Why Am I Always Tired? | Signs & Solutions

If you keep asking yourself why am I always tired, you are not alone, and there is rarely one simple answer. Ongoing tiredness can come from sleep, diet, stress, a vitamin deficiency or a health condition, which is why a good first step is a careful look at your whole day. In this short video, Dr. Brenda Chau, who earned her medical degree in Peru and works in Toronto using a functional medicine approach, walks through what she checks when someone tells her they are exhausted.

Key takeaways

• Dr. Chau starts by looking for vitamin deficiencies and at how you eat.
• She also asks about memory and how your overall day goes, not just how tired you feel.
• Daily habits are part of the picture: "what kind of food he or she eats, how well they sleep."
• Next come the tests that are needed, then a treatment plan that may include supplements, medication and lifestyle changes.

What Dr. Brenda Chau says

Dr. Chau's approach is less about one quick fix and more about detective work. "When someone comes to me saying that he or she is very tired, I usually look for, first of all, vitamin deficiencies," she says. From there she looks at diet, then widens her questions to memory and "how's the patient's overall day."

She stresses looking at "the patient's lifestyle on a day-to-day basis," including what you eat and how well you sleep. Only then does she "order the tests that are needed" and build a plan, which can include "supplements if it's needed, medication and then some lifestyle changes."

What causes constant tiredness?

Sleep is only one piece. According to MedlinePlus, from the US National Library of Medicine, common causes of fatigue include anemia, iron deficiency, depression or grief, sleep disorders such as insomnia or sleep apnea, a thyroid that is underactive or overactive, ongoing pain, some medicines, and alcohol or drug use (MedlinePlus). Emotional stress and boredom can also leave you drained.

Fatigue is usually not a sign of a serious disease. But if it doesn't improve with enough sleep, good nutrition and less stress, it is worth getting checked. Before an appointment, try tracking your sleep, meals, mood and energy for a week or two. That gives your provider the same kind of day-to-day picture Dr. Chau looks for.

Everyday habits that affect your energy

Some tiredness has everyday roots you can work on while you wait for answers. If you wake up drained after a full night, read our guide to why you might wake up tired after 8 hours of sleep, and see how your diet affects your mental health and mood. Small changes to sleep and food won't fix a medical problem, but they make it easier to see what's left.

Video transcript

Transcript (lightly edited for reading):

When someone comes to me saying that he or she is very tired, I usually look for, first of all, vitamin deficiencies. See how the patient's diet is, and go from there. I started asking a few things like memory: how is his or her memory, how's the patient's overall day. So we have to see the patient's lifestyle on a day-to-day basis: what kind of food he or she eats, how well they sleep, and we go from there, order the tests that are needed, and then create a treatment plan with supplements if it's needed, medication and then some lifestyle changes.

Common questions

What vitamin deficiency causes fatigue?

Low vitamin B12 and low iron are two common ones. MedlinePlus lists fatigue and lack of energy among the symptoms of vitamin B12 deficiency anemia (MedlinePlus). A blood test can check your levels, which is why it's one of the first things Dr. Chau looks at. It's best to test before taking supplements, so you know what you actually need.

How do you know if fatigue is serious?

MedlinePlus advises contacting a provider right away for confusion or dizziness, blurred vision, little or no urine, or recent swelling and weight gain. Make an appointment if the fatigue is unexplained, especially with a fever, unintended weight loss or regular sweats, or if you feel sad or depressed. If you are having thoughts of harming yourself, call or text 988 (US) right away.

What illnesses start with extreme fatigue?

Many conditions can, including diabetes, thyroid problems, anemia, autoimmune diseases such as lupus, eating disorders, infections such as COVID-19, and depression. Fatigue alone can't tell you which one, which is why proper testing matters.

Can depression make you tired all the time?

Yes. Depression and grief are on the list of common causes of fatigue. If low mood, loss of interest or hopelessness come along with the tiredness, talk to a doctor or therapist.

About the expert: Dr. Brenda Chau earned her medical degree in Peru and works in Toronto at Vivagen Life Sciences, where she uses a functional medicine approach.

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