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“Doctor why do I feel so tired all the time?”

As GPs we get asked this a lot and as you would expect there are lots of reasons and these can be physical and psychological and of course lifestyle related.

Before you visit your doctor it might be worthwhile spending some time thinking about your life and if any of it can be contributing to your tiredness levels. Start with the basics – family and work. Has anything changed or is different that could be affecting you? Are things at home ok? Has work changed in terms of hours you work or your role/ stress levels?

Psychological causes of tiredness are much more common than physical ones. Most psychological causes lead to poor sleep or insomnia, both of which cause daytime tiredness. Causes include: Stress – The strains of daily life can worry most of us at some point. It’s also worth remembering that even positive events, such as moving house or getting married, can cause stress. Emotional shock – such as bereavement, redundancy or a relationship break-up can make you feel tired and exhausted. Depression – If you feel low and lacking in energy and you also wake up tired, you may have depression.
See your GP to discuss this more. Anxiety – If you have constant uncontrollable feelings of anxiety, you may have a generalised anxiety disorder (GAD).

Physical causes of tiredness can include: Anaemia from a lack in iron, B12 or folic acid. An underactive thyroid – usually picked up by a blood test. Sleep apnoea – where due to problems like being overweight – breathing overnight is compromised leaving people tired during the day. Pregnancy is an obvious cause and particularly in the first 12 weeks. Weight issues can make you tired too – either being overweight or obese as your body has to work harder to do everyday activities or being underweight as poor muscle strength can make you tire more easily. Medications can cause tiredness as one of their side effects ( your
GP should usually warn you about these ) and obviously cancer treatments, such as radiotherapy and chemotherapy can have a massive effect on the body. Carbon monoxide poisoning from gas appliances – so it’s important to get your gas boiler serviced regularly.

If you feel the level of tiredness is too much and/ or has been going on too long visit your
GP. It’s a good place to start. Routine bloods will screen out thyroid problems and anaemia and may pick other underlying abnormalities. We can also discuss lifestyle causes too such as too much alcohol or caffeine, snacking on sugary or high fat foods instead of a balanced diet. Exercise – which strangely may be too much or too little depending on your body’s needs. Your working pattern is also important and any changes to this can affect your quality of sleep and your tiredness levels. If you’re worried go and see your GP but have a think about things first as it may be very helpful for your doctor to know what’s going on.

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