Why Am I Always Tired? Chronic Fatigue Symptoms - Family Medicine

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Feeling sleepy all day long?


In the past two weeks, I've been feeling unusually fatigued and waking up with sore eyes every day.
I underwent an abdominal ultrasound and liver function tests, all of which came back normal, except for the presence of small polyps in my gallbladder.
I would like to ask the doctor why I am experiencing these symptoms.

Hong, 20~29 year old female. Ask Date: 2016/08/12

Dr. Zhang Hongwei reply Family Medicine


Hello, I'm not sure about your sleep schedule, including what time you go to bed, the duration of your sleep, your daytime routine, and whether you spend long periods using your phone or computer screens.
If the abdominal ultrasound shows a polyp that is less than 1 centimeter, it can usually be monitored.
Your concerns may require a more detailed medical history, laboratory tests, and a physical examination.
I recommend visiting a family medicine clinic for further discussion.
Thank you for your inquiry.

Reply Date: 2016/08/12

More Info


Chronic fatigue is a complex and multifaceted condition that can significantly impact your daily life. Based on your description, it seems you have been experiencing persistent tiredness, even after what should be adequate sleep. This phenomenon can be frustrating and concerning, especially when medical tests, such as abdominal ultrasounds and liver function tests, return normal results.
There are several potential reasons for your ongoing fatigue, and understanding these can help guide you toward effective management strategies.
1. Sleep Quality vs. Quantity: It's essential to distinguish between the amount of sleep you get and the quality of that sleep. Even if you are sleeping for a sufficient number of hours, factors such as sleep apnea, restless leg syndrome, or other sleep disorders can disrupt your sleep cycles, preventing you from reaching the deeper, restorative stages of sleep. Obstructive sleep apnea (OSA) is particularly common and can lead to excessive daytime sleepiness and fatigue.

2. Mental Health Factors: Psychological conditions such as depression and anxiety can manifest as chronic fatigue. Symptoms of depression often include fatigue, lack of motivation, and difficulty concentrating. If you have been under significant stress or experiencing emotional turmoil, it could be contributing to your feelings of exhaustion.
3. Lifestyle Factors: Your daily habits play a crucial role in your energy levels. Poor diet, lack of physical activity, and inadequate hydration can all contribute to feelings of fatigue. Additionally, excessive caffeine or alcohol consumption can disrupt sleep patterns and lead to increased tiredness.

4. Medical Conditions: While your recent tests showed normal results, there are numerous medical conditions that can cause chronic fatigue. These include thyroid disorders (such as hypothyroidism), anemia, chronic fatigue syndrome, fibromyalgia, and even certain infections. It may be worthwhile to follow up with your healthcare provider to explore these possibilities further.

5. Nutritional Deficiencies: Deficiencies in essential vitamins and minerals, such as vitamin D, vitamin B12, iron, and magnesium, can lead to fatigue. A blood test can help determine if you have any deficiencies that need to be addressed.

6. Chronic Stress: Prolonged exposure to stress can lead to adrenal fatigue, where your adrenal glands become overworked and struggle to produce adequate amounts of hormones, leading to feelings of exhaustion.
7. Medications: If you are taking any medications, it’s essential to consider their side effects. Some medications can cause fatigue as a side effect, and discussing this with your doctor could lead to adjustments that improve your energy levels.

To address your fatigue, consider the following steps:
- Sleep Hygiene: Establish a regular sleep schedule, create a comfortable sleep environment, and limit screen time before bed to improve sleep quality.

- Physical Activity: Engage in regular physical activity, as exercise can boost energy levels and improve sleep quality.

- Nutrition: Focus on a balanced diet rich in whole foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Consider consulting a nutritionist for personalized advice.

- Stress Management: Incorporate stress-reducing practices such as mindfulness, meditation, or yoga into your routine.

- Medical Follow-Up: If your fatigue persists, consider revisiting your healthcare provider for further evaluation. They may recommend additional tests or refer you to a specialist, such as a sleep medicine expert or a mental health professional.

In summary, chronic fatigue can stem from various factors, and addressing it often requires a comprehensive approach that includes lifestyle changes, medical evaluation, and possibly psychological support. By taking proactive steps and seeking appropriate care, you can work towards improving your energy levels and overall well-being.

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