14 medical reasons why you might be tired all the time

Constantly exhausted? Look out for these telltale signs that something serious is amiss.

Dog-tired all the time and don't know what to do about it? If you find yourself pressing the snooze button every morning and battling the post-lunch slump every afternoon, you're not alone. The average Brit spends seven-and-a-half years feeling tired, according to a Healthspan survey.

Frequently feeling tired for long periods of time takes its toll, and can affect your mental health, your physical health and your quality of life. While it's normal to feel sleepy every now and then, if you're constantly fighting the urge to drop into a deep slumber, then something could be amiss.

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We asked Dr Kat Lederle, head of sleep health at Somnia, nutritional therapist Jo Gray, and personal trainer Luke Gray – co-founders of Feelnoo – to pinpoint 14 possible causes of feeling tired all the time, and reveal how exhaustion affects your health:
14 medical reasons you're tired all the time
While fatigue is a common symptom of several health conditions, most of the time a good night's sleep is all it takes for our energy levels to be restored. Here are 14 key reasons why you might feel tired all the time and when to seek help:

1. Burnout
If you feel like you're permanently running on empty, you could be suffering from burnout. The World Health Organisation (WHO) now recognises burnout as a medical condition, defining it as a syndrome resulting from chronic workplace stress. Burnout develops slowly, and is associated with decreased motivation, a lack of energy, reduced performance, and poor sleep.

'Sleep is a basic human health behaviour that everybody needs in order to perform during the waking hours,' says Dr Lederle. 'All animals show a rest-activity rhythm. Without downtime, the body is unable to repair and restore its functions. What follows are physical and mental illnesses and health problems.'
Work stress and burnout are mutually reinforcing, a study by Johannes Gutenberg Universitaet Mainz found, so addressing it isn't always straightforward. To combat burnout, delegate tasks at work, take frequent breaks from technology, set aside time for rest and relaxation – yoga, meditation and deep breathing exercises are useful tools – prioritise regular exercise and a healthy diet, and try taking up a creative hobby.

2. Poor diet
One of the biggest culprits of feeling tired all the time relates to your diet. The old adage 'you are what you eat' rings true. Refined carbohydrates – like those found in pastries, white pasta and breakfast cereals – cause a rapid rise in your blood sugar levels, and when they inevitably drop, it can leave you feeling extremely tired.

A lack of protein can also impact your energy levels. 'Protein builds muscle, and lack of muscle causes your metabolic rate to reduce right down – making you feel sluggish and fatigued,' Jo Gray says. 'When you're on a diet of more carbs than protein, a slump in the afternoon can be inevitable as you're crashing out from sugar.'

When you eat too few calories, your metabolism slows down to conserve energy.

Not eating enough food can also leave you feeling drained and impact the quality of your sleep. When you eat too few calories, your metabolism slows down to conserve energy. Follow a healthy, balanced diet and avoid missing meals to keep your engine running. You could also try eating for better sleep by adding some well-timed snacks to your diet.

'Certain foods trigger the sleep-inducing hormone melatonin,' says Gray. 'Foods rich in magnesium – like oats – encourage the production of insulin, which helps neural pathways access tryptophan, an amino acid that acts as a relaxant to the brain. It's true that a warm glass of milk does help you sleep better. Dairy is a natural source of sleep-inducing tryptophan and the sugar in the dairy provides a great carrier for the amino acid.'
3. Sedentary lifestyle
It's somewhat ironic, but inactivity can totally drain your energy stores. Leading a sedentary lifestyle can negatively impact sleep quality and make you feel more tired than usual, so it's important to include exercise in your daily routine. 'People who exercise infrequently tend to have higher heart rates and lower oxygen consumption than fitter and more active people,' says Luke Gray –tw0 key factors associated with feeling fatigued.

The good news? Even minimal increases physical activity seem to be beneficial, so the smallest of healthy habits will go a long way. You could do 10 squats when you wake up every morning, swap your office chair for a stability ball, go for a 15 minute walk every lunchtime, and commit to taking phone calls standing up. 'Get up every hour and move or stretch a little,' says Dr Lederle. 'Regular exercise will also help to promote healthy sleep.'
4. Vitamin deficiency
If you're tired all the time, it could be a sign of vitamin deficiency, including low levels of vitamin D, vitamin B-12, iron, magnesium, or potassium:

• Vitamin D deficiency
Vitamin D is essential for healthy bones and teeth, but research also links a lack of the vitamin with a host of issues, including heart disease, depression, and chronic fatigue syndrome. 'Vitamin D deficiency is associated with an increased risk in developing sleep disorders,' says Dr Lederle. 'High quality supplements may be able to ameliorate this risk.'

• Iron deficiency
Iron deficiency anaemia is one of the most common medical causes of tiredness, particularly in women who are pregnant or menstruating. Symptoms can include heavy-feeling muscles, heart palpitations and shortness of breath. Your GP should be able to diagnose iron deficiency anaemia using a simple blood test and may prescribe iron supplements.

• Magnesium deficiency
Magnesium is an essential mineral that is also important for energy production. Key symptoms include feeling tired, muscle cramps, aches and twitches, restless legs and problems sleeping. It's hard to test for magnesium deficiency but the symptoms are red flags in themselves.

• Vitamin B12 deficiency
A lack of vitamin B12, also known as folate deficiency anaemia, comes with a wide range of symptoms including muscle weakness, pins and needles, disturbed vision, mouth ulcers, memory problems and depression and can lead to a number of health problems. If you have symptoms seek urgent medical assistance, as some problems caused by B12 deficiency can be irreversible if left untreated.
• Potassium deficiency
Potassium is a mineral found in the foods you eat that helps your muscles work. Fatigue is often the first sign of potassium deficiency, but common symptoms also include muscular aches and pains, heart palpitations and breathing difficulties. If you are concerned speak to your GP, as potassium deficiency can be linked to a number of serious health issues including hypertension and kidney disease.

💊 Vitamin deficiency diagnosis: A routine blood test can help identify a vitamin deficiency. Ask your GP to run a full blood count (FBC) to check for levels of red and white blood cells in the body. A diet overhaul and supplements can make a huge difference with vitamin deficiency. Ask your GP for advice.

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5. Stress
Stress is a physical and mental reaction to life's pressures. Not only has it been shown to adversely affect sleep quality and duration, but insufficient sleep can lead to an increase in stress levels – so it's easy to get trapped in a cycle of worry. Developing stress management strategies can go a long way towards facilitating a better night's sleep and restoring your energy levels.
'Stress is a common trigger of sleep problems, and leaves the body in an aroused state,' says Dr Lederle. It activates your sympathetic nervous system, triggering the release of stress hormones such as adrenaline and cortisol. Practicing mindfulness can help calm your relaxation response. 'Daily meditation practices help you to learn ways to step back from worrying thoughts and feelings allowing you to remain calmer,' she suggests.

To combat stress, keep your caffeine intake in check. 'A good way to use caffeine is if you’re about to exercise,' says Jo Gray. 'When you drink caffeine your cortisol levels increase, which will actually enhance your performance. However, if you are just manually raising this cortisol to give you a boost, sitting at your desk after lunch then you’re not putting that cortisol to good use. Try swapping your afternoon tea for a non-caffeinated hot drink.'
6. Depression
While