What level of fatigue warrants seeing a doctor?

February 28, 2010 8:38 AM

How can I tell what a normal level of fatigue is and what merits more looking into, maybe medically?

When I wake up in the morning, whether I've had 6 hours of sleep or 11 or anywhere in between, I feel pretty tired, and it lasts the whole day. It's not quite asleep-at-the-wheel tired, but I yawn a lot, feel kind of foggy-headed, and given a stretch of time and a moderately comfortable place (bus, couch, comfy chair..) I can fall asleep quite quickly.

Is this normal? I don't drink coffee, but everyone around me seems to - does everyone start out this tired and wake up with caffeine? Or could I have sleep apnea or something like that?

Possibly relevant information: I'm 21, female, and living in Vancouver, BC, Canada. I've been exercising less than I used to (down to ~once/week) but I've always been this tired even when I was exercising a lot. I try to eat well and stay hydrated, though there is room for improvement. This happens whether I get up naturally (usually after 8 hours) or with an alarm.

posted by daelin to health & fitness (20 answers total)

I would get some light exercise every day before speaking with a doctor - maybe a 30 minute walk. That did the trick for me.
posted by pintapicasso at 8:42 AM on February 28, 2010

Not everyone feels as tired as you describe. This could be nothing, or it could be something minor, or it could be something serious. Only a medical professional will be able to tell you. See a doctor, and ask for a sleep study.
posted by decathecting at 8:51 AM on February 28, 2010 [1 favorite]

What pintapicasso and decathecting said, and have them check you out for general nutritional deficiencies - might be low on b vitamins or other essentials.

It might be a "simple" as vitamin deficiency, sleep problems requiring a CPAP at night, or indicative of an underlying issue such as an autoimmune disorder or other illness.
posted by tilde at 9:07 AM on February 28, 2010

Also - this earlier question has good tips about allergies and changes in diet. I've seen dramatic improvement myself in getting my allergies under control.

They also mention carbon monoxide poisoning ... check your alarms to ensure they're working.
posted by tilde at 9:10 AM on February 28, 2010

when I was younger (17-23 years) I would get tired whenever I had to concentrate. For example, if I was studying, I would get drowsy, when I was at work trying to concentrate on a task, I would get drowsy and it would be a "bad drowsy" - I would sleep, but then I would wake up, even more tired (and full of guilt, since I was so unproductive).

For me, I had to change my work habits - never study just by "reading", always have a pen and paper handy to take notes, to keep me stimulated; find work/jobs that required me to be alert or that required me to be "on the move", either physically or mentally.

Maybe it's the same for you - nothing medical, just a need to be stimulated more?

Good luck!
posted by bitteroldman at 9:15 AM on February 28, 2010

Do you snore?

I think you need to get checked to rule out sleep apnea.

Other thoughts-do you keep a regular sleep schedule? Do you drink enough water? Do you eat a lot of carbs?
posted by St. Alia of the Bunnies at 9:43 AM on February 28, 2010

Do you have heavy periods? Yawning and unrelenting sleepiness can be anemia. (And the more anemic you get, the sleepier you get.) See your doctor, absolutely, but if iron might be the culprit, get some Eurofer (the cheaper version of pallifer) from your local pharmacist (you'll have to ask for it, it's behind the counter) and take one a day with orange juice. If you feel noticably better within 4-5 days of that, it was a touch of anemia.

It's a pretty harmless bit of triage. You can try it while you wait for your dr.'s appointment.
posted by Hildegarde at 9:54 AM on February 28, 2010

what you're describing is not normal. Do check out Carbon monoxide in your home, but it is more likely statistically to be something like anemia, nutritional deficiencies or viral.

