By Phoebe Chi, MD, MPH
Do you always feel tired? Do you often have difficulty getting through the day because of lack of energy? Sometimes, being tired is expected and normal (for example, after an all-nighter, after a bout of the flu, or after a busy non-stop week). However, if you find yourself always feeling worn out despite adequate rest, to the point your tiredness negatively affects your quality of life, it’s time to do something about it.
In this post, I will discuss six common health conditions that can lead to chronic fatigue. While this is by no means an exhaustive guide, these are conditions that frequently affect people and (for the most part) are easily diagnosable and treatable. In a subsequent post, I will discuss practical ways in which you can effectively combat your fatigue…regardless of the cause.
Medical Causes of Fatigue
Many medical conditions, unsurprisingly, can cause you to feel tired. To give you an idea, the following is a non-comprehensive list of conditions that can lead to chronic fatigue:
Chronic fatigue syndrome
Chronic obstructive pulmonary disease
For this post, I have selected six common conditions that I feel are important for everyone to be aware of, especially if you do suffer from chronic fatigue. If you do think that you might have one or more of these conditions, I encourage you to have a honest discussion with your health care provider and to get a check up.
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Affecting millions of people worldwide, anemia is one of the most common blood conditions. It is a condition in which you don’t have enough red blood cells—either because you are losing blood (such as with heavy periods or stomach ulcers) or your body is not making enough (such as in the case of iron, folic acid, or vitamin B12 deficiency).
Especially for women in their childbearing years, anemia is a common hidden cause of fatigue. Furthermore, those who take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin are at higher risk for stomach irritation and ulcers that can also lead to anemia. If you think any of the characteristics listed below applies to you, I encourage you to talk to your doctor.
Consider getting checked for anemia if:
- You have heavy menstrual cycles or periods that last over a week
- You have uterine fibroids or polyps
- You take NSAIDs frequently (pain medications such as ibuprofen, aspirin, and naproxen)
- You find yourself craving the taste of dirt, clay, ice, or other non-nutrient substances (this is a condition called “pica” that often results from vitamin deficiency)
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Seasonal allergies, or “allergic rhinitis,” is one of the most common unsuspecting causes of chronic fatigue. Allergies can be triggered by pollen, dust mites, cockroaches, animal dander, molds and mildew, or even weather changes. A simple evaluation by a health care professional can determine whether you indeed have allergies as well as work with you to find the best solutions. If you do have allergies, the good news is that most cases are easily manageable with over-the-counter medications and some environmental precautions.
Other symptoms you might experience if you have allergies:
- Itchy or watery eyes
- Itchiness in general
- Sneezing or coughing
- Nasal congestion, runny nose, or post-nasal drip
- Wheezing or tendency to breathe through the mouth
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Depression or Anxiety
Both depression and anxiety are common causes of chronic fatigue that can keep you feeling tired even when you get enough sleep. While depression can be caused by many things, it can seem to come out of the blue after a pregnancy (postpartum depression) and can also hit unsuspecting people in the wintertime (seasonal affective disorder, or SAD).
Symptoms you might experience if you have depression:
- Frequent sadness
- Loss of interest in things you used to enjoy
- Constantly feeling weighed down
- Difficulty concentrating
- Feeling of hopelessness or worthlessness
- Feeling helpless
- Sleeping a lot, or trouble sleeping
- Changes in appetite
- Thoughts of death or dying
Anxiety symptoms may include:
- Feeling agitated or restless
- Difficulty sleeping
- Excessive worrying
- Feeling “on alert” a lot of the time
- Feeling of impending doom
While this article will not go into further details on mental health, if you feel like you may be depressed (or are just feeling really sad), please talk to someone you know or do it anonymously and confidentially through the free National Suicide Prevention Hotline:
National Suicide Prevention Hotline:
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Underactive Thyroid (Hypothyroidism)
The thyroid is a small, butterfly-shaped gland located at the front base of your neck. It helps set your metabolism (the rate at which your body uses energy). When you have an underactive thyroid, your metabolism slows down. This not only causes you to feel tired, but it can lead to many other symptoms and changes in your body. Incidentally, fatigue can also result from the opposite condition—hyperthyroidism—where you have too much thyroid. Fortunately, this condition is easy to test for with a simple blood test, so if you are experiencing the symptoms below, talk to your doctor about it.
Other signs and symptoms that can accompany an underactive thyroid:
- You feel cold frequently or cannot tolerate the cold
- Unexplained weight gain
- Frequent constipation
- Extremely heavy menstrual cycles
- Thinning hair
- Dry skin
- Joint pain, stiffness, or swelling
- Muscle weakness
- Puffiness in the face
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Obstructive sleep apnea is a condition that occurs when your airway become partially (and intermittently completely) blocked when you are sleeping, preventing you from getting enough air into your lungs. This results in low oxygen levels in the blood which end up affecting your health in many ways—one of which is chronic fatigue. When sleep apnea is left untreated, it can actually increase your risk of a stroke or heart attack.
Talk to your health care provider if any of the below characteristics apply to you or if you suspect you might have sleep apnea. If your doctor also thinks you might have this condition, he or she will conduct a sleep study to help diagnose it.
Consider getting checked for sleep apnea if the following applies to you:
- You snore a lot
- You have been told that you occasionally stop breathing for a few seconds during the night
- You always feel exhausted upon waking
- You are obese
- You smoke tobacco
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Fibromyalgia is a common cause of chronic fatigue and musculoskeletal pain, and it tends to affect women more than men. People with fibromyalgia often feel that no matter how long they sleep, they never feel rested, and as a result always feel tired during the daytime. Sometimes the fatigue can get so severe that it significantly gets in the way of their living a normal life. Some people with fibromyalgia walk around with a constant hazy, mental feeling that makes it difficult to even concentrate; this is often called the ‘fibro fog.’ There are ways to manage the symptoms of fibromyalgia, but the first step, if you suspect that you may have it, is to get evaluated by a health care professional.
Other symptoms you might experience with fibromyalgia:
- Deep muscle pain
- Painful tender points
- Morning stiffness
- Sleep problems
- Painful menstrual cramps
- Numbness and tingling in hands, arms, feet, and legs
- Symptoms of anxiety or depression
Now that you know some important information about these common health issues, stay tuned for my next post where I will discuss ways in which you can control and manage chronic fatigue.