It’s been heard from everyone–old, young, men, women–“I’m retired…I was tired yesterday and I’m tired today, “My legs feel like lead, like tree stumps,” “I need toothpicks for my eyes,” “my face fell asleep right into my dinner plate.” Even a popular minion was known to have said, “Feeling so tired that I think I might have that Chinese disease called Dragon Ass.”
It may be widespread, but is it simple tiredness, fatigue, or weakness that may pass quickly? Or, something more prolonged and potentially serious? Let’s take a look and find out.
These terms are often used one for the other–but they do describe different sensations. So, what exactly do you mean if you say I feel weak, I am fatigued, or I am tired? And what is it that causes you to feel that way? You need to narrow down what you mean and possible causes of your symptoms – or “get to the root” of the problem as we say in dentistry!
Weakness is that lack of physical or muscle strength, or that feeling you really have to push extra than normal to move your limbs or muscles. It’s a general weakness that often happens when you have done too much of an activity at one time for your body. Your muscles may be sore and you may feel weak, and you may feel tired too, but you know you have done a little too much. This type of weakness can also be caused by physical exertion that tipped the balance of electrolytes that are natural in the body like potassium or sodium– which are usually remedied by gator aid, a banana etc. These sensations usually go away in a few days– unless you have sprained or more severely stretched or torn something. In rare cases a general muscle weakness can be caused by a health problem. Muscle weakness that gets worse, should never be ignored. You should see your doctor, as chronic muscle weakness could indicate other serious body problems.
Fatigue or tiredness is a feeling of exhaustion, where you need to rest because of a lack of energy or a lack of strength. Like weakness, fatigue or tiredness is a symptom, not a disease. Even though Ben Franklin said “fatigue is the best pillow,” your pillow may not be awaiting you at an appropriate time if you find yourself continually fatigued and feeling like the card that reads, “you don’t know what fatigue is until you have to rest after taking a shower!.”
Fatigue is that awful feeling–just like when you are down and out with the flu. It’s a lingering tiredness–it is constant or unexplained, relapsing–and it limits your daily life. You may wake up mornings feeling as though you have not slept a wink. You can’t function at work or at home. Some people jump out of bed in the morning invigorated, and ready for whatever the day brings! But others crawl out barely, from under the covers, wishing it were a holiday, or the weekend! If any of this sounds familiar, you are not alone. This kind of fatigue is a common complaint.
The Royal College of Psychiatrists have suggested that at any one time 1 in 5 people feel unusually tired and 1 in 10 have prolonged fatigue. It is important to differentiate between tiredness due to lack of sleep and tiredness when you do have adequate sleep.
The advertising, industry has promoted fatigue as common fashion. You know the red bulls, and super punch packed smoothies to go, the array of starbucks on every corner–all for instant pick me ups to make it through another couple of hours. But, coffee and energy drinks are not the healthiest way to deal with chronic fatigue.
In no particular order of popularity or severity, here are the precursors of symptoms of tiredness, fatigue, exhaustion
Caffeine and sugar, simple carbs, sugary soft drinks, have the ability to get you up and going, but also leave you down, out and flat. The flattening can happen even more quickly with those more susceptible to low blood sugar.
Nutritionists recommend more balanced protein and complex carbs–fruits, veggies, lean protein– to keep your fuel levels going–first thing in the morning, and at those energy leaving breaks in between meals. Breakfasts get your blood sugar going if you make your healthy choices like smoothies, yogurt, breakfast bars, granola cereals. Energizing snacks are balanced snacks like apples with peanut butter or hummus, string cheese and whole grain crackers, fruit smoothie, low sugar granola, dried or fresh fruit and nuts…Also, it is important to keep your portions small, just enough fuel to help your body performing.
If you have coffee or tea or a caffeine laden beverage, or cookie or doughnut, do balance it out with some protein–especially if you are relying on successive refills of all or any of these to keep you awake and moving.
That afternoon fatigue or slump–which can be at any time of day actually, can be caused by low blood sugar or dehydration. The worst thing is candy bars and caffeine to counteract because they do work immediately, but in a short while–boom, your energy levels plummets again. Doctors recommend eating small protein and complex carb meals every 3 or 4 hrs to prevent energy lulls.
