In today’s fast paced and competitive times, one cannot afford to become tired or laidback. Yet, chronic tiredness and fatigue is deterring more and more people from doing their best at work and at home. Find out why…

A lot of patients I meet, mostly women, complain of lacking energy and feeling tired all the time. These are not lazy women who are making excuses. There are plenty of medical and psychological conditions which can leave you feeling too tired to get out of bed, or focus on even the most menial mental tasks. Chronic fatigue can also lead to headaches, restlessness, irritability, muscle aches, food cravings and poor judgement.
Any severe illness, pregnancy, surgery or chemotherapy can cause extreme tiredness. However, when fatigue persists for more than a few months with no apparent explanation, one must consult a physician who will try to rule out underlying physical, emotional or nervous system disorders. These include –

1. Anemia – This is fairly common among menstruating women, especially those who are vegan or have had multiple childbirths or illnesses. Anemia can be diagnosed by a blood test which confirms “low haemoglobin”. This condition can make you look pale, feel tired, lose hair and go out of breath very quickly. Iron supplementation can help in regaining physical strength and stamina.

2. A sluggish Thyroid gland – This condition is also more common among women. The symptoms are vague and the illness may go undiagnosed for months or years. Hypothyroidism can cause tiredness, sluggishness, weight gain, irregular cycles, dry skin, hair fall, brittle nails, hoarseness of voice, low appetite, constipation, irregular cycles and other symptoms which most women tend to ignore. Every patient may not experience every symptom. Exercise, weight loss and medication can help in correcting some of these symptoms, including the feeling of constant fatigue.

3. Diabetes – High blood sugar can cause excessive hunger, thirst, urination, fatigue and weight loss. Diabetes medication can sometimes cause the blood sugar to go plummeting very low. This can also cause tiredness and dizziness. Exercise, medication, diet control, and having meals at regular intervals can help in controlling and managing the symptoms.

4. Sleep Apnoea – This is a condition when your nasal and throat passages constrict during sleep. People with sleep apnoea will stop breathing several times during their sleep. This leads to snoring, disturbed sleeping and frequent awakening. This condition is more common in overweight middle-aged men. Patients wake up feeling tired and not rested. Alcohol and caffeine intake worsens the condition.

5. Glandular Fever – This is a viral infection which generally affects children and young adults. Symptoms include fever, sore throat, fatigue, rash and swollen glands in the neck and armpit. There is no medication and the body generally recovers on its own in a few weeks. The fatigue may last for 2-3 months in some cases. In some unfortunate people, it may trigger the poorly understood and ill-defined condition known as ‘Chronic Fatigue Syndrome’.

6. Anxiety and Depression – It is said that fatigue is often caused not by work, but by worry, frustration and resentment. One of the many manifestations of depression and anxiety is the overwhelming feeling of tiredness, and an inability to get out of bed and face the world. One lacks motivation to work and loses interest in activities which were once a source of pleasure. Depressed patients often suffer from insomnia. They sleep very late and very poorly. And they wake up very early, feeling tired and yet unable to go back to sleep. Fatigue is a symptom of several mental health disorders like schizophrenia and post partum depression.

7. Restless Leg Syndrome –People with this condition have an irresistible urge to move their legs during night, usually at sleep. The symptoms have been described as a dull ache, or cramps, or pins-and-needles sensation in the legs. This condition can be triggered by certain illness like Parkinson’s disease. Or by certain medications like antipsychotic drugs. The symptoms can disrupt sleep and lead to tiredness and fatigue. Treatment includes avoiding stimulants like coffee, avoiding alcohol, exercise, leg massages and a regular sleep schedule. Medications are only prescribed in severe cases.

8. Food Intolerance – Most of us are aware that food intolerance can cause stomach cramps, indigestion, bloating, diarrhoea and skin rashes. But food intolerance can also cause fatigue, depression, migraine and aches and pains in the muscles and joints. Caffeine, gluten and dairy products are known culprits. Gluten is a protein found in wheat, oats and barley. While gluten and dairy products are highly nutritious, they are also addictive and are known to create cravings and mood swings. On the other hand, when one is allergic to a major food group like gluten or dairy, then complete elimination of these food groups from the diet can lead to malnutrition, which is also responsible for fatigue.

9. Chronic Fatigue Syndrome (CFS) – It is said that 200,000 people in UK suffer from Chronic Fatigue Syndrome. And yet, this condition often goes undiagnosed and is poorly understood, even by the medical community.
Chronic Fatigue syndrome is also known as Myalgic Encephalomyelitis (ME) or Systemic Exertion Intolerance Disease (SEID).
This condition can be triggered by stressful events or by viral infections like glandular fever. It can also be linked to hormonal imbalances originating from the hypothalamus, pituitary gland, thyroid gland or the adrenals. There might even be a genetic component, as the condition is more common in some families.
It is more likely to affect women in the 20-40 age group. In order to be diagnosed with CFS, you must have unexplained, persistent fatigue for six months or more, along with at least four of the following diagnostic criteria –

(i) Loss of memory or concentration
(ii) Sore Throat
(iii) Enlarged lymph nodes in the neck or pit
(iv) Unexplained muscle pains
(v) Pain that moves from one joint to the other without redness or swelling
(vi) Headaches
(vii) Unrefreshing sleep
(viii) Extreme exhaustion lasting more than 24 hours after physical or mental exercise, which is not relieved by rest.

There may be other symptoms like a foggy mind, dizziness, balance problems, irritable bowel, mood swings, panic attacks and blurred vision.
CFS can significantly impair your ability to work, study, attend to your household chores and participate in sports and leisure activity. This in turn can lead to depression and low self-esteem. Severity may vary from person to person. Severe illness can be nearly debilitating. Doctors and family members often treat the patient with cynicism and may label them as hypochondriacs. There is no test to cinch the diagnosis; which means the doctor should be empathetic and have a high index of suspicion to correctly diagnose this disorder.
There is no treatment for CFS. Medications are aimed at managing the symptoms. Rest alone, is not helpful. Patients are asked to avoid alcohol, tobacco and caffeine. They need to exercise to keep muscle aches away, but it is necessary that they pace themselves, and take it easy, even on “good days”. Antidepressants and sleep medications can be helpful in controlling the symptoms. Psychological counselling maybe needed to deal with mental fatigue and cope with the setbacks at work and home. There is hope for complete recovery, especially among younger patients with mild symptoms.

Medical fatigue is much more than having the occasional tiring day. Do not try to diagnose yourself. If rest, meditation, good sleep and a balanced diet do not help improve your energy levels, then contact a physician for the right diagnosis.