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If you find yourself asking “why am I always tired?”, you’ll want to read these 10 reasons, plus tips for how to combat fatigue.
What Am I Always Tired?
In a recent survey of my website readers, feeling fatigue and being tired were the top health complaints (unexplained weight gain was the other big concern). I get it! I experienced overwhelming fatigue and tiredness for a long time before I figured out the root causes.
This article includes ten reasons why you might always be tired, plus some ways for you to combat fatigue.
Note: I am not a licensed healthcare practitioner. It is important that you check with your provider if you’re experiencing fatigue that won’t go away. This article is not a substitute for qualified medical advice.
Quick Fixes vs. Root Causes
It can be tempting to opt for quick fixes to feeling tired or fatigued in the form of caffeine, energy drinks, sugar-laden processed foods, and over-the-counter medications. Beware of these short-term energy boosts!
It will be better in the long run to explore the real reasons why you could be experiencing fatigue in the first place. It’s time we consider why we’re tired so that we can combat and resolve our fatigue in order to thrive instead of merely survive.
You may not necessarily have an immediate diagnosis or answer even with the right doctor and tests, but here are ten reasons why you may be tired, and some ideas for how to combat fatigue and feel better.
1. You’re Not Eating Enough
Food provides us with calories which is energy for our bodies. Without enough calories from food, our bodies cannot perform daily functions adequately and will go into “starvation mode.” The truth is that women who are dieting might actually be causing their bodies to slow down their metabolism.
To put this in perspective, we can use the Mifflin-St. Jeor Equation to determine the minimum caloric needs for survival. For females the formula is: 10 x (weight in kg.) + 6.25 x (height in cm.) – 5 x (age) – 161
So for a 40-year-old woman who is 150 lb. and 5’5” the equation would look like this:
(10 x 68) + (6.25 x 165) – (5 x 40) – 161 = 1,350.25 calories minimum
(use a search engine to convert pounds to kilograms and inches to centimeters)
The Mifflin-St. Jeor Equation was found to be the most reliable predictor in determining actual resting caloric expenditure within 10%. This is the formula recommended by the American Dietetics Association and is used by most nutritional professionals.
I cannot stress enough that this formula determines your minimum caloric needs just so your body can perform daily functions. If you’re active you will need to consume more calories. Too often I hear of women trying to stay under 1,200 calories a day to lose weight. This doesn’t work. It puts your body into starvation mode. It also causes fatigue since your body is in an energy deficit.
A 2006 study published by the journal “Obesity” reports that very low-calorie diets are not effective for long-term weight loss. Fatigue is not the only adverse effect of a diet too low in calories. Some people have reported nausea, diarrhea, constipation, gallstone formation, malnutrition, dizziness, hair loss, and headaches as well.
Calories should not be feared if they are coming from clean, whole food sources. Consume foods that are nutrient-dense and try to stay within the recommended macronutrient ratios of 40% carbohydrates, 30% protein and 30% fat.
If you’re focusing on consuming unrefined carbohydrates, clean and organic protein sources, and healthy fats, then you have nothing to worry about when it comes to food consumption and you can rest assured that you’re likely fueling your body properly.
Therefore, you might be able to combat your fatigue simply by eating more!
2. Your Hormones Are Changing
Hormonal changes are inevitable for women. Not only do we experience monthly changes with the menstrual cycle, but we also go through life seasons, including pregnancy, perimenopause and menopause.
Perimenopause is a time in a woman’s life when the ovaries gradually begin to make less estrogen. Perimenopause can start as early as a woman’s mid-30s and last until menopause, the point where the ovaries stop releasing eggs altogether.
Fatigue is one of the main complaints of women going through hormonal changes like perimenopause and menopause. Other symptoms of perimenopause include hot flashes, breast tenderness, insomnia, worsening PMS, lower libido, vaginal dryness, sexual discomfort, irregular periods, incontinence, and headaches. Estrogen, progesterone, thyroid hormones and adrenal hormones are all changing at this time and can contribute to fatigue.
Supplements can be very helpful during hormonal changes to fight fatigue. One of my favorite resources is The Period Repair Manual (2nd edition), by Lara Briden, ND. This book has been hugely helpful in helping me find supplements as I enter perimenopause.
Other good ways to combat fatigue caused by hormonal changes are by developing a good sleep routine, practicing meditation, staying hydrated, consuming balanced and nutrient-dense meals, and trying some low-impact exercises like walking or yoga.