That’s right–a big glass of water. Being hydrated is essential to keeping up energy. Dehydration can make you feel tired. There are amazing types of sparkling waters or flavored waters, or iced or hot tea too. Decaffeinated teas are all wonderful with antioxidants and many flavors
Most people need 7-8 hours of sleep for best functioning. But if you rely on your alarm clock and you are chugging the caffeine – or can sign your name to this letter: Dear Sleep, I’m sorry I hated you when I was little, but now I can’t get enough of you – you are not getting enough sleep for sure!
Maybe you just need more or better sleep. Work on a regular sleep routine. Sometimes staying up late on weekends causes a shift like jet lag. Turn off screens. Get up and do something relaxing if you can’t fall asleep. Associate your bedroom with sleeping. Make your to do list a good hour before bedtime so you are not to worrying at bedtime.
Do not have a “nightcap.” According to the experts, alcohol actually disrupts sleep, takes away slow wave sleep, wears off quickly and often leaves you with nightmares and sleep fragmentation.
Too much exercise, over use of muscles excessive aerobics for your level of endurance causes fatigue, tiredness, weakness that normally will pass as your body recovers.. However, lack of exercise can also lead to tiredness. Research reveals that exercise breeds energy, relieves fatigue. Note though if your normal range of exercise suddenly shifts and you find yourself saying, “I’ll never be over the hill because climbing a hill sounds quite exhausting” you may need to check up on yourself.
Research has shown that healthy but tired adults can get an energy boost from workouts. In a study participants rode a stationary bike for 20 minutes at a slow to average page, 3 times a week, and this was enough to fight fatigue.
Anemia is a common cause of fatigue especially for women. It affects about 3.5 million Americans. Anemia is a leading cause of women’s fatigue because of an iron deficiency. A simple blood test can check on this and can be remedied with iron laden food such as meat, dark greens, liver, shellfish or beans. Typically, if you are anemic you feel your muscles are heavy, you get tired quickly, and as if you can’t be bothered to do anything.
Nutrient deficiency such as low potassium can lead to fatigue. This can occur after a bout with diarrhea, extreme sweating, or with certain medications. This can be checked with a blood test and easily remedied.
The thyroid is a small gland at the base of your neck that regulates the way your body uses energy. Both an overactive and an underactive thyroid can cause fatigue. Common thyroid problems result in fatigue, lethargy, weight gain, depression constipation, intolerance to cold and other symptoms. A blood test can check on your thyroid levels and functions. Underactive thyroid or hypothyroidism, results in sluggishness, run down feeling, extreme fatigue, depression cold intolerance, and weight gain. Blood tests will detect thyroid hormones if they are low, medication can bring you up to speed.
This disease usually leads people to feel fatigued, draggy, tired all the time, with increased hunger, urination, weight gain. It is caused by too much sugar in the blood. A blood test can diagnose for this, and a program of smart self management including: losing excess weight, increasing activity, maintaining glucose control, diabetes medications, smoking cessation, and blood pressure control.
Depression and anxiety can literally be exhausting! Depression can cause chronic fatigue. You may have little interest in normal activities, feeling fatigued you may eat too much or too little, over or under sleep, feel hopeless. Anxiety, that feeling of impending doom, agitation, and worrying also causes exhaustion. If there is no physical cause for depression or anxiety your doctor may prescribe medication or refer you to counseling to relieve symptoms. Depression makes you feel drained of energy and can stop you falling asleep.
If an everyday task you used to do easily leaves you feeling exhausted it can be a sign that you may have heart disease. See your doctor for advice about lifestyle changes, medication and getting it under control.
Allergies are a common cause of fatigue. A doctor can discuss your symptoms and testing to see whether your allergies are triggered by pollens, insects, dander, molds, weather, food or other causes. With food allergies elimination diets are found to help to find the cause. Elimination diets help where you isolate particular food to avoid for a period of time to see if that makes a difference. In some people, allergies result in sleepiness in 1- or 30 minutes of eating the allergen. Celiac disease is a food intolerance to gluten. Symptoms usually include tiredness, anemia, weight loss and diarrhea. A blood test can determine if you have this.
This type of fatigue is very severe, often also accompanied by muscle pain, tender joints, sleep problems, anxiety, or depression. With fibromylgia you may feel no matter how long you sleep its never restful. Chronic fatigue also called myalgic encephalomyelitis is a disabling tiredness that goes on for maybe 6 months also usually including sore throat, muscle or joint pain and headache.
