Why am I so tired?

This is an article that answers the question.

Why Am I So Tired? 7 Causes of Fatigue

Getting plenty of sleep but still exhausted? Before you blame your multi-tasking, super-woman lifestyle, learn more about what might be at the root of your unexplained fatigue.
By Colette Bouchez
WebMD Feature
Reviewed by Louise Chang, MD

We are in the midst of a global energy crisis but it has nothing to do with oil. The problem is unexplained fatigue.

"I'm so tired; I just can't do what I used to do."

"I'd love to go but honestly, I just don't have the energy."

"Sex? You mean right now?"

If you're like most women, these phrases have become mantras, the echo of our collective yawn growing louder every day.

"The single biggest complaint I hear from my patients, day in and day out, is fatigue," says cardiologist Nieca Goldberg, MD, Director of the NYU Medical Center Women's Heart Program and associate professor at the NYU School of Medicine.

Of course, for some of us the problem is simply multi-tasking to the max and not getting enough sleep, or good quality sleep. "If you're continually logging in just 5 or 6 hours a night, it's going to catch up with you, no matter your age," says Rebecca Amaru, MD, clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City.

But if you are getting a healthy 7 to 8 hours a night and you're still tired, Goldberg says it's time for a check-up to uncover the causes for fatigue.

"If your fatigue goes on for more than a week and there is no explanation for feeling tired, then yes, see your doctor," says Goldberg.

While occasionally fatigue may be a sign of a serious illness, experts say most often it's caused by a minor problem, with a relatively easy fix.

To help you zero in on why you can't stop yawning, here are 7 hidden causes of fatigue -- potential health problems you should discuss with your doctor.

Fatigue Cause # 1: Anemia

"If you are in your reproductive years, and particularly if you experience heavy menstrual cycles, have fibroid tumors or uterine polyps, or if you've recently given birth, the blood loss may have caused you to develop anemia -- a leading cause of fatigue in women," says Amaru.

Problems occur, she says, when the bleeding leads to a deficiency of hemoglobin, the iron-rich protein in red blood cells that carries oxygen from the lungs to other parts of your body. When your tissues and organs don't get enough oxygen, she says, the result is fatigue.

Other causes of anemia include internal bleeding, or a deficiency of iron, folic acid, or vitamin B12. Anemia may also be caused by chronic diseases like kidney disease, for example. Symptoms can include dizziness, feeling cold, and irritability.

To confirm a diagnosis of anemia, your physician will give you a blood test. Treatment, she says, usually consists of iron supplements if iron deficiency is the cause, and adding iron-rich foods -- such as spinach, broccoli, and red meat -- to your diet.

Fatigue Cause # 2: Underactive thyroid (hypothyroidism)

If you are generally sluggish, run down, and even a little depressed, Goldberg says the problem may be a slow thyroid, also known as hypothyroidism. The thyroid is a small, butterfly shaped gland that sits at the base of your neck and controls your metabolism, the speed at which your body operates.

"I believe that undiagnosed thyroid disorder is one of the major female health problems in this country. I think it is even more widespread than anyone realizes," says Goldberg.

According to the American Thyroid Foundation, by age 60 approximately 17% of all women will have a thyroid disorder and most won't know it. The most common cause, they say, is an autoimmune disorder known as Hashimoto's thyroiditis. This condition causes the body to destroy the cells responsible for producing thyroxin and other hormones secreted by the thyroid gland. The result is hypothyroidism, or a slow metabolism.

Blood tests known as T3 and T4 will detect thyroid hormones. If these hormones are low, Goldberg says synthetic hormones can bring you up to speed and you should begin to feel better fairly rapidly.

Fatigue Cause # 3: Undiagnosed Urinary Tract Infection (UTI)

Although most women associate a urinary tract infection with symptoms such as burning or urgency, Goldberg says in some instances fatigue may be your only clue.

"Not every woman has obvious symptoms of a UTI. Some have no symptoms or mild symptoms that go unnoticed, except for the fatigue," she says.

In most instances, a UTI is caused by bacteria in the urinary tract, often the result of improper bathroom hygiene (wiping back to front, for example). Sexual intercourse can increase the risk because it can push bacteria from the vagina into the urethra.

If your physician suspects that you have a UTI, your urine will be tested. Treatment is quick and easy, and usually involves an oral antibiotic medication. Goldberg says the fatigue will lift within a week or less.

If your symptoms return, get tested again, she says, because in some women, UTI's are chronic. If this is the case, talk to your doctor about preventive care, including low dose antibiotics.

Fatigue Cause # 4: Caffeine Overload

Many of us grab a coffee or cola for a quick burst of energy, but for some women, caffeine can have the opposite effect.

In an article published in the journal US Pharmacist, author W. Stephen Pray, PhD, RPh, reports that caffeine is a stimulant, but if you take too much, the tables can turn.

