated beverages may harm your sleep cycle and lead to fatigue.
Therefore, cutting back on caffeine may help restore your sleep and energy levels.
Staying well hydrated is important for maintaining energy levels. The many biochemical reactions that take place in your body every day result in a loss of water that needs to be replaced.
Dehydration occurs when you don’t drink enough liquid to replace the water lost in your urine, stools, sweat, and breath. Several studies show that being dehydrated leads to lower energy levels and a decreased ability to concentrate (28, 29).
In fact, dehydration affects your entire body, including your sleep cycles.
A study in over 26,000 Chinese and American adults associated inadequate hydration with shorter sleep times (30).
Being dehydrated may also make you feel more fatigued during exercise and negatively affect exercise endurance (31).
Although you may have heard that you should drink eight, 8-ounce (240-mL) glasses of water daily, hydration needs depend on several factors, including your weight, age, sex, and activity levels.
The key is drinking enough to maintain good hydration. Common symptoms of dehydration include thirst, fatigue, dizziness, and headaches (28).
SummaryEven mild dehydration may reduce energy levels and alertness. Make sure to drink enough to replace fluids lost during the day.
Maintaining a healthy body weight is essential to overall health.
Not only is obesity significantly linked to a greater risk of many chronic illnesses like type 2 diabetes, heart disease, and certain cancers, but it may also increase your risk of chronic fatigue (32).
Obesity greatly increases your risk of obstructive sleep apnea, which is a common cause of daytime fatigue. It’s also linked to increased daytime sleepiness regardless of sleep apnea, suggesting that obesity directly affects the sleep cycle (33, 34, 35, 36).
What’s more, people with obesity have a higher risk of conditions associated with fatigue, including depression and type 2 diabetes (37, 38, 39).
Plus, poor sleep quality and sleep restriction may cause weight gain or obesity (40).
Maintaining a healthy body weight may support good sleep and energy levels, while getting high quality sleep may help prevent weight gain and reduce fatigue.
SummaryObesity has been linked to poor sleep quality and conditions associated with fatigue like obstructive sleep apnea.
Many other conditions may lead to tiredness. It’s important to understand that several factors may be contributing to your exhaustion.
Here are a few other common reasons why you may feel tired:
If you need help overcoming your addiction contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357).
It may be difficult or impossible to identify the factor(s) behind your fatigue on your own, which is why it’s important to work with a doctor you trust. They can help you find the cause and suggest possible treatments.
SummaryMedications, drug or alcohol dependence, a sedentary lifestyle, and shift work may all contribute to fatigue.
Even though everyone has days when they feel exhausted, constantly feeling run down and tired isn’t normal.
Many possible factors cause chronic fatigue, such as underlying medical conditions, nutrient deficiencies, sleep disturbances, caffeine intake, and chronic stress.
If you’re experiencing unexplained fatigue, it’s important to talk with your doctor to find the cause.
In many cases, your fatigue should improve once you identify the underlying cause(s) and make appropriate lifestyle and dietary adjustments — or get the right treatment for medical conditions.
For more sleep support, check out our sleep shop.
Try this today: When I started to feel extremely tired during the day, I knew that something was off. I ended up being diagnosed with Hashimoto’s disease after many months of visiting different doctors.
You know your body best and know when something isn’t right. If you’re feeling chronically exhausted even when you get adequate rest, there may be a medical condition contributing to your fatigue.
Work with a doctor you trust to get the right testing to rule out common health conditions that may be contributing to your fatigue.
Read this article in Spanish
Feeling exhausted is so common that it has its own acronym, TATT, which stands for "tired all the time".
We all feel tired from time to time. The reasons are usually obvious and include:
But tiredness or exhaustion that goes on for a long time is not normal. It can affect your ability to get on and enjoy your life.
Unexplained tiredness is one of the most common reasons for people to see their GP.
Before you see a GP, you may want to work out how you became tired in the first place.
It can be helpful to think about:
A GP will look at the following causes of tiredness:
Psychological causes of tiredness are much more common than physical causes.
Most psychological causes lead to poor sleep or insomnia, both of which cause daytime tiredness.
Psychological causes include:
The strains of daily life can worry most of us at some point.
It's also worth remembering that even positive events, such as moving house or getting married, can cause stress.
Read more about how to deal with stress.
A bereavement, redundancy or a relationship break-up can make you feel tired and exhausted.
If you feel sad, low and lacking in energy, and you also wake up tired, you may have depression.
Check how to tell if you have depression. See your GP if you think you are depressed.
