From your working environment to your diet, many things can cause fatigue, the experts say
Gerry Gajadharsingh writes:
“The article below gives some practical solutions to tiredness/fatigue, which is a common presentation in many patients. Whilst there can be medical causes of fatigue, most of the causes are lifestyle related. Of course, the article misses “the elephant in the room” of sugar regulation and accessing fat as an energy pathway, something that is done extremely well by following the principles of Metabolic Balance and proper relaxed breathing, optimising oxygen delivery on a cellular level.
Commercial energy drinks are also another way, but given many of them contain mostly caffeine, taurine and sugar (or artificial sweeteners) many people have realised they are not really that healthy.
So perhaps you might want to try Gerry’s Tonic Energy, due to be released commercially in early 2020, watch this space.”
How often do you feel that you are fighting fatigue, that familiar wave of weariness that leaves you flagging? According to the Royal College of Psychiatrists, at any given time one in every five people feels unusually fatigued, and one in ten has prolonged tiredness. These figures are supported by a survey of 300 GPs four years ago that revealed that a fifth of all visits to the doctor are down to patients feeling extraordinarily wiped out.
“It’s phenomenally common,” says Dr Arun Thiyagarajan, the medical director of Bupa Health Clinics. “And there are so many reasons it might be happening. Our sleep schedules are the most obvious thing that might need addressing and serious medical issues from tiredness will need eradicating. If unusual and sudden fatigue persists for more than a week or two, then it is recommended you do ask your doctor for tests.”
Everything from diet to your desk at work can have an impact on how tired you feel. Even reading about being exhausted makes people feel fatigued, so you are probably fading right now. Here’s what may be wrong and what you can do about it.
You are dehydrated
It’s not a myth that dehydration can leave you feeling tired. Researchers at the University of Connecticut’s human performance laboratory recruited 25 healthy women, who were well hydrated before they took part in three exercise tests that required them to walk on a treadmill to induce dehydration. They were then put through a battery of mental tests and their scores compared with results obtained when they were not dehydrated.
The findings, published in the Journal of Nutrition, showed that even mild dehydration — defined as a 1.5 per cent drop in the body’s normal water volume — increased fatigue levels and lowered the women’s ability to concentrate on tasks.
What to do “Consume around two litres of fluid a day — this can comprise water and fluid from soups, fruit and tea and coffee,” says Helen Bond, a dietician and spokeswoman for the British Dietetic Association. “You may need more if it is very hot or you are very active.”
Hauling about too much body fat is hard work. “It takes more energy to move around during the day and the inevitable upshot is that you feel fatigued just by your normal routine,” Thiyagarajan says. Body fat also releases leptin, a hormone that sends signals to the brain about the body’s energy stores. Too much leptin has been shown to increase perceptions of fatigue, thought to be an evolutionary response to prevent the body from seeking more energy supplies when it has enough. “Overweight people are also more prone to sleep problems, which causes more fatigue,” he says. “Be aware that being very underweight with a BMI of sub-18 can also mean you lack energy and muscle strength.”
What to do If you are carrying too much surplus weight, losing some is obviously going to make a difference to your energy levels, but how to do it? People who practise intermittent fasting or IF (such as the 16:8 approach, in which you eat within an 8-hour time frame and fast for the remaining 16) initially find the approach leaves them tired, but reportedly feel more energetic after they have been doing it for a while.
Studies at Johns Hopkins University in Baltimore have shown that humans evolved in situations where food was limited and that IF can optimise brain function and energy levels.
Your intake of B vitamins is too low
The B vitamins play an important role in providing energy and other processes in the body. “It’s important to get all the ‘B vitamin family’ as they do work synergistically,” Bond says. “Figures from the latest National Diet and Nutrition Survey revealed that most people get enough vitamins B1, B3, B6, B12 (except some vegetarians and vegans) and B7, but that there are shortfalls in B2 (riboflavin) and B9 (folate).”
Levels of riboflavin, which helps to reduce fatigue and contributes to the release of energy from food, are particularly low in teenagers, with 26 per cent of girls aged 11-18 years and 13 per cent of boys not getting enough. However, 14 per cent of adult women (and 6 per cent of men) also have low levels. Statistics also showed a folate shortage in 15 per cent of teenage girls and adult women (3 per cent of boys and adult men).
What to do Make sure you get enough foods rich in B vitamins: wholegrains, meat and fish, dairy, green and leafy vegetables, seeds, nuts and legumes. Taking a multivitamin that “will help to top up stores and reduce tiredness and fatigue”, is also an option, Bond says.
You need to exercise more
Anyone who is flagging regularly might not like to hear it, but it could be that you aren’t active enough. “The less activity people do, the more tired they tend to feel,” Thiyagarajan says. In a study published in the journal Psychotherapy and Psychosomatics researchers from the University of Georgia in the US found that energy levels increased by 20 per cent and reported fatigue decreased by 65 per cent when people took part in regular low-intensity exercise.
