It’s widely known that to feel well-rested, we must get enough sleep. No one is surprised when they feel tired after a late night, but what if you’re consistently getting seven-plus hours of sleep and still waking up exhausted? It’s a frustrating experience that can leave you feeling confused. If lack of sleep isn’t to blame, then what could be causing such low energy?
SLEEP APNEA
Daytime grogginess and fatigue are hallmark symptoms of sleep apnea—a condition that causes you to stop breathing repeatedly during sleep, leading to lowered oxygen levels and repeated interruptions of your sleep cycle. Although not always associated with sleep apnea, the presence of these symptoms increase its likelihood:
- loud snoring
- gasping in your sleep
- lapses in breathing during sleep and/or waking up with dry mouth
If you suspect you may have sleep apnea, make sure to ask your doctor for a referral to a sleep study. This is not a condition that you want to ignore, as it can have serious long-term consequences for your health.
IRON DEFICIENCY
Iron deficiency is one of the most frequent causes of fatigue that I see in my practice. It’s most common in people with periods (especially if their menstrual flow is heavy), vegans and vegetarians, and people with digestive troubles. Luckily, iron deficiency can be easily diagnosed with a few simple blood tests. If iron deficiency is severe enough, it can cause anemia—a condition where your body can’t produce enough red blood cells or hemoglobin. This makes it very difficult for your body to carry enough oxygen to your tissues, leading to low energy levels. Other signs of iron deficiency include:
- pallor (paleness)
- shortness of breath
- cold extremities
- weakness
- dizziness
- fast heartbeat
- chest pain
- increased fatigue after physical activity
- hair loss
- weak or brittle nails
THYROID PROBLEMS
When your thyroid gland is sluggish or under-functioning, everything slows down, including your energy levels. This is known as hypothyroidism or an underactive thyroid. Some additional signs that suggest a thyroid condition include:
- weight gain
- constipation
- dry skin
- thinning hair and eyebrows
- feeling cold
- achy muscles and joints
- hoarse voice
- muscle weakness
- low mood
- heavy or irregular periods
If you suspect a thyroid condition, make sure to ask for blood work to investigate further. Many practitioners will order a test called Thyroid Stimulating Hormone (TSH), but don’t stop there. I recommend a full thyroid panel, including tests for your thyroid hormones and thyroid antibodies. This provides a complete picture of your thyroid health, which is difficult to ascertain with TSH alone.
VITAMIN D DEFICIENCY
Vitamin D deficiency is common among Canadians due to our long winters and limited sun exposure. If you follow a vegan diet your risk of developing a vitamin D deficiency is further increased. Persistent fatigue is one of the first signs of a vitamin D deficiency, followed by:
- low mood
- frequent illnesses and infections
- hair loss
- weakness
- aches and pains, and eventually bone pain
I recommend that all Canadians have their vitamin D levels assessed annually via a blood test for general wellness and disease prevention.
DEHYDRATION
Drinking enough water is one of the simplest ways to boost your energy levels. Our bodies are made up of about 60 percent water, which is why staying hydrated is essential for our overall health. When we don’t get enough water, it affects nearly every organ and cell in the body. Some signs that you may be dehydrated include:
- headaches
- hunger
- light-headedness
- mood swings
- constipation
- dark-coloured urine
Aim for eight glasses of water per day, and even more if you’re very active.
VITAMIN B12 DEFICIENCY
This nutrient deficiency is another common cause of persistent tiredness and one that I check for regularly in my fatigued patients. Like the other nutrient deficiencies discussed, a vegan or vegetarian diet increases the risk of inadequate vitamin B12, as does regular alcohol consumption, having a digestive disorder, use of antacid medications, and having an autoimmune disease. Similar to iron deficiency, a vitamin B12 deficiency can also cause anemia. For this reason, the symptoms of B12 deficiency are similar to the symptoms of iron deficiency. Low B12 is also associated with:
- numbness and tingling in the extremities
- smooth and tender tongue
- ulcers around the mouth
- reduced vision
- memory troubles
Vitamin B12 can be easily tested via blood work.
CAFFEINE OVERUSE
Ironically, one of the most common “cures” for low energy also causes fatigue. Overuse of caffeine has several symptoms, including:
- energy crashes
- dependance on caffeine to function normally
- chronically low energy levels
This is because caffeine doesn’t actually provide the body with additional energy. Instead, caffeine works by blocking the action of adenosine, a neurotransmitter that promotes sleep in humans. When we consume caffeine, the sleepy effects of adenosine are inhibited, and we temporarily feel more energetic. But caffeine’s effect is short-lived, so once it wears off, all the adenosine that’s been building up in your brain comes rushing back to bind to its receptors, leaving you feeling exhausted. Eventually, this catches up with you, which is why I recommend taking regular breaks from caffeine use (two days on, two days off).
SEDENTARY LIFESTYLE
The human body has not evolved to sit for hours each day. We are built to move regularly and travel long distances on foot; our evolutionary physiology is, unfortunately, at odds with the structuring of modern society. Living a sedentary lifestyle reduces energy levels and promotes declining mental and endocrine health, further contributing to fatigue. Our cardiovascular, respiratory, and skeletal-muscular systems become de-conditioned from sedentary behaviour, which is one of the reasons it saps our energy. Moving your body, even for a few minutes each day, can provide a much-needed boost to energy and mood thanks to the release of dopamine and serotonin. Aim for 20 minutes of intentional movement daily—this is planned movement above and beyond your day-to-day chores and tasks.
ELECTRONIC DEVICE OVERUSE
Electronic devices are a major source of “junk light,” which mucks up our sleep-wake cycle and wreaks havoc on our energy levels and mood. The human body is very sensitive to changes in ambient light; regulation of our circadian rhythm is dependent on exposure to different types of light. It wasn’t that long ago that artificial lighting was introduced into our lives, and sadly, our bodies have not adjusted to this relatively new addition quite yet. The blue light emitted by electronic devices is particularly harmful to mood and energy, and can leave us feeling “tired but wired.” I recommend setting screen-time limits on all devices and being especially mindful of exposure to artificial light after sunset.
MENTAL HEALTH CONDITIONS
If all other conditions have been ruled out, it’s important to investigate the possibility of a mental health condition as the source of fatigue. Depression is well known to cause low daytime energy, but other mental health conditions, such as anxiety, can lead to fatigue as well. Sometimes this is because of a sleep disturbance triggered by a mental health condition; insomnia is a notorious symptom of most mental health concerns. Poor mental health can cause fatigue even if you’re sleeping well, so it’s important to speak to a professional who can help you manage your mental health, instead of sweeping it under the rug as so many of us are socialized to do. Your mental health matters and has a real impact on your quality of life. Don’t hesitate to reach out to a practitioner for help.
