Ask Dr. Aunna: Why am I so tired all of the time?

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Source: cdc.gov

Source: cdc.gov

 

Dear Dr. Aunna,

I have been dealing with low levels of energy for the past few years and it only seems to be getting worse. I have seen a few doctors for this but my blood work is normal except for a borderline high cholesterol. Everyone keeps attributing my symptoms to depression, but except for a little stress here and there I feel pretty happy. Coffee doesn’t work anymore and I can barely stay awake during the day. I am at my wits end and need your advice because I am falling behind in everything!

– AH

*AH, a coaching client of mine, like many others, struggles with low energy and fatigue. AH’s doctors did a thorough workup, checking every possible cause of fatigue from anemia to thyroid disease and even sleep apnea and narcolepsy. Most people fail to realize that their lifestyle habits greatly contribute to their fatigue, rather than a serious disease or “hormones.”  Here is a snapshot of part of AH’s holistic health assessment:

Breakfast: Muffin or bagel, coffee with sugar and creamer
Lunch: Don’t have time to eat lunch usually, but will get a snack from the snack machine or run to the cafeteria when I get the chance.
Dinner: My husband and I usually order out or I make a sandwich or heat up a TV dinner.
Snacks: Pretzels, peanut butter crackers
Beverages: Diet mountain dew, 4-5 cups of coffee per day
Water: Don’t usually drink water. Most of the fluids are from diet soda or coffee.

Alcohol: 3 glasses of wine at night
Tobacco: Never
Drug use: Never

Exercise: Don’t have the time or energy
Stress Release (yoga, meditation, etc): No time, but will watch TV until I fall asleep.

Sleep (duration and quality): 5-6 hours per night. Not good, toss and turn

AH may be considered healthy based on her labs and lack of any specific organic disease, but as you can see above, there are many other factors at play. In fact, there were many other emotional and social issues affecting AH not mentioned above. AH was convinced that she had a diagnosis that no one had discovered yet, but given the fact that she was willing to try anything, she implemented the simple solutions I suggested.  She not only regained energy but her cholesterol level dropped and she lost weight. Here are some take away points from her case.

ProblemLack of awareness. AH didn’t even realize how unhealthy her lifestyle was until she wrote things down. Many people are on the go and  accustomed to certain habits, that they don’t even question them or realize how harmful these habits can be.
Solution: Practicing mindfulness is an effective way to be conscious of your habits. You can start out with keeping a journal and seeing what you can change, or take the time to slow down and consciously make healthy choices throughout the day.

Problem: Excuses. Enough said.
Solution: Many people say they don’t have time, but we make time for what we prioritize. You are worthy of being healthy so start making yourself a priority. (Read more about how to overcome obstacles and make effective change here).

ProblemUnhealthy diet. AH’s diet is filled with refined carbs, low fiber, sugar, and barely any fresh fruits or vegetables. Restaurant and frozen meals are often filled with unhealthy ingredients. Whenever we eat high glycemic index foods, our blood sugar spikes and so does insulin, leading to a crash and feeling drained. An unhealthy diet can also lead to obesity, diabetes and heart disease which will definitely cause fatigue.
Solution: Eating a diet filled with whole grains, protein, and fresh fruits and vegetables (all which contain healthy fiber) leads to a slow steady state of glucose release in our blood. This helps avoid crashes and the fiber keeps us full longer. Cooking meals is a great way to not only eat healthy but practice mindful habits.

ProblemSkipping meals. A drop in blood sugar can lead to feeling weak.
Solution: Don’t skip meals. If you don’t have the time to eat a full meal, keep healthy snacks such as nuts or apples handy to snack on until your next meal.

ProblemDehydration. Dehydration not only leads to fatigue, but can also lead to feelings of hunger.
Solution: It’s recommended that you drink eight 8 oz servings of fluids per day. It’s best if most of your daily fluid intake is from fresh water, rather than fluids from sweetened and artificially sweetened beverages.. Limit salt intake, as salt without enough water can also cause dehydration.

ProblemCaffeine overload. While caffeine can give you some energy, it can also cause insomnia and throw off your sleep. Caffeine also activates the sympathetic nervous system, so with your body on continuous adrenaline drive you are bound to get worn down. It can also cause or worsen anxiety adding to even more stress. AH was also likely so fatigued throughout the day and developed a tolerance for caffeine, which is why coffee no longer helped.
Solution: Limit caffeine to one to two cups of coffee per day. Since a cup of coffee’s caffeine effects can last up to 4 hours, make sure your last cup is in the early afternoon to avoid insomnia at night. Cutting back on sugar and creamer in your coffee will also help. Applying the other solutions mentioned will also increase energy and decrease the need for caffeine.

ProblemAlcohol. Alcohol may help you fall asleep but the quality of your sleep will be affected. The restful cycles during sleep shorten with alcohol use.
Solution: Cut back on alcohol. Limit yourself to a glass of wine a few nights per week.

ProblemLack of Sleep. Stress, caffeine and alcohol all disrupt sleep. TV, especially at night can be activating and interfere with sleep. What’s worse is that the less we sleep, the more we accumulate a sleep debt. Lack of sleep not only causes fatigue but also increases our risk for infection and can lead to depression.
Solution: Make sleep a priority. Go to bed at the same time every night and use the 30 minutes before to wind down instead of watching TV. Make sure to get at least 7-8 hours of sleep per night.

Problem: Lack of physical activity. Exercise helps maintain a healthy weight, boosts energy and helps release stress.
Solution: Current exercise recommendations are to engage in moderate intensity exercise, 30 minutes per day, 5 days per week. Make sure not to exercise too close to bedtime as it can cause insomnia

Problem: Lack of coping mechanisms. If we don’t release stress we wear ourselves down and can lose sleep. Using alcohol and drugs to cope with stress has detrimental effects on our body.
Solution: Practice daily stress release, whether it be journaling, exercise, yoga or meditation.

If you struggle with fatigue, it’s important to consult with a healthcare professional as serious causes for fatigue always need to be ruled out first. Practicing healthy lifestyle habits will improve your quality of life regardless.

Do you have a health question you would like answered? Send us your question for a chance to be featured. Find out more about Dr. Aunna’s Holistic Health Coaching here.

*Information from AH’s assessment was posted with permission. Names are changed to protect privacy.

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