Tiredness and fatigue

chronic fatigue syndrome Feeling tired and fatigued can be considered a normal side effect of leading a busy and full life. When symptoms start to impact a person’s ability to carry out normal tasks it is a good idea to see if some simple dietary and lifestyle modifications can get things back on track.

How common is tiredness and fatigue?

Feeling more tired and fatigued than normal is a very commonly reported symptom, estimated to effect 1 in every 5 people.

What are the symptoms of tiredness and fatigue?

This article addresses short-term periods of tiredness and fatigue unexplained by a medical condition. A pattern of fluctuating energy levels throughout the day is often reported. A typical example may be difficulty waking in the morning and post-lunch energy slumps, followed by an increase in energy late afternoon and/or in the evening. Other related symptoms may include poor sleep, irritability, poor concentration, cravings and reliance on stimulants such as coffee and other caffeinated drinks.

What are the causes of tiredness and fatigue?

Tiredness and fatigue is not a disease condition, rather unspecific symptoms, so causes relating to other medical conditions should first be investigated. Illnesses associated with tiredness and fatigue include iron deficiency anaemia, coeliac disease, chronic fatigue syndrome, underactive thyroid, diabetes, depression and anxiety (read more at NHS Choice) (http://www.nhs.uk/Livewell/tiredness-and-fatigue/Pages/medical-causes-of-tiredness.aspx). Diet and lifestyle habits associated with tiredness and fatigue include: regular alcohol consumption, staying up late, working long hours, difficult and demanding work and poor diet. Symptoms may follow a stressful life event or bereavement. Factors that may underpin tiredness and fatigue include:

Disruptions to normal sleep-wake cycle: cortisol is a stress hormone, which is typically at highest levels in the morning to get us up and on the go and at low levels in the evening. Because cortisol is affected by stress and unusual and poor sleep patterns, lifestyle factors may cause disruptions to normal daily patterns of hormone release, thus disturbing the sleep and wakefulness cycle.

The stress factor: extreme mental stress and facing difficult problems on a daily basis is exhausting and can have an affect on mental performance.

Blood sugar imbalance: eating highly processed (e.g. white bread) and sugary food may cause blood glucose to steeply rise, which is brought down again by the hormone insulin. Because insulin is dose matched to the rise in blood glucose, blood sugar levels may drop steeply. This could result in undesirable energy fluctuations throughout the day, a rollercoaster-like effect.

Adrenal stress: the body adjusts to everyday, similar, life stressors by effectually getting used to those stressors and reacting less. This is known as allostasis – maintaining balance by adaptation. This balancing act can eventually fail, which could be a result of: sustained stress; frequent stressors; an inability to adapt; an insufficient stress response. The adrenal glands’ production of stress hormones also places large demands on the body in terms of physical resources such as raw nutrients used to make hormones. This competition may compromise other body systems. Poor nutrition: tiredness is a symptom of iron deficiency due to its role in transporting oxygen around the body. However diets low in energy and other nutrients (e.g. protein, folate, vitamin E, C and D) could also contribute to symptoms of low energy, poor post-stress recovery, impaired energy production, imbalances of hormones and reduced antioxidant and immune defence. Overweight and obesity: carrying excess weight can make everyday tasks and exercise harder. Joint pain, blood sugar imbalances, inflammation, metabolic and respiratory problems can further contribute to feeling tired and fatigued.

What can you do to support tiredness and fatigue?

  • Cut out chemical stimulants: caffeinated drinks may feel like quick fixes but they could increase tiredness and make people reliant on chemical crutches. Reduce intake gradually to avoid withdrawal headaches.
  • Balance your blood sugar: have a regular pattern of meals and snacks throughout the day. Include food from mixed food groups (protein, fats and oils, low glycaemic index starchy food, vegetables and fruit).
  • Eat wholegrain and wholemeal carbohydrates: avoid refined grains and processed foods (e.g. white bread, white rice and pasta), choosing wholegrain and lower glycaemic index carbohydrates (e.g. porridge, brown rice, rye bread, sweet potato, wholemeal bread). These generally have more vitamins, minerals and fibre, which help increase your daily intake of nutrients and balance energy levels.
  • Exercise regularly: this may seem counterproductive, however regular short exercise regimes can boost energy, support mood, help relaxation and improve sleep.
  • Get into a good bedtime routine: going to bed and getting up at the same time each day may help to support natural sleep rhythm cycles. Sleep disrupting habits include drinking alcohol and caffeine, exercising close to bedtime, using electronics and watching television, working late and daytime naps. Find out more at NHS Choice
  • Limit alcohol consumption: alcohol can reduce sleep quality.
  • Counselling and cognitive behaviour therapy: may help to support tiredness and fatigue related to stress, anxiety and other psychological problems.