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DEFINITIVE GUIDE

Fatigue symptoms, remedies and treatment

Fatigue is the main health issue for 5-7% of people attending primary care (seeing their GP). Extreme fatigue can dramatically impact a person’s life with a loss of motivation and energy.

Sufferers can often dismiss the symptoms of fatigue as simple tiredness, failing to treat it with the attention it deserves.

Understanding the symptoms and underlying causes of fatigue is essential to help identify the right treatment for you. Find out everything you need to know about fatigue with our definitive guide.

Written by Dr Abby Hyams and Dr Adam Abbs. Reviewed by Rajan Mistry. Last reviewed on 20/01/2020. Next review date 20/01/2023.

Fast facts

How do you know if you are suffering from fatigue?

If you find yourself lacking energy and motivation, you may suffer from fatigue. It is more than just a feeling of tiredness – fatigue at its worst can make it difficult to carry out simple day-to-day tasks and leave you feeling exhausted. It can also cause a number of physical, mental and emotional symptoms.

How can I stop feeling tired all the time?

There are many steps you can take to help overcome tiredness and increase your energy levels. Lifestyle changes such as increased exercise, less alcohol consumption and dietary changes can all contribute to reducing tiredness. Further steps include lowering stress levels, losing weight and monitoring your sleep.

CHAPTER ONE

Fatigue signs and symptoms

Fatigue affects everybody in a different way. Some people will experience physical aches and pains, while others may experience mood swings or irritability.

Most common, however, is a feeling of constant tiredness and a lack of motivation that does not go away with sleep. Fatigue can leave you worn out every day, and you may not feel like yourself. If you think you might suffer from fatigue, we can help with:

What does it feel like to be fatigued? And what are the signs of fatigue?

What does fatigue mean?

Fatigue is defined as a lack of energy and motivation, both physically and mentally. While it is not the same as tiredness, fatigue generally causes an increased desire to sleep. Sufferers of extreme fatigue feel exhausted and run down as well as experiencing other physical and emotional symptoms.

What’s the difference between tiredness and fatigue?

While everybody experiences tiredness, this can usually be solved through a good night’s sleep and some rest. However, if this tiredness is excessive and isn’t solved by sleep and rest, you may suffer from fatigue.

Fatigue is not simply feeling tired or drowsy. When you’re feeling fatigued you lack energy. You may experience difficulty concentrating, lowered stamina or dizziness. While being tired may be a symptom of fatigue, it’s not the same thing.

Important

It is important not to dismiss the symptoms of fatigue as tiredness as they are often a sign of an underlying problem. If you think you may suffer from fatigue see a doctor for a full review.

What are the symptoms of fatigue?

Fatigue can cause many physical, mental and emotional symptoms. The main symptoms of fatigue include:

  • Drowsiness or tiredness
  • Headaches, nausea and dizziness
  • Aching muscles
  • General weakness
  • A feeling of slowness
  • Impaired judgement and decision-making
  • Mood changes
  • Impaired hand-eye coordination
  • Poor appetite
  • Recurrent illnesses
  • Short-term memory loss
  • Poor concentration
  • Loss of motivation

What are the effects of fatigue?

Everyone who suffers from fatigue will experience it differently. To some fatigue may be mild and not interfere with their daily lives, while for others it can have a very disruptive effect.

Fatigue can affect the way that you think and feel. You may have difficulty concentrating, impacting your work and your leisure time. You may become impatient with those around you, or avoid socialising because it is too much effort.

You may experience a whole range of physical, mental and emotional symptoms.

When should I see a doctor about fatigue?

You should see a doctor if your fatigue has lasted for two or more weeks despite taking proactive steps such as lifestyle changes. Medicspot offers same-day doctor appointments at hundreds of locations across the UK.

You should seek emergency help if you are having suicidal thoughts or you are concerned that you might harm yourself or somebody else.

CHAPTER TWO

What causes fatigue?

Extreme fatigue can often be traced back to habits or lifestyle factors. However, lifestyle is not the only cause of fatigue.

Fatigue also acts as a symptom of other physical health conditions that may require medical treatment. A mental health condition, trouble sleeping or stress can also cause constant tiredness. If you want to know what causes fatigue, we can help with:

Why am I always tired and have no energy? And what is the main cause of fatigue?

Physical health conditions

Feeling fatigued is a common symptom of many medical conditions. When you see a doctor they will try to identify the causes for your fatigue; initially the doctor will attempt to rule out any physical health conditions that may be the underlying cause. Examples of these conditions include:

  • Anaemia
  • Underactive thyroid
  • Coeliac disease
  • Diabetes
  • Glandular fever
  • Arthritis
  • Fibromyalgia
  • Sleep apnoea
  • Vitamin D deficiency

Mental health conditions

Many mental health conditions can also cause constant tiredness. Studies have shown that conditions such as anxiety and depression are common causes of fatigue.

