One in four Americans complain of fatigue lasting longer than two weeks. Such a condition can signal anything from inadequate sleep to serious ailments. It can be a side effect of drugs, from antihistamines to beta blockers. Therefore, diagnosis can be tricky and time consuming.
People say vague things like "I find myself feeling tired". It's more helpful to look at other tired symptoms. A fever can mean infection. If a patient’s voice is hoarse, and the doctors may think thyroid. Here are some reasons for being constantly tired, and tips for fighting back with extreme fatigue.
It's exhausting just listening to Carrie King describe her days: up at six o'clock, a 30-mile drive to campus, classes, home to cook dinner, then off to take the kids to music lessons and ball games. "I can't start my school work until after nine,” she says. "I try to get six hours of sleep but often don't. I don't have the energy to exercise. "
Most people need seven to nine hours of shut eye a night, but many of us get less. As truck drivers have found, that can be dangerous, leading to micro sleeps — brief periods, lasting one to ten seconds, when you're snoozing even though your eyes are open.
When, you've lost “zzz”, make up for it by going to bed earlier the next night. If you can't, you might sleep longer on weekends to catch up. Another way: after work, set the alarm clock and take a 20 to 40 minute nap— no longer or you may toss and turn that night.
Have trouble sleeping? One in three Americans do, and one in ten have chronic insomnia. It's natural to have sleepless nights when you're stressed out or ill. If that's not the reason, avoid caffeine within six hours of bedtime and alcohol within one to two hours. Go to bed only when you're tired; if you're still awake after 20 minutes or so get up and read or watch TV until you feel like nodding off. If insomnia persists, or if daytime drowsiness interferes with work, see a doctor.
2. Iron-Deficiency Anemia
Seven and a half million Americans — mostly women, infants and children—are run-down because of iron-deficiency anemia: their blood has too little hemoglobin. The molecule that carries oxygen to cells. Hemoglobin levels can fall because of eating too little iron, especially with strict vegetarian and weight loss diets, and because of blood loss. Anemia is common among women with heavy menstrual periods, and may develop in people with chronic bleeding from peptic ulcers, colon cancer, colitis, or other diseases of causes of fatigue.
It may seem smart to take iron pills just to be safe. Actually that's not safe for everyone. Anemia can be a sign of serious illness, such as kidney failure or colon cancer, and pills won't solve the problem. Another reason not to pop iron casually is that fatigue also can be caused by iron overload. Some people are genetically prone to store high levels of iron, which can lead to irreversible organ damage and death. One sign of severe iron overload is a gray-brown cast to the skin. Anemia, by contrast, makes people pale, especially around the nail beds, palms and lips.
If you suspect you are anemic, blood tests can measure your hemoglobin and the number of red blood cells. Then get a doctor's advice.
3. Grief Reaction
After a tragedy such as a death in the family, it's normal to feeling tired. Almost all recently widowed people sleep either too much or too little, grieving people are expected to bounce back within a year, but a study by the Institute of Medicine in Washington D. C. found that it can take up to three years to readjust after losing a spouse.
Life is filled with less obvious losses than a death—a divorce, lost job, declining health or passing youth. These can also cause grief and exhaustion.
Support groups help people with losses of all kinds. Check your newspaper or call a library, church, synagogue, hospice or hospital social services department. If grieving seriously interferes with everyday life, you may need to be treated for depression. For some, it helps simply to know that time is a healer.
4. Sleep Apnea
Some people had the classic symptoms of obstructive sleep apnea. This "snoring sickness", which can run in families, affects four percent of adult women and nine percent of adult men—particularly middle-aged, overweight men.
During an episode of obstructive sleep apnea, the upper airway collapses, cutting off breathing. This is signaled by raucous snoring, followed by gasping and waking. People with apnea may wake up hundreds of times a night, often unknowingly. The fractured sleep leaves them constantly tired.
