10 Reasons Why You Are So Tired All The Time

If you’ve found yourself asking the question, “why am I so tired all the time?” then you’ve come to the right place.

If you have had a sleepless night, daytime sleepiness is nothing but ordinary. Your body needs to rest and recover, and you might feel exhausted.

But what if you do not have any sleep disorder, but you still feel exhausted?

Some people have this problem, and it is a symptom called fatigue. It is similar to normal tiredness, but you have this sensation even after a good night’s sleep.

In this article, we’re covering this issue and telling you some causes behind your symptoms.

Remember that this information varies per individual.

Thus, if you relate to any descriptions laid down in this article, we recommend talking to your doctor to see what’s going on.

Is constant exhaustion normal?

As noted above, you can feel exhausted if you have a sleep disturbance or after a long and stressful day. It is a normal sensation after strenuous physical activity or physical work that drains your energy.

Another cause of constant exhaustion is if you have a chronic disease. Surgical procedures also trigger this symptom because they place your body under a lot of physical stress. 

But what if you don’t have any of the above problems but still feel exhausted? What if this sensation extends throughout the day and becomes a constant problem? This type of exhaustion is not normal, and a doctor should assess you promptly. It is sometimes a sign of chronic disease and may have deep psychological causes.

Regardless, chronic fatigue often causes disability. These patients feel anxious and depressed because the body does not respond appropriately. They usually have cognitive problems and severe intolerance to physical activity.

It is common to see a progressive loss of social interaction, and the problem keeps progressing if we do not do something about it. The first thing we need to do is to determine the cause (1).

In the following section, we will explore ten causes one by one and tell you when it is appropriate to see a doctor.

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Why am I so tired all the time? 10 Possible Reasons

As noted above, feeling tired is a part of the human experience. But you’re not meant to feel exhausted all day long. If you do, look for medical help.

It is usually due to a medical condition such as:

1) Anemia

Anemia is the clinical name of a reduction of hemoglobin levels in the blood. This is an essential protein that carries oxygen to the cells. Thus, not having enough hemoglobin means not delivering enough oxygen.

Every cell in the body needs oxygen and glucose to create an ATP molecule, a small energy cell. This is why fatigue is a common symptom in patients with iron deficiency anemia and other types.

If you are in hospital for severe diseases, the chance of experiencing anemia is even higher.

In most cases, anemia triggers constant tiredness and excessive daytime sleepiness when hemoglobin levels are deficient.

Most people need to reach 8 g/dL or lower levels before they feel fatigued. However, the symptoms of anemia can be very different from one person to the other (2).

2) Uncontrolled Diabetes

There’s an entity known as diabetic fatigue syndrome. It is persistent fatigue triggered as a side effect of diabetes, usually when you don’t control your blood sugar levels.

Some recently diagnosed patients with type 2 diabetes started feeling constant fatigue as part of their alarm signs. This is because the glucose stays in the blood and does not reach the muscle tissue. The muscle does not have enough energy, and the body feels tired and weak. 

But tiredness is also common in a late stage of type 2 diabetes. It is usually due to chronic complications of diabetes, cardiovascular disease, neuropathic pain, or kidney disease. All of these entities cause fatigue in diabetes patients (3).

3) Thyroid problems

The thyroid gland has a significant role in the human body. It controls metabolism and how the chemistry of the body works.

A higher level of thyroid hormones will speed up our metabolism and make us feel anxious.

A lower level of thyroid hormones will have the opposite effect. It will slow down the metabolism and make us feel tired all the time.

Hypothyroidism is the name of the clinical entity that features an underactive thyroid gland. These patients are usually overweight because they do not use enough energy. It is more common in females and treated with replacement hormones (1).

4) Heart disease

You can have excellent hemoglobin levels, but if your heart is not pumping blood appropriately, you will still feel exhausted.

Congestive heart failure is one of the most common causes of exhaustion in patients with a heart condition. In this disease, the heart does not function as intended.

When a normal organ pumps 1 liter of blood, congestive heart failure causes a drop of less than half of this measure. Thus, your tissues won’t receive a whole load of oxygen and won’t have enough energy.

