4 Reasons You’re Tired All the Time (Beyond Lack of Sleep)

Jodi Helmer
by Jodi Helmer
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4 Reasons You’re Tired All the Time (Beyond Lack of Sleep)

We’re a nation of sleepyheads. Up to 15% of Americans struggle with extreme fatigue, according to the U.S. Centers for Disease Control and Prevention and one international study found an estimated 30% of all visits to the doctor were related to feeling tired all the time.

For those getting less than the recommended 7–9 hours of sleep per night, adjusting your sleep schedule to spend more time in bed could ease symptoms of fatigue such as headaches, moodiness, aching muscles and dizziness. If you’re tucked in from 10 p.m.–6 a.m. and still struggle with overwhelming exhaustion, it could be time to see a doctor because one of these four underlying medical issue could be to blame.


When your blood carries too little oxygen, a condition called anemia, it can leave you feeling tired, cold, dizzy and short of breath. An estimated 5 million Americans are anemic. The most common causes include lack of iron, heavy periods and pregnancy.

A simple blood test can detect the condition, notes registered dietitian Erin Palinski-Wade. If your iron levels are low, your doctor may recommend supplements or a diet containing iron-rich foods such as red meat and seafood. Though a 2017 study found vegetarians were more apt to be anemic than meat eaters, Palinski-Wade points to several plant-based foods that are high in iron, including lentils, black beans and spinach.

“Combining iron-rich foods with a source of vitamin C can also increase absorption so try making a spinach salad topped with lentils and strawberries for a plant-based, iron-rich meal,” she says.


You might have sleep apnea and not even know it. It’s often a partner who spots symptoms, such as loud or chronic snoring and gasping for air in your sleep, according to Dr. Dan Root, board-certified sleep specialist and founder of Oregon Sleep Associates. Sleep apnea causes repeated pauses in breathing throughout the night — sometimes up to 100 times.

“When people with sleep apnea awaken, they commonly do so with more adrenaline than those without sleep apnea, so they are more likely to be more alert [and] that can make it harder to go back to sleep,” Root says.

Don’t brush off complaints about severe snoring, especially if you’re overweight or obese — common risk factors for sleep apnea. Research published in the Journal of Clinical Sleep Medicine linked the condition to an increased risk of stroke and cancer.


Depression is exhausting. In a 2018 study, fatigue affected more than 90% of those with major depressive disorder. Even mild depression can make you feel tired and, according to licensed professional counselor Stacee Reicherzer, PhD, “Fatigue is often our [warning] symptom that we’re starting to slip into a period of depression.”

Sleep problems, including poor sleep quality, are hallmark symptoms of depression. One study linked fatigue to greater severity of depression.

In addition to fatigue, those with depression also experience sadness, loss of interest in activities, trouble concentrating and poor appetite. Seeking treatment can help boost your mood and improve your sleep quality, leaving you feeling energized, not exhausted, notes Reicherzer.


An underactive thyroid gland could be the reason you’re tired all the time. Hypothyroidism interferes with the production of thyroid-stimulating hormone or TSH. “The thyroid gland is part of metabolic control. Simply put, when [the gland] is not making enough hormone, it slows everything down,” Root explains. Fatigue is the most common symptom but hypothyroidism can also cause dry skin, weight gain, muscle weakness and depression.

New research published in the journal Frontiers in Endocrinology found low levels of thyroid hormones were associated with chronic fatigue syndrome, a condition associated with fatigue, weakness and depression. Root notes that treating hypothyroidism, often with medication to restore hormone levels, helps alleviate fatigue.


If you get restful sleep most nights and still spend your days feeling overwhelming fatigue, call your doctor.

About the Author

Jodi Helmer
Jodi Helmer

Jodi Helmer writes about health and wellness for publications like WebMD, AARP, Shape, Woman’s Day, Arthritis Today and Costco Connection among others. She often comes up with the best story ideas while hiking with her rescue dogs. You can read Jodi’s work or follow her on Twitter @helmerjodi.


30 responses to “4 Reasons You’re Tired All the Time (Beyond Lack of Sleep)”

  1. TzuZen says:

    Vitamin B12 deficiency, aka ‘pernicious anemia’, can be a cause of extreme fatigue. Some folks have lessened ability to absorb B12 from food or supplements.

