If you often feel deep fatigue, you’re not alone, says Dr Sarah Jarvis, who rounds up the potential causes and best solutions for this all-too-common problem
One of the most regular complaints I receive from patients is tiredness. In fact, 5-7% of patients attending their GP have a primary complaint of fatigue. Of course, occasional tiredness is a normal part of life, but feeling continuously shattered can also be a sign of various underlying problems. Here are some potential causes – plus solutions.
PHYSICAL CAUSES
If a patient comes to me with tiredness, I always check blood tests first. There are many physical causes of tiredness, which tend to come on gradually. They include:
• Underactive thyroid. Tiredness will often go hand in hand with weight gain despite not eating more; feeling cold; dry skin; coarse hair; and constipation.
• Anaemia. In this case, a patient may also feel faint, become breathless easily or get palpitations, headaches or tinnitus.
• Type 2 diabetes. Other symptoms include thirst, needing to pass water more often and minor infections such as boils or thrush. Type 1 diabetes symptoms are similar but usually come on more rapidly and progress quickly to severe illness.
• Chronic kidney or liver disease, particularly if skin is itchy or yellowed.
• High calcium levels, usually as a result of overactive parathyroid glands. Other accompanying symptoms can include feeling or being sick, muscle spasms, palpitations, joint pain and confusion.
• Coeliac disease. Along with tiredness, weight loss, bloating, diarrhoea or constipation and mouth ulcers are likely.
• Heart failure. Symptoms also include shortness of breath on exercise or when lying flat, a persistent cough, palpitations and swollen ankles, legs or tummy.
If there’s a physical cause found, treatment for the underlying condition often improves the tiredness issue.
WHEN FATIGUE BECOMES CHRONIC
Chronic fatigue syndrome, now called ME, leads to exhaustion that isn’t made better by resting and that can be dramatically worsened by doing too much. With the arrival of long Covid, there has been more recognition of how ME often begins with a viral infection. There’s no single effective treatment for either ME or long Covid, and you should be referred for a care and support plan where possible – usually through your GP, although in some areas (eg parts of Wales), you can refer yourself. Pacing yourself – planning, prioritising and not overdoing it on days you have more energy – is advised with either condition.
WINTER BLUES
Feeling sluggish is more common at this time of year. Seasonal Affective Disorder (SAD) is a form of depression that tends to develop in autumn, peak