"In some patients, continued abuse results in fatigue," according to Pray. And if you think this means you simply require more caffeine to get the kick, this isn't the case. "Any attempts to solve the problem by increasing caffeine intake causes the fatigue to worsen," he says.

The solution: Eliminate as much caffeine from your diet as possible. This means not only cutting out coffee. Chocolate, tea, soda and even some medications also contain caffeine and could be causing unexplained fatigue.

Fatigue Cause # 5: Food Intolerances

While food is supposed to give us energy, some doctors believe hidden food intolerances can do the opposite. According to Rudy Rivera, MD, author of Your Hidden Food Allergies Are Making You Fat, even mild food intolerance can leave you feeling sleepy. Eat the offending food long enough and you could find yourself feeling continually exhausted.

"Evidence indicates food intolerance as a cause of fatigue, and even suggests that fatigue may be an early warning sign of food intolerance," he says.

If you suspect that food may be behind all that yawning, Rivera says to start with an elimination diet, cutting out foods that cause you to feel sleepy within 10 to 30 minutes of eating them.

Fatigue Cause # 6: Sleep Apnea

If you're not getting enough sleep, it stands to reason you'll be tired. But what if you don't know that you aren't getting sufficient sleep? This is often the case with a condition called sleep apnea -- a sleep disorder that causes you to momentarily stop breathing, often many times during the night. Each time you stop breathing, you awaken just long enough to disrupt your sleep cycle, usually without being aware of it. Your only clue, says Goldberg, is that you experience constant fatigue no matter how many hours you sleep each night.

According to Goldberg, sleep apnea, which is caused by an upper airway obstruction, often occurs in women who are overweight or obese. Snoring is often a sign of sleep apnea. Diagnosis requires a visit to a sleep lab, or to a doctor specializing in sleep apnea.

If you have sleep apnea, your physician will recommend lifestyle changes, including losing weight and quitting smoking. Medical treatment includes devices that keep airway passages open while you sleep. In extreme cases, surgery may be necessary to ensure proper airway flow. Left untreated, sleep apnea can increase your risk of stroke or heart attack.

Fatigue Cause # 7: Undiagnosed Heart Disease

If you find yourself becoming exhausted after activity that used to be easy, it may be time to talk to your doctor about the possibility of heart disease.

According to Goldberg, when overwhelming fatigue sets in after ordinary tasks -- such as vacuuming the house, doing yard work, or commuting from work each day -- your heart may be sending out an SOS that it needs medical attention.

"This doesn't mean that you should panic every time you yawn," says Goldberg. "Most of the time, fatigue is not the first sign of heart disease, and it's usually linked to something far less serious."

At the same time, Goldberg points out that heart disease is the leading cause of death in women. "If fatigue following activity is significant, and no other possible reason comes to mind, see your doctor for a check-up," she advises. If your fatigue is related to your heart, medication or treatment procedures can usually help correct the problem, reduce the fatigue, and restore your energy.

Spotlight on the drummer girl

C's drum teacher has been making videos of his students playing their favourite song and it's no surprise that our Justin Bieber fan chose 'Eenie Meenie' to perform in her video, posted by teacher via YouTube.

School break

The one-week break is here! We kicked it off on Saturday by dining out at a new place called The Pork Place (so much for abstinence during Lent...although I'm not Catholic). The food turned out to be nothing to shout about. C had tri-coloured spiralli with meatballs (dry meatballs and too litle gravy over the pasta), E had a pork, ham and cheese burger (tasted normal) while I had their shoulder loin steak (the crust was overdone and they should have used a better cut of meat). I took some pics but unfortunately it was with my 'new' mobile which I have yet to figure out how to send pictures or load it to the computer.

The 'new' phone saga is another story. Mobile phones don't seem to last very long these days.

C had fun yesterday. She got almost the entire collection of the Legend of the Guardians book series and set us back over RM200 unexpectedly when we dropped in at the Popular book fair at IPC shopping mall. We just need book 9 and 11 to complete the 15-book collection. For those unfamiliar with the name change (like me at first), IPC is the new name for Ikano Power Centre. Later in the evening, E and C took off to the Putra Indoor Stadium to catch the EPL Masters vs. Malaysian selection footy game. It was C's first live soccer match and she thoroughly enjoyed it according to E.

Today, C also had her first experience going to a karaoke joint. Her classmate celebrated her ninth birthday with a karaoke party. She practically hogged the mike singing Justin Bieber songs and a few Taylor Swifts. She's still sticking to her current ambition of becoming a singer I guess...At this time of writing, she is splayed out on the sofa in dreamland after her singing marathon followed by a reading marathon of book 4 of the Legend of Guardians....

Last Friday she agreed to some 'homeschooling' this week in preparation for her piano exam this Thursday and school exam next week. Monday's almost over and I wonder if 'homeschooling' will start tomorrow.

