What can you do about fatigue?

Ask anyone and most people will tell you that they are tired these days.  When thinking about the causes of fatigue, very often they are straightforward, simple or lifestyle causes mostly, rather than fine print, nasty disease causes.  However, when doctors think about fatigue, they like to rule out all the initial lifestyle and simple causes first but make sure that they don’t miss any serious important causes.

Lifestyle causes of fatigue are listed below:

  • Drug and alcohol abuse.
  • Sleep deprivation.
  • Over work or burn out.
  • Not enough exercise.
  • Poor diet.

These are simple things that you can analyze yourself and correct, one-by-one, and you may be surprised as to how much better you will feel.

Social stress and general stress also account for a lot of causes of fatigue and they include:

  • Stress at work or bullying.
  • Bereavement.
  • Unemployment.
  • Marital or relationship problems.
  • Financial problems.

Once again, identifying these causes and doing the best that you can to deal with them will bring relief.

Don’t forget any medications that you might be on from the doctor. Common offenders can be medicines for blood pressure or heart and these can include beta blockers. Also, sleeping pills and antidepressant medicines can affect energy levels as well, along with any other drug.

Once the doctor has ruled out any lifestyle or stress causes, he or she will think about whether you might have a deficiency which are listed below:

  • Iron
  • Vitamin B12
  • Slow thyroid
  • Low vitamin D
  • Magnesium.

The commonest deficiency amongst women is iron. Sometimes, although your result is within the normal range, you might feel better when your iron levels are still a bit higher so discuss this with your doctor.

Vitamin B12 testing is known to be unreliable, so if your vitamin B12 is near the low end, it is worth asking your doctor for an injection to see if it will help you. 

Vitamin D is not routinely tested at present in New Zealand, but more and more doctors are understanding the value of doing this and the importance of this vitamin in interacting with 913 genes and preventing 17 cancers. You cannot tell whether someone has enough vitamin D by looking at them because even if they have a suntan, they may not be able to make it in their body if they are deficient, on drugs, or obese – so testing is the best way to check. 

The thyroid blood tests can be unreliable too, so if you are convinced that you have a slow thyroid, try filling in an online thyroid questionnaire and take that to your family doctor with a request to have a trial of thyroid replacement. People more likely to have an underactive thyroid are women as they age, especially after menopause.

Most doctors don’t consider magnesium deficiency as a cause of fatigue but if you have leg cramp, ringing in the ears or twitching eye, you can try taking some magnesium yourself to see if that will help.

Food intolerances can be a surprising cause of fatigue and because some foods cause a reaction up to 48hrs after they have been eaten, it can be very difficult to find out which foods are the offenders. I would suggest if you are suspicious about this, you could look at gluten, dairy and salicylates.

Chemical poisoning is not commonly thought of as a cause of fatigue. You should be suspicious for mercury poisoning if you have been involved with hospitals, thermometers, nursing or medical profession, or the dental profession. You should be concerned about lead poisoning if you have lived in a highly polluted city overseas or have been involved in renovating old houses. You should be concerned about pesticide poisoning if you have been in a farming community or have used pesticides yourself.

Disease can cause fatigue and there are a huge number of diseases that the doctor will consider if the initial medical screen does not turn anything up. These diseases can include the following:

  • Infection, e.g. flu, virus, hepatitis.
  • Heart failure, heart disease.
  • Kidney failure, diabetes.
  • Hormone imbalance, e.g. underactive thyroid, Addison’s disease.
  • Neurological diseases, e.g. Parkinson’s disease, multiple sclerosis.
  • Cancer.
  • Autoimmune diseases, e.g. rheumatoid arthritis, lupus.

Of course there are the unknown causes of fatigue which are listed below:

  • Chronic fatigue syndrome.
  • Fibromyalgia syndrome.
  • Chemical sensitivity syndrome.

These conditions will be discussed in forthcoming articles.


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