Fatigue can have many causes so it is often difficult to uncover the root cause. Doctors are so used to hearing about tiredness and low energy levels, they have developed a shorthand way of writing it on patient notes – TATT for Tired All The Time.
TATT – is frequently due to stress, which drains your adrenal glands and depletes levels of the B group vitamins your body needs to produce energy efficiently. Other common contributors include working long hours, irregular eating habits, lack of exercise, and poor sleep. Symptoms tend to be worse in winter when there is a natural tendency to slow down as part of the hibernation responseto reduced sunlight exposure. In some people, this is pronounced enough to cause seasonal affective disorder (SAD) with low mood, fatigue and sleepiness.
Many illnesses start off with tiredness as one of their first symptoms. Although only one in ten people with TATT are likely to have an underlying medical cause for their symptoms, it is important to have a medical check to rule out problems such as anaemia, diabetes or an underactive thyroid gland if you feel TATT for longer than two weeks. This is especially important if you have also noticed other symptoms such as unexpected weight loss or weight gain, cough, shortness of breath, urinary problems or thirst.
Chronic fatigue syndrome (CFS) affects an estimated one in 250 people and most commonly comes on between the mid-teens and mid-40s. Women are three times more likely to be affected than men.
CFS is associated with persistent physical and mental fatigue, muscle pain and twitching, poor memory and concentration that are not relieved by sleep or rest. It usually comes on after a viral infection (eg glandular fever) or follows major physical or emotional stress. Those affected often feel unwell with ‘flu-like symptoms, sore throat and enlarged glands. Symptoms are disabling and typically worsen on exertion, following a characteristic delay that can vary from a few hours to a day or more. Not surprisingly, many people also develop depression. Most people with CFS experience fluctuating relapses interspersed with periods of normality. Many people make a full recovery, although this may take considerable time, and it is important to remain positive. Cognitive behaviour therapy (CBT), graded exercise, gentle yoga and meditation may help.