Feeling tired can seem like the ultimate symptom of modern life. It often is a byproduct of our go-go-go, 24/7, fall-asleep-next-to-your-laptop, wake-up-with-your-phone lifestyle.
Rachel Bonnema, MD, associate professor of medicine at the University of Nebraska Medical Center sees patients complaining of this on a daily basis. “It’s very, very common,” she says.
For this type of fatigue, Dr. Bonnema suggests prioritizing rest and managing stress.
But always feeling tired–that chronic, ongoing sense of fatigue–can also be a sign of something more than too much screen time. It could indicate the presence of one of a wide range of health conditions. While that might sound a little scary, most of these conditions–and their accompanying fatigue–can be treated.
Here’s how to distinguish “modern fatigue” from fatigue that requires medical help.
Anemia means you don’t have enough red blood cells to take oxygen to all the distant outposts of the body. Less oxygen means lower energy and more fatigue.
“People typically can make blood cells, but if you’re losing more than you’re making, you can feel fatigued,” Dr. Bonnema explains.
The most common form of anemia occurs when you’re low in iron, which, in turn, could be the result of gastric bypass surgery, heavy periods, chronic diseases, or vitamin deficiencies.
A simple test can verify if you have anemia. Treatment depends on what’s causing your lack of red blood cells. Any underlying conditions should be addressed first. Otherwise, your doctor may recommend vitamin supplements and/or changes in your diet.
Celiac is an autoimmune disease that causes the immune system to attack the small intestine when a person eats gluten, a protein found in wheat, rye, and barley.
“The small intestine is so disturbed, you’re not necessarily getting the nutrients that you need,” says Gerald Bernstein, MD, endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City.
This can lead not only to fatigue but also anemia, diarrhea, and weight loss.
The only treatment is avoiding foods that contain gluten. Naturally gluten-free foods include fruits and vegetables, fish and meat, beans, rice, potatoes, and quinoa.
Sleep apnea is more than just trouble getting enough Zz’s. It’s when your airways close and you actually stop breathing repeatedly during the night, which, needless to say, wakes you up pretty quickly. Because of those frequent disruptions, people with sleep apnea walk around exhausted.
It’s more common in people who are obese and, like obesity, adds to your risk for high blood pressure, heart disease, and stroke.
The go-to treatment for sleep apnea is a continuous positive airway pressure (CPAP) device, which keeps the airways open while you sleep. CPAP machines work, but many people don’t like wearing them and are turning to oral devices now on the market instead. The only actual cure for sleep apnea is losing weight or surgery to remove tissue from your throat.
The defining symptom of chronic fatigue syndrome (CFS) is, of course, fatigue–but with specific characteristics. It’s fatigue that lasts for at least six months, that gets worse with mental or physical exertion, and that doesn’t get better no matter how much you rest. It’s more common in women in their 40s and 50s.
No one is sure what causes CFS, and it’s usually diagnosed by ruling out other conditions and taking into account other common symptoms like a sore throat, swollen lymph nodes, muscle aches, and trouble concentrating.
There’s no cure for the condition or even a specific treatment. Instead, lifestyle measures like pacing yourself can give you more energy. Some people benefit from medication or cognitive therapy.
Being in constant pain–for any reason–will tire you out.
“It requires energy,” says Dr. Bernstein. Your body is busy coping with the inflammation that’s causing the disease. Dealing with pain can also make it hard to sleep and exercise, adding to the run-down feeling. Certain pain-relieving drugs may also sap you of energy.
Contact your doctor to see if there’s a way to treat the underlying condition causing the pain while also addressing that tired feeling.
Any chronic disease, not just chronic pain, can cause fatigue because it diverts energy away from everyday living, Dr. Bernstein says.
Both an underactive and an overactive thyroid can cause fatigue. The more common culprit though is an underactive gland, which doesn’t produce enough thyroid hormone. Having an underactive thyroid, also called hypothyroidism, can also mean weight gain and sore muscles.
“With an underactive thyroid, the body compensates up to a point, but if the gland is unable to put out a normal amount of thyroid hormone, the body will slowly lose the ability to … create energy, not only for day-to-day activity, but also for the growth and metabolism of cells,” says Dr. Bernstein.
Hypothyroidism is treated with replacement thyroid hormone. Different medications and sometimes surgery can treat an overactive gland, also called hyperthyroidism.
The stress of everyday life can make you tired. Being depressed or anxious can compound this significantly.
Fatigue due to depression is more than just a lack of energy going about your day; it’s also apathy, problems focusing and remembering, and feeling overwhelmed and unmotivated. That can become a vicious cycle, with the depression fueling the fatigue, which fuels the depression.
And some antidepressants may make it worse. Talk to your doctor about antidepressants that don’t cause fatigue and explore non-drug treatments like cognitive behavioral therapy.
The fatigue of multiple sclerosis, a chronic disease that damages the nerves, can have several different causes, some of which would exhaust anybody.
Problems with your bladder may get you up several times a night, as might muscle spasms. Depression, common in MS, can add to fatigue, as can all the energy it can take to do once-simple tasks such as brushing your teeth.
Then there’s lassitude, a type of fatigue that only people with MS get. This so-called “MS fatigue” is more severe, usually happens every day, gets worse with heat and humidity, and can come out of seemingly nowhere.
Talk to your doctor about treatments for MS and treatment for specific symptoms including fatigue. These can range from physical or occupational therapy to medications to staying out of the heat.