3. Your Diet is Too Restrictive
I’m just not a fan of overly restrictive diets. Restrictive diets are especially detrimental to those who have a past history of an eating disorder. Some examples of restrictive diets include the vegan diet and the ketogenic diet.
Both the vegan and keto diets can be used short-term under medical supervision in a therapeutic setting but are not recommended for long-term use for most people. Avoiding animal products can lead to nutrient deficiencies. Some common ones are low iron and low B vitamin levels. Some people wonder if not eating meat will make you tired. A restrictive diet that cuts out whole categories of foods can definitely lead to fatigue.
The ketogenic diet cuts out most carbohydrates. It’s too bad that carbs are taught to be feared. Complex carbohydrates are beneficial because they help our bodies burn fat without depleting muscle stores for energy. Plus the right carb choices (think: sweet potatoes and other starchy vegetables) provide us with fiber to slow the digestion process.
Restricting certain food groups such as on a vegan diet can also place an added stress on our bodies that we just don’t need. Restrictive diets can also cause adrenal burn-out, which will make us extra tired. You can read more about the various types of clean eating diets and my thoughts on their pros and cons here.
The bottom line is that by expanding your dietary choices, you might resolve your possible nutritional deficiencies and combat your fatigue that way.
4. Your Thyroid is Underactive
Hypothyroidism is the term given to underactive thyroid. This condition occurs when the thyroid gland fails to produce enough thyroid hormones. Energy production within the body requires thyroid hormones. Therefore, an underactive thyroid can lead to low energy levels, making you feel weak and fatigued. Hypothyroidism is an epidemic in our country, and women are more often affected than men!
A simple blood panel can normally determine if your thyroid is underactive. Ask your doctor to test your thyroid stimulating hormone (TSH) levels, along with Free T3 and Reverse T3. He or she may order other thyroid tests as well.
The optimal range you want to see for TSH is anywhere between 1.0-2.5. Anything from 2.5-4.0 is slightly elevated, meaning your pituitary gland is telling your thyroid to pump out more TSH to boost thyroid activity. A number above 4.0 is too high (some doctors are now considering a TSH over 2.5 as cause for concern), so talk to your doctor about treatment options. Unless you’ve had the right tests done to check your thyroid in the last 6 months, don’t assume that you’re thyroid is functioning optimally!
From personal experience, I can say that getting my thyroid hormone balanced was the fastest way for me to combat relentless fatigue. Once I increased my hormone intake, my energy improved literally overnight.
5. You’re Not Sleeping Well
Insomnia is a common side effect of hormonal changes, which, as stated above, are nearly inevitable. Stress and overthinking can also contribute to insomnia. Some people use a sleep tracking device to gauge how they’re sleeping (I use this affordable sleep tracker).
My best advice for better sleep is to create a sleep routine. Go to bed and get up at the same times every day or as often as possible. This will help reset your circadian rhythm and combat fatigue. Studies show that wearing blue blocking glasses in the evening can also help reset circadian rhythm for better sleep. I wear these amber glasses because they fit over my regular glasses.
Cutting back on caffeine and setting a ‘caffeine curfew’ can help you sleep better and fight fatigue. Create a nightly routine of turning off all screens two hours prior to your desired bedtime. Take a bath, meditate, read a book, or write in a gratitude journal to help yourself wind down before bed. Do this every night or as often as possible. Read more of my sleep hacking tips here.
6. You Are Over-Exercising
Believe it or not, it is possible to overdo it with your exercise routine which leads to fatigue. While the majority of people don’t exercise enough, there are quite a few people who exercise too much.
When you exercise too much your body can see this as a stressor causing you to overproduce cortisol. Too much cortisol will lead to sleep problems which will lead to fatigue and feeling tired. Either you won’t be able to fall asleep easily at night or you’ll wake up in the middle of the night and not be able to get back to sleep. You might also be so sore from over-exercising that it impairs your ability to sleep well.
Another thing I see with some women is that they wake up very early to get in a sweat session regardless of how many hours they slept the night before. A general rule is that if you did not sleep for at least six hours the night before, you should skip an intense workout. Do some light stretching or yoga, or go for a 20 minute moderately-paced walk. Skipping the gym and sleeping in is an option as well.
Noelle from Coconuts and Kettlebells wrote a great post titled 6 Signs You’re Overtraining and Need More Rest. It’s definitely worth reading if you’re an avid exerciser experiencing unexplained fatigue.