    If you’re fatigued and it’s not a lack of sleep, see your physician to get checked out.

  2. BC says:

    Yes, it’s true for me. I’ve had more energy since taking vitamin b12 shots.

  3. hostile_17 says:

    This article is very poorly written.

    1) “We’re a nation of sleepyheads. Up to 15% of Americans struggle with extreme fatigue”. No. Americans are a nation of sleepyheads. MyFitnessPal is used internationally, unless I am the only non-American to somehow sneak in… please don’t talk like we’re not here in the ‘room’.
    2) “4 Reasons You’re Tired All the Time” Is that true? All four are why we’re all tired all the time? Is that likely? Or have you named four separate issues, and one (or possibly more) are the culprit? But the headline makes it sound like they are all part and parcel, all four are your issue. Irresponsible.
    3) “You might have sleep apnea and not even know it.” And what do you do when dropping this huge statement about a serious health issue… erm… nothing. No way to diagnose it. No information of the serious dangers. No information on next steps. In fact the related reading item is “READ MORE: Cheesy Polenta with Mushrooms”.

    Ahh yes, I have a potentially fatal breathing disorder – I’ll go look up a cheesy polenta recipe.

    This is the problem with cookie cutter blog content. You’re delving into very serious issues but with none of the responsibility required in doing so.

    • Beth Stone says:

      The expect YOU to have the commons sense to go see a Dr. They are not physicians. Thus, they can’t give medical advise beyond “Go see a Dr.” They have no responsibility to you or anyone else. They are only providing the information. They can’t make you exercise when they share an article on exercise. People need to take personal responsibility. No depend on articles to take care of their problems.

      • JGray1 says:

        doctors know just about as much as you do about what’s wrong and what to do about it. te endocrine system is still mysterious and trying different dosages and sometimes there’s a difference between brand names and generics are some of the strategies to explore.. but mainly, we are very imperfect and some of us are more energetic and some are more sedentary and give the opportunity to trade it’s likely no one would really want to change reading for hiking on a regular basis. Americans like to believe anything can be solved, fixed, re arranged and perfected. including the human condition. sigh.

        • Beth Stone says:

          Of course they don’t. That isn’t what I said. I said this article is not responsible for your needs. Only to pass along the information. I believe anything can be fixed, solved , rearranged and perfected, by the way. I’m in a wheelchair. Yet. I manage to workout, eat right and do all I can to be healthier. No excuses. If I can fix, rearrange , and solve my health issues to be perfected some day, so can anyone else.

      • hostile_17 says:

        You’ve kind of unpicked your own argument. You say in the same breath that they have no responsibility and that people need to take personal responsibility. Well yes. These writers need to take responsibility. You say they have none, but this is a site that is focused on health and they have a certain standard to upload. Throwing up info about sleep apnea then suggesting ” Cheesy Polenta with Mushrooms” as the next step is irresponsible. If you read other comments there are also errors about TSH. These people should not be writing articles if they can’t get it right, as lack of information or wrong information could be more damaging. Leave proper health matters to sites like the NHS.

        • Nichole Keller Lesniak says:

          The comment about TSH was incorrect. The article is right about.

          • hostile_17 says:

            Perhaps, I’m not an expert on TSH. However I am right that the article is trashy blog filler, with little value. They probably just bought it off the shelf.

          • Nichole Keller Lesniak says:

            Or, if you’re really looking to the internet for true medical advice, you have bigger problems.

          • hostile_17 says:

            Well, people do. Some don’t even have access to proper healthcare, so perhaps that’s the “bigger problem” that you refer to. So that’s where site owners have an ethical obligation. But then this is the site that allowed 150m accounts to be hacked putting people at risk – and didn’t once say the word sorry. So I think I probably expect too much.

        • Beth Stone says:

          The pass on information . You can’t take it or not. But, they have no responsibility if you take it or not, or if something happens to you as a result of taking or not taking the advice. That is all I meant. That is up to you. They don’t tell you how to eat eat, what to eat, when to exercise,etc. That is up to you. People blame others for their problems all the time. Even articles like this.

