If you feel like you can’t function without multiple coffees throughout the day, or you wake up feeling like you could happily sleep for another eight hours, I wouldn’t be surprised if you keep asking if it’s normal to feel tired all the time. Feeling tired occasionally can be completely normal. If you’ve had a poor night’s sleep, been travelling and dealing with jet lag, or had a particularly stressful week, it’s fine that your energy levels might dip for a few days.
However, feeling exhausted every day is different. While fatigue is incredibly common, it shouldn’t be considered normal. Research suggests that around one in eight people in the UK feel tired all the time. An Irish study of more than 1,400 GP consultations found that fatigue was reported in 25% of appointments, making it one of the most common reasons people seek medical advice.
The challenge is that fatigue can have many different causes. Sometimes it’s related to lifestyle factors, while other times there may be underlying health issues that need investigating. One thing I don’t want you to blame it on is ‘getting older’. If you’re always tired, your body may be trying to tell you something. Let’s look at seven common causes of fatigue and what you can do about them.
1. Nutrient Deficiencies
One of the first things I consider when a client is struggling with low energy is whether they are deficient in key nutrients involved in energy production.
Common deficiencies include:
- Iron
- Vitamin B12
- Folate
- Vitamin D
- Magnesium
These nutrients all play important but slightly different roles in helping you produce energy. They can also influence other organs in the body that affect energy levels, too.
Iron helps transport oxygen around the body. If your iron levels are low, less oxygen reaches your tissues and muscles, which can leave you feeling exhausted, breathless, and unable to concentrate.
Vitamin B12 and folate (B9) are involved in the production of red blood cells and support the nervous system. Low levels can contribute to fatigue, brain fog, low mood, and poor concentration.
Vitamin D is involved in immune function, mood regulation and muscle function. Low levels are extremely common in the UK, particularly during the winter months.
Magnesium is involved in hundreds of biochemical reactions throughout the body, including those involved in energy production, muscle function and sleep quality.
What to do
The only way to know if you’re deficient in these nutrients is via a blood test. In our 1:1 sessions I like to run a big blood panel to check for all nutrient levels, alongside other causes of fatigue. As this helps to rule out multiple causes at once. But I can also work with clients to help them get their GP to do a blood test to check for some of these nutrients too.
The standard lab ranges for nutrients are very big. So sometimes clients will say I’ve had my bloods done but everything came back as normal, but when I double check them, their folate level was 3! 2-4ng/ml is classed as deficient, but optimal is 15-25ng/ml. A similar thing can happen with iron, B12 and vitamin D. So while you won’t be classed as deficient, your levels are low enough for it to be impacting your energy levels.
This is why I also like to look through any previous testing you’ve had done, just incase something has been missed or you just weren’t ‘deficient enough’ to require a prescription. We can help correct the deficiency through supplements.
2. Stress and Burnout
I would say that most people underestimate the impact that long-term stress can have on energy levels.
I often explain it to clients by comparing it to driving a car without stopping to fill up with petrol. We know we need to stop off and have a ‘break’ while driving to fill up with petrol, otherwise our car will break down. But for some reason, we ignore the fact that if we keep pushing our bodies through stress, eventually something is going to give.
Stress can be triggered in many ways too. Clients will often tell me they’re not stressed, they just have a busy life. But that busy life includes a demanding job, looking after young children, travelling for work, and also trying to get on with life while navigating a health or skin issue. All of this adds up and affects your body more than you realise.
Some signs of burnout can include:
- Feeling overwhelmed
- Increased anxiety
- Low motivation
- Social withdrawal
- Poor concentration
- Feeling tired even after resting
Many people push through these symptoms for months or even years before recognising that stress may be contributing to how they feel.
What to do
Unfortunately, burnout isn’t usually fixed with one long weekend or a single day off. Instead, it’s important to look at the bigger picture and identify where changes can be made to your lifestyle.
For some it might mean slowing down as much as you can where possible. Rather than forcing yourself through intense gym sessions when you’re already exhausted, gentle movement such as walking, yoga or stretching may be better to help your energy without pushing yourself too far. It might mean you need to try and make some time for hobbies, or learn to be bored instead of filling your spare time with so many different activities.
Chronic stress can also increase demand for nutrients, including vitamin C, magnesium, zinc and B vitamins. So it is important to help replenish these nutrient levels to give your body the boost it needs. In some cases, adaptogenic herbs may also be helpful. These are herbs that can support the body’s response to stress and help regulate cortisol levels.
3. Thyroid Imbalances
Your thyroid plays a key role in regulating metabolism and energy production. When thyroid function starts to decline and you see a decrease in thyroid hormones, one of the most common symptoms is fatigue that doesn’t seem to improve, no matter how much sleep you get.
Other symptoms of an underactive thyroid can include:
- Hair thinning
- Weight gain
- Difficulty losing weight
- Constipation
- Dry skin
- Low mood
- Feeling cold
In the UK, most investigations through your GP begin with testing TSH and sometimes T4. While these markers are useful, they’re only two thyroid hormones and alone don’t provide a big enough picture. Similar to the nutrient deficiencies, the ranges for thyroid hormones are quite large. Most people won’t be flagged as having an issue until their TSH level is quite high, but optimal can be around 1-2.
