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Fighting fatigue: why are we so tired all the time?

Life in Hong Kong is hectic, so it’s not uncommon for all of us to feel tired at times. Yet fatigue can be a symptom of a bigger issue, and, as Dr Nichola Salmond from Optimal Family Health explains, there’s more to it than just getting enough sleep.

There can be many reasons why you feel fatigue
There can be many reasons why you feel fatigue

Usual suspects

When severe fatigue becomes a prolonged, constant feature of daily life, it’s important to consult your doctor, who should be able to investigate and diagnose any underlying medical conditions which could be the cause. Any illness can cause fatigue but common ones are anaemia, thyroid disorder, vitamin B and iron deficiency, diabetes, autoimmune conditions, adrenal disease, chronic infections and cancers. Long-term stress and psychological issues like anxiety and depression can also be a cause, and can significantly alter sleep patterns and quality. While lack of sleep can be to blame, sometimes people may not realise that the quality of their sleep is being disturbed by conditions such as sleep apnoea or ear, nose and throat disorders. Allergic rhinitis is easy to diagnose and manage, yet sleep apnoea may need to be diagnosed in a sleep clinic – it’s important not to miss this, as it can significantly increase the risk of heart disease.

Hidden culprits

Sometimes no diagnosis is made – even after excluding these more common issues – and the patient is left feeling frustrated because the fatigue is still there. In my experience, it’s worth looking further to identify less common conditions that may be overlooked such as insulin resistance, coeliac disease, hormonal imbalance, low cortisol (adrenal fatigue), borderline thyroid, vitamin D deficiency, heavy metal toxicity and unusual infections such as Lyme disease. Some people may experience symptoms of fatigue when levels of iron and B12 are at the low end of the normal range. This also applies to thyroid and adrenal hormones; in those cases, I find people can benefit from further investigation and management.

Fighting fatigue

The good news is that, once you’ve found the cause, it’s often treatable. Addressing the cause directly through diet and supplements or through lifestyle changes such as resting and avoiding stress can have a significant impact. While exercise in moderation is good at alleviating mild fatigue, excessive exercise can lead to fatigue. The US Center for Disease Control advises that you engage in at least 30 minutes of moderate intensity aerobic activities (such as fast walking) or 25 minutes of vigorous exercise five times per week, in addition to muscle strengthening activities twice weekly. If you feel a significant increase in fatigue that is unexplained, do insist on further investigation to ensure that these conditions aren’t missed. The majority of cases of fatigue can be successfully treated once the underlying cause is found.

Optimal Family Health is at 1903a, 19/F, The Centrium, 60 Wyndham Street, Central.

2666 6300 | optimalfamilyhealth.com.hk

This article first appeared in the Dec/Jan edition of Expat Living magazine. Subscribe now so you never miss an issue.

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