If you suffer from any of the following conditions, this may be a cause of your fatigue:

  • Depression
  • Anxiety
  • Stress
  • Grief
  • Seasonal affective disorder
Important

To rule out any physical and mental health conditions that may be causing fatigue, it is important to visit a doctor. Through appropriate investigations and an analysis of your medical history, your doctor can help identify any underlying causes.

Lifestyle factors

An honest analysis of your lifestyle is often the first step towards reducing constant fatigue. Your activities and other lifestyle choices may be the cause of extreme tiredness. Fatigue can result from:

  • Excessive physical exertion or lack of exercise
  • Lack of, or poor quality, sleep
  • Being overweight
  • Consumption of alcohol
  • Drug use
  • Caffeine consumption
  • Poor dietary habits
  • Use of sleeping tablets

Sleep factors

Adults typically need around eight hours of sleep every night. Getting too much or too little sleep can add to your feeling of extreme fatigue. It is important not to rely on naps taken during the day.

Try to settle into a routine of good quality sleep. Where possible, eliminate any disturbances such as noise or light, and ensure you have a comfortable sleeping environment, to improve the quality of your sleep. Keeping a log of how much sleep you are getting and when will help you identify what changes you need to make.

Workplace-related factors

Long hours, excessive physical exertion, irregular work or night shifts can all contribute to fatigue. A stressful job, or one that disrupts your natural sleep cycle, can have a severe impact on your body.

Working too hard can lead to burnout, and can have an impact on your social life and personal interests. Financial pressures, repetitive tasks or boredom can also cause undue mental strain. If you feel that your work is having a negative impact on your sleep or health in general, try talking to your manager or HR department, or examining opportunities to change.

How do I know what is causing my fatigue?

Due to the wide range of causes, it can be difficult to understand exactly why you’re feeling tired all the time. Medicspot offers a comprehensive blood test to identify physical causes for your tiredness.

CHAPTER THREE

What are the treatments for fatigue?

Your treatment will depend on the cause. As fatigue is often a symptom of an underlying medical condition, once this is identified, an appropriate treatment can target this.

Otherwise a number of lifestyle changes and over-the-counter options can also help you overcome certain types of fatigue. If you’re looking for advice on how best to treat fatigue, we can help with:

How do you get rid of fatigue? And what is the best medicine for fatigue?

Can fatigue be cured?

For most people where there is no physical cause, fatigue will get better over time on its own or by making some simple lifestyle changes. Increased exercise, reduced stress and a healthy diet can all help reduce the effects of fatigue.

However, if constant tiredness is a symptom of a wider medical condition, curing your fatigue will generally mean resolving the underlying cause. Thankfully, many conditions which cause fatigue are easily treated.

Important

While there is no cure for Chronic Fatigue Syndrome, there are a number of treatments available. More information can be found in our chapter on CFS.

Can fatigue be prevented?

Addressing the underlying cause of fatigue is the best way of preventing extreme tiredness. The early recognition of decreased energy levels and then the underlying condition will allow you to seek medical care, and receive treatment, earlier.

While it can be difficult, it is important to remain objective when feeling fatigued so that you can seek help. If you are worried that you are suffering from fatigue, ask friends or family members if they have noticed any change in you or your behaviour.

Medical treatments

If your fatigue is not caused by a lifestyle factor, your doctor may want to undertake some tests and ask about your medical history to help rule out any underlying conditions. Diabetes, anaemia, coeliac disease, thyroid problems, depression and anxiety are only some of the conditions that can cause body aches and fatigue.

If and when an underlying condition is identified as the cause of fatigue, the treatment for this condition should result in resolution of the fatigue.

Lifestyle treatments

Fatigue may also be caused by a number of lifestyle factors. A lack of physical exercise, poor nutrition or an irregular sleep pattern can all contribute to a feeling of excessive tiredness.

If you are suffering from fatigue, reflect on your lifestyle. Your job may be causing you too much stress, or a noisy environment may be stopping you from sleeping. By making some changes to your daily life, you may find the solution to your fatigue.

CHAPTER FOUR

Coping with fatigue

Fatigue can leave you with little energy and struggling to keep up with day-to-day tasks. Whether it’s due to medical conditions, lifestyle factors or problems with your mental health, extreme tiredness can make even the smallest of tasks difficult.

