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No more "I'm so tired"

Feeling exhausted all the time? Here's how to tell what's wrong and what to do about it.

 

"I'm exhausted". How often have you said that as you yawn and reached for a second cup of coffee? Fatigue is such a common complaint that it's easy to overlook it as a possible warning sign that something else is wrong. If you are frequently tired, and your energy drops and does not lift after plenty of rest, your system might be alerting you to an undiagnosed illness. Use this guide to help you figure out what might be happening and what to do about it now:

 

Anemia

When the amount of oxygen-carrying hemoglobin in red blood cells falls below normal, anemia occurs. The body is forced to work harder to get oxygen to vital organs, straining the heart. Eventually, severe anemia can lead to heart attack. Possible causes include deficiencies of iron, folate (a B vitamin), or vitamin B12; blood loss from surgery or heavy menstrual periods; chemotherapy treatments; and chronic diseases, such as kidney disease, diabetes, and hepatitis C.

What the fatigue feels like: You get tired easily, are lethargic, and notice that tasks you used to do with ease, such as shopping for groceries or taking out the garbage, now require a lot of effort.

Other symptoms: Chest pain, shortness of breath, pale complexion, rapid heart rate, feeling cold.

What to do: See your family doctor. Depending on what is causing your anemia, he may recommend supplements, healthier food choices, prescription medication, or other treatments or tests. Women who have heavy menstrual flows might benefit from birth control pills, which can reduce blood loss.

 

 

 

Chronic fatigue syndrome

CFS is characterized by a persistent or relapsing fatigue of 6 or more consecutive months. No one really knows what causes CFS, but some researchers speculate that extreme stress or a viral infection such as a cold or flu may somehow send your immune system into overdrive, leaving your body fighting as though you had a perpetual case of the flu.

What the fatigue feels like: Profound exhaustion and poor stamina that are not alleviated by bed rest. Symptoms may worsen for days following even minor physical or mental exertion.

Other symptoms: Unrefreshing sleep; poor concentration and short-term memory; flu-like symptoms, including muscle and joint pain, tender lymph nodes, and headache; blurring and other vision problems; and irritable bowels. But CFS is difficult to diagnose, so if you are experiencing any four of the above symptoms, and you've felt severely fatigued for 6 months or more, then it's a possibility.

What to do: Find a primary care doctor or specialist who is knowledgeable about CFS, and make an appointment. If your doctor is skeptical about CFS, call a nearby medical school, and ask if they have a CFS clinic. Rheumatologists, immunologists, and primary care physicians also treat CFS.

Be prepared for lots of tests: blood work, urinalysis, a thyroid test, even cognitive exams that ask about your concentration or memory. Before your doctor can diagnose you with CFS, she needs to rule out everything else that can cause fatigue, such as depression, sleep problems, and autoimmune diseases.

Depression

One of the most common mental illnesses, depression affects more than 19 million Americans each year. Although depression is considered a mental disorder, it has physical symptoms (such as fatigue and difficulty sleeping) in addition to psychological ones.

What the fatigue feels like: For some, it is a debilitating, all-day fatigue; for others, it's a sluggish feeling that never leaves, even after plenty of rest. It may be more noticeable in the morning. You may find yourself sleeping too much or too little.

Other symptoms: Changes in eating habits; lack of motivation; lethargy; irritability; hopelessness; not finding pleasure in activities, hobbies, sex, or friendships.

What to do: Contact a mental health professional such as a psychologist, psychiatrist, social worker, or pastoral counselor. If you need help finding one, ask your family doctor for a referral.

 

 

 

Kidney disease

This condition occurs when your kidneys don't filter enough waste from your blood, causing toxins and fluid to build up and make you feel sick. Diabetes and high blood pressure are the two most common causes of kidney disease. The condition can cause high blood pressure as well as anemia, thinning bones, nerve damage, and poor nutritional health, and it also increases your risk of heart and blood-vessel disease.

What the fatigue feels like: You are easily tired and feel like you are constantly out of breath, especially at the end of the day. The fatigue is caused by anemia, which most people with kidney disease develop.

Other symptoms: Weight loss, itching, loss of appetite, nausea, vomiting, swelling or numbness in hands or feet, frequent urination.

What to do: Ask your doctor about the gold standard GFR (glomerular filtration rate) test, especially if you have diabetes, high blood pressure, or a parent or sibling with kidney disease. If you have a condition that predisposes you to kidney disease, early screening is critical because you can lose up to 70% of your kidney function before symptoms appear. The National Kidney Foundation also recommends a blood pressure measure and test for protein in urine.

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