By Gena Anderson
If I had to make a list of the most common reasons people come to see me in the clinic, being tired would be toward the top. Sometimes they tell me this is new, and other times they’ve had this issue for a while and it’s progressed to the point of unbearable exhaustion. If you feel like you don’t have the energy to do the things you need to do, much less do what you want to do, this is for you.
Often, we have our own theories on what might be wrong.
“It must be my hormones.”
“I need you to check my thyroid, my sister has thyroid problems and that’s got to be the problem.”
“I’m worried I’m anemic.”
These are the top theories I hear patients present to me, and I’ve personally been there on the patient side of things, feeling fatigued and wondering why. All of these things are possibilities, and reasons for regular check-ups. Routine labs can screen for pathophysiologic reasons for being tired. What I find as a provider myself, is that often the labs come back normal and this tired soul and I are left trying to determine the source of their fatigue, and figure out how to get them feeling better.
I’ve noticed there usually isn’t one magic answer, but a lot of little factors that accumulate. Some of these factors are simple to change, others are difficult, and some originate from problems that are completely beyond our control. What we do have the power to change is the choices we make. Our daily habits and behaviours are within our control. All the little things we do on a regular basis add up and have the ability to nourish or harm us.
The following is a brief summary of the seven most common issues I see contributing to fatigue, and what we can do to avoid fatigue-inducing habits and make life-giving choices in these areas.
“How is your sleep?” This is my first question when someone complains of fatigue, and you would be surprised to learn how many people have significant sleep deprivation. Without sleep, we have difficulty concentrating, making decisions, and learning1. Most adults need 7-9 hours of sleep, and if that’s not what you are getting, this is an issue1. Sleep interruptions, insomnia, or bad sleep habits may be the culprit. Once you’ve figured out what’s reducing your total sleep, it’s easier to address the culprit. Talk to your provider about sleep issues. One serious consideration is snoring and the possibility of obstructive sleep apnea. If you snore or have periods of gasping during sleep, you need to discuss this with your healthcare provider2.
Sleep is our body’s needed physical rest, but our mind and soul need a different type of rest, one the Bible calls Sabbath rest. Are you constantly on the go? Maybe you are currently walking through a trial or a busy season? When was the last time you took a whole day to cease working in any way and rest? Deuteronomy 5:12-14 outlines God’s command to have a Sabbath day of rest for ourselves and those around us. This is so hard for me to do, yet I always find it beneficial. Another consideration is whether you have daily respite. Resist the temptation to see free time as an opportunity to be productive. Rest produces restoration, and it’s necessary for human existence by design. Pray about it, ask for help from those around you if you’re struggling to do this, and make sure you are resting.
When I ask people about their diet I often hear “I eat pretty good.” I’m not sure what that means, but I fear many of our diets may not be as good as we think. Are more than half the foods you eat from a naturally occuring source like a plant or animal? If not, work to change that ratio with simple substitutions. How often are you eating processed foods? If it’s more than every now and then, this could be contributing to your fatigue. How much sugar and simple carbohydrates, like potatoes and bread, are you eating? Diets high in sugar and simple carbohydrates are associated with inflammation, poor gut health, fatigue, and known to exacerbate auto-immune conditions like diabetes and thyroid disorders. Nutrition is a deep topic, but the above are a few red flags that, depending on your answer, may clue you in to areas you need to change.
Caffeine, alcohol, nicotine, and many other things fall under this list. A few things to consider about your habits surrounding these things: they all affect our level of fatigue, moderation is necessary, and in some instances abstinence is better. Smoking of any kind is terrible for you, period. We could argue about alcohol, but the recommended amount for women is up to one drink per day, and for men it’s up to two3. If you’re drinking more than that, try cutting back and see if you feel better. Caffeine in limited quantities is usually fine, but if you are getting more than the equivalent of two cups of coffee per day, or having it late in the day, it may be contributing to sleep issues, fatigue, or even anxiety. Other substances are a hairy topic about which I’ll choose to simply say, refer to the second sentence in this paragraph.
Adults should participate in 150 minutes per week of moderate-intensity aerobic physical activity, or 75 minutes per week of vigorous-intensity activity, or an equivalent combination of both4. If you already do this, fantastic! If this isn’t something you do, start and be consistent. What if you don’t like to exercise? Do it anyway! Why? Exercise is associated with improved sleep, mood, cardiovascular health, and overall wellness. I am not suggesting you torture yourself with activities you loathe, but find an enjoyable way to move your tired body on a regular basis. Bonus: if you can do this outside, the benefits increase! I cannot stress the value of exercise to the human body enough.
#6: Mental health
Depression and anxiety are prevalent. Fatigue can either be a symptom or a contributing cause of both. It’s important to be aware of a decrease in your overall mood and lack of enjoyment of activities, or feelings of restlessness, excess worry, or behavior that you cannot control. All of the other issues discussed, if managed well with good daily habits, can improve our mental health. If you feel your mental health is not where it should be, I urge you to seek professional help. You are not the only one, and you do not have to suffer. Most of us would never endure a heart condition or even a sinus infection without seeing a healthcare professional, yet when it comes to our mental health, we hesitate. Don’t. Get help.
#7: Spiritual health
Healthcare professionals hesitate to discuss spirituality. We don’t want to encroach on your beliefs, and it’s honestly just awkward. Spiriituality gives people a sense of inner peace, even about the things we cannot control, and it affects our overall health5. It focuses on a higher power, rather than our own abilities. Science doesn’t know why we seem to have a need for spirituality, but acknowledges this need exists. I believe it’s because it’s how God designed us, to need him and have a relationship with him. If all of this sounds greek to you, consider getting in touch with your spirituality, and give God a chance to provide you with that peace I mentioned. If you know God yet are still tired of being tired, ask him to help you. Psalm 34:17-9 says God hears us and he rescues us, and that includes you.
My hope is we would all open our eyes to the power we have to change the trajectory of our wellness and address fatigue. If you’ve identified one or more issues above, you now have a foothold, a starting point. Knowledge is power, and what we do with it can be our superpower. Start working today to address the fatigue-inducing issues you’ve uncovered, seeking your healthcare provider if needed.
- National Institutes of Health. Brain Basics: Understanding Sleep (2020). https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
- Mayo Clinic. Obstructive sleep apnea(2019). https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
- Centers for Disease Control and Prevention. Facts about moderate drinking (2019). https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
- World Health Organization. Physical Activity (2020). https://www.who.int/news-room/fact-sheets/detail/physical-activity
- Familydoctor.org. Spirituality and Health (2020). https://familydoctor.org/spirituality-and-health/
*The above article is not to be construed as or replace medical advice from your personal healthcare provider.