Fatigue: why am I so tired all the time?
We all feel tired from time to time. A busy family and social life, a few late nights, and deadlines at work can all contribute. But you may have realised that you’re feeling tired all the time and this might be for no apparent reason. It’s a common problem. Around one in 20 people who visit their GP go because they’re feeling tired. And many more probably feel like this but don’t tell anyone. It even has its own acronym: TATT.
Feeling tired all the time may be common, but that doesn’t mean it’s something you should just ‘put up with’. There are lots of reasons for feeling tired all the time – many of which you can do something about. Asking yourself the following questions may make it easier to work out what’s going on. And if you can identify the cause, you’re already on the way to helping yourself feel better.
Am I getting enough sleep?
If you don’t sleep well at night, you’ll feel tired during the day. You may have worries which keep you awake, you may have insomnia, or you may have just developed some bad sleep habits. Looking at your current sleep routine and identifying any changes you can make may help.
Download Bupa's six steps to a sound night's sleep infographic (PDF, 0.2MB), you can also click on the image below to download the PDF.
Am I under a lot of stress at the moment?
Coping with stress and worry can be very tiring. This is especially true if you can’t see an end to your troubles. You may have recently gone through an emotional shock such as a bereavement or a relationship break up. You may have worries about work, money or family. The pandemic has also been difficult for everyone, so it’s understandable to feel weary.
Even positive events, such as moving house or getting married, can be very stressful and tiring.
Learning how to manage work-place stress, building resilience, and knowing how to cope and deal with your worries is an important part of self-care.
You can click on the image below to open the interactive worry tree infographic (PDF, 0.3MB). For the best user experience, please view this interactive PDF on desktop, rather than on mobile or tablet devices. If the viewer you are using does not support this PDF, try opening it with Adobe Reader.
What am I eating and drinking?
What you eat and drink can affect how tired you feel. If you don’t get enough vitamins and minerals in your diet, or enough glucose (sugar) in your blood, this can make you feel tired, lack energy and feel foggy.
Not having enough iron in your blood can cause fatigue. This is called Iron deficiency. It may be that you’re not getting enough iron in your diet. If you have periods or are pregnant, you can have a higher chance of iron deficiency. Speak to your GP who may arrange a blood test and iron tablets.
Drinks containing caffeine (coffee, tea and some soft drinks) may interfere with your sleep and make you feel tired the next day. And if you drink alcohol in the evenings, this can wake you during the night. Eating a healthy balanced diet and keeping well hydrated may help you to feel less tired.
How active am I during the day?
You may feel you’re too tired to exercise. But being active during the day actually helps you feel less tired and improves the quality of your sleep. Try starting with a small amount of exercise, then build it up so you get the benefits of regular activity. Choose something you enjoy. Exercising with friends or family, or joining a group, might help you to stay motivated. But don’t over exercise, as this can make you more tired. And try not to exercise in the four hours before you go to bed. It can be difficult to go to sleep so soon after exercising.
Regular exercise has benefits for everyone.
This information is based on the UK recommendations for adults.
You'd be surprised just how many benefits there are, and the good news is it can be as easy as getting off the bus a little earlier. Introduce active habits to your day and you'll be well on your way.
So what are the benefits of regular exercise? Regular exercise is great for the heart, reducing your risk of a stroke and cutting your chance of cardiovascular disease by a third. Why not take a lunchtime walk, leave your car at home or up your walking pace when you're out and about? Regular exercise keeps your muscles, bones and joints strong and functioning well, but also helps prevent falls and fractures. Try doing exercises that strengthen your bones and muscles twice a week. Exercise burns calories and helps to maintain a healthy weight which in turn reduces your risk of many health problems.
But be sure to maintain a healthy balanced diet alongside exercise. Help maintain a healthy weight by walking to the shops or cycling the children to school. A healthy weight in turn reduces your risk of certain cancers. In fact you can cut your risk of breast and bowel cancer by around a quarter if you exercise regularly. If you have children encourage healthy habits and routines from an early age and they'll be more likely to continue being active through life.
