Is it reasonable to go to the doctor for feeling mildly tired?
October 24, 2018 9:00 AM Subscribe
I've been feeling extra run-down and tired for the last few months, despite generally getting what should be enough sleep. I know standard advice is to talk to a doctor, but I'm having imposter syndrome. Is this really serious enough to talk to her about? Should I just suck it up and try to be better about sleep hygiene?
I generally need a lot of sleep—consistently in my adult life I've found that about 9 hours is what my body wants. But lately (past two months or so) even 9 hours has not felt like enough. I feel less resilient than normal, too: if I get 7 or 8 hours I feel really tired instead of just mildly sub-optimal. Drinking coffee doesn't really seem to help although usually I'm very responsive to caffeine. My sleep hygiene is pretty good but not perfect; I have been sleeping through the night as far as I can tell.
I've been having a lot of trouble with energy, motivation and focus in general and especially at work. I feel like I want to take three weeks off and just sleep the whole time. Some of these symptoms I've had before, but they got better thanks to therapy and a lowish dose of anti-anxiety/anti-depression medication, which I am still on. So maybe this is just depression again? I don't particularly want to up my dosage if I can help it.
Because the symptoms are more about feeling low-energy instead of, like, literally falling asleep during the day, I'm feeling weirdly at fault for this. Like if I go to the doctor she will say that a) this isn't all that bad, everyone is tired and doesn't want to work, so stop whining, and b) this isn't a physical thing, it's a problem with you being undisciplined, you need to manage your life/energy levels better.
I kind of know that I am not thinking about this rationally but I can't shake this feeling that I am being a whiny imposter. Can you help give me some perspective on whether this is major enough to talk to my doctor about? If I do talk to her, any tips for how to frame it?
I generally need a lot of sleep—consistently in my adult life I've found that about 9 hours is what my body wants. But lately (past two months or so) even 9 hours has not felt like enough. I feel less resilient than normal, too: if I get 7 or 8 hours I feel really tired instead of just mildly sub-optimal. Drinking coffee doesn't really seem to help although usually I'm very responsive to caffeine. My sleep hygiene is pretty good but not perfect; I have been sleeping through the night as far as I can tell.
I've been having a lot of trouble with energy, motivation and focus in general and especially at work. I feel like I want to take three weeks off and just sleep the whole time. Some of these symptoms I've had before, but they got better thanks to therapy and a lowish dose of anti-anxiety/anti-depression medication, which I am still on. So maybe this is just depression again? I don't particularly want to up my dosage if I can help it.
Because the symptoms are more about feeling low-energy instