“Why am I tired all the time?”: 11 Possible Causes of Your Fatigue

“Why am I tired all the time?”: 11 Possible Causes for Fatigue and Exhaustion

Fatigue is one of the most common presentations I’ve seen in my clinical practice. It’s also a condition that is challenging to get a solid answer for from conventional healthcare. If you’re feeling tired all the time, have no energy, are getting sick regularly and have been told by your doctor that there’s nothing abnormal, this one is for you!


11 Possible Causes for Feeling Tired all the Time


1. Stress & Adrenal Dysregulation

Stress is exhausting, especially over a long time!

The body responds to stress by releasing a cocktail of adrenaline and cortisol, which gets us thinking and moving fast. It’s what we’ve inherited as a part of our survival toolkit to run, fight and hide from danger quickly.

But when stress is sustained for an extended period, these communication systems are recalibrated. The body goes into conservation mode by signalling that we’re tired. It makes it seem counter-productive, but it’s the way this system tries to preserve the body. In naturopathic terms, we refer to this as ‘adrenal dysregulation’.

The hallmark symptoms of adrenal dysregulation are:

  • poor sleep quality, particularly waking up between 2 and 3 a.m
  • feeling tired throughout the day but not being able to drop off to sleep at night
  • experiencing a significant energy dip in the afternoon
  • you’ve been through a long period of stress
  • getting dizzy or faint when you stand up
  • you don’t feel refreshed after waking

If you’ve gone from university into full-time work to becoming a mother and haven’t ever had a chance to stop, rest and replenish, this is not an unusual cluster of symptoms. This kind of fatigue is usually many years in the making, but the good news is rest, proper nutrition, and herbs are all fabulous ways to help restore this system.  If this sounds like you, you earn more about healing after a season of stress in this free webinar.

2. Poor Quality Sleep

Adrenal dysregulation can be one reason for poor quality sleep, or it could be several other factors, such as:

  • living in a busy city and your bedroom doesn’t get -full darkness/is noisy
  • doing shift work
  • you have young children or animals that are waking you throughout the night
  • physical discomforts, such as back pain or other musculoskeletal aches.

Reduced quality sleep = fatigue. It may sound overly simplistic, but it’s incredible when we’re in an overwhelmed state and feeling tired all the time; we can forget the simple things. Getting a full 7 to 8 hours of sleep can make all the difference, and it can be an essential circuit breaker.

3. Chronic Pain

Not only can chronic pain affect your sleep, but it is exhausting in its own right. If the pain is due to inflammation, inflammatory compounds affect your whole body and mood. When the messaging pathways that communicate pain are always active, your nervous system is continuously in a high alert state.

4. Thyroid Issues

The leading symptom of low thyroid function is fatigue.

Other signs to look out for are:

  • difficulty losing weight despite exercise and a -restricted diet
  • dry skin and dry hair
  • cold hands and feet
  • a general intolerance to the cold
  • putting on weight without knowing why

This cluster of symptoms often overlaps heavily with adrenal dysregulation because the adrenal gland and thyroid gland are in very close communication with one another. When one gland is out of alignment or is in overdrive, the other will also be affected.  You can learn more about low thyroid function over here.


5. Blood Sugar Imbalances

Typically a doctor will run tests if you’re presenting with fatigue to screen for pre-diabetes, diabetes, and insulin resistance.

Blood sugar imbalances can cause feeling tired all the time because when sugars are broken down in the body, they get converted to fast energy. If you’ve been in the habit of having sugary or sweet foods, this system can become dysregulated.

Signs that a blood sugar issue is contributing to your fatigue are:

  • craving sugar when you’re feeling fatigued
  • experiencing significant blood sugar crashes – jittery hands, foggy brain or “hangriness.”
  • if you are somebody who finds it very difficult to skip a meal or to go 2 or 3 hours without eating

If this is you, the most simple place to begin is to take simple sugars out of your diet. This includes anything white, refined or processed. Instead, go for slow-burning carbohydrates, such as whole grains, legumes, and starchy vegetables.

6. Nutrient Depletion

When it comes to feeling tired all the time, we often think of iron. Low iron is particularly relevant for women as we lose blood every month.

While iron is one of the essential nutrients for energy production, it is not the only one. Vitamin B12, vitamin D, folate, and zinc are all essential nutrients for energy and can be overlooked.

Zinc is essential if you are getting sick all the time, in addition to feeling tired all the time. Zinc depletion is one of the most common causes of the immune system not appropriately handling infections quickly and getting stuck in an infection-fatigue loop. I always recommend getting all of these nutrients checked, especially if you’re a vegetarian or if you know you haven’t been eating properly.

7. Poor Elimination & Detoxification

By elimination, I mean through sweat, wee, and poo.

If you don’t drink enough water, tend towards constipation, or if you experience skin conditions like acne, eczema, dermatitis, psoriasis or rashes, your body is struggling to eliminate toxins.

This is especially important if you are regularly exposed to chemicals, solvents or any other environmental hazardous products (I’m thinking of you if you’re a hairdresser, artist or work with common agricultural chemicals).

Doing guided detoxification for 2-4 weeks and observing if your energy shifts is a straightforward way of determining if this is an issue for you.

8. Poor Digestive Function

Poor digestive function is a massive cause of fatigue. The saying you are what you eat is not entirely true. What is more accurate is you are what you absorb. We could be eating the most beautiful, wholesome and balanced diet and not be getting the nutrients our body needs to function correctly if there is an absorption issue.

Symptoms of poor digestive function are:

  • gas
  • bloating
  • the tendency towards either constipation or diarrhea or, in some cases both
  • stomach pain
  • indigestion
  • nausea

Other signs that your body is struggling to absorb its nutrients are:

  • soft nails brittle nails
  • cracks in your lips
  • peeling skin tags next to your fingernails

The number one thing to do to get on top of poor digestive function is to identify the foods that are harming and alarming your system. And from there, working out which foods will heal and calm your system. I’ve written more in-depth about healing your gut in previous posts.

9. Food Intolerances or Food Allergies

You may have a food intolerance or food allergy that you’re not aware of. Both allergies and intolerances exist on the same spectrum. An intolerance is often temporary – there may be foods that you’re generally able to tolerate and digest when you’re fully healthy, but if you’ve had a lot of stress going on, had an infection or had to take antibiotics, your body is not able to break and eliminate these foods properly leading to poor digestive function.

At the other end of the spectrum, food allergies trigger the immune system. An allergy to gluten (also known as celiac disease) is one of the most common causes.

If you suspect you have a food intolerance or allergy, the most simple thing you can do is trial eliminating gluten, dairy, sugar, eggs, and soy from your diet for 2 to 3 weeks and see how you feel. If any of those are causing a significant issue, you’ll notice a big difference in your energy. Please don’t do this long-term without a practitioner guiding you on replacing your diet with lots of replenishing and healing foods!

10. Unresolved Infections

Unresolved infections are something I see more and more clinically as a cause of fatigue. The most common infections that the body can have a difficult time eliminating are Epstein Barr virus (also known as glandular fever ) and cytomegalovirus. However, there are many more, and to get a proper workup, you need a clinician to do appropriate testing. If you are experiencing:

  • low-grade fever
  • swollen glands
  • feeling achy
  • regularly feel chilled or suddenly sweaty

I suggest you work with a holistic practitioner who can help you investigate further.

11. Entering Perimenopause

Feeling tired all the time is not at all uncommon when the great change comes. The inner processes – physically, mentally, emotionally and spiritually – during menopause require a significant amount of energy. Add in disrupted sleep because of night sweats or other physical discomforts, and you’ve got quite the equation for feeling tired all the time.

So there you have it.

Those are the 11 clinical questions I am asking in my consultations when clients present with fatigue. It can take some detective work, but once you know what factors contribute to your fatigue and what you can do about it, you can begin to feel like yourself again!

If you are experiencing fatigue and you’re not finding any answers, please know that there are many ways of understanding your body and the possible causes of your unique situation.

This is a tiny extract from my course, The Peace Protocol; click here to read more about it.

References & Resources

Ader, R., & Cohen, N. (1993). Psychoneuroimmunology: Conditioning and Stress. Annual Review of Psychology, 44(1), 53–85. https://doi.org/10.1146/annurev.ps.44.020193.000413
Bland, J. (2015). Functional Medicine: An Operating System for Integrative Medicine. Integrative Medicine: A Clinician’s Journal, 14(5), 18–20.
Bland, J. S. (1995). Psychoneuro-nutritional medicine: An advancing paradigm. Alternative Therapies in Health and Medicine, 1(2), 22–27.
Melamed, S., Ugarten, U., Shirom, A., Kahana, L., Lerman, Y., & Froom, P. (1999). Chronic burnout, somatic arousal and elevated salivary cortisol levels. Journal of Psychosomatic Research, 46(6), 591–598. https://doi.org/10.1016/S0022-3999(99)00007-0
Minich, D. M., & Bland, J. S. (2013). Personalized lifestyle medicine: Relevance for nutrition and lifestyle recommendations. TheScientificWorldJournal, 2013, 129841. https://doi.org/10.1155/2013/129841
Schmidt, M. A., & Bland, J. S. (1997). Thyroid gland as sentinel: Interface between internal and external environment. Alternative Therapies in Health and Medicine, 3(1), 78–81.
Selye, H. (1976). Stress without Distress. In G. Serban (Ed.), Psychopathology of Human Adaptation (pp. 137–146). Springer US. https://doi.org/10.1007/978-1-4684-2238-2_9
Survival Mode and Evolutionary Mismatch. (n.d.). Psychology Today. Retrieved December 2, 2019, from http://www.psychologytoday.com/blog/the-embodied-mind/201212/survival-mode-and-evolutionary-mismatch
Editors note: This post was originally published in January 2020 and has been revamped and updated for accuracy and comprehensiveness in April 2021.
“Why am I tired all the time_”_ 11 Possible Causes for Fatigue and Exhaustion by Clara Bailey, Naturopath & Herbalist

Healing Wise

April 14, 2021

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