Why am I so tired all the time?
Fatigue is a feeling of constantly feeling tired or weak, either physically, mentally, or both. People often described it as feeling tired, low in energy, constantly sleepy or unmotivated and irritability. It can affect people from all walks of life and can be transient or long term. Fatigue itself is not a condition but a symptom of an underlying problem.
There are many different causes of fatigue. There are often divided into medical and non-medical related causes. The list of medical causes of fatigue is exhaustive, but some of the more common causes include Iron deficiency (even with individuals who are not anaemic), anaemia (low haemoglobin levels), Hypothyroidism (low thyroid hormone levels), obstructive sleep apnoea, and congestive cardiac failure. Certain medications to treat common medical conditions can also cause fatigue.
Non-medical related fatigue is often caused by, or in combination of alcohol or drugs, work-related stress, difficult emotions (anxiety, depression, grief), lack of sleep, sedentary lifestyle or a lack of exercise, and a poor diet.
If you are eating a well-balanced diet, getting enough sleep, and moderating your alcohol intake but still find it hard to carry on day-to-day activities or experience any of the symptoms as described above, you may be experiencing fatigue that needs further investigation by a medical professional. You should see your GP, who will take a full medical history, perform a physical examination to check for signs of illness or disease and perform laboratory investigations that will include a blood test, a urine test, imaging studies and other investigations to identify the reasons for your fatigue.
A recent systematic review has shown that if you have iron-deficiency anemia, it may be worthwhile considering an iron infusion prior to major surgery.
Although more studies are required to further validate this, the authors of that study have concluded with moderate certainty, that intravenous iron supplementation is associated with a significant decrease in the blood transfusions rate, and modest hemoglobin concentrations rise when injected pre-surgery compared with placebo or oral iron supplementation. Discuss with your GP to consider optimizing iron levels prior to surgery as an optimised iron level may also benefit cardiac function and help with wound healing.