14/03/2024
Hibernation season is over. Winter is gradually slipping away, and spring is just around the corner. The brighter mornings make it a little easier to get up for many of us. But if you’re still feeling exhausted when you wake up or throughout the day, this may be due to an underlying issue. These can range from a simple vitamin deficiency or could be the sign of a more significant problem. You may just need to go to bed a few hours earlier. But rather than playing dice with your health, a blood test could help identify if there is something more sinister working to make you tired all the time.
Explaining Fatigue.
Fatigue is a constant feeling of exhaustion or lack of energy, sometimes referred to as burnout, and can be the result of mental stress, physical stress, or both.
Tiredness is a little different from fatigue; tiredness normally refers to being tired at the end of a long day, whereas fatigue is more consistent and is usually influenced by a combination of lifestyle, social, psychological, and general health issues, but can also be an indication of another, potentially more serious condition.
That said, fatigue can have serious consequences of its own, regardless of the root cause. When your body is fatigued, your reactions are considerably slower. This can lead to accidents in the workplace or on the roads, which could have severe implications for you and the people around you. Tiredness and fatigue can also have less malevolent effects too. It can affect your recovery rate when training, increase your heart rate and even affect your balance.
Another way to consider the difference between tiredness and fatigue is to regard tiredness as acute and fatigue as chronic. Acute tiredness can be the result of a few late nights at the office, a couple of particularly taxing gym sessions, a night in the pub or even jet lag. A good night’s sleep or two is usually the solution here. But what about when some rest doesn’t quite do the trick? Chronic fatigue is a more serious, persistent problem and often the result of an underlying health condition.
Why am I Tired All The Time?
Some causes of tiredness and fatigue can seem less obvious. The body relies on many highly regulated processes to carry out its litany of functions. This means even small deficiencies or changes can cause alterations in your rest, recovery, and energy levels.
Vitamin B12, otherwise known as cobalamin, is a protein abundant in red meat, dairy and eggs. It is an essential cofactor for enzymes involved in DNA synthesis, as well as the synthesis of fatty acids. Vitamin B12 is the unsung hero of your health, contributing to your well-being in a variety of complex ways. In the UK, up to 6% of adults under 60 have been diagnosed with vitamin B12 deficiency and figures are much higher in elderly populations1.
Unexplained fatigue is a symptom of vitamin B12 deficiency and due to its importance in many biological processes, B12 deficiency can lead to serious complications. These can include megaloblastic anaemia (abnormally large red blood cells), gastrointestinal issues2, neurological complications 3, and has also been associated with an increased risk of an adverse cardiovascular event, such as heart failure4, infertility5 and some autoimmune conditions including multiple sclerosis6, rheumatoid arthritis, and lupus7.
The extra energy people feel in the summer months, may be related to their vitamin D levels. Vitamin D is unique as the body can only synthesis it when your skin is exposed to sunlight. Vitamin D deficiency can lead to rickets and osteomalacia – bone conditions in children and adults, respectively. Additionally, new evidence is indicating a connection between vitamin D deficiency and depression, diabetes, and heart disease8.
Like vitamin B12, vitamin D deficiency is relatively common and is closely associated with fatigue. Studies have shown that supplementation in people with vitamin D deficiency who were otherwise healthy, significantly improved their fatigue9.
The thyroid gland a butterfly-shaped endocrine gland consisting of a left and right node, located on either side of the windpipe, connected by a small bridge of thyroid tissue known as the isthmus.
It is responsible for the production of hormones which are crucial in preserving the intricate equilibrium of cellular metabolism, essential for the optimal performance of cells, tissues, and ultimately, organs. These roles involve regulating heart and breathing rates, activating the nervous system to promote wakefulness and alertness, and supporting reproductive health10.
An underactive (hypothyroidism) or overactive thyroid (hyperthyroidism) causes changes in the tightly regulated levels of the hormones produced by the thyroid and can result in tiredness or fatigue, as well as a variety of other conditions including, cardiovascular complications11,12.
Iron deficiency causes a reduction in red blood cells which are essential for transporting oxygen around the body. Iron is an essential component of haemoglobin, the protein in red blood cells required for oxygen binding.
There are 4 iron molecules in each haemoglobin molecule, allowing for the binding of 4 oxygen molecules. A shortage of iron means the body cannot produce as many red blood cells, resulting in inefficient oxygen transport.
Iron deficiency anaemia can cause fatigue or lethargy (lack of energy) as well as shortness of breath and heart palpitations. Left untreated, the repercussions could be severe.
Iron deficiency can lead to increased risk of other illness or infection and cardiovascular complications. However, it is generally easy to treat by including iron-rich foods like dark-green, leafy vegetables, meat, and pulses (beans, peas, lentils)13.
Fatigue is often the first symptom in people with diabetes. High or low blood sugar levels cause an imbalance in a person’s glucose and circulating or effective insulin levels. In the face of high blood glucose levels, insufficient or ineffective insulin inhibits the cells of the body from obtaining the glucose necessary for cellular metabolism, meaning these cells can’t produce the energy they need. Similarly, when blood sugar is low, the required levels of glucose are not available, and the cells cannot produce enough energy to carry out their functions14.
Therefore, undiagnosed, or uncontrolled diabetes can result in fatigue and lethargy. If you are feeling tired all the time and haven’t been diagnosed with diabetes, it’s worth getting tested to find out if this might be the source of your fatigue. If you have been diagnosed, it’s possible your blood sugar levels aren’t as under control as you think15.
Fatigue and lethargy can be indications that there’s a problem with your kidneys. Sub optimal kidney function can result in a buildup of toxins in the blood, which can make you feel tired, weak and make it difficult to concentrate. Additionally, kidney problems can cause sleep disturbances and anaemia, which as we’ve discussed, can lead to fatigue.