A healthy weight also reduces your chances of diabetes. It's estimated that around 3.5 million people in the UK have it. Regular exercise is hugely important to help reduce your risk of type 2 diabetes and if you have type 2 diabetes, exercising regularly can help you manage it by lowering blood glucose levels. Exercising regularly is also good for your mind. It's thought that it can reduce your risk of developing depression and dementia. Exercise can help relieve stress and anxiety and improve your mood. Use the great outdoors, it's a hit for your physical and mental health - there's no catch!
Start reaping the benefits of exercise today.
Medical reasons for tiredness
Most people who go to their GP because they feel tired all the time don’t have a medical problem. But tiredness can sometimes be due to an underlying illness, especially if you’re getting other symptoms as well. Many conditions can make you feel tired, including:
- depression, including seasonal affective disorder (SAD)
- iron deficiency and anaemia
- underactive thyroid (hypothyroidism)
- diabetes
- sleep apnoea
Some medicines, such as beta-blockers, can also cause tiredness.
You can also feel very tired during pregnancy – especially in the first 12 weeks.
Vitamin D deficiency can also cause fatigue, and it’s common in the autumn and winter months. You can buy vitamin D supplements over the counter to help prevent this. Speak to a GP or pharmacist if you have any questions.
You should see your GP if you’re worried about your tiredness, and especially if you have other symptoms. These might include unintended weight loss, unusual bleeding, shortness of breath, or new lumps or bumps that aren’t going away.
Other health conditions can cause extreme tiredness too. For example, there’s a condition called chronic fatigue syndrome (CFS). This is also known as myalgic encephalomyelitis (ME). It’s a complicated condition that causes a range of symptoms that vary in severity. Extreme tiredness is a key symptom. Your GP will be able to explain chronic fatigue syndrome, and whether it’s a possibility in your case.
If you’ve had COVID-19 and feel very tired, there’s a possibility you might have long covid. Again, it’s important to speak to your GP for support and help for COVID fatigue.
Talking to your GP
If you go to your GP, it may help to think about the answers to these questions so you can describe how you’re feeling.
- How would you describe your tiredness – is it physical or mental exhaustion that you’re feeling?
- Have there been any lifestyle changes, such as change in sleeping pattern, diet or activity levels?
- Is it worse when you wake up, do you feel tired all day every day, or at certain times?
- Can you remember when you first noticed feeling tired? Is there a particular event or time that it came on? Is it getting worse?
- Have you noticed any other changes to your health?
- How do your energy levels compare to how they were when you were feeling better?
- Have you started or changed any medication recently?
Feeling better
There’s no magic cure for tiredness. If you’ve felt tired for a long time, it can take a while to get back to your normal self. Be kind to yourself and set realistic goals. Follow any advice your GP gives you, and try to create a good balance between work, rest and fun in your life.
Do you know how healthy you truly are? Bupa health assessments give you a clear overview of your health and a view of any future health risks. You'll receive a personal lifestyle action plan with health goals to reach for a happier, healthier you.
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Sources Sources
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- Insomnia. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2021
- Stress. Mind. www.mind.org.uk, last reviewed November 2017
- Food and mood. British Dietetic Association. www.bda.uk.com, published August 2020
- UK Chief Medical Officers' Physical Activity Guidelines. Department of Health and Social Care, Llwodraeth Cymru Welsh Government, Department of Health Northern Ireland and the Scottish Government. 2019 www.gov.uk
- Depression. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2021
- Iron deficiency anaemia. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2021
- Hypothyroidism. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2021
- Type 2 diabetes. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2021
- Obstructive sleep apnoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2021
- Atenolol. The British National Formulary. bnf.nice.org.uk, accessed 9 November 2021
- Physiology of pregnancy. The MSD Manuals. www.msdmanuals.com, last full review May 2021
- Common pregnancy complaints and questions. Medscape. emedicine.medscape.com, updated 8 April 2020
- Fatigue and TATT. Patient. patient.info, last edited 30 April 2019
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Patient. patient.info, last edited 21 December 2018
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