"Doctor, I'm tired all the time"

This is an enormously common problem. I’m not sure anyone understands why it is so common but it would seem likely that it has something to do with the way we all lead our lives. If people are asked at random about this about 40 percent (almost half) would admit to feeling exhausted at any particular time.

"How do I know I'm not ill"

This is a difficult question to answer. If everybody who feels tired all the time were investigated in as much detail as possible then perhaps one in every twenty might have something wrong physically which might explain their symptoms. Another one in every twenty would have a mental reason for feeling this way, for example depression. In 8 out of ten patients complaining of excessive tiredness there will be nothing wrong. Serious illnesses and even mental illness such as depression are often associated with weight loss(although weight gain can also occur in conditions such as depression and underactive thyroid).

Tests the Doctor can do

Regular weighing by the practice nurse will indicate whether you are losing weight despite a normal appetite. The Doctor might feel you are depressed and suggest medication or counselling or both. Blood tests can be taken by the nurse to check for anaemia (fairly common), glandular fever, thyroid problems (unusual but often missed) or rheumatism. A blood pressure check will exclude high blood pressure although this disease usually does not have symptoms. A sugar test will exclude diabetes. You may be on tablets which cause tiredness as a side effect.

Other Possible Causes

• Some people worry that they might have a vitamin deficiency. There is no reason why you should not take a regular multivitamin tablet but do not overdo it.
• If you are overweight this may make you feel tired. If you do not take enough exercise or do not have enough to do or to think about you may feel tired (although having too much to do or think about may have the same effect).
• Try to reduce the stresses in your life (see separate ‘problem solving sheet’).
• If you snore at night this might mean you do not wake feeling refreshed.
• Some people worry about things like candida: certainly any infection can make you feel tired. The majority of infections are caused by viruses and there is simply no treatment for these; the body must fight them off itself (see separate help sheet on antibiotics).
• Chronic infection in the gums or teeth can make you tired: regular dental checks are important.
• Make sure you have regular breaks from routine: if you are able to take a holiday book the next holiday when you have finished one.
• Shift work is not tolerated well by the body and so if you do work shifts you must make allowances for rest time: you will not be able to burn the candle at both ends.
• Chronic fatigue syndrome can occur as a result of viral illness - it has been shown that people can suffer excessive fatigue following infection with the glandular fever virus. If you have chronic fatigue (otherwise known as myalgic encephalomyelitis)you may be interested in the CFS/ME telephone Helpline 08451232390 which provides access to information and support for people with CFS/ME living in the Bristol Bath Somerset Wiltshire and Gloucestershire areas.

General Advice

• Gentle exercise, a good diet, a positive attitude can all work wonders.
• Avoid smoking and drinking to excess.
• Regular breaks are good but do not feel you have to go away to an exotic location. Sometimes it is equally relaxing to spend some time at home.
• If you still feel exhausted after a break and after trying to deal with some of the life style issues addressed above it would be worth seeing the doctor again for advice about further investigations to exclude a treatable cause.

Resources

Action for ME

PO Box 1302

Wells

BA5 2WE

Tel: 0891 122976

ME Association

4 Corringham rd,Stanford Le Hope,Essex,SS17 0AH Helpline:01375 361013

Tel:01375 642466 Fax:01375 360256

Website:http://www.meassociation.org.uk

Bristol ME association

Andy Rees

34 Kersteman Rd,Redland Bristol BS6 7BX Tel:01179656285