Why am I so tired and when is it time to see the doctor about it? A general practitioner explains | Natasha Yates

Everyone feels tired sometimes. But how do you know if your fatigue is a problem worth seeing a doctor? And with all the mental and emotional strain we've been under due to the pandemic, isn't it normal to feel tired?

Fatigue is subjective; what is normal for one person will not be for the next. Many people see their GP reporting fatigue (a recent study in Ireland found it was present in 25% of patients).

As a GP , my first question to someone who feels tired is: "How can you function?"

If fatigue is interfering with your daily life and your ability to do what you like to do, it should be explored further.

Some common causes of persistent fatigue

Lack of sleep is an obvious and very common cause of fatigue. Often patients tell me "Oh, lack of sleep is not the cause, I sleep well, maybe too much!" But on questioning them, they admit that they don't wake up rested. "model .dotcomrendering.pageElements.RichLinkBlockElement" class="dcr-1mfia18"/>

That's a bit telling because it means their sleep quality is poor, even though the quantity seems sufficient. They could be suffering from sleep apnea, where breathing stops and starts again while a person is sleeping. Apnea can lead to serious long-term health issues, so it's worth investigating.

Alcohol can also wreak havoc on sleep quality a person and they wake up not feeling rested.

Another common cause of fatigue is depression - and remember that a person can be depressed without feel like you're in a bad mood. For example, they may feel irritable or frustrated, or have trouble concentrating. This is concerning, as these patients may fly under the radar and not realize that it is actually depression. Unexplained fatigue may be the predominant symptom of depression, with other symptoms appearing only after careful questioning.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME /CFS) is a serious long-term disease. - term disease which, among other symptoms, causes extreme fatigue – far beyond “normal” fatigue. It can start with patients noticing a different degree or type of fatigue than their past experience, and can be difficult to diagnose in the early stages.

There are other potential causes of fatigue – issues such as lack of iron, thyroid disease, diabetes, kidney disease, heart disease and many more. Treatment of these can also relieve fatigue.

Fatigue also accompanies many illnesses, but should not persist after recovery.

The take home message is: if fatigue is interfering with your life, there are many possible causes and it is worth talking to a GP.

What does it look like? really "interference with life"?

Screening tools for a level of fatigue of concern include the Epworth Sleepiness Scale and the Stop-Bang Score. You can do both tests at home and take the results to your GP.

But even if your results are normal, your fatigue is worth investigating if you:

< p> feeling too tired to exercise (this can be a vicious cycle as regular exercise can actually give you more energy - however, it can be risky for people with dementia) ME/CFS to exercise, so caution is required for these patients)

you feel too tired to go out, see friends, or do things you used to enjoy

press the snooze button often because you don't wake up feeling rested

sleep regularly in front of the TV

spending all day wishing you could go back to bed.

If, in addition to fatigue, you also have one of the following "red flags", it is essential that you see a GP as soon as possible: unexplained weight loss, s...