In my clinic, I often recommend a more comprehensive thyroid assessment that includes:
- TSH
- Free T4
- Free T3
- Thyroid antibodies
I’ve worked with clients whose thyroid hormone levels appeared relatively normal, but whose thyroid antibodies were elevated. High thyroid antibodies may indicate an autoimmune condition, such as Hashimoto’s thyroiditis, which can affect thyroid function and contribute to symptoms including fatigue. But if you don’t check the antibodies, you’ll never pick it up.
What to do
If testing identifies a thyroid issue, there are several ways we can support it. Some people may require medication such as Levothyroxine to replace thyroid hormone. But alongside this, we can also look at nutritional support. The thyroid relies on nutrients including selenium, iodine, zinc, iron and vitamin A to function effectively – so we want to make sure there’s good levels of those nutrients. We can also explore other factors such as inflammation, gut health and liver function, all of which can influence thyroid hormone production and conversion.
4. Blood Sugar Imbalances and Insulin Resistance
Blood sugar imbalances are another common but often overlooked cause of fatigue.
Your body uses glucose from food to create energy. However, if you’ve become insulin resistant, glucose has a harder time entering your cells where it can be used effectively. As a result, you may experience fatigue despite eating regularly. For some people, they may feel like they need a nap after eating a meal that’s higher in carbohydrates. So if you’re falling asleep after your lunch at work, this might be something to look into.
Even without insulin resistance, diets high in refined carbohydrates and sugar can cause repeated blood sugar spikes and crashes throughout the day. You might recognise this if you eat your breakfast in the morning, only to feel hungry within an hour or two. This is one reason why some people find themselves relying on caffeine or sugary snacks to keep going – because of blood glucose issues.
When assessing fatigue, I often like to include:
- HbA1c
- Fasting glucose
- Fasting insulin
- C-peptide
HbA1c is a blood test that provides insight into your average blood sugar levels over the previous two to three months. It can help identify patterns that may not be obvious from a single glucose reading.
What to do
First you want to make sure you’re eating enough protein with every single meal. Breakfast, lunch, dinner and snacks! Protein helps slow the release of glucose into the bloodstream and can improve energy levels.
Exercise is also incredibly effective for improving insulin sensitivity. Even a five to ten minute walk after meals can make a meaningful difference.
5. Post Viral Fatigue
A lot of people notice ongoing fatigue after recovering from a virus. For some people, energy levels return within a few weeks. For others, symptoms can persist for months. This is something I experienced myself after having glandular fever in my early 20s. After I recovered from the infection, I felt tired and completely wiped out for months.
This issue can be a little more complex because it may influence multiple areas and systems in the body. From the health of the mitochondria (known as the powerhouses of cells) to the immune system. It may also trigger the development of other conditions which could influence energy levels.
What to do
Similar to burnout, this can mean taking it very slowly and not pushing yourself too hard too soon. And you shouldn’t feel guilty for getting a lot of rest. Using functional medicine, there are lots of areas we can look into and support, such a mitochondria function, the gut microbiome, and the immune system.
6. Poor sleep
This one may sound obvious I know. But we have to rule out that you are sleeping for long enough, and that the sleep quality is good. You could be sleeping for 8 hours per night, but not getting into deep restorative sleep which will help you to feel refreshed the next day.
Factors that can affect sleep quality include:
- Stress
- Sleep apnoea
- Alcohol consumption and drinking alcohol before bed
- Excessive caffeine intake, or drinking caffeine later in the afternoon/evening
What to do
Some simple strategies include:
- Going to bed and waking up at similar times each day
- Reducing screen time before bed (ideally 1 hour before)
- Limiting caffeine later in the day
- Creating a cool, dark sleeping environment
- Avoiding large meals immediately before bedtime
- Avoiding the news, or anything stressful before bed
7. Your diet!
Food provides the raw materials your body needs to produce energy. If your diet is low in protein, fibre and healthy fats, and/or made up mostly of ultra-processed foods, it’s not surprising that your energy levels may dip, because you’re not giving your body what it needs to create energy.
Hydration is another important factor that so many people overlook. Your brain is up to 75% water, and a drop body water as little as 2% can affect brain function. This can cause symptoms like fatigue, difficulty concentrating and headaches. You might feel like you need a nap, but you might actually need some water!
I know, another one that sounds too simple, but sleep, diet & exercise should be the places you start (not buying random supplements).
What Supplements Can Help With Energy?
A lot of people jump straight to supplements to try and find something to help improve their energy. But the reality is that supplements only help if they’re addressing an underlying issue.
As you’ve seen throughout this article, there are many possible causes of fatigue. A supplement that works brilliantly for someone with an iron deficiency is unlikely to help someone whose fatigue is being driven by burnout, poor sleep or an underactive thyroid. And in some cases, taking a supplement (especially something like iron) when you don’t need it, is going to cause more harm than good.
This is why I always recommend testing before supplementing. By understanding what’s driving your symptoms, you can take a more targeted approach and actually get results rather than spending (wasting) money on supplements that may not address the root cause and inevitably don’t work.
Need Some Help?
If you’re always tired, please don’t ignore it and continue to push through. Your body is trying to communicate with you that something isn’t right.
If you’ve been feeling exhausted for weeks or months, I would encourage you to investigate it rather than accepting it as normal. And if you have spoken to your GP and been told there’s nothing wrong, then please get in touch as we can dig a little deeper into what’s affecting your energy levels.
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