However, there are many self-help tips that can help you take control and restore your energy levels. By prioritising your time and working with your fatigue, not against it, you can help ease the effects of your condition. If you’re looking for advice on coping with fatigue, we can help with:

How can I reduce fatigue? And how does work affect fatigue?

Planning

It is important to actively plan your day when you are suffering from fatigue. Try to be realistic about what you can do so that you don’t exhaust yourself. Allow yourself time to rest and to do the things you most want to do.

Housekeeping

We all know the importance of a clean and tidy home, but it can prove difficult to keep your home as you’d like it while suffering from fatigue. Tasks can add up when you can’t find the energy or motivation to complete them.

It may help to spread your tasks out over the course of your week, doing a little bit each day rather than attempting the whole task in one go. You can also make chores easier by sitting down to do them where possible, using a wheeled shopping bag when visiting the shops, and using anti fatigue mats, long-handled dusters, mops and dustpans.

Tip

If you have any heavy work to do, ask other people if they could assist you or do it for you. There’s no shame in seeking support as undue stress and exertion will only increase your fatigue.

Shopping

Leaving the home can be challenging when suffering from fatigue. If you find that you can’t, ask friends or family to do the shopping for you. Another option is shopping online and having it delivered. However, getting outside for a walk is good for your cardiovascular health and mental health too.

If you can leave the home but still find yourself lacking energy, there are steps you can take to make shopping easier.

  1. Write a shopping list before leaving
  2. Use the shopping trolley for support
  3. Avoid the busiest times
  4. Ask for help packing and carrying groceries, or ask them to deliver
  5. Shop with a friend, interacting socially can be good for your mental health

Laundry

The laundry can easily be forgotten when low on energy or motivation. To make things easier for you when suffering from fatigue, follow these steps:

  1. Ask friends or family for help hanging up your washing
  2. Sit down when ironing
  3. Use a lightweight iron
  4. To avoid lifting the iron, slide it onto a heat-proof pad
  5. Hang your clothes up after washing to reduce the need to iron

Cooking

Healthy eating habits can help ease your recovery from fatigue, so it is important to keep cooking where possible. However, there are many easy tips that can help to ease this along:

  • Cook simple dishes
  • Try to eat little and often throughout the day
  • Avoid big heavy meals or meals high in fat
  • Prepare extra dishes or double portions and freeze them for later
  • Use oven dishes that you can serve from to cut down on the washing up
  • Use a dishwasher
  • Ask for help moving heavy items

Child care

Looking after your family can be hard at the best of times, but fatigue can make this even more difficult. Extreme tiredness might make you feel like you’re letting your children down or can’t spend enough time with them.

Thankfully, there are simple steps that you can take to help make child-care easier for yourself:

  • Explain to your child that you are feeling tired and so won’t be able to do as much as before
  • Plan activities you can do sitting down, or where you can sit while the children enjoy themselves
  • Try to find activities that both you and your children enjoy, so that you can spend time with them without it using too much of your energy
  • When out and about, use a pram or pushchair instead of lifting your children, or encourage them to walk where possible
  • Let friends or family look after your children or take them to and from school
  • Hire a babysitter from time to time so you can do some of the things you enjoy

Work

Fatigue can impact the amount of work you can do from day-to-day, or whether you can work at all. It can help to talk to your employer about fatigue as you may need some time off due to illness or treatment. Your doctor can help you with a fit note that will inform your employer of any adaptations that they can make to ensure you can still work and stay healthy.

Don’t push yourself to work if you’re too tired as this can make your fatigue worse. However, if you do want to keep working, you can make suggestions to your employer that could support you:

  • Changing your hours so that you commute outside of rush hour
  • Letting colleagues support you with some of your work
  • Finding a parking place near to your place of work
  • Letting you take a short break every now and then
  • Allowing you to work from home
  • Finding lighter jobs that require less physical exertion
Important

If you are self-employed, the Department for Work and Pensions can advise you on any benefits you may be entitled to claim. This cannot be done without a diagnosis from a doctor and you will most likely require a referral to a specialist for this.

CHAPTER FIVE

Lifestyle changes

Fatigue is a common symptom of several physical and mental health conditions, but it is often caused by simple lifestyle factors.

By making small changes in your diet, routine or other aspects of your day-to-day life, you can help reduce the effects of fatigue. If you want to know what changes you can make to reduce fatigue, we can help with:

How can I reduce tiredness and fatigue? And what foods cause fatigue?

Does food affect fatigue?