In the early stages of this disease, patients feel fatigued after engaging in light exercise. As the disease advances, it affects their lifestyle and self-care ability. Thus, they need to live with this physical limitation and use medications to improve their tolerance to exercise (4).

5) Sleep apnea

Patients with poor sleep often suffer from daytime sleepiness. Sleep apnea is one of these sleep-related conditions.

In sleep apnea, patients have respiratory issues when they are deeply asleep. They snore because there’s an obstruction in the airways.

Moreover, obstructive sleep apnea features recurrent periods of not breathing followed by a very loud snore. This often wakes up patients and impairs their capacity to sleep.

Sleep apnea may also affect the patient’s partner. Their sleep problems cause somnolence and fatigue throughout the day.

This condition should be solved promptly because it links to cardiovascular problems in the long run.

According to studies, fatigue in sleep apnea is more common in younger patients, especially if they have insomnia (5).

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6) Depression

Psychiatric patients may also display chronic tiredness and fatigue problems. Depression is a clear example.

Every patient experiences depression differently, but low energy levels are common in this group. They feel a significant reduction of motivation and often feel very tired all the time.

It is very common to see depressed patients lying down in bed for a very long time throughout the day. They also report excessive sleepiness, concentration problems, and muscle weakness.

Anxiety and sustained stress may also have similar symptoms of chronic fatigue. In this case, people often report fatigue when the problem is solved, and stress and anxiety levels subside (6). 

7) Vitamin D deficiency

Vitamin D is traditionally a vital nutrient for bone health. But the function of this vitamin goes beyond this simple application. It is also essential for the differentiation of cells. It plays a significant role in muscle tissue, and a deficiency causes impairment in all of these organs. 

Patients with vitamin D deficiency may display chronic fatigue as a symptom. This is particularly common in older adults and is usually accompanied by decreased muscle strength and cognitive problems. Thus, it is crucial to consider this cause in this age group, especially in dark-skinned older adults and those who rarely receive sunlight (7).

8) Arthritis and autoimmune problems

Several pain syndromes are associated with significant fatigue. For example, rheumatoid arthritis causes inflammation in the articulations. Inflammatory cytokines keep circulating in the body and cause tiredness in different brain regions.

Moreover, pain causes a state of physical stress that we may not initially detect. But then, we feel drained due to this sustained state of stress. That is why people with fibromyalgia usually have fatigue symptoms as well (8, 9). 

9) Burns and trauma

Another source of physical stress is trauma and burns. They place the body in significant metabolic stress.

Our organs try to defend themselves; there’s a surge of adrenaline by the adrenal glands, a considerable increase in blood pressure and heart rate, and other factors. All of them converge in increasing energy consumption and causing exhaustion. This is also known as adrenal fatigue.

The same happens right after surgery, and you can maintain the symptoms for an extended period.

In burned patients, an extensive burn will also cause dehydration, which contributes to the sensation of tiredness. The symptoms are usually limited to the healing period. However, after the burns fully heal, patients can also display chronic fatigue syndrome (10).

10) Cancer and other weakening diseases

In cancer, there is progressive wear down of our tissues known as cachexia. Patients with cachexia display symptoms such as chronic fatigue, unintended weight loss, and low appetite levels.

In most cases, cachexia and chronic fatigue is a sign of bad prognosis in cancer. In other cases, it is due to chemotherapy and other aggressive cancer therapeutics.

This weakening disease features a subtraction of energy and nutrients by the growing tumor. It is robbing energy from the patient, which is not available elsewhere. Thus, they often feel drained and weak (11).

When to see a doctor

As noted above, tiredness is a common problem, but it shouldn’t last for a long time. If your symptoms have lasted several weeks, you need to look for medical help. 

Look for urgent medical assistance if your symptoms of exhaustion are accompanied by confusion, blurry vision, sudden weight loss or weight gain, or inability to urinate.