This disease is considered a result of autoimmune problems where your immune system attacks healthy joint tissue resulting in fatigue, stiffness in joints, inflamed joints and swelling. Your doctor’s consultation with a physical exam and testing can determine if you suffer from this.
If you get about 10 hours of sleep but you are still sleepy and groggy when you wake up, perhaps you did not sleep well because of snoring. Snoring will interrupt your sleep and this will cause you to be tired, fatigued during the day. Snoring and sleep apnea, discussed next, are different levels of similar situations, and should be looked into to determine which level you are at.
Sleep apnea is one of the most common problems causing excessive tiredness, trouble concentrating during the day, fatigue, difficulty focusing and sometimes even worse physical problems such as high blood pressure and heart disease.
Sleep apnea needs to be diagnosed and is often one of two types: obstructive sleep apnea and central sleep apnea. In ether one, your breathing is disrupted while you sleep, waking you up, depriving your brain of oxygen. In obstructive sleep apnea, your upper airway collapses partly or all, and oxygen level of your blood can be low. Usually the sympathetic nervous system is stimulated that can put stress on the heart. Snoring, especially very loud snoring is a red flag for this condition, as is of course daytime fatigue.
Central sleep apnea happens when the central nervous system does not signal correctly to the muscle that controls breathing. Snoring is usually accompanied by one or more of these: high blood pressure, excess weight, having a large neck circumference, gagging noises during sleep, gasps for air, nocturia or frequent need to urinate during the night, depression, dry mouth, night sweats, morning headaches the throat narrows or closes during sleep and repeatedly interrupts your breathing which results in snoring, a drop-in blood oxygen levels waking up in the night and feeling exhausted the next day.
Drinking alcohol and smoking is reported to worsen this condition.
Sleep apnea is disruptions of breathing during sleep. Someone with obstructive sleep apnea may stop breathing many times a night. But sleep apnea can lead to heart disease, high blood pressure and stroke so it is important to be tested.
Testing often involves various types of tests and/or an overnight stay at a sleep clinic that monitors your sleep, breathing changes and brain activity.
There are various scales to determine how likely you are to fall asleep or doze off in situations, which can be compared to just that general tired feeling. So this way, you could determine if you have a problem that should be addressed.
Here are some of the available sleepiness tests to determine your situation.
The Epworth scale has you answer each question with a 0 never doze, 1 slight chance of dozing, 2 moderate chance of dozing, 3 high chance of dozing. And the activities include: watching TV, sitting inactive in a public place, sitting as a passenger in a car for an hour, lying down to rest, sitting talking to someone, sitting quietly after lunch without alcohol, sitting in a car while stopping in traffic. Excessive daytime sleepiness was determined to be greater than 10.
Another test for sleepiness is measured with the multiple sleep latency test. This measures how fast you fall asleep during the day, after an overnight sleep study has determined you had good opportunity for sleep the night before. During 4 or 5 naps of 20 minutes, 2 hours apart, you are told to fall asleep. A normal time is more than 10 minutes needed to fall asleep. Excessive sleepiness is defined as falling asleep in less than 5 minutes.
This test measures daytime sleepiness. In this test, you are told to try to stay awake, repeated for 4–minutes sessions 2 hours apart. If you don’t have daytime sleepiness you don’t fall asleep in all 4 tests.
Do stay tuned for more discussion of sleep apnea and my own sleep apnea solutions in upcoming chapters.
The truth is, we all are living very busy lives. We all have high, sometimes unrealistic, expectations of what you can achieve in a day. Which means late nights, early mornings and lack of relaxation, all of which result in exhaustion. This gives rise to passed around joking like “I went to a doctor for fatigue, forgetfulness, inability to concentrate, and I was diagnosed with motherhood!”
But as you see, there also can be more serious symptoms and results of tiredness weakness and exhaustion. Daytime sleepiness, tiredness or exhaustion can be dangerous for you and everyone because you.
If you feel tired all the time it is recommended that you give yourself about 2 weeks to make some lifestyle changes to see if that will help. Get more sleep, trim your social responsibilities, eat more wholesome foods, take vitamins, cut back on caffeine and alcohol, and take steps to avoid the allergens. But if nothing changes, seek professional help.