Why You Feel Constantly Tired — A Physician Explains Chronic Fatigue

• Feeling tired all the time is one of the most common complaints worldwide
• Fatigue is a symptom, not a disease
• It may originate from physical, psychological, metabolic, or lifestyle causes
• Proper understanding prevents unnecessary anxiety and over-investigation

General Readers
You may be experiencing chronic fatigue if:
• You feel exhausted even after adequate sleep
• Daily tasks feel unusually difficult
• Motivation and concentration are reduced
• You feel physically weak or mentally drained

Common everyday causes:
• Poor sleep quality
• Stress and anxiety
• Dehydration
• Irregular meals
• Excess screen exposure
• Sedentary lifestyle

Medical Students
Common etiologies to remember:
• Physiological
• Sleep deprivation
• Overwork
• Metabolic
• Anemia
• Hypothyroidism
• Vitamin B12 or D deficiency
• Psychological
• Depression
• Anxiety disorders
• Systemic
• Chronic infections
• Inflammatory states

Key learning point:
• Fatigue is multifactorial in most patients.

Young Doctors
Clinical approach:
• Take a structured history:
• Duration and pattern
• Sleep quality
• Stressors
• Weight changes
• Review medications
• Screen for mood disorders
• Avoid labeling fatigue as “functional” without evaluation

Basic initial workup:
• CBC
• Thyroid profile
• Blood sugar
• Electrolytes

General Practitioners
Common patterns seen in clinics:
• Iron deficiency in women
• Vitamin D deficiency
• Poor sleep hygiene
• Stress-related fatigue
• Sedentary lifestyle

Management principles:
• Identify reversible causes
• Reassure patients
• Avoid polypharmacy
• Encourage lifestyle correction

Pathophysiology
Mechanisms contributing to fatigue:
• Reduced oxygen delivery (anemia)
• Hormonal imbalance (thyroid, cortisol)
• Neurotransmitter dysregulation
• Chronic inflammation
• Autonomic nervous system imbalance
• Mitochondrial energy dysfunction
Fatigue often reflects energy production–consumption mismatch.

When to See the Doctor
Seek medical advice if fatigue:
• Persists beyond 3–4 weeks
• Is worsening
• Is associated with:
• Weight loss
• Fever
• Breathlessness
• Palpitations
• Low mood
• Interferes with daily functioning

Chronic fatigue is common, real, and treatable. Most cases improve once the underlying cause is identified and lifestyle factors are corrected. Early evaluation prevents long-term physical and emotional consequences.

Dos and Don’ts

DO
• Maintain regular sleep
• Eat balanced meals
• Stay hydrated
• Engage in light physical activity
• Manage stress
• Get basic tests done if fatigue persists

DON’T
• Ignore persistent tiredness
• Self-medicate supplements blindly
• Rely excessively on caffeine
• Skip meals
• Overwork without rest

FAQs

• Is constant fatigue normal?
• No, it signals an underlying issue

• Can anxiety cause fatigue?
• Yes, very commonly

• Does poor sleep alone cause fatigue?
• Yes, even without disease

• Are vitamins always needed?
• Only if deficiency is documented

• Can exercise reduce fatigue?
• Yes, regular mild exercise improves energy