Let’s talk about feeling tired as we are tired of feeling tired
By Dr Brighton Chireka
We feel tired and try a lot of things to boost our energy levels. I think it’s time we look at this issue of getting tired as I am tired of getting tired.TIREDNESS is a normal reaction to physical, mental or emotional exertion. The function of tiredness is to prompt rest which allows the body to restore its ability to undertake new tasks. We must not ignore this need so we must have time to rest. For Christians you know that resting is a must as the creator rested after creating everything. The creator knows that you need rest so do not argue with your creator. Tiredness becomes excessive when: it follows only minor activity, it is present most of the time, it starts to interfere with everyday life or it is not relieved by normal rest.
Tiredness is an extremely common presentation in my work as a general practitioner. I see a lot of patients complaining of feeling tired and this can be challenging to my clinical skills and also to the patient as they try to explain how they are feeling. The healthcare professional needs to have an ordered approach, focusing on physical, psychological and social issues with a view to discovering the true cause and providing rational treatment or management.
There are some interesting statistics that I would like to share with you. At any given time, one in five people feels unusually tired, and one in 10 have prolonged fatigue, according to the Royal College of Psychiatrists. Women tend to feel tired more than men. About 5-7% of people visiting their general practitioner will be complaining of feeling tired. About half of these patients will have investigations carried out and only a few of these tests will be abnormal meaning that the majority of people complaining of feeling tired do not need all those tests. Having said that, healthcare professionals need to take these patients seriously as in some cases there may be serious underlying diseases. It is always good practice to make sure that the patient does not think that they are seen as time wasters or hypochondriac.
What are the worrying symptoms of feeling tired?
As mentioned already, only a minority of patients presenting with feeling tired will have a serious underlying physical cause. The following symptoms must not be ignored and must prompt one to see their healthcare professional. There’s more chance of a medical reason for tiredness if there are other symptoms as well, such as heavy periods, weight loss, a change in bowel habits, hair loss, extreme thirst, loss of weight, swollen glands that are not painful and are hard, larger than 2cm and keep on growing, coughing up blood, problems with swallowing, bleeding from the back passage, a lump in the breast, bleeding from down below in women who have gone through their changes, chest pain and shortness of breath, to just mention a few symptoms.
What are the causes of feeling tired?
It’s unusual to find anything physically wrong. Most of the time, tiredness is linked with mood and the accumulation of lots of little stresses in life. Tiredness can be due to lifestyle activities, physical causes or psychological causes. I will briefly list some of the causes and will be writing articles on some of the individual diseases as a summary will not do justice here.
Physical causes of feeling tired
Being overweight or underweight can cause tiredness. That is because your body has to work harder than normal to do everyday activities. If you’re underweight, you have less muscle strength, and you may feel tired more quickly. For woman, we should not forget about pregnancy as the tiredness can be due to that; so a simple pregnancy test will solve the problem.
Several infections will weaken the body and make someone feel tired but the tiredness from most infections is short and, once the infection is cured, the tiredness goes away. There are some infections such as those caused by Human Immunodeficiency Virus (HIV) which will result in one feeling tired all the time.
Coeliac disease can cause one to feel tired and is a type of food intolerance where your body reacts badly when you eat gluten, a substance found in bread, cakes and cereals. There are 250,000 diagnosed cases in the UK, but research suggests that up to 90% of sufferers don’t know they have it. Other symptoms of coeliac disease, apart from tiredness, are diarrhoea, anaemia and weight loss.
The other cause of feeling tired is anaemia (low blood). One of the most common medical reasons for feeling constantly rundown is iron deficiency – anaemia. It affects around one in 20 men and post-menopausal women, but may be even more common in women who are still having periods. Typically, you’ll feel you can’t be bothered to do anything, your muscles will feel heavy and you’ll get tired very quickly. Women with heavy periods and pregnant women are especially prone to anaemia.
Chronic fatigue syndrome (also called myalgic encephalomyelitis or ME) is a severe and disabling tiredness that goes on for at least six months. There are usually other symptoms, such as a sore throat, muscle or joint pain and headache.
