Why am I so tired?
It is a question that I hear quite often in my practice, and one that can cause significant stress in patients' lives. There are a variety of reasons why a patient could be experiencing tiredness and fatigue.
Often I have to consider many factors to get to the root of the problem. I like to start with the history of the symptoms, which often leads me down a specific path.
In my evaluation of fatigue. I ask about sleep habits, which frequently are the cause of feeling overly tired during the day. Patients might have trouble falling asleep and staying asleep, have anxiety that gives them racing thoughts, have sleep apnea that causes awakenings, or just aren't getting enough good quality sleep.
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Every person is different, and everyone needs a different amount of sleep to be at their best. Tailoring your sleep habits and using a sleep aid if necessary can help improve fatigue if you suffer from insomnia or sleep disturbance.
Evaluating fatigue often involves getting blood work, t to make sure that the thyroid is not to blame, there is no anemia (low blood count), vitamin levels are not deficient, and that all of the major organs are functioning normally.
A discussion on mood is often involved as well, and as I tell my patients, "The brain can do all sorts of things to the body." Depression and anxiety can cause significant sleep disturbances and cause a person to feel "tired" and like they don't want to get out of the house and do things they once enjoyed. I find that even if mood isn't to blame for the fatigue, aerobic exercise, a healthy diet, hobbies and socializing can help reduce fatigue.
Fatigue often comes with weight gain and inability to lose weight, body aches or pain, and a variety of other bodily complaints.
Sometimes there is no definite answer as to why someone is fatigued, and this can be very frustrating to doctor and patient. Most likely there are several that should be dealt with by the patient and his or her primary-care doctor, and it might take time to improve.