If you have constant uncontrollable feelings of anxiety, you may have what doctors call generalised anxiety disorder (GAD) in adults.
As well as feeling worried and irritable, people with GAD often feel tired. See a GP, as medication and talking therapies can help.
If you think your tiredness may be a result of low mood or anxiety, try this short audio guide to dealing with your sleep problems.
In this audio guide, a doctor explains what you can do to give yourself the best chance of a good night's sleep.
Media last reviewed: 2 March 2021
Media review due: 2 March 2024
There are several health conditions that can make you feel tired or exhausted.
These include:
Tiredness can also be the result of:
If you have been feeling constantly tired for more than 4 weeks, it's a good idea to see your GP so they can confirm or rule out a medical condition that could be causing your tiredness.
In today's 24/7 "always on" world, we often try to cram too much into our daily lives.
And to try to stay on top of things, we sometimes consume too much alcohol or caffeine, or eat sugary and high-fat snacks on the go rather than sitting down for a proper meal.
The main lifestyle causes of tiredness include:
Drinking too much interferes with the quality of your sleep. Stick to the guidelines of no more than 14 units a week for both men and women.
Read more about tips on cutting down on alcohol.
Too much or too little exercise can affect how tired you feel.
Read more about the benefits of exercise.
Too much of this stimulant, found in tea, coffee, colas and energy drinks, can upset sleep and make you feel wound-up as well as tired.
Try decaffeinated tea and coffee, or gradually cut out caffeine altogether.
Night workers often find they get tired more easily. This is more likely if the timing of the shifts keeps changing.
If you're tired, you may nap during the day, which can make it more difficult to get a good night's sleep.
Page last reviewed: 25 March 2021
Next review due: 25 March 2024
Tired all the time is so common that in English it has its own abbreviation - TATT (tired all the time).
From time to time we all feel tired and exhausted. The causes of these conditions are usually obvious - lack of sleep, a busy work schedule, or raising small children who often wake up at night.
But if you feel tired all the time and cannot find objective reasons for it, this is no longer normal and a reason to seek medical help.
Constant breakdown has a serious negative impact on your ability to enjoy life.
Unexplained fatigue is one of the most common reasons people visit general practitioners (GPs).
Before you go to see a doctor, try to analyze your fatigue. Maybe you are especially exhausted by work or home life? Have there been events in the recent past that affect your well-being, such as the loss of a loved one or the breakup of a relationship that is important to you? Maybe you changed jobs or started sleeping less? Try to understand the possible source of fatigue so you can share it with your doctor. During the consultation, the doctor will ask you questions about the psychological and physical causes that may affect your condition.
Psychological causes of fatigue
Most often, fatigue is caused by the psychological aspects of your life. Many psychological problems lead to insomnia or restless sleep, which leads to fatigue during the day. The most common problem is stress , and it can arise both from negative events (conflicts with loved ones, problems at work) and from positive changes (wedding, moving, childbirth).
Fatigue may appear as a consequence of emotional shock from loss, dismissal or rupture of relations with a loved one.
If you often feel sad and lack energy and wake up tired in the morning, this may indicate depression .
Persistent, uncontrollable anxiety for any reason could mean that you have generalized anxiety disorder. In addition to constant worries and irritation, people with GAD often feel tired.
If you suspect that you have one of the conditions described above, do not delay visiting a doctor - all of these syndromes respond well to treatment with psychotherapy, lifestyle changes and medications.
Physical causes of fatigue
There are several diseases that can be symptomatic of unexplained fatigue:
- anemia (lack of hemoglobin)
- underactive thyroid
- sleep apnea (disturbed breathing during sleep)
Fatigue can also be caused by:
- pregnancy - especially in the first 12 weeks
- being overweight or obese - your body needs to expend more energy performing daily tasks
- being underweight - muscle weakness can make you tired more quickly
- cancer treatment - chemotherapy or radiation therapy
- carbon monoxide poisoning - especially if your home boiler has not been regularly checked
- side effects from certain drugs or supplements
lifestyle as a cause of fatigue
In the realities of today's world, we are often constantly busy We are trying to do everything at once.
Because of this, we often drink a lot of alcohol and caffeine and eat malnourished meals on the run instead of taking the time to prepare and eat healthy meals.
Here are the main lifestyle causes of fatigue:
- alcohol - drinking too much alcohol disrupts the quality of our sleep
- physical exercise - both too little and too much of it
- too much caffeine
- irregular work schedule (for example, night shift work)- daytime sleep that interferes with normal night sleep
If you have been suffering from constant fatigue for more than a month, you need to urgently see a doctor to understand that is the cause of this condition. Our Russian-speaking therapists will be happy to receive you at a convenient time for you, or go for a home visit. Call us on 0203 808 3629.