Meanwhile, I've been following news of the devastating earthquake, tsunami and nuclear plant problem in Japan. Just a few weeks before this, Christchurch was hit by an earthquake too...Life is fragile.

A time for everything

I attended the funeral of a friend last Monday. He was one whom I never expected would leave so suddenly. On the morning when I learnt of his death from the newspaper, I had actually woken up thinking of him. It was just a few days after the major quake in Christchurch, NZ. I remember his son lived there and had thought of checking with him if his son was ok. Little did I know that he had gone to a better place the evening before without regaining consciousness from a hemorrhagic stroke. It was a beautiful ceremony for a person whose life touched many.

The song that was played just before he was wheeled out of the church for burial was the one titled Turn, Turn, Turn by The Byrds. It's lyrics were adapted from the Bible, Ecclesiastes 3:1-15 (New International Version, ©2011).

Ecclesiastes 3
A Time for Everything
1 There is a time for everything,
and a season for every activity under the heavens:
2 a time to be born and a time to die,
a time to plant and a time to uproot,
3 a time to kill and a time to heal,
a time to tear down and a time to build,
4 a time to weep and a time to laugh,
a time to mourn and a time to dance,
5 a time to scatter stones and a time to gather them,
a time to embrace and a time to refrain from embracing,
6 a time to search and a time to give up,
a time to keep and a time to throw away,
7 a time to tear and a time to mend,
a time to be silent and a time to speak,
8 a time to love and a time to hate,
a time for war and a time for peace.

9 What do workers gain from their toil? 10 I have seen the burden God has laid on the human race. 11 He has made everything beautiful in its time. He has also set eternity in the human heart; yet no one can fathom what God has done from beginning to end. 12 I know that there is nothing better for people than to be happy and to do good while they live. 13 That each of them may eat and drink, and find satisfaction in all their toil—this is the gift of God. 14 I know that everything God does will endure forever; nothing can be added to it and nothing taken from it. God does it so that people will fear him.

15 Whatever is has already been,
and what will be has been before;
and God will call the past to account.



Yes, there's a time for everything. And as verse 11 says, "He has made everything beautiful in its time. He has also set eternity in the human heart; yet no one can fathom what God has done from beginning to end."

S.M., may you rest in peace. At this time, I'm also thinking of all the people I once knew and loved who have gone to a better place where I believe has no pain or suffering. I'm thinking of how our lives connected, the words, moments and lifetimes we shared. Thank you, that's all I can say.

Bieber bleah!

This worldwide frenzy about Justin Bieber has reached my doorstep! While popular mass media coin it as 'Bieber fever', I feel a bit hot in a different way about this teenager that's got all our young ones bopping to his tunes. It goes without saying that his genre, if it can be considered one (how do I classify his songs? Rap? He says here that it's not a specific type of music, 'just good music'... *eyes rolling*) is meant for generation Z, not the old soul in me who prefers pre-80's music. But still, what are his songs promoting or teaching kids of this generation? Look at what's portrayed in this video and its lyrics for instance.



Eenie meenie miney mo
Catch a bad chick by her toe
If she holla (if, if, if she holla) let her go

Shes indecisive
She cant decide
She keeps on lookin
From left to right

Girl, cmon get closer
Look in my eyes
Searchin is so wrong
I'm Mr. Right

You seem like the type
To love em and leave em
And disappear right after this song.
So give me the night
To show you, hold you
Dont leave me out here dancin alone

You cant make up your mind, mind, mind, mind, mind
Please dont waste my time, time, time, time, time
Im not tryin to rewind, wind, wind, wind, wind
I wish our hearts could come together as one

Cause shorty is a eenie meenie miney mo lova
Shorty is a eenie meenie miney mo lova
Shorty is a eenie meenie miney mo lova
Shorty is a eenie meenie miney mo lova

Let me show you what your missin
Paradise
With me you're winning girl
You dont have to roll the dice.....

C enjoys his tunes and the rhythm but I doubt she gives much thought to the actual meaning of what she's singing along to. But with repeated viewing of such videos and repeated singing of such lyrics, what's the subliminal effect?

She discusses with her classmates about this babyfaced-perfectly-coiffed-hair boy every now and then, and they probably get their latest info from one of the girls' older sister who together with her own classmates are also very likely suffering from the fever.... talk about viral marketing!

While we can't entirely prevent (and we're not being realistic if we do) our kids from enjoying the likes of Bieber or other negative influences, we need to prepare and strengthen them to have the right view and values relating to the opposite sex, boy-girl relationships, proper dressing and behaviour, etc.

So the fever rages on and C has asked her daddy to compile a CD of Bieber's songs (together with another new collection of Christian songs, mind you, haha!) for her to listen to in the car. Meanwhile, daddy (are you reading this, daddy?) and me have to look out for teachable moments to remind her about what's right and wrong....

Parenting, parenting, parenting - the joys and sorrows of it all.