Fatigue

What is fatigue?

Fatigue is not the same as feeling just tired or sleepy, although there is a link. When you feel fatigued, you have no energy, to the point that it affects your daily living, and your mental and emotional state.

Fatigue is a very common complaint. Physical or psychological conditions, and sometimes a combination of the two, can cause fatigue.

What symptoms are related to fatigue?

Symptoms of and associated with fatigue include:

• feeling very tired
• growing tired quickly after you start an activity
• lacking motivation
• problems with concentration and memory
• slower reaction times
• poor mood
• problems focusing
• problems with hand-eye coordination
• increased chance of taking risks or making errors

Fatigue often gets worse gradually. You might not realise how much it is affecting you until you think about all the things you could do previously.

What causes fatigue?

Fatigue is usually caused by stress, anxiety, depression, viruses — such as the flu or COVID-19 — or sleep problems. Some medications may also cause you to feel fatigued.

Sometimes fatigue is a symptom of a physical condition such as:

• anaemia — not having enough iron in your blood
• sleep apnoea — a condition that affects your breathing while you sleep
• underactive thyroid — when you have too little of the thyroid hormone thyroxine
• coeliac disease — when you are allergic to gluten
• chronic fatigue syndrome — when you have severe, disabling fatigue that lasts for at least 4 months. You may also have other symptoms such as pain in your joints and muscles. Chronic fatigue syndrome is also called myalgic encephalomyelitis (ME).
• diabetes — when your body cannot metabolise glucose. This common condition also causes thirst, a need to go to the toilet frequently and weight loss.
• glandular fever — an illness caused by a virus that also gives you a sore throat and swollen glands
• restless legs syndrome — when you have the urge to keep moving your legs at night
• cancer
• heart disease
• problems with the liver or kidneys
• multiple sclerosis

When should I see my doctor if I have fatigue?

See your doctor if you have fatigue for more than 2 weeks and it is not getting better. Ask your doctor about whether it is safe to drive or carry out your normal work duties.

How is fatigue treated?

To find out what is causing your fatigue, your doctor will ask you about any other symptoms and do a full examination. They may order blood tests or imaging tests, depending on what they think your condition might be.

Treatment will depend on the condition that is causing your fatigue. Sometimes, after treatment, you will feel better almost straight away. However, it might take several weeks for your fatigue to lessen.

Mindfulness, meditation, yoga and cognitive behavioural therapy are non-medical treatments that may be effective for some people to treat fatigue.

How can I manage fatigue myself?

You should make sure you have good quality sleep to help you manage fatigue. Ensure you go to bed at the same time each night and stick to healthy sleep habits.

Eating a healthy diet and doing regular physical activity will also help improve your sleep and lessen fatigue. Eat small, frequent meals throughout the day with plenty of fresh fruit and vegetables. Avoid junk food, and try to avoid alcohol and caffeine since these may affect your sleep.

Other ways to help lessen fatigue, include:

• • Losing weight: if your body is carrying excess weight, it can exhaust you. It also puts extra strain on your heart, which can make you tired. Lose weight and you will feel much more energetic.

• • Reducing stress: feeling stressed uses up a lot of energy. Try to introduce relaxing activities into your day. This could be going to the gym, or gentler options like listening to music, reading, or spending time with friends.

• • Talking about it: chatting with a friend may help ease the stress of feeling fatigued.

• • Cutting out caffeine: if you are feeling tired, you should cut down on caffeine to help improve your sleep. You should have no more than 200mg of caffeine a day and not have any at least 4 hours before bedtime.

• • Drinking less alcohol: although a few glasses of wine in the evening may help you to fall asleep, you will sleep less deeply after drinking alcohol. You will feel tired the next day, even if you sleep for 8 hours.

• Drinking more water: you may feel tired because you are mildly dehydrated. A glass of water will help to hydrate you, especially after exercise.

Can fatigue be prevented?

Fatigue is a symptom of several conditions, so it is hard to prevent. But it is important that you get enough quality sleep to help minimise the risks of fatigue, such as workplace accidents. If you do feel fatigued at work, take a break.

Listen to your body, and if you have a sleeping problem, see a doctor so they can address any underlying causes.