Very common. About one in four Americans complain of enduring fatigue, and blames everything from a lack of sleep to that general bugaboo: stress.

The first step is to figure out what's making you tired. Some possible causes:

Skimping on sleep

Most people need a solid 7 to 9 hours of sleep a night to feel their best. But with today's hectic lifestyles, that can sometimes be difficult to achieve.

How to feel better: If you feel sleepy during the day, you need at least 8 hours a night in bed, according to an expert at the National Sleep Foundation. Exposure to natural sunlight will help get your sleep-wake cycle back to normal. Making your bedroom comfortable and relaxing will also make it more inviting to fall asleep there.

Insomnia

Sometimes the problem isn't lack of time to sleep--it's that you can't fall asleep.

How to feel better: Try getting more exercise; it's one of the most effective ways to combat insomnia. It's also a good idea to cut back on caffeine, nicotine, and alcohol, especially before bedtime. (Although alcohol is a sedative, it tends to keep you in light sleep rather than more restful deep sleep, so you wake up feeling tired.) You might also try putting a few drops of essential oil of lavender on your pillow, which one study found can make you sleepy. Finally, don't lie awake in bed. If you can't sleep, get up and do something relaxing--read a book or watch TV--until you feel drowsy.

Sleep Apnea

People with sleep apnea generally snore up a storm, then suddenly stop breathing--which is marked by a period of eerie silence. After a minute or two without air, they wake up with a start, often gasping and snorting. This may happen hundreds of times a night, and sufferers may not remember ever waking up. But when they rouse in the morning after such a restless night, they're exhausted.

How to feel better: Sleep apnea is caused by a blockage in the airway. Losing excess pounds can often ease the problem, as can sleeping on your side. Your doctor may also suggest that you wear a dental device at night to keep your airway clear or a mask hooked up to a machine that can help you breathe. Finally, in some cases surgery is recommended to remove obstructions or enlarge the airway.

Recent illness

Just because you've gotten over a cold or the flu doesn't mean you're back to your usual self. Being sick can make you feel tired -- sometimes for weeks after the illness has passed.

How to feel better: Take it easy, and let your body recover at its own pace.

Side effects from drugs

Many medications can cause drowsiness and fatigue, including antihistamines, antidepressants, and beta blockers.

How to feel better: Ask your physician if your medicine can be making you tired, and what alternatives are open to you.

Anemia

Without sufficient iron, your blood can't carry enough oxygen to the cells in your body. The result: fatigue, weakness, faintness, and dizziness.

How to feel better: In order to replenish your iron stores, you're going to have to find out what's depleting them. That's where your doctor comes in. If an iron-poor diet is to blame, an iron supplement should help. If you're a woman, you may be losing too much iron during your menstrual period, in which case supplements are again the answer. Sometimes anemia is a symptom of a more serious disorder, such as a bleeding ulcer or colon cancer. If this is the case, the treatment is to correct the underlying condition. Before you start taking supplements, make sure you're not prone to store high levels of iron before taking supplements (insist that your doctor give you a transferrin saturation blood test); getting too much iron can lead to irreversible organ damage.

Iron Overload

An estimated one in three-hundred people in the United States inherits a tendency to accumulate iron in the blood. Fatigue is the most common symptom. Left unchecked, this condition can lead to organ damage and even death.

How to feel better: The only way to know if you have this condition is to have one of two tests: a transferrin saturation blood test or a serum ferritin test. These tests are not the same as the one used to check for anemia and doctors do not routinely perform them. (Ironically, you can have both anemia and iron overload at the same time.) If you test positive for iron overload, your doctor will draw out units of your blood once or twice a week until the excess iron is removed. After that, simply giving blood three to five times a year is usually enough to keep your iron at normal levels as long as you aren't taking iron supplements.

Depression

Sometimes the most noticeable symptom of depression is fatigue. This is especially likely if you're also feeling melancholy or "blah"; you've lost interest in your usual activities, including those you used to enjoy; you're having difficulty concentrating or making decisions; you've lost your appetite or are hungrier than usual and may have either lost or gained weight as a result; and you're having trouble sleeping.

How to feel better: There's no shame in being depressed. In fact, experts call it the "common cold" of mental health because no one is immune and it strikes so frequently. Fortunately, effective treatment is available. Talking to a counselor, sometimes combined with antidepressants (either a prescription drug or the herbal remedy St. John's wort ), often does the trick. In addition, studies show exercise is a good way to raise sagging spirits.

