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  • Writer's pictureDr. Raisa Lerner

Why am I always tired?

Fatigue and a lack of energy are a problem for many people. To solve these problems, we need to understand the underlying cause. If you are feeling tired all the time, you should see your personal physician for a checkup.

A few of the possible causes of fatigue include the following:

Lack of Sleep

It is a surprisingly common reason for feeling tired. Many people do not get the sleep they need to feel good. Aim for at least 7-8 hours of sleep per night. Sleep hygiene is important, which includes having a consistent sleep and wake time, making sure your sleep environment is quiet, dark, cool, and comfortable, avoiding caffeine, alcohol, and nicotine 4 to 6 hours before bedtime, avoiding naps, avoiding exercise 4 hours before bedtime, developing sleep rituals, and making sleep a priority.


When you are anemic your body doesn’t get enough oxygen, which can make you feel tired or weak. You may also have symptoms such as pale skin, shortness of breath, dizziness, or headaches. Iron deficiency alone, even without anemia, is also a cause of chronic fatigue. A blood test at your doctor’s office can tell you if you have anemia. There are many causes of anemia in addition to iron deficiency.


Hypothyroidism is a disease in which thyroid gland does not produce enough thyroid hormone. Thyroid disease is very common, especially in women. Thyroid hormones control your metabolism so that when levels are low, you may have symptoms of tiredness, weight gain and feeling cold. Hypothyroidism can also mimic depression symptoms. A blood test can determine if your thyroid gland is functioning normally and treatment can be started if needed.

Sleep Apnea

Sleep apnea is a chronic condition in which the person has pauses in breathing, or shallow breathing which can be related to snoring. This disrupted and poor-quality sleep can be a common cause of daytime sleepiness. Other symptoms associated with sleep apnea include morning headaches, memory problems, poor concentration, irritability, depression, and a sore throat upon waking. A sleep study is often recommended to document sleep apnea, and if present, treatments such as CPAP may be recommended. Untreated sleep apnea not only results in tiredness, but can lead to other dangerous conditions such as heart disease, stroke or even sudden death.


People with depression tend to have problems with sleep and energy level. Some of the other symptoms of depression include feeling sad or empty, losing interest in activities that you once enjoyed, changes in appetite or weight, feeling worthless or guilty, and having recurring thoughts of death or suicide. If you feel like you may be depressed, talk to your doctor. You may need medication, therapy or both.

Heart Disease

Heart disease, especially heart failure, can cause you to feel tired all the time and unable to tolerate exercise. With heart failure, ​the heart is less effective in pumping oxygenated blood to muscles and other tissues in the body. Other possible symptoms of heart disease include chest pain, palpitations, dizziness, fainting, and shortness of breath. Symptoms of heart disease in women may be more subtle and present as fatigue rather than chest pain. It’s important to talk to your doctor about all your symptoms, as well as your family history.


Diabetes is a condition in which either the body doesn’t make enough insulin, or it doesn’t use insulin as effectively as it should. Other symptoms of diabetes include frequent urination, extreme thirst, unexplained weight loss, extreme hunger, sudden vision changes, tingling or numbness in the hands or feet, dry skin, slow-healing wounds or more infections than usual. A blood sugar test can be done in most medical clinics, and a blood test called hemoglobin A1C can help determine what your average blood sugar has been over the past three months.


Fatigue can be a side effect of several different medications. Some of the most common medications which may cause fatigue include blood pressure medications, benzodiazepines, antihistamines, diuretics and narcotic pain medications. Your doctor or pharmacist can tell you if fatigue is a possible side effect of any medications that you are taking.

If you feel your tiredness is out of the ordinary, make an appointment to see your doctor. Finding a reason for your fatigue can not only result in improvement of your symptoms but may detect other dangerous medical conditions.

Reference: VeryWell Mind, Common Causes of Fatigue By Nancy Schimelpfening

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