Poor dietary habits and being overweight are significant risk factors for fatigue. Dietary habits that can lead to fatigue include eating too much junk food, lacking vitamins or minerals, or eating foods that you have an intolerance of.

There are a number of simple steps you can take to help reduce the risks of your diet causing fatigue:

  • Keep a diary of what you eat and how you feel
  • Try to eat when you’re hungry
  • Consult your doctor or nurse for leaflets which provide dietary advice
  • Ask your doctor to refer you to a dietitian if you need detailed advice

Exercise and fatigue

It’s important to keep active even when you feel like you don’t have the energy to do so. While too much exercise might make you more tired, so will too little. Try to find the right balance for you.

Light exercise such as walking has been shown to reduce fatigue and aid sleep. Where possible, try to build some light exercise into your daily routine and monitor how it affects your sleep.

Sleep and fatigue

While fatigue may make you want to sleep all the time, it is important to maintain a normal sleeping pattern even when you’re ill. Good quality sleep may help fight fatigue as well as reduce your need to rest during the day.

If you think that irregular sleep may be causing you fatigue, try the following tips:

  • Sleep just long enough to feel refreshed (usually no more than 9 hours)
  • Try and wake up at the same time every day (even if you went to bed late)
  • Exercise regularly
  • Reduce noise in your bedroom
  • Make your bedroom as dark as possible
  • Avoid stimulants such as caffeine and nicotine (especially in the afternoon)
  • Avoid alcohol
  • Only sleep in your bedroom, don’t use it to study or rest when not sleeping
  • Keep your bedroom at a steady temperature, and a little lower than you’d expect
  • Reduce screen time just before bed

Does relaxation affect fatigue?

It is very important to find time for relaxation if you suffer from fatigue. Stress can use up your energy and make you feel even more tired.

Try to find the right form of relaxation for you. This may be talking to friends, meditation, light exercise, or practising mindfulness and breathing exercises. Experiment to find the method of relaxation that works for you.

Talking about fatigue

You may find it difficult to talk about fatigue, especially as the condition can negatively affect your mental health. However, discussing your symptoms honestly and openly with a doctor is essential to getting the right treatment. You should never feel embarrassed as your care and wellbeing is their priority, and they understand how the physical, social and psychological elements of your life are strongly linked.

You may also want to attend local support groups or talk to other sufferers of fatigue. Accepting and moving past the stigma of the illness will help you to find solutions that work for you.

CHAPTER SIX

Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome is estimated to affect 17 million people worldwide. Also known as myalgic encephalomyelitis (ME) or post-viral fatigue syndrome (PVFS), chronic fatigue syndrome is a long term condition of persistent fatigue.

Sufferers of CFS/ME experience extreme fatigue and after minor exertion the body struggles to recover, causing symptoms to flare up. If you’re looking for information on chronic fatigue syndrome we can help with:

What is chronic fatigue syndrome? And how do you test for CFS?

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a long-term condition of extreme fatigue or tiredness that does not pass and cannot be explained by an underlying medical condition.

Also known as ME (myalgic encephalomyelitis) or SEID (systemic exertion intolerance disease), chronic fatigue syndrome can affect anyone, including children. However, it is more common in women and usually develops between your mid-20s and mid-40s.

Types of chronic fatigue syndrome

Everybody suffering from chronic fatigue syndrome is likely to have their own experience of the condition, and this may be determined by the type of CFS that they have. While severity often changes over time, the National Institute for Health and Care Excellence (NICE) defines three levels of CFS.

People suffering from ‘mild’ CFS are able to carry on with everyday tasks such as work or education, but these activities become more difficult. Because their spare time is needed for rest, they may give up hobbies or sacrifice their social life.

People suffering from ‘moderate’ CFS struggle to move around easily and everyday tasks become difficult to complete. They may give up work or education, sleep frequently in the afternoon, rest between activities and have trouble sleeping at night.

People suffering from ‘severe’ or ‘very severe’ CFS experience mobility issues and may require the use of a wheelchair. They may spend most of the day in bed and find themselves unable to leave the house. They may also suffer sensitivity to noise and light.

What are the symptoms of chronic fatigue syndrome?

People suffering from chronic fatigue syndrome experience extreme tiredness. However, other symptoms include:

  • Poor sleep
  • Unexplained joint or muscle pain
  • Headaches, dizziness and nausea
  • Sore throat
  • Trouble thinking, concentrating or remembering
  • Heart palpitations
  • Flu-like symptoms

What are the causes of chronic fatigue syndrome?

While it isn’t known what exactly causes CFS, there are a number of explanations. Chronic fatigue syndrome may be triggered by an infection, while certain factors may make you more likely to develop the illness.

