Ask the Doc :: Drifting Off
Dear Doctor Jason,
I used to be so energetic - going out dancing, active in sports, always happy and awake. Lately, it's all I can do to keep my eyes open past 9pm. I know I'm getting older (I'm upper 30's) but I don't think I should be this tired all the time, and I'm getting concerned that something else is going on. What's your advice?
Signed, Drifting off
Doctor Jason's Response:
Well, some say, "it's all downhill after 25."
Fatigue is a vague symptom, meaning that it is not associated with just one thing. It could be related to your overall metabolism, hormone concentrations, sleep patterns, diet, or blood counts. It can be an initial symptom of other more serious conditions too, but it would typically have other associated symptoms, such as fever, diarrhea, frequent urination, or headache.
The thyroid gland secretes thyroxine, a hormone that generally regulates your metabolism and consequently energy level. If the gland is underproducing thyroxine, then you very well may develop fatigue, sluggishness, weight gain (or inability to lose weight despite trying), or even hair loss. It can be hereditary, so it would be important to check your thyroid if you have any family members with known thyroid problems.
If your testosterone level is too low, you may also develop fatigue and muscle weakness, as well as decreased libido. If you suffer from sleep apnea or if your sleep is disturbed and not restorative, you can develop daytime fatigue and sleepiness.
A diet that is rich in carbohydrates may cause some sluggishness, as can changes in your blood sugar levels. Anemia can also cause fatigue, and this too can be caused by diet, such as iron-deficiency or vitamin B12 deficiency. If the fatigue is prolonged (daily or nearly daily for more than 1 month) or if any of these other symptoms are present, then it would be best to be evaluated by your primary care provider.