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Why Am I Always Tired?

Thomas J. Boud, MD - November 20, 2012

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Many people feel exhaustion creeping up on them during the holiday season, but it is possible to overcome the tide and find energy again.

Fatigue can tax just about every aspect of our lives. Short-term tiredness usually has a readily identifiable cause, and simple steps can be taken to correct this. But for some people, every day is like climbing another mountain. Finding the cause of chronic exhaustion is much like doing detective work. I like to break the potential causes down into three general categories: lifestyle, physical, and emotional.  

Lifestyle. Often, a good look at our daily habits will help us determine why we are so tired. Most of us need seven to eight hours of sleep, and too little or too much rest can cause tiredness. Our bodies thrive on consistency, and an alternating work shift can lead to recurring weariness. Inactively sitting on the couch over time can weaken our muscles and heart and lead to lethargy. But even over-exercising can cause temporary languor (sorry, marathoners). Gluttony and obesity, as well as lack of nutrition, are also common reasons for feeling tired. 

All the chemicals we take—by prescription or on our own—can also lead to fatigue. Some common ones are antihistamines, blood pressure pills, heart medications, and even anti-anxiety/antidepressant pills. Caffeine is commonly used to counter fatigue and can help if used in modest doses. Unfortunately, high doses, as well as the sugar load that often accompanies it, can lead to a sensation of a crash and withdrawal. Tiredness, headaches, and irritability are common consequences of caffeine overuse. 

Physical. If the cause of your fatigue is not initially obvious, you should see a competent physician who can review a thorough personal and family history, do an exam, and possibly do some laboratory testing. Some simple labs can answer a lot of questions. A low blood count; mononucleosis or other infections; and liver, kidney, potassium, diabetes, and thyroid problems are some of the most common lab results. Diseases of the heart and lungs, as well as the possibility of cancer, are important not to miss. Sleep disorders such as restless leg syndrome or sleep apnea may be the culprit. Based on your age, most doctors will even consider low testosterone in men or waning female hormones as a potential cause. Even pregnancy can present as feeling drained of all energy, as it is extremely taxing on the physical body. Conditions such as chronic fatigue syndrome and fibromyalgia may also be at play.

Emotional. Let’s face it: life is stressful. We stretch ourselves to the limit, and there is a whole lot of emotion that comes with it. Finances, work, school, and home stresses can each take their toll in sapping our energy reserves. The grief from losing something or someone close to you can show up as feeling completely spent. Anxiety and depression are extremely common and often present with varying levels of fatigue. These are each treated in a variety of ways, and it helps to talk to someone competent in caring for them. 

It is very difficult to separate the connection between our spiritual health from these other symptoms. Spiritual issues that can lead to internal conflict are intimately connected with how we feel otherwise. If there is anything in this area that needs attention, I suggest it not be ignored. 

As we identify and take steps to correct those things we have some control over in our lives, we can work our way back to days filled with vitality. Seeing a doctor or a therapist if you think the problem lies in one of those areas is a good starting point, but all of us can focus on getting a good, consistent night’s rest, participating in regular exercise, and practicing proper nutrition to help us move through life with a little more energy. 

Now let’s get healthy!
—Dr. Boud

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Thomas J. Boud, MD, is board certified in family medicine and practices in the Salt Lake Valley. He is also a volunteer physician for the Church’s Missionary Medical Department and cares for the health care of many of the local full-time missionaries. He is an avid runner, having completed more than 60 full marathons. He is married to a very patient wife and has six beautiful children.

© LDS Living, November/December 2012.
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