Constant Fatigue? Here’s When to See a Doctor If You’re Tired All the Time

When you’re feeling tired all the time, it’s easy to dismiss the constant fatigue as no biggie. After all, practically everyone is exhausted; it’s an unfortunate side effect of living through such stressful, unprecedented times.

But there’s a difference between instantly drifting off at bedtime and actually struggling with extreme fatigue all day. When you’re super drained, it’s usually your body’s way of trying to tell you that it needs something. That doesn’t necessarily mean it’s something super serious. The answer could be as simple as reducing your stress levels or, ya know, getting more regular sleep. Sometimes, though, having low energy 24/7 can be a sign of an underlying health issue, so it’s not something you want to ignore if it persists. 

Feel like constant fatigue is just your everyday reality? Here’s what that might mean and when you should consider seeing a doctor about it.

What’s the difference between tiredness and fatigue?

Feeling tired or sleepy simply means you’re having trouble staying awake and want to nod off, sleep specialist Christopher Winter, M.D., owner of Charlottesville Neurology and Sleep Medicine, tells SELF. Constant fatigue, on the other hand, is when you’re seriously lacking energy on a consistent basis.

This can be a tricky thing for even doctors to suss out. “Fatigue is a subjective feeling,” Alfred F. Tallia, M.D., MPH, professor and chair of family medicine and community health at the Rutgers Robert Wood Johnson Medical School, tells SELF. And in his experience, it’s one of the most common symptoms that prompt people to make an appointment with their family doctor.

Laurie A. Kane, M.D., an endocrinologist at Providence Saint John’s Health Center in Santa Monica, agrees that it can be difficult to figure out if a patient has constant fatigue or just normal tiredness. “It’s a matter of semantics,” she tells SELF. “We have to really try to understand what a patient means when they come in and talk about what they’re experiencing.”

In general, though, “normal” fatigue gets better when you’re able to rest (think your arm gets fatigued after you do a bunch of bicep curls but feels better 10 minutes later), and “normal” sleepiness gets better with more sleep.

But when fatigue regularly keeps you from doing the things you want to do, it’s a problem, Dr. Winter says. “That doesn’t mean ‘I can’t run 38 miles because I get fatigued.’ It’s more like ‘I have trouble getting up and down stairs,’ or ‘A walk from the parking lot to my office exhausts me,’” he says. In most cases, fatigue is your body telling you to slow down, and you should probably listen to it.

What are the symptoms of constant fatigue?

Fatigue is technically a symptom of its own, Dr. Tallia points out, meaning it is your body’s internal alarm firing, whether that’s due to a lack of sleep or something potentially more serious, like a chronic health condition.

However, there are a few signs that you might be dealing with constant fatigue versus general tiredness:

• You feel persistently and overwhelmingly tired.

• You feel tired even after you rest.

• You don’t have the same energy to do the everyday things you used to.

• You have no desire to do things you love because you’re tired.

• You have difficulty concentrating because you’re always wiped out.

• You feel unusually impatient, irritable, or anxious.

Fatigue can present with other symptoms, according to the Cleveland Clinic, which may include:

• whole-body tiredness, from your eyes to your legs

• stiff, achy, or weak muscles

• feeling uncomfortable or uneasy

• sleep that is disturbed or nonrestorative

It’s important to note that these symptoms are especially concerning if they last for six months or longer and interfere with your ability to do work or schoolwork, attend social events, or enjoy personal hobbies you once regularly made time for.

Is it ever normal to feel fatigued every day?

While it’s perfectly normal to long for your bed at the end of a hectic workday, all of the experts SELF spoke to agree that constant fatigue—meaning you feel significantly tired daily and it starts to disrupt your day-to-day life—is not something you should have to put up with. “​​Daily fatigue, even in our pandemic-disrupted, high-stress lives now, is just not normal,” Dr. Tallia says.

“You should absolutely not feel significantly fatigued every day,” Dr. Kane agrees. “That needs an explanation.”

What are the main causes of constant fatigue?

When Dr. Winter sees patients who say they’re tired all the time, he often tries to distinguish whether they’re sleepy or fatigued. “Sleepiness is pretty easy—it’s a defined group of problems,” he says. “But if they’re talking about fatigue, you could make a list a mile long of what could be causing it.”

When Yvonne Bohn, M.D., an ob-gyn at Providence Saint John’s Health Center in Santa Monica, hears her patients talking about extreme fatigue, she starts asking questions about certain lifestyle factors first. “Sleep, stress, and diet can have a huge influence on how some people feel,” she tells SELF.

If those types of factors—like using your phone too much before bed, or recent life events such as caring for a new baby or training for a marathon—are ruled out, she’ll typically do a blood panel to dig a bit deeper. Remember, constant fatigue is a symptom, so it can be a sign of a health issue. Here are a few culprits that may easily fly under the radar:

• nutrient deficiencies, particularly a lack of iron (which can lead to anemia), vitamin B₁₂, or vitamin D

• mental health conditions, including depression or anxiety

• other emotional disturbances, such as grief over the loss of a loved one

• sleep disorders, such as insomnia, sleep apnea, or narcolepsy

• yhyroid issues, including hyperthyroidism or hypothyroidism

• autoimmune conditions, including lupus, rheumatoid arthritis, and type 1 diabetes