If you take an iron supplement do take Vit C with it, maybe a glass of orange juice, to aid absorption but watch out for stomach issues or constipation.
posted by Wilder at 10:53 AM on February 28, 2010

When I was pregnant I was told I had low iron and was given supplements, the result left me feeling like I was on speed. I am also big on the vitamin D bandwagon, there is a ton of info online about it. I have had points in my life when I was so fatigued all the time I was hoping to learn I had mono just to know what it was. Doctors never tested for vitamin D and I didn't know to ask. I had myself tested independently and was pretty low. I have been supplementing and feel much better.
posted by InkaLomax at 11:05 AM on February 28, 2010

Daelin, I'm puzzled why you just don't go and see a doctor, its not like you live somewhere where access to health care is a barrier for whatever reason.

You can try it while you wait for your dr.'s appointment.

Yeah, but if the doctor is going to run a full blood panel including checking iron levels and iron stores its going to skew her results. She's better off imho to just hold off until the results are in.
posted by squeak at 11:11 AM on February 28, 2010 [1 favorite]

Nthing see a doctor and that the most likely cause is anaemia (though of course it could be anything, this is probably one of the first things that the doctor will test for.) Definitely go and see your GP as soon as you can, as it could be a simple nutritional deficiency that is easily sorted, or something more complex which is nontheless relatively easily treated.
posted by different at 11:38 AM on February 28, 2010

Try getting 8 hours of sleep every night, at the same time, i.e., 11-7, for a week. Eat properly and drink/use recreational drugs, sparingly. Get some exercise, and spend some time outdoors, every day. If you still feel tired enough to yawn and/or fall asleep during the day, talk to your doctor. A lot of people, including me, don't really get enough sleep. And some of the people who say they get by on 5 hours a night are doing crappy math, or are underperforming.
posted by theora55 at 12:20 PM on February 28, 2010

Please ask for a sleep study. Even people who don't snore can have sleep apnea.
posted by elsietheeel at 12:45 PM on February 28, 2010

It takes a long time to bring iron levels up, sometimes as long as several months to be back where you should be. If you think you might be a bit anemic, make an appointment and start taking some iron (pallifer/eurofer is best for this). Your doctor will be able to tell if you were a little low or not even if it takes a week or two to get in to see her/him. Worst case scenario: the iron doesn't make you feel better, and your doctor checks other things. Best: you do feel better, and you can communicate your actions to your doctor, who should run some tests anyway to see if anything else is awry.

Women who menstruate very commonly become mildly anemic.
posted by Hildegarde at 12:52 PM on February 28, 2010

Are you taking an iron supplement right now? If so, try laying off of it for a while and seeing what happens. Excessive iron can also be a problem.
posted by Kid Charlemagne at 12:58 PM on February 28, 2010

Hypothyroidism can have these symptoms. I started having signs in my early 20s, and despite thyroid problems being very common, I was tested for just about everything else first.
posted by lunalaguna at 8:46 AM on March 1, 2010

I don't think you should be taking iron without checking your levels first, too much can be a problem as well as too little.
posted by Gor-ella at 8:49 AM on March 1, 2010

This can be a huge change if your not gung ho on it, but waking up early to work out, and appreciating the work out can pick you up for the rest of the day. Nothing crazy, 30-45 minutes on the elliptical or tread mill, something like that. There's something about working out and taking a shower before the day starts that makes you feel like you got a step ahead on everyone to deal with there ish. Also gives you time to think about what you are and are not looking forward to dealing with that day.
posted by Dubs at 10:26 AM on March 7, 2010

Just in case anyone is still reading, I took most of your advice and went to see a doctor who ordered some bloodwork...and it came back totally normal, which I was afraid of. It looks like I may just need to get more exercise or ask for a sleep study (although I don't want to be more of a hypochondriac than I already feel like) or just deal with being tired. Thanks for all your help and advice, though; I really appreciate it!
posted by daelin at 8:58 AM on March 11, 2010

First, good on you for going to see the doctor as a first step.

What tests did they run? What exactly were the results? B12 Deficiency? Thyroid? Have they run thyroid before? Are they using the newer or older guidelines?

If the basics are clear, do they not have an idea of "what next"?

You've got to be your own best advocate.

Good luck.
posted by tilde at 12:56 PM on March 16, 2010