Anton Shishenok / hromadske
One day you may notice that you are constantly "out of stock".
No matter how much you sleep, you cannot get enough sleep, and any activity takes a lot of energy. It is likely that you have chronic fatigue syndrome. The World Health Organization estimates that up to 30.5% of the population suffers from it. Our partners from Zaborona talk about the disease, its causes and possible treatment.
1
This is a complex illness characterized by extreme fatigue lasting at least six months. Another important condition for making a diagnosis is that the doctor must rule out other causes of your fatigue. This fatigue can be exacerbated by mental or physical activity and often persists even after rest.
This condition is also called myalgic encephalomyelitis (ME). The last proposed term is systemic exercise intolerance disease.
2
Diagnosis can only be made by a neurologist or psychiatrist.
There are no studies or tests that can fully confirm that you have chronic fatigue syndrome. As we said, other possible causes must be ruled out - for example, mononucleosis, Lyme disease, multiple sclerosis, major depressive disorder, severe obesity, sleep disorders, and the like. This will require medical research.
The symptoms of chronic fatigue syndrome can vary from person to person, and their severity can change from day to day. Here are the most characteristic of them:
3
Specific causes have not yet been established, but there are several theories regarding this, ranging from viral infections to severe or chronic stress.
Some believe that the syndrome is caused by a combination of factors.
Viral infections. Researchers have noticed that some people develop chronic fatigue syndrome after a viral infection. A logical question arose: could certain viruses cause this disorder? Investigated "suspicious" viruses, after which CFS was observed most often: Epstein-Barr virus, human herpes virus and the like. No convincing relationship has yet been found.
Problems with the immune system. The immune system of people with chronic fatigue syndrome is slightly weakened. But it is not yet clear whether this is one of the symptoms of the disease or one of its likely causes.
Hormonal imbalance. Sometimes clinical tests of people with chronic fatigue syndrome show abnormal levels of hormones in the blood that are produced by the hypothalamus, pituitary gland, or glands. But the significance of these anomalies is also still unknown.
Physical or emotional injury.
Some people report experiencing trauma, surgery, or significant emotional distress shortly before the onset of symptoms.
Factors that may increase the risk of chronic fatigue syndrome include:
Age. Chronic fatigue syndrome can occur at any age, but is most common in people between 40 and 50 years of age.
Pos. Women are much more likely to be diagnosed with chronic fatigue syndrome than men, but women may simply be more likely to report their symptoms to their doctor.
Side effects of some medications, such as antihistamines and alcohol-based drugs, can also mimic the symptoms of CFS.
4
Firstly, chronic fatigue syndrome differs from simple fatigue (even if very strong) in that it does not go away after rest. That is, no matter what you do, no matter how much you sleep, no matter how long vacation you take at work, CFS will not go anywhere.
Another important clarification: long life with chronic fatigue syndrome can lead to other problems. For example, a person may worsen social ties, have problems at work or place of study. Against the background of all this and the very condition in which a person with CFS is located, serious depression can develop.
5
There is currently no cure for this disease. But its symptoms can be alleviated. Most likely, you will need complex treatment - be sure to coordinate its plan with your doctor.
The first thing to take care of is lifestyle changes . You will need to find your own, individual balance of mental and physical activity, plan these actions, and then relax in order to stay in the resource. Some doctors refer to being within this framework as an "energy sheath." Keeping an activity diary can help you find that balance.
Limiting or eliminating caffeine intake can help you sleep better and relieve insomnia.
You should also limit or avoid nicotine and alcohol. Try not to sleep during the day if it prevents you from sleeping at night. In general, create a sleep schedule: go to bed at the same time every night and try to wake up around the same time.
As we have already mentioned, there is no cure for chronic fatigue syndrome. But if CFS develops into an anxiety disorder, depression, or other severe conditions, they will come in handy. You may need low-dose antidepressant therapy or referral to a psychiatrist.
If lifestyle changes are preventing you from getting a good night's sleep, your doctor may recommend sleeping pills. And pain relievers can help manage joint pain caused by CFS.
There are a number of tips to help alleviate chronic fatigue syndrome. They are also useful in the case when you are just very tired at work or school.
Keep a diet. Be sure to include "anti-inflammatory" foods like fish and olive oil in your diet. Try to consume as little sugar and fried foods as possible.