People who suffer from chronic kidney disease (CKD) often report fatigue. If diagnosed early, CKD is a manageable condition, but if left untreated, it can lead to end stage renal disease (ESRD). ESRD is a condition in which one or both of your kidneys no longer function on their own. People with ESRD require dialysis or, in some cases, kidney transplant16.
These days, most of us are familiar with ‘long-COVID’, but this isn’t a new phenomenon.
Post-viral fatigue, as the name suggests, is the development of fatigue after a viral infection.
Even common infections like the cold or flu can cause fatigue that can last anywhere from days to months post-infection17.
Chronic Fatigue Syndrome (CFS) or myalgic encephalomyelitis, is the name given to a syndrome of long-term conditions, including post-viral fatigue, in which the most common symptom is extreme fatigue. It can affect people of all ages but is most seen in people in their mid-20s and mid-40s. It can be caused by all the complications we’ve discussed, as well as some genetic factors. CFS can affect your quality of life, mental and emotional health, and make it difficult to conduct your daily activities. There are currently no know cures for CFS, however, with treatment CFS can improve overtime18.
Tests For Those Tired All The Time.
Everyman/Everywoman
If you’re feeling more like a sleeping bear than a spring chicken, you should consider getting tested at Randox Health. Our Everyman/Everywoman packages include biomarkers associated with the deficiencies and conditions mentioned including a full blood count, kidney health, bone health, infection and inflammation, nutritional health, thyroid health, iron status and diabetes health.
Our Everyman/Everywoman packages also tests for a lot more, measuring up to 150 biomarkers from simple blood and urine samples to provide you with a comprehensive overview of your health. You’ll get 2 health checks per year, allowing you to track how the changes you’ve made effect your body. We provide you detailed results within 2-5 working days as well as the option of a GP consultation and health and well-being discussion.
Everyathlete
Whether you’re an Olympian in training, or simply take your training seriously, you track a host of data. From your personal bests to changes in your physical appearance, you’re never finished optimising your training schedule and nutrition regime. However, tiredness and fatigue can quickly stop you in your tracks.
Our Everyathlete package measures 80 data points linked to nutrition, muscle, joint, hormonal health, including thyroid health, to provide you with key health insights to help optimise your training and nutrition for maximum performance. While you can train while tired, your performance and recovery might see improvements if you can get to the root cause of your fatigue.
Like our everyman/everywoman packages, you’ll get your results in 2-5 working days. Along with the detailed description of your results, you have the option of booking a health and wellbeing discussion with one of our team, or you can book a consultation with one of our GPs.
If you’re sick of being tired all the time, have any concerns about your health, or would simply like some peace of mind, get in touch with us today. Book an Everyman/Everywoman, an Everyathlete if your eager for sports performance improvements or get more information about our other tests at https://randoxhealth.com/en-GB/.
- Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349(sep04 1):g5226-g5226. doi:10.1136/bmj.g5226
- Ankar A, Kumar A. Vitamin B12 Deficiency.; 2023.
- Patel S V., Makwana AB, Gandhi AU, Tarani G, Patel J, Bhavsar V. Factors associated with vitamin B12 deficiency in adults attending tertiary care Hospital in Vadodara: a case control study. Egypt J Intern Med. 2022;34(1):11. doi:10.1186/s43162-022-00104-0
- Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D. How prevalent is vitamin B12 deficiency among vegetarians? Nutr Rev. 2013;71(2):110-117. doi:10.1111/nure.12001
- Green R, Graff JP. Megaloblastic Anemia. In: Atlas of Diagnostic Hematology. Elsevier; 2021:47-51. doi:10.1016/B978-0-323-56738-1.00004-X
- Najafi MR, Shaygannajad V, Mirpourian M, Gholamrezaei A. Vitamin B(12) Deficiency and Multiple Sclerosis; Is there Any Association? Int J Prev Med. 2012;3(4):286-289.
- Segal R, Baumoehl Y, Elkayam O, et al. Anemia, serum vitamin B12, and folic acid in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus. Rheumatol Int. 2004;24(1):14-19. doi:10.1007/s00296-003-0323-2
- Sizar O, Khare S, Goyal A, Givler A. Vitamin D Deficiency. StatPearls Publishing ; 2024.
- Nowak A, Boesch L, Andres E, et al. Effect of vitamin D3 on self-perceived fatigue: A double-blind randomized placebo-controlled trial. Medicine. 2016;95(52):e5353. doi:10.1097/MD.0000000000005353
- Armstrong M, Asuka E, Fingeret A. Physiology, Thyroid Function.; 2023.
- National Institute for Health and Care Excellence. Hyperthyroidism: Background Information. Health topics A to Z. Published January 2021. Accessed November 13, 2023. https://cks.nice.org.uk/topics/hyperthyroidism/background-information/
- National Institute for Health and Care Excellence. Hypothyroidism: Background Information. Health Topics A to Z. Published May 2021. Accessed November 13, 2023. https://cks.nice.org.uk/topics/hypothyroidism/background-information/
- NHS. Iron deficiency anaemia. https://www.nhs.uk/conditions/iron-deficiency-anaemia/.
- Diabetes.co.uk. Tiredness and Diabetes. https://www.diabetes.co.uk/tiredness-and-diabetes.html.
- Kalra S, Sahay R. Diabetes Fatigue Syndrome. Diabetes Therapy. 2018;9(4):1421-1429. doi:10.1007/s13300-018-0453-x
- National Kidney Foundation. Kidney Failure. https://www.kidney.org/atoz/content/KidneyFailure.
- Millar A. What you need to know about post-viral fatigue. https://patient.info/news-and-features/what-you-need-to-know-about-post-viral-fatigue.
- NHS. Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/.