A doctor can determine if you suffer from sleep apnea by testing you, usually at sleep lab. Mild cases can improve with weight loss; sleeping on one's side can also help. For more severe cases, there are devices that hold the tongue away from the throat or move the jaw forward. Also available are continuous positive airway pressure masks, which force air through the nose and down the throat. In very rare cases, surgery may be required.
5. Depression
Many of the fatigue cases doctors see arc due to clinical depression. This serious but treatable condition is so prevalent it could be considered the common cold of mental illness: about 24 percent of women and 15 percent of men will suffer one or more episodes of clinical depression during their lives.
Clinical depression is thought by many to result from an imbalance in the brain chemicals (such as serotonin and norepinephrine) that influence mood and behavior. These neurotransmitters, as they're called, can be affected by illness, prolonged stress, and emotional traumas like divorce and even by genetics.
How can you tell whether your fatigue is due to depression and not to an illness like the flu? Someone who's depressed often feels worn out in the morning, and the tiredness tends to come and go. Ill people, in contrast, usually feel better after a night's rest but gel more tired as the day wears on.
Depression-fatigued people typically lack motivation to do things they normally enjoy. They often can't concentrate, remember things or make decisions and these are certainty causes of fatigue.
Depression can be treated by medication and psychotherapy. Ironically, antidepressants can have drowsiness as a side effect, but some are less sedating than others.
6. Thyroid Imbalance
If you're sleeping a lot, even 16 hours at a time, yet still have to drag yourself through the day, you may have a thyroid problem, The thyroid gland, located in the neck just below the Adam's apple, produces hormones, that tell your cells how fast to work. If the gland produces less than a normal amount of thyroid hormone, the body suffers a metabolic slowdown: your heart rate may decline? You may get constipated and experience muscles cramps, your skin can become dry your hair thin and your voice husky; and you may gain weight for no obvious reason. This condition, called hypothyroidism, typically affects women over 50.
Oddly, having too much thyroid hormone—hyperthyroidism can also cause fatigue, because high hormone levels can weaken muscles. Other symptoms are rapid heartbeat, sweating and weight loss. Hyperthyroidism can strike at any age and usually results from the autoimmune disorder Graves' disease.
Doctors test for thyroid trouble by feeling for an enlarged gland and by ordering special blood tests. Both hypothyroidism and hyperthyroidism require medication for the treatment of feeling tired.
7. Chronic Fatigue Syndrome
People with this aliment aren't just tired; their fatigue is debilitating, keeping them away from work and play for six months or longer. It can be accompanied by a bizarre constellation of symptoms that come and go, including muscle pain, sore throat, tender lymph nodes, headaches and impaired memory. For some reason, exercise can bring exhaustion one to three days later.
Doctors still aren't sure what causes chronic fatigue syndrome, but some believe it affects up to 400,000 adults in the United States. One theory suggests that a virus, stress or trauma jump-starts the immune system, which then remains activated instead of gearing down as it should. As a result, immune factor—some of which cause fatigue—may remain in high concentration in the blood.
Chronic fatigue syndrome has similarities to fibromyalgia, a rare disorder of the soft tissues; some experts even believe they are the same, people with fibromyalgia also tire, but their main complaint is muscle pain. Many say they hurt all over.
There's no lab test for either condition. A diagnosis of chronic fatigue syndrome is made only after a medical workup has ruled out other problems. Low-dose antidepressants and pain medications can help relieve some symptoms. Doctors also recommend moderate exercise.
8. Post-Flu Ennui
In his years of practice, some doctors seen it happen time and again: sick people get well, and then worry when their languor doesn't lift. Actually, that post-flu ennui is due to the body's immune system. When you get an infection, you produce proteins called cytokines that help white blood cells devour bacteria and other invaders. These cytokines also lay you low,and for fatigue to persist for a month or so after the runny nose, fever and muscle aches are gone.
Prematurely jumping back into the swing of things can bring on a relapse, and then, if you've been sick lately or had a fever, go slow with the activities and get plenty of rest. If you or someone you love is constantly tired, you can get the helps you need from doctors and find causes of fatigue.