          • hostile_17 says:

            You best buddies with the author perhaps? Or the author under another name?. No one shows this much interest naturally in defending a crap article from common sense criticism unless they are a) invested b) very very bored.

            Edit: it’s like shooting fish in a barrel. Beth Stone, Marketing Director at Under Armour. Owner of MyFitnessPal.

            You should stop arguing with your customers and instead focusing on making sure your millions of users don’t get hacked and maybe just maybe UA says “sorry”.

          • Beth Stone says:

            Woah! I’m not a friend of the author and I’m not the author myself. Though I do use the myfitness pal app. Like I said, getting this upset over an article?? You really might consider counseling. Now, let it go.

          • hostile_17 says:

            Oh my god you’re back two weeks later to have another go and you’re telling ME to let it go?

            And you are weaponising mental health to troll other users?

            Kindly fuck off. Thanks.

        • Beth Stone says:

          Keep your name too. Hostile is an understatement. To get that worked up over an article?? Certain foods do help with sleep. You are responsible to confirm any information you read. Otherwise, you are just a sheep.

          • hostile_17 says:

            Hostile, for CARING? For calling for INTEGRITY? Then call me hostile?

            You are not content with tearing down opinion that contradicts your corporate opinion, you are going on a personal attack because it makes you feel better. And you keep on attacking.

            You put MILLIONS at risk with your hacks and you think little old ME in a comment section is the issue? That I’m the great evil that must be taken down?

            You are despicable.

    • Gary “solobo58” Bowling says:

      Man! You need a nap!

  4. Melissa Young says:

    Hypothyroidism does not interfere with the production of TSH. Actually, TSH (the hormone from your pituitary that tells your thyroid to work harder) goes up with hypothyroidism.

    • Nichole Keller Lesniak says:

      No, you misread. Hypothyoridism DOES interfere with the production in TSH, as it CAUSES it to go up. That is interfering, is it not? The article didn’t say it STOPPED it from producing TSH. It just said it interfered.

  5. SR S says:

    Maybe it’s because I go to work at 7 a.m. and get back home at 7 p.m. with hardly a break in between?

    • Beth Stone says:

      That is against the law. Report your employer to OSHA

      • SR S says:

        I am on a salary; it’s my “choice”.

        • Beth Stone says:

          Salary or not. The law is the law. By saying “choice” , you mean you don’t have to or they are making you, regardless of the law. Either isn’t right.

          • cattail722 says:

            Sometimes, when you have a good paying job with a short commute that you like, you’d rather work the extra hours and get the job done right, than complain and risk losing your job and then being stuck with a job you hate with a long commute. It’s called life.

          • Merrilyn Tattersall says:

            Yes agree cattail722, it’s life & it sucks! I also work 12hr shifts at the detriment to my health & wellbeing but it’s the only way to pay the bills (I’m 57 & live in a dodgey old house & drive dodgey old cars & go without many things including sleep, hoping to own the house & ditch the mortgage by the time I’m 60 so maybe then I can sleep better & be a bit healthier if I don’t die of starvation from lack of money/living on the dole or some other work-inflicted ailment (working in dodgey environment & manual hard labour to boot), But on the brightside I will be free finally enjoy life after 17yrs of this gig!

          • Beth Stone says:

            If you don’t get sick from working so hard, you will be free to enjoy life. Life is, that people get sick because they worked so hard,and they don’t get to enjoy retirement. Sad. But, true.

          • Beth Stone says:

            I’d don’t have a problem with working extra hours. I do have a problem with people not getting their breaks required by law. They are entitled to them. If they are not getting them, they should report it. You can’t lose your job for that.

  6. tbo says:

    I don’t see anything about children in here…

  7. Danielle says:

    I had been going to my doctor for years with a list of symptoms, but excessive sleepiness was definitely one of the most pressing symptoms. She tested for anemia and hypothyroidism but both came back negative. It wasn’t until 6 months ago that I was diagnosed with type 2 diabetes. Once I got my blood sugar under control all my symptoms vanished. High blood sugar can also make you really tired so make sure you check for that too if you find yourself tired all the time

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