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Why am I so tired and when is it time to see the doctor about it? A GP explains

0 2 years ago

Tiredness is subjective; what’s normal for one person won’t be for the next. Many people see their GPs reporting tiredness (a recent study in Ireland found that it was present in 25% of patients).

As a GP, my first question to someone who feels tired is: “how well can you function?”.

If tiredness is interfering with your everyday life and your ability to do what you like to do, it should be explored further.

Some common causes of persistent tiredness

Poor sleep is an obvious and very common cause of tiredness. Often patients tell me “Oh, lack of sleep is not the cause, I sleep fine, possibly too much!” But on questioning they admit they don’t wake up feeling refreshed.

That’s a bit of a giveaway because it means their sleep quality is poor, even if the quantity seems enough. They could be suffering from sleep apnoea, where breathing stops and starts while a person is asleep. Apnoea can lead to serious long-term health problems, so it’s worth investigating.

Alcohol can also wreak havoc on a person’s sleep quality and they wake feeling unrefreshed.

Another common cause of tiredness is depression – and don’t forget, someone can be depressed without feeling they have low mood. For example, they may feel irritable or frustrated, or struggle to concentrate. This is concerning, because such patients may fly under the radar and not realise this is actually depression. Unexplained tiredness may be the predominant symptom of depression, with other symptoms only coming to light with careful questioning.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious long-term illness that, among other symptoms, causes people to feel extreme fatigue – well beyond the range of “normal” tiredness. It can begin with patients noticing a degree or type of tiredness different from their past experience, and can be difficult to diagnose in the early stages.

There are other potential causes of tiredness – problems such as low iron, thyroid disease, diabetes, kidney disease, heart disease and many more. Treatment for these can alleviate the tiredness too.

Tiredness also accompanies many illnesses, but should not persist after recovery.

The take-home message is this: if tiredness is interfering with your life, there are many possible causes and it’s worth speaking to a GP about it.


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