We all have days when we feel tired. Maybe we stayed up too late, had a particularly busy week or simply haven’t had enough time to recharge. But when fatigue becomes an everyday feeling, even when you think you’re getting enough sleep, it may be worth looking a little deeper.
When a patient comes to me saying, “I’m tired all the time,” one of the first places I start is with their sleep.
It isn’t only about how many hours you’re getting. I want to know how long it takes you to fall asleep, whether you’re waking throughout the night and, importantly, what might be waking you.
For some women, hormonal changes can disrupt sleep. Parents may be waking with young children. Others wake during the night and suddenly feel completely alert. You can spend eight hours in bed, but if that sleep is consistently interrupted or isn’t restorative, it can show up as fatigue throughout the day.
But what if you’re sleeping well and you’re still exhausted?
That’s when our conversation starts to widen.
I look at when you last had lab testing, what your diet looks like and whether there are other symptoms happening alongside the fatigue. Nutritional deficiencies are one possible contributor. Iron, vitamin B12 and vitamin D are some of the levels I may consider depending on the individual.
Diet can provide additional clues. For example, someone who follows a vegan or plant-based diet or eats very little red meat may need to pay closer attention to certain nutrients. Food sensitivities, aversions or a limited diet can also affect whether the body is receiving what it needs.
The thyroid is another piece we may investigate. Fatigue combined with changes in your hair or skin, feeling unusually sluggish, or changes in digestion and elimination can help determine whether thyroid testing should be considered.
And then there is something many of us underestimate: stress.
If you’re working long hours, constantly taking care of other people or moving from one responsibility to the next without much time to recover, sleeping at night doesn’t necessarily mean you’re feeling restored. Your daily demands matter when we’re trying to understand your energy.
This is why I don’t look at fatigue as a one-size-fits-all symptom. A detailed conversation helps determine which tests make sense for that particular patient.
When we review lab results, I also make a point of discussing what’s going well, not just what’s outside the expected range. Testing helps us rule possibilities in and rule possibilities out.
If we discover something such as low iron, for example, that information can be incredibly validating. There is now something measurable that may help explain why you’ve been feeling the way you have.
More importantly, it gives us direction.
Once we identify what may be contributing to the fatigue, we can build a treatment plan around those findings rather than simply trying to push through another tired day.
Your energy is part of your overall health. If feeling exhausted has become your normal, it may be time to start asking why.
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