There is a tipping point. Too much intense exercise with too little recovery between sessions can give rise to overtraining syndrome, the symptoms of which include overwhelming fatigue. “Some vigorous exercise is good if you allow the recovery,” Thiyagarajan says. “Regular activity also means you sleep better, which raises energy levels.”
What to do Start by walking daily, upstairs if you can. In 2017 researchers at the University of Georgia reported in the journal Physiology & Behaviour that adults who were fatigued through lack of sleep felt more energised after they walked up and down stairs at a regular pace for 10 minutes than if they consumed 50mg of caffeine, the average amount in a can of cola.
You are low on iron
It’s not unusual to get too little iron; the World Health Organisation describes it as a global public health problem and “the most common and widespread nutritional disorder in the world” and symptoms include breathlessness and high levels of fatigue. “It’s more common among women, with over half of teenage girls and 27 per cent of adult females experiencing iron deficiency anaemia compared with 12 per cent of teenage boys and 2 per cent of men,” Bond says, “but we all need to make sure we get enough.”
What to do Eating iron-rich foods is important. “Lean red meat, offal and oily fish all supply iron in a form that’s more easily absorbed by the body,” Bond says. “Eggs, pulses including baked beans and lentils, nuts, seeds, green, leafy veg and dried fruit also provide iron, but in a form that is less well absorbed — non-haem iron.”
Vitamin C from fruit and vegetables helps the body to absorb iron from these foods. If you are concerned that your levels are low, ask your GP for a blood test, the only reliable way to check your iron stores. An iron supplement may be prescribed.
You eat too many ready meals
Last year a study of the eating habits of 19 European countries, published in the journal Public Health Nutrition, revealed that UK families buy more ultra-processed food than any others in Europe, amounting to more than half of all food bought.
“It’s no coincidence that the national diet and nutrition survey showed insufficiencies in levels of micronutrients like calcium, magnesium, iodine and selenium, which can impact our energy levels,” Bond says. “It’s almost certainly linked to the fact that nutrient-poor processed food is plentiful and consumed regularly.” Diets high in sugar and low in fresh fruits and vegetables have also been linked to inflammation in the body and elevated levels of inflammatory markers, such as IL6, associated with higher levels of fatigue.
What to do “Obviously, cooking and preparing as many fresh-ingredient meals from scratch is a hugely important step,” Bond says. “Choose meals that are easy to make such as stir-fry meals and vegetable pasta sauces and increase your overall intake of fruit and veg.”
Your office is causing fatigue
An office with too little ventilation or that has central heating cranked up in winter can reduce our ability to perform cognitive tasks; a slightly cool environment has been shown to keep employees more alert and less sleepy. And according to the Health and Safety Executive (HSE), poor lighting is linked to symptoms including lethargy and poor concentration.
What to do The HSE issues guidelines that place a legal obligation on employers to provide a “reasonable” temperature to work in and if more than 10-15 per cent of employees think an office is too warm, you can push for the dial to be turned down. The HSE also advises that there should be as much natural light as possible. “Changing your work environment can make a big difference to your fatigue levels,” Thiyagarajan says.
Your hormones are to blame
Fatigue is more prevalent at certain times of a woman’s menstrual cycle. “In the first few days pre or post the cycle starting, a lower blood volume and fluctuating hormone levels can mean you feel much more tired,” Thiyagarajan says. “For women in the perimenopausal stage, falling levels of oestrogen and decreased bone and muscle strength can mean energy levels plummet too.” For men there is anecdotal evidence that diminishing testosterone and human growth hormone levels from the forties onwards can increase fatigue.
What to do “One important factor for people in this category is that diminishing muscle mass that accompanies hormonal changes can exacerbate fatigue,” Thiyagarajan says. “According to Public Health England, all adults should do strength training exercises on two or more days a week in order to work all the major muscles and preserve muscle mass. It is very important for everyone, but particularly as we get older.”
Anxiety levels are too high
Mental health, including anxiety, depression and low mood, are strongly implicated in fatigue for many people. “Most people with these conditions report fatigue,” Thiyagarajan says. “Studies have shown that when the brain is overstressed it can affect the body’s muscles and everything becomes fatigued.”
Levels of dopamine and serotonin, neurotransmitters that help to regulate mood, are lower in people with anxiety and mood disorders, all contributing to feelings of tiredness.
What to do Physical activity of any sort stimulates the release of dopamine, serotonin and norepinephrine, which will raise your mood and energy levels. Activities that help your mind to focus on the present, such as yoga and meditation, are particularly beneficial. “They don’t bring immediate relief, but stick at them and they will pay off,” Thiyagarajan says.