7. You Might be Fighting an Infection
Most of us have infections that our immune systems keep at bay. For example, did you know that 95% of adults in the US have been exposed to Epstein-Barr virus? It’s normal to have been exposed to viruses, but they can certainly lead to unexplained fatigue if they start to replicate and the immune system can no longer manage them. Some viruses that have been linked to a disorder known as Chronic Fatigue Syndrome including Epstein-Barr virus and xenotropic murine leukemia virus-related virus, or XMRV.
If you suspect you are fighting an infection from a virus, it’s important to work with a qualified healthcare practitioner to do the proper lab testing, plus develop a health plan. In this case, I recommend finding a functional medicine practitioner who will have lifestyle and supplement recommendations outside of taking an anti-viral drug.
You can learn more about functional medicine and how it might help you in this interview I did with a prominent functional medicine doctor.
8. You Have Food Intolerances
Food interolarances are different from food allergies. An intolerance can show up anywhere from immediately ingesting a suspect food, to days later. The symptoms can be really wacky, too, including skin rashes, restless leg, headache, fatigue, and many more. The two best ways to know if you’re experiencing food sensitivities are to do an elimination diet or to do food sensitivity testing.
You might be eating foods you’re sensitive to and not even know it. After I did food sensitivity testing, I found out I am severely reactive to ginger and tomatoes, two well-known health foods. I started sleeping better and feeling less tired once I stopped eating foods that didn’t work well for my individual needs.
9. Your Iron Levels Are Low
Iron is necessary for optimal health. Low iron levels have been shown to cause fatigue, with or without clinical anemia. Factors that can contribute to low iron in the body include not eating enough iron-containing foods, lacking the cofactors needed for iron absorption, heavy menstruation, pregnancy, certain medications, and overconsumption of diuretics (coffee, tea, alcohol, soft drinks, and sugary fruit juices).
Iron is important because it helps us transport oxygen from our lungs throughout our body in our blood. It also helps our muscles store and use oxygen. Low iron not only contributes to fatigue, but it can also affect memory and mental function. When iron levels are too low for too long, a person can develop anemia which will cause fatigue and many other very unpleasant symptoms.
The best sources of iron come from nutrient-dense foods like grass-fed beef, wild-caught shellfish, and organic spinach. It’s also a good idea for women of child-bearing age to take a daily iron supplement (this is a good one). A simple blood test for ferritin can help determine if you’re at risk for low-iron related fatigue. See my choices for the best multivitamin for women over 30.
10. You Aren’t Practicing Enough Self-Care
A lot of people are always on the go these days overworking themselves to the point of exhaustion. It’s important to take a break every once in a while and dedicate some much needed time to self care. Some of my favorite forms of self care are moderate walks in nature, meditation, yoga, getting a massage, or just taking a day off and using it to do whatever you want.
Not taking time to relax keeps you in a fight and flight state of mind, which is a major stressor and adrenal taxer. If you find yourself losing interest in activities that usually energize you, then you probably need to take a break. Make yourself a priority and remember to breathe every now and then. It’ll give you an energy boost and allow you to rest a bit.
Other Articles About Fatigue & Energy
- Six Lab Tests You Need (& How to Order Them Without a Doctor)
- How to Eat Clean (Without Starving Yourself)
- 10 Tips for How to Have More Energy
Is being tired all the time a sign I have a disease like cancer?
Probably not! But, it’s important that you do some digging to find out why you are tired all the time. Check out the reasons below to see if any of these apply to you. Then, please do consider working with a functional medicine practitioner if you are still feeling intense fatigue.
Why do I always feel sleepy?
The most obvious reason is that you’re not sleeping well enough or long enough. I would suggest making sure you’re going to bed early enough that you can stay in bed at least 9 hours. This should help make sure you’re getting at least 8 hours of full sleep time, plus a little wriggle room to account for time to fall asleep and some time if you wake up in the middle of the night.
How can I stop feeling tired?
This answer will be different for everyone, but the bottom line is that you need to identify the causes of your fatigue. The possible reasons listed below should be a good starting point, but you should probably talk to your healthcare provider about your fatigue if it lasts longer than a few weeks.
My Experience With Combating Fatigue
As an example, I had to switch doctors to find someone who would take me seriously when I complained about feeling tired. It made all the difference to have the right practitioner who listened to my concerns, the right lab tests, and the right person to interpret them. I can’t overemphasize how important and transformative it was to my health to have these things.
Conclusions About Why You Might Always Be Tired
If you’re experiencing fatigue that you just can’t shake, it’s important that you seriously consider what might be the cause. Long-term insomnia and unexplained fatigue can lead to neurological problems and disease.
There’s no better time to address your tiredness and fatigue than now! Please report back, I am always interested to know if these tips help you on your journey to better health.
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