• inflammatory bowel disease, including ulcerative colitis or Crohn’s disease

• weight fluctuations, which can include a sudden weight gain or loss

• other chronic conditions, including fibromyalgia and multiple sclerosis

• chronic fatigue syndrome, a complex condition that is marked by extreme, long-lasting fatigue that can’t be otherwise explained by other health factors

Sleep apnea—a condition in which you intermittently stop and start breathing while sleeping—is a particularly common sleep disorder to pay special attention to, as the symptoms are often missed. Even though it is estimated that up to 1 in 15 people have moderate to severe obstructive sleep apnea, researchers believe that 85% of people with clinically significant symptoms have never been diagnosed.¹ 

Constant fatigue, in rare cases, can also be a symptom of cancer, though it’s not typically the first or most obvious sign of disease. “About one in five breast cancer patients experience severe fatigue as a symptom of breast cancer,” Heather Jim, Ph.D., an assistant member of the Health Outcomes & Behavior Program at Moffitt Cancer Center in Tampa who studies fatigue and cancer, tells SELF. “Cancer-related fatigue tends to be severe and does not get better with rest.” It’s not totally clear why this happens, but cancer can cause chronic inflammation, which has been linked to fatigue.

Why it’s important to see a doctor about constant fatigue

Sure, many health conditions can lead to overwhelming fatigue, but so can being super overwhelmed by work for months or going through a period of grief that screws with your sleep.

However, if this exhaustion comes out of nowhere or doesn’t get better when you take the time to relax and catch up on sleep, especially if it lasts for at least six months, that’s when you should consider seeing your primary care doctor. Whether it’s an undiagnosed condition or the result of lifestyle factors that need an overhaul, they can help you get to the bottom of it or refer you to a specialist if needed. “If it’s interfering with you getting your usual activities done, it’s a day-in and day-out problem, and you don’t feel restored after a good night’s sleep, that’s a problem,” Dr. Kane says.

You’ll also want to seek help ASAP if sudden fatigue develops alongside these symptoms, according to the Mayo Clinic:

• chest pain

• shortness of breath

• irregular or fast heartbeat

• feeling like you might pass out

• severe abdominal, pelvic, or back pain

• thoughts of harming yourself or someone else

• abnormal bleeding, including bleeding from your rectum or vomiting blood

• severe headache

What does constant fatigue treatment look like?

The right constant fatigue treatment really depends on what’s causing your exhaustion in the first place, Dr. Kane says. To get you on the road to better energy, your doctor should ask questions about what’s happening in your life, when you first noticed the fatigue, and anything else that may have coincided with it, she says.

“One of the first questions I always ask is, ‘How much sleep are you getting?’” Dr. Tallia says. “In my practice, one of the most common causes of fatigue is people not getting adequate amounts of sleep, which they usually don’t realize.” He tends to follow that up with questions about nutrition. “It’s amazing how many people are not eating balanced diets,” Dr. Tallia says. “Part of that is a consequence of our stressful world right now.”

Your doctor should also order basic blood panels and urine testing to check certain physical indicators of your health, like your thyroid hormones, essential vitamin and mineral levels, blood glucose levels, and inflammation markers, among others, Dr. Kane says. Treatment can then be tailored based on your results. If your doctor suspects a sleep disorder is at play, they may refer you to a sleep specialist, who will likely recommend doing a sleep study that takes place either in a sleep center or in your home (some can easily be done online).

Your doctor may also suggest making certain lifestyle changes to see where that gets you—and there is a lot you can try out, according to the Cleveland Clinic:

• Prioritize sleep hygiene: That doesn’t just mean aiming for seven to nine hours of shut-eye each night. It also includes nixing caffeine around 2 p.m. and avoiding screens or workouts right before bed. It’s also a good idea to try to go to sleep and wake up around the same time every day, even on the weekends.

• Cut back on booze: Your doctor may recommend that you only drink alcohol in moderation or skip it entirely.

• Tweak your diet: Eating a balanced diet rich in whole foods can help give you the essential nutrients you need to power through each day.

• Boost your hydration: It’s common advice for a reason. Everyone’s hydration needs are slightly different and can even vary from day to day based on activity levels. But the U.S. National Academies of Sciences, Engineering, and Medicine recommends that people assigned male at birth have about 15.5 cups of fluids a day and that people assigned female at birth strive for 11.5 cups of fluids daily, which includes liquids you take in from foods and beverages.

• Reduce your stress levels: Sure, easier said than done. But trying grounding techniques, like yoga, meditation, and regular exercise, can help you find some calm in the chaos.

• Find a workout you love: Exercising regularly can help you feel more energetic (once you get used to it). The Centers for Disease Control and Prevention recommends aiming for 150 minutes of moderately intense activity per week, along with muscle-strengthening activity for two days out of the week. Keep in mind that exercising too much can make you feel wiped out, so check in with your doctor before starting a new fitness routine if you’re already fatigued.

It’s easy to read all of this and worry that your recent exhaustion is a sign of something serious. But rest assured that’s probably not the case. “It may not boil down to one thing alone,” Dr. Tallia says. “It really takes a little bit of detective work to figure out what is going on.”

Still, you shouldn’t let your doctor dismiss it if they have some trouble identifying the source of your fatigue. “You need to find a doctor who will investigate all possible causes,” Dr. Kane urges. “If not, there is always another who will.”

Dr. Winter agrees: “If your doctor can’t figure it out, it’s time to find a new doctor who has a long list of health conditions to investigate.”

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