Sleep apnoea is a condition where your throat narrows or closes during sleep and repeatedly interrupts your breathing. This results in bad snoring and a drop in your blood’s oxygen levels. The difficulty in breathing means that you wake up often in the night, and feel exhausted the next day. It’s most common in overweight, middle-aged men. Drinking alcohol and smoking makes it worse.
An underactive thyroid gland (gland in front of your neck) means that you have too little thyroid hormone (thyroxine) in your body. This makes you feel tired. You’re also likely to put on weight and have aching muscles. It’s most common in women, and it happens more often as you get older.
One of the main symptoms of DIABETES a long-term condition caused by too much sugar in the blood, is feeling very tired. The other key symptoms are feeling very thirsty, going to the toilet a lot, and weight is a common viral infection that causes fatigue along with fever, sore throat and swollen glands. Most cases happen in teenagers and young adults. Usually, glandular fever symptoms clear up within four to six weeks, but the fatigue can linger for several more months.
Psychological causes of tiredness
As well as making you feel very sad, DEPRESSION can also make you feel drained of energy. And it can stop you dropping off to sleep or cause you to wake up early in the morning, which makes you feel more tired during the day. You can read more about depression in my previous article.
Feeling anxious is sometimes perfectly normal. However, some people have constant, uncontrollable feelings of anxiety, which are so strong that they affect their daily life. We call it generalised anxiety disorder (GAD). It affects around one in 20 people in the UK. As well as feeling worried and irritable, people with GAD often feel tired. Too much stress, bereavement, relationship break-up, financial problems and lack of sleep all can make one feel tired. Addressing the underlying cause will help the person recover from feeling tired.
Lifestyle causes of feeling tired
Excessive consumption of ALCOHOL is not good and can damage the organs resulting in one feeling tired all the time. ALCOHOL drinking may be a coping mechanism or an underlying cause, especially if cirrhosis or other alcohol-related problems are developing. If alcohol is being used as a coping mechanism it is likely to make things worse rather than alleviate the problem. If you drink alcohol in the evening, it tends to wake you in the middle of the night. And if you drink a lot regularly, it can make you depressed and affect your SLEEP
Certain medication prescribed by doctors can cause tiredness and alternative or natural remedies are just as likely to have side-effects. Because a treatment has not been adequately researched does not mean that there are no adverse effects. Illicit drugs are a more likely problem, especially amfetamines and cocaine. Cannabis is not a ‘safe drug’, especially if taken in large amounts and can cause SLEEP problems and mental health issues.
I know a lot of us have extended families in Zimbabwe that we are looking after. We tend to overwork in order to raise enough money to look after those people back home. We tend to forget that perhaps very long hours worked or the addition of parental or caring responsibilities makes it a very arduous week. Sometimes people do shift work with frequent changes of shifts between early, late and even night work. The constant changing of the pattern of waking and sleeping with frequent changes of shifts upsets the functioning of the brain and results in poor SLEEP and feeling tired.
Management of feeling tired
It is important to find the underlying cause, and this calls for a good working relationship between the healthcare professional and the patient. There should be mutual respect and the patient should be treated as an equal partner. The patient should be able to discuss his or her ideas, concerns and expectations without being hurried or belittled. Management plans should be fully discussed and options should be explored as well, and the patient should choose the best plan that suits their lifestyle. Patients must also be willing to change behaviours that may be contributing to their feeling of tiredness.
It may be common to feel tired all the time but it isn’t normal. If you’re worried, see your doctor for advice and reassurance. Your doctor can rule out anything serious. Remember just knowing there’s nothing wrong can be reassuring in itself.
This article was compiled by Dr Brighton Chireka who is a GP and a Patient Engagement Advocate (PEA) in Folkestone Kent in UK. You can contact him on firstname.lastname@example.org or read about his work on DR CHIREKA’S BLOG
Disclaimer: This article is for information only and should reka has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.