4 Common Sources of Fatigue—and How to Re-energize

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Fatigue is a lack of energy, motivation, and/or concentration. The all-too-worn-out phrase, “it takes energy to make energy,” gets at the crux of the “chicken or egg” problem. How can such a nebulous word hold so much power over you? You would think that just as a day only has 24 hours, you too only have so much energy at your disposal on any given day.

Taking E=MC 2 to another level, you may be surprised to find out that our bodies hold the equivalent of 1.86 million kilotons of TNT energy, or 88,403 times more explosive energy than the hydrogen bomb that destroyed the city of Nagasaki in World War II. Not the nicest image, but you get the point. We have more energy in us than we can imagine. Now how do you harness this into figuring out why we are so tired? The first step is to realize that fatigue is your body, mind, and spirit’s way of telling you that something is out of balance.

The following are the most common sources of fatigue.

1. Sleep: Poor Quality and/or Quantity

Studies have shown that nightshift work and sleep duration of less than six hours or greater than nine hours is detrimental to your health. In addition, taking sleep medication to obtain optimal hours of sleep does not ensure improved sleep quality.

How do you know if you have poor sleep quality or quantity? First, ask yourself the following questions:

  • Do I wake up tired?
  • Do I wake up with a dry mouth?
  • Do I wake up with a headache? 
  • Do I get up at night more than once to urinate? 
  • Do I snore?

If you experience any of these, you may have sleep apnea and should discuss your sleep further with your doctor. Also ask your bed partner if you ever stop breathing at night. If you usually snore or make a gentle noise of breathing as you sleep, this sound may disappear for a few seconds and you may gasp for air as you try to inhale more air.

Other behaviors that make it difficult to achieve optimal sleep quality include:

  • Drinking alcohol or caffeine too close to your bedtime
  • Staring into bright light (for example, watching TV or working on your computer) too close to bedtime. This means no closer than one hour to bedtime for bright light and two to three hours for blue light. 
  • Sleeping with your pet in the bedroom (if your pet wakes you up)
  • Doing work in your bedroom, or anything that makes your bedroom something other than a place to sleep and have intercourse (not necessarily in that order)

If you find yourself doing any of the above activities, try removing them from your lifestyle—you may be surprised to see that your sleep quantity and quality improve.

2. Exercise: Lacking or Excess

Optimal exercise is equivalent to putting fuel in your car (optimal exercise) versus driving your car until it’s out of gas and expecting it to keep going (excessive exercise) or not driving your car and having it sit and rust (lack of exercise).

Your daily goal activity should be about 8,000-10,000 steps per day depending on your age and fitness level, or around 20 to 30 minutes of movement. Too little or too much can be detrimental to your health and contribute to fatigue. If your body mass index is less than 18.5, your periods become irregular or absent, you are having frequent unexplained injuries or you feel unwell, you should contact your health care provider.

Even though exercise has been shown to improve depression, inflammation, and longevity, too much exercise can contribute to excessive stress on the body. Excessive exercise is more unusual than too little exercise, but if you are organizing your life activities around an exercise routine and continuing to exercise when injured or sick, consider reducing your activity.

Opportunity for recovery from exercise is important. This depends on your level of fitness, type of exercise and age but encompasses refueling and repairing.

3. Medication Side Effects

The following medications can contribute to fatigue:

  • Blood-pressure–lowering medications
  • Antacids, like proton pump inhibitors
  • Cholesterol-lowering medications, such as statins and fibrates
  • Allergy medications, such as antihistamines
  • Anti-anxiety medications, such as benzodiazepines 
  • Antidepressants

If you do not recall when you started a medication, you can call your pharmacist to find out if the time you started the medication correlates with your symptoms of fatigue. If it does, please notify the prescriber of the medication that you would like to discuss whether the medication is contributing to your fatigue.

4. Medical Conditions

Many different medical conditions can contribute to fatigue, including the following:

  • Diabetes: Symptoms of high blood glucose are increased thirst, increased urination, poor wound healing, frequent urinary tract infections, and fatigue. A simple blood test can determine if your glucose is within a normal range.
  • Thyroid abnormality: Symptoms of hypothyroidism are weight gain, cold intolerance, dry skin, and fatigue. A simple blood test can determine if your thyroid levels are in the normal range.
  • Depression: Feeling more fatigued than usual can be a sign of depression. If you identify with feeling guilty or hopeless, are experiencing a loss of interest in activities that used to bring you pleasure, or have had thoughts of causing harm to yourself, you should contact your doctor immediately. You can answer these questions to determine if you should seek additional help.
  • Nutrition deficiency. If your iron and/or B vitamins are low, they can contribute to anemia, which can cause fatigue.

If you don’t have any of these health conditions yet you are still experiencing fatigue, you may want to assess your stress level. Too often we get used to pushing ourselves more than is good for us. Making time for a stillness practice like meditation and reconnecting with our breath and nature are very restorative. Sometimes it is the smallest things that have the biggest impact over time.


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About the Author
Danielle’s educational experience has taken her across the U.S.A., from an undergraduate at the University of California, San Diego to New York University School of Medicine, residency at Scripps Mercy San Diego, and Endocrinology Fellowship at Stanford University. She is Board Certified in Internal Medicine and in Endocrinology and Metabolism. She is happy to return back to her hometown of San Diego to her private Endocrinology practice . Within the broad field of Endocrinology, her areas of expertise include the management of obesity, diabetes, metabolic syndrome and nutritional counseling, thyroid, pituitary, adrenals, lipids,...Read more