Fatigue: When to rest, when to worry

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Fatigue: When to rest, when to worry

Fatigue — Causes can be lifestyle related or result from an underlying medical condition.

Some days you're so low on energy that you're drowsy by lunchtime and in need of a nap by midafternoon. What's making you so tired all the time? Stress, poor eating habits, overwork, even medical treatments can wear you down.

Most of the time, fatigue can be traced to one or more of your habits or routines. You have the power to put the vitality back in your life.

Why so weary?

Taking a quick inventory of the things that might be responsible for your fatigue is the first step toward relief. Fatigue can have a variety of lifestyle causes, including:

  • Lack of sleep. Getting even an hour less than the sound slumber you need each night can leave you drowsy and unable to manage your daily routine. You may not go to bed early enough. Or more likely, you go to bed but can't sleep well. As you get older, it becomes harder to get uninterrupted sleep. You sleep less soundly. You awaken earlier.
  • Stress and anxiety. If you're running from one task to the next without a break, it's eventually going to wear you down. Going through life anxious and on edge can keep you from relaxing and getting the rest you need.
  • Inactivity. You're too tired to exercise, so you don't. But then when you do exert yourself, you tire easily because you're out of shape. Engaging in moderate physical activity for a half-hour or longer most days of the week may decrease stress, improve mood and leave you feeling energized. Don't schedule your activity too close to bedtime, though, or you might have trouble falling asleep.
  • Eating habits. If you're not eating properly or drinking enough fluids, your body isn't getting the fuel and fluid it needs. Trying to remedy this with caffeine can backfire, especially if you consume it late in the day. Caffeine not only makes it harder to fall asleep, it also interferes with sound sleep and may keep you tossing and turning throughout the night.
  • Certain medications. Some medications, including many beta blockers and antihistamines, can cause fatigue. In addition, some cold medications and pain relievers contain caffeine and other stimulants that can keep you up at night.

Battling fatigue

To beat fatigue, try these tips:

Reduce stress
Take some of the pressure out of your day. Learn to say no. Set priorities. Then organize your activities so that you avoid confusion. Pace yourself. Put aside time each day to do something you enjoy. Take a midday stroll around the block, or get up 15 minutes earlier to give yourself more time to start your day.

Manage workplace tension
On-the-job aggravation can add to work-related fatigue. Sit down and try to resolve conflicts with co-workers. Become better acquainted with your boss and clarify what he or she needs from you. Be realistic about your limitations. Take time out to get up from your desk and stretch for a few moments several times a day.

Be active
Try to include at least 30 minutes of moderate physical activity in your day. Don't worry about doing a full workout all at once — start with 10 minutes of activity at a time. Whether you walk, garden or swim, once you get moving, you'll likely notice you have more stamina. While 30 minutes is the minimum recommendation, you may need up to an hour of moderate activity daily to maintain fitness and a healthy weight.

Eat well
Start your day with a low-fat, high-fiber breakfast that includes plenty of complex carbohydrates, such as whole grains and fruits for lasting energy. Stay away from sugary cereals and juices and caffeinated drinks. They can make you feel sluggish later in the day. Don't skip meals; refuel every three or four hours. Very low calorie diets are guaranteed to increase fatigue.

Avoid alcohol
Alcohol depresses your central nervous system and acts as a sedative, making you tired for hours after consuming no more than only a drink or two. It may also disrupt your sleep, if you drink just before bed.

Practice good sleep habits
Avoid eating, reading or watching TV in bed. Keep your bedroom cool, dark and quiet. And set your alarm for the same time each day — the routine can help you establish a regular sleep schedule. Naps are OK, but keep them short and early in the day. Schedule workouts at least six hours before bedtime. Small snacks may help you drift off, but large late-night meals can keep you up. If you can't sleep, don't toss and turn, go into another part of the house and read or relax until you feel drowsy.

When to see your doctor

Sudden or persistent fatigue, despite adequate rest, may mean it's time for you to consult your doctor. Unrelenting exhaustion may be a sign of an underlying medical problem. In general, talk to your doctor if you're extremely tired or unable to regain your energy after several weeks of increased rest. Medical causes of fatigue can include:

Anemia
This blood disorder results from a number of problems that affect your blood's ability to transport oxygen, causing fatigue.

Cancer
Fatigue can be a symptom of cancer. A thorough checkup, including routine cancer screenings, can help rule out malignancy as a cause of your fatigue.

Depression
A loss of energy that's accompanied by any number of symptoms, including sadness, loss of appetite, difficulty sleeping or oversleeping, a lack of interest in pleasurable activities, and difficulty concentrating may be a part of depression.

Diabetes
Extreme fatigue can be a warning sign of diabetes. Signs and symptoms of diabetes, in addition to fatigue, include excessive thirst, frequent urination, blurred vision and recurring infections.

Medications
Prescription or over-the-counter medications may cause fatigue or make you too restless to sleep well. Antihistamines, cough and cold remedies, some antidepressants, and many other drugs may make you tired. Talk to your doctor if you suspect your medications are making you tired.

Restless legs syndrome (RLS)
This condition is characterized by an inability to keep your legs still and by tingling or aching sensations in your legs, feet or arms. The symptoms generally occur at night, preventing sound sleep.

Sleep apnea
Signs of this disorder include loud snoring, pauses between breaths and awakening frequently while gasping for air. It's a common source of fatigue because it interferes with sound sleep. Losing weight and quitting smoking may help, as well as an adjustment in sleeping position. Lying on your side or facedown may reduce snoring.

Thyroid problems
Hypothyroidism is a condition in which your thyroid gland fails to make or release enough thyroid hormone. Signs and symptoms include sluggishness, chronically cold hands and feet, constipation, dry skin and a hoarse voice. Hyperthyroidism is a condition in which your thyroid produces excessive amounts of hormone. Too much hormone also can cause fatigue, muscle weakness, weight loss, increased heart rate, nervousness and irritability.

A diagnosis of exclusion: Chronic fatigue syndrome
Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that doesn't improve with bed rest and may worsen with physical or mental activity. Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious.

Severe and debilitating fatigue, muscle aches and difficulty concentrating are the most commonly reported symptoms of chronic fatigue syndrome. In some cases, low-grade fevers and swollen lymph nodes also may develop.

A diagnosis of chronic fatigue syndrome is based on exclusion. This means that before arriving at a diagnosis, a doctor has ruled out any other disease or condition that may be causing your fatigue and related symptoms.

Don't let fatigue keep you from getting help

Once you face your fatigue head-on, you'll find that making small lifestyle changes or treating an underlying medical condition will go a long way toward giving you back your get-up-and-go.

Last Updated: 08/16/2006
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