Thyroid problems

Your thyroid gland produces hormones that tell your cells how fast to work. If it's not producing enough, everything slows down: your heart rate drops, your digestive system becomes constipated, your skin dries out, your hair thins, you gain weight, you feel cold -- and, yes, you feel tired. Oddly enough, too much thyroid hormone can also cause fatigue (in addition to triggering rapid heartbeat, sweating, and weight loss).

How to feel better: Fortunately, both conditions can be effectively treated with medication that either replaces or blocks thyroid hormones. With hyperthyroidism, radiation or surgery may also be used to knock out or remove part of the problematic gland.

Diabetes

Your body's primary source of energy is glucose, a sugar found in food. In order to absorb glucose, you need a hormone called insulin, which is produced by your pancreas. If you have diabetes, your pancreas either stops making insulin or doesn't make enough. Without insulin, your body can't absorb glucose, which means you don't have enough energy. In addition to feeling tired, signs of diabetes can include unusual thirst, extreme hunger, frequent urination, blurry vision, excessive irritability, tingling or numbness in the hands, feet or legs, and losing weight without trying.

How to feel better: Making changes in your diet mostly to regulate the amount of sugar and other carbohydrates you eat helps manage the condition so you can live a normal, active life. In most instances, medication and insulin shots are also needed. Exercise can help a lot, too.

Chronic fatigue syndrome (CFS)

If you're so exhausted that you're having trouble going about your usual activities, your fatigue has been going on for more than six months, and your doctor can't find any other medical reason to explain it, CFS may be the culprit. No one knows what causes this mysterious malady, but symptoms can last for months or years. In addition to overwhelming fatigue, people with CFS have at least four of the following symptoms: difficulty concentrating, forgetfulness, sore throat, tender lymph nodes, muscle pain, joint pain, headaches, fatigue on waking up, and feelings of illness and exhaustion after even light exertion.

How to feel better: Because so little is known about CFS, no definitive treatment plan has been established. Most experts recommend living as healthfully as possible: Exercise regularly, eat a balanced diet, get enough rest, learn to pace yourself, ask for help when you need it, don't smoke, and cut back on alcohol and caffeine. Your doctor can also help relieve specific symptoms with pain relievers for muscle aches, antidepressants for depression, and so on. In addition, some people find dietary supplements, such as vitamins and herbs, and alternative therapies like acupuncture and hypnosis to be helpful. (To avoid interactions with prescription drugs, always talk to your doctor or pharmacist before using any over-the-counter medicine or supplements.)

Neurally mediated hypotension (NMH)

Experts now believe that some cases of chronic fatigue syndrome are actually NMH, a blood pressure disorder that causes your nerves to overstimulate your heart, starting a chain reaction that results in lightheadedness, fainting, and fatigue. If you have fainting spells that leave you feeling overwhelmingly tired for hours or days afterward, ask your doctor about NMH.

How to feel better: Eating more salty foods will help prevent the fainting spells that trigger fatigue. Your doctor may also suggest medications such as florinef and beta-blockers.

Mitral valve prolapse syndrome (MVPS)

Once considered a heart disorder, MVPS is now believed to be a malfunction of the nervous system that causes the amount of fluid in your body to drop, leading to fatigue, rapid or irregular heartbeat, dizziness, chest pain, and panic attacks.

How to feel better: You can boost your fluids, which will help you feel more energetic, by drinking more water, eating more salty foods (sodium helps the body retain water), cutting out caffeine (which drains your body of water), and exercising regularly. If these changes don't help, your doctor may suggest medication, such as beta-blockers or florinef.

Congestive heart failure

Despite how it sounds, congestive heart failure does not mean your heart stops; rather, it means your heart is not pumping as well as it should. The result: fatigue, shortness of breath, and bloating and weight gain due to water retention. This condition is a symptom of heart disease and needs to be monitored by a doctor.

How to feel better: Get plenty of rest, but don't become totally inactive. Regular activity keeps your circulation flowing. It's also important to avoid salt, which causes you to retain even more water. Your doctor may also prescribe medications to reduce water retention and help your heart do its work.

Addison's disease

Your adrenal glands produce corticosteroid hormones that regulate many important functions in your body. When the outer layer, or cortex, of your adrenal glands fails, fatigue, loss of appetite, weight loss, weakness, and anemia result.

How to feel better: Addison's disease can be effectively treated with corticosteroid medication that replaces what your adrenal glands are no longer producing.

-- Kate Lee is a former associate editor at Consumer Health Interactive and researcher at Time Inc. Health. She is currently a senior editor at BabyCenter.

References

First published October 1, 1998
Last updated September 11, 2008
Copyright © 1999 Consumer Health Interactive

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