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Experiencing extreme fatigue goes beyond sleep deprivation. Sleep quality and adequate sleep hygiene will indeed help you stay active throughout the day. But some people have brain fog, constant tiredness, and chronic fatigue without an alteration in their circadian rhythm

If your tiredness and fatigue are not related to sleep problems, there are many other causes to rule out. One of them is anemia when the blood doesn’t have enough hemoglobin. Heart disease can also lead to severe fatigue. An underactive thyroid gland and a vitamin D deficiency can make you feel very tired as well. 

Other conditions include cancer, rheumatoid arthritis, and other diseases that your doctor needs to assess. In some cases, no clear cause is found, and you can be diagnosed with idiopathic hypersomnia. However, most of these tiredness and brain fog cases have a clear cause we can treat successfully.

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  1. Sandler, C. X., & Lloyd, A. R. (2020). Chronic fatigue syndrome: progress and possibilities. Medical Journal of Australia, 212(9), 428-433. Available from: https://pubmed.ncbi.nlm.nih.gov/32248536/
  2. Prochaska, M. T., Newcomb, R., Block, G., Park, B., & Meltzer, D. O. (2017). Association between anemia and fatigue in hospitalized patients: does the measure of anemia matter?. Journal of hospital medicine, 12(11), 898. Available from: https://pubmed.ncbi.nlm.nih.gov/29091977/
  3. Kalra S, Sahay R. (2018) Diabetes Fatigue Syndrome. Diabetes Ther. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064586/
  4. Walthall, H., Floegel, T., Boulton, M., & Jenkinson, C. (2019). Patients experience of fatigue in advanced heart failure. Contemporary nurse, 55(1), 71-82. Available from: https://pubmed.ncbi.nlm.nih.gov/30961451/
  5. Kim, S. A., Koo, B. B., Kim, D. E., Hwangbo, Y., & Yang, K. I. (2017). Factors affecting fatigue severity in patients with obstructive sleep apnea. The clinical respiratory journal, 11(6), 1045-1051. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/crj.12682
  6. Milrad, S. F., Hall, D. L., Jutagir, D. R., Lattie, E. G., Czaja, S. J., Perdomo, D. M., … & Antoni, M. H. (2018). Depression, evening salivary cortisol and inflammation in chronic fatigue syndrome: a psychoneuroendocrinological structural regression model. International Journal of Psychophysiology, 131, 124-130. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851813/
  7. Pennisi, M., Malaguarnera, G., Di Bartolo, G., Lanza, G., Bella, R., Chisari, E. M., … & Malaguarnera, M. (2019). Decrease in serum vitamin D level of older patients with fatigue. Nutrients, 11(10), 2531. Available from: https://pubmed.ncbi.nlm.nih.gov/31635199/
  8. Montoya, J. G., Holmes, T. H., Anderson, J. N., Maecker, H. T., Rosenberg-Hasson, Y., Valencia, I. J., … & Davis, M. M. (2017). Cytokine signature associated with disease severity in chronic fatigue syndrome patients. Proceedings of the National Academy of Sciences, 114(34), E7150-E7158. Available from: https://pubmed.ncbi.nlm.nih.gov/28760971/
  9. Teodoro, T., Edwards, M. J., & Isaacs, J. D. (2018). A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review. Journal of Neurology, Neurosurgery & Psychiatry, 89(12), 1308-1319. Available from: https://pubmed.ncbi.nlm.nih.gov/29735513/
  10. Tsai, S. Y., Lin, C. L., Shih, S. C., Hsu, C. W., Leong, K. H., Kuo, C. F., … & Shi, L. (2018). Increased risk of chronic fatigue syndrome following burn injuries. Journal of translational medicine, 16(1), 1-7. Available from: https://pubmed.ncbi.nlm.nih.gov/30518392/
  11. Sadeghi, M., Keshavarz-Fathi, M., Baracos, V., Arends, J., Mahmoudi, M., & Rezaei, N. (2018). Cancer cachexia: diagnosis, assessment, and treatment. Critical reviews in oncology/hematology, 127, 91-104. Available from: https://pubmed.ncbi.nlm.nih.gov/29891116/

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