The alarm is set for 6 am to go for a morning walk, filled with determination to start on a routine walk from the next morning, she went to sleep early. But, like any other day, the alarm went off but, as usual, she couldn’t get out of bed. With each passing day, it got difficult even to get up for work. This happened almost for 2-3 months when Ananya realized this was not just laziness but something beyond and decided to see the doctor.
Ananya described that she had no energy to wake up in the morning and felt tired and exhausted by the end of the day. Sounds familiar??!! Yes, this happens to many around us or even to us. This Syndrome is called fatigue.
Fatigue is generally defined as a feeling of lack of energy and motivation that can be physical, mental or both. Fatigue is very common. Fatigue can be caused by Physical (around 60%) as well as Mental causes (40%). Unfortunately, it can also occur in normal individuals that experience intense physical or mental activity (or both).
However, in contrast to fatigue that occurs with some diseases and syndromes, normal fatigue in healthy individuals is quickly relieved in few hours to about a day when the physical or mental activity is reduced and adequate rest is taken.
So what are the most common causes of fatigue??
- Sleep Problems-Sleep Apnea, insomnia working in shifts or work shift changes, pregnancy, extra night hours at “work”, gadget time. For such problems, including foods like nuts or milk that are rich in tryptophan (sleep inducing hormone) can help get better sleep.
- Dysglycemia – Skipping Breakfast, long gaps between meals is known to cause irregular fluctuations in sugar levels. To avoid such irregularities one must have a healthy breakfast every day preferably within one hour of waking up. Always plan for a mid-meal snack especially when the gap exceeds 5 hours.
- Nutritional deficiency – Eating a healthy, balanced diet (proteins, carbohydrates, fats and fibre) is an important part of maintaining good health, and can help you feel your best. Include fruits, whole grains, and protein rich foods and avoid junk food, processed/packaged food.
- Gut disturbances – An acidic body doesn’t allow oxygen to be absorbed and in turn causes fatigue. Gastric issues like bloating, constipation, food sensitivity/allergy, leaky gut (gastric reflux) all create havoc in our body resulting in physical and mental fatigue. Including adequate quantity of fibre, probiotics like curd and a good intake of water keep your gut happy and healthy.
- Caffeine overload – Limit tea/coffee/green tea to 2 cups/day. Avoid having it post sunset and near bed time.
- Dehydration – When dehydrated, the fluid loss causes a drop in blood volume, which makes the heart work harder to push oxygen and nutrients through the bloodstream to the brain, skin, and muscles. Maintaining a water intake to 2.5-3 litre is adequate for the majority of the population.
- Metabolic/endocrine causes – Vitamin D deficiency, Hypothyroidism, Diabetes, Electrolyte abnormalities, kidney disease, Liver disease can all cause varying degrees of fatigue.
- Anemia (Iron deficiency, Vitamin B12 deficiency) – It is one of the most common reasons of fatigue or tiredness in India and especially common amongst the women.
- Infectious diseases -Viral infections, Hepatitis, Tuberculosis, cytomegalovirus (CMV), HIV infection, Influenza (flu), Malaria and many other infectious diseases.
- Medications –It might come as a surprise to you but many drugs like antidepressants, anti-anxiety medications, sedatives, antihistamines, steroids and even some blood pressure medications can cause fatigue.
- Mental Health (psychiatric) –Stress, Depression, Anxiety, Drug abuse, Alcohol abuse, eating disorders, (for example bulimia/anorexia), Grief and Bereavement are all few of the most ignored causes of fatigue. Awareness and proactive management of mental disorders is a must for living healthy.
Depending on the above reasons, the right treatment must be decided as it is important that the root cause of fatigue be treated and not just the symptom.
In the case of Ananya, on taking a proper history and some blood tests, she was found to have nutritional and Vitamin D deficiency. Once these were corrected she felt strong and active enough to start with her healthy regime.
Fatigue is a natural part of all our lives, because of which we tend to ignore it and instead learn to live with it which in the long run causes more trouble. We must look out for tell-tale signs of things we could do earlier but can’t do anymore, unrelated aches and pains or headaches and if found positive we must seek the right help. Don’t let feeling tired today ruin your attempt to feel healthy tomorrow!