WHY AM I ALWAYS TIRED?

Q. Dear Dr. Jody, I am tired ALL the time. I do not want to take medication and I am already on so many supplements and nothing is working. My doctor says all my blood work is normal and there is nothing wrong with me. How can I improve my energy and be a better wife and mother?

A. Thanks for bringing attention to such a common and all too often ignored problem. You are not the only one out there who is exhausted by their own exhaustion. Here are some simple lifestyle tips that may help you to gain more energy. Also, don't be afraid to talk to your doctor or naturopath about the severity of your symptoms and ask that a few simple tests be run to rule out any underlying conditions.

Fatigue!

By far, this is the most common concern I hear from men and women alike. Fatigue can not only be very difficult and discouraging to deal with, but it can also be extremely difficult to treat because there are so many possible causes. There are lifestyle and dietary reasons for fatigue, such as lack of sleep, stress and malnutrition. There are also a number of pathologies that cause fatigue

The most obvious and seemingly simple reason for fatigue is a lack of sleep. As a general rule, we want to be aiming to get 7-9 hours of sleep a night, as well as aiming to be asleep by 11pm. It is always best to turn your TV or computer off by 10, and opt for a book or hot bath. Keep the lighting low for the last hours before bed, to increase natural levels of melatonin and prepare your body for sleep. As far as sleep hygiene goes, a lot of this is straight forward, but a good reminder. Your room should be as dark as possible, with as little artificial light as you can manage. You should keep the TV out of the bedroom and look for a battery operated alarm clock that does not give off any artificial light. Use your bedroom for sleeping and sex only, although reading a few pages before sleep is not a problem. Again, keep the lighting low and turn on a little desk lamp or small light if you are reading. Getting up and going to bed at the same time everyday (or as close as you can) is also highly recommended. Sleep routine is just that, a combination of steps you take before you go to bed. Write them down if you are just starting out and stick to them. The ease with which you fall and stay asleep through the night will increase as this routine becomes habit.

Stress! Stress definitely plays a role in fatigue and also lack of sleep, which in turn makes us more easily stressed. It's a vicious cycle. Stress is manageable, but a conscious effort must be made, as our ineffective coping mechanisms can also quickly become habit. Incorporate Yoga or Pilates, meditation, acupuncture of regular massages into your weekly routine. If you are simply too busy to add one more thing to your schedule, then be sure to take 15 minutes twice a day to sit and focus on breathing, call a friend, or get outside for a nice LEISURELY stroll. Remember, as important as exercise is, it is also physical stress on the body. To best compliment your exercise routine, you must also look for activities that are completely stress free! Have a hot bath before bed. This will not only help with relaxation, but it can also be a sleep aid. You can also try washing your hair at night in the bath or shower. It may just provide you with the few extra minutes to significantly lower the "rush" factor in your morning routine, thereby lowering morning stress.

In terms of specific conditions, chronic fatigue syndrome (CFS), hypothyroidism and anemia, among many others, are common causes of fatigue. More and more health care practitioners are acknowledging the possibility of sub clinical hypothyroidism, meaning lab work or blood tests are all coming back normal but symptoms all fit with a hypothyroid state. If you suspect that there may be a disease process at play, talk to your healthcare practitioner about testing your TSH, T3 and T4 levels, as well as your ferritin, B12 and vitamin D, as abnormal findings or deficiencies in these may be the cause of fatigue and may provide helpful clues in terms of treatment.

Food allergies are also extremely common and can severely impact energy levels. The body is constantly reacting to what it sees as a foreign substance, producing antibodies to fight off the substance and causing inflammation in the process. If it is a food that you are eating on a fairly regular basis, this reaction is happening continuously and the body becomes (and rightly so) exhausted! Food allergy testing can be expensive, but it is an efficient way to pinpoint which foods you are reacting to so they can be eliminated from your diet. An elimination diet is another way to address food sensitivities. This consists of eliminating the most common allergies from the diet for about 3 weeks and then systemically reintroducing each food and monitoring for symptoms. This is a much more cost effective method of assessing for food sensitivities but may not detect a more unusual allergy. Ask your naturopath or MD about options in terms of food allergy testing.

Don't forget about the importance of a well balanced diet. Cut out the excess sugar, caffeine and alcohol, especially close to bed. Focus on incorporating good fats, lean sources of protein and an abundance of vegetables and fruits into all your meals.

Exercise. I know when you are tired, the last thing you feel like doing is exercise, but it may be the key to improving your energy levels. If you are starting from scratch, start out simple! Incorporate 30 minutes of moderate exercise (a brisk walk) 3-5 times a week and work up from there. Try to exercise in the morning, if possible, when you have the most energy and to make sure it does not interfere with sleep. If you must exercise in the evening, try not to do it within 2-3 hours of bedtime.

It's not always what you take, but how you live that makes the real difference. I hope these tips help to put a little skip back into your step.

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