Why Am I Always So Tired?

You went to bed at a reasonable hour, and you’re still dragging by 10 a.m. By afternoon you’re staring at your screen, reading the same line twice. You’ve had a second coffee, and a third. Everyone around you seems to run on less sleep and more energy.

The sleep-and-life causes

The NHS¹ suggests aiming for 6 to 9 hours of sleep, with regular sleep times and a relaxing sleeping area that isn’t too bright, noisy or warm. It also recommends regular exercise and a healthy diet, and avoiding smoking, excess alcohol and screens before bed. Our articles on trouble falling asleep, waking at 3 a.m. and waking to pee cover common ways sleep gets cut short.

The medical causes worth ruling out

Anemia. The National Heart², Lung, and Blood Institute (NHLBI) lists weakness, paleness, tiredness, chills, shortness of breath, headache, dizziness and fainting as symptoms. It says mild anemia may not cause any symptoms, and that symptoms can develop quickly or slowly, depending on the cause.

On causes, the NHLBI³ says any condition that causes you to lose a lot of blood increases your risk. It names heavy periods, defined by changing a pad or tampon within 2 hours, among the risk factors, and says people who don’t get enough iron, B12 or folic acid, including vegetarians and vegans who may not get enough dietary iron, have a higher risk. If your periods are heavy, see how to know if your period is too heavy.

Sleep apnea. Tiredness despite a full night is on the NHS¹ list. See sleep apnea in women.

Thyroid problems and diabetes. Both are on the NHS¹ list. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)⁴ lists fatigue as a symptom of diabetes, along with increased urination, feeling intensely thirsty or hungry, blurred vision, sores that do not heal and frequent infections, including yeast infections. See repeat yeast infections.

Menopause and mood. The NHS¹ names hormonal changes in menopause and depression. See perimenopause and mood changes in menopause.

What a clinician usually does

The NHS¹ says a GP may order blood tests to rule out anaemia, diabetes or thyroid problems, and may refer you to a specialist if the cause is still unclear.

The play

Try this: a two-week energy log

Each day, write your bedtime, wake time, how you slept, caffeine and alcohol, meals, exercise and when your energy dipped.

Note anything that goes with it: heavy periods, night sweats, snoring, dizziness, more thirst or more bathroom trips than usual.

Bring the log to the visit. It makes the blood tests easier to choose.

When to get checked

Don’t wait if

1. Urgent

   Get urgent care if tiredness comes with chest pain or trouble breathing.

The NHS¹ says to see a GP if you’ve been feeling tired for a few weeks and you’re not sure why, or if it’s affecting your daily life.

Book an appointment if any of these fit:

• You’ve been tired for a few weeks without an obvious reason
• You also have heavy periods
• You’re pale, dizzy or short of breath
• You’re unusually thirsty, urinating more or seeing blurrier than usual
• Fatigue is affecting work, home or mood
• You snore or wake unrefreshed despite enough sleep

Being tired all the time isn’t a personality trait. It’s a symptom, and symptoms have causes that can be checked.