Problems with the immune system, viral infections, bacterial infections, hormonal imbalances, mental health problems, such as stress, and genetics may all contribute to chronic fatigue syndrome.

How do you test for chronic fatigue syndrome?

As there is no specific test for chronic fatigue syndrome, your GP will diagnose you based on your symptoms. CFS has many symptoms that are similar to other illnesses, so your GP will ask your medical history and may organise some tests to look for other causes.

Important

As the symptoms of chronic fatigue syndrome are similar to those of common conditions that get better over time, a diagnosis of CFS may be provided if you do not recover as quickly as expected.

Chronic fatigue syndrome treatment

As there is no cure for chronic fatigue syndrome, treatment aims to relieve your symptoms. The treatment offered to you will depend on how CFS affects you.

Treatments for CFS include cognitive behavioural therapy (CBT), graded exercise therapy (GET) and medicine to help with your mood, control your pain or aid sleeping problems.

Most sufferers of CFS get better over time, although some don’t make a full recovery. Your symptoms will likely vary in severity over time. Children and young people with CFS are most likely to recover fully.

Living with chronic fatigue syndrome

It can be difficult living with CFS. Physical symptoms and extreme fatigue can impact your daily life, maybe forcing you to make some lifestyle changes. CFS can also take its toll on your mental and emotional health and impact your self-esteem.

It is important to turn to your family and friends for support, as well as other people with CFS.

Charities such as the ME Association provide information, support and advice for people affected by chronic fatigue syndrome. You can also find a support group near you on their website.

CHAPTER SEVEN

How can I get tested for fatigue?

It can be difficult to pinpoint the exact cause of why you’re feeling tired all the time. Fatigue can be attributed to a variety of different causes and there may be more than one reason for your tiredness.

There are, however, ways you can better understand why you’re feeling tired, fatigued and lacking energy. We can help with:

Why am I feeling tired all the time? Do I have fatigue?

Fatigue test

Medicspot offers comprehensive blood tests designed for those who feel tired all the time, fatigued or low on energy.

Medicspot’s Fatigue Test includes an extensive set of tests to help pinpoint the cause of your tiredness:

  • Full blood count – this examines your blood, looking at the number and types of cells that your blood contains, and checks for anemia
  • ESR – is raised if there is inflammation inside your body
  • Urea and electrolytes – measures the performance of your kidneys by looking at important salts in your body
  • Bone profile – looks at calcium, phosphate and uric acid levels for your bones and joints
  • Glucose – this will check the levels of glucose in your blood
  • Cholesterol – checks the amount, and types, of cholesterol in your blood
  • Vitamin D – this checks for one of the most common deficiencies in the UK, responsible for fatigue and anxiety
  • Iron profile – low iron and ferritin levels can restrict your body from making enough red blood cells, leading to anaemia
  • Thyroid profile – an under or overactive thyroid can lead to many different symptoms including tiredness

Talk to a doctor

There are clear guidelines available to help doctors diagnose chronic fatigue. This may involve a doctor asking you about your medical history and performing an examination. Your doctor may offer you specific blood tests to help rule out conditions such as an underactive thyroid gland or anaemia.

Medicspot offers same-day private doctor appointments at hundreds of locations across the UK.

CHAPTER EIGHT

Get same-day treatment with Medicspot

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CHAPTER NINE

About the authors

Written by Dr Abby Hyams and Dr Adam Abbs. Reviewed by Rajan Mistry. Last reviewed on 20/01/2020. Next review date 20/01/2023.

Dr Abby Hyams

Dr Abby Hyams grew up in Manchester and did her medical training in Bristol. She has been a GP for over ten years, many of them as a partner in an NHS practice in Hemel Hempstead. Dr Hyams loves being a GP because of the wide spectrum of people she encounters every day.

Dr Adam Abbs

Dr Adam Abbs qualified as a doctor from Hull York Medical School in 2010. He started training in hospital medicine but then retrained as a general practitioner. Following leading the development of urgent care services in North Manchester, he joined Medicspot in April 2019. He has a special interest in urgent care and also volunteers for numerous children’s cancer charities.

Rajan Mistry

Rajan Mistry qualified as a pharmacist from The University of Hertfordshire in 2014. He completed his pre-registration with Boots and managed the store in Stanmore, London. Rajan has worked in both community and hospital pharmacies, giving him exposure to clinical governance and dispensing. He is particularly interested in minor ailments and infectious diseases. Rajan joined Medicspot to help make pharmacies the first port of call in primary care and broaden their clinical services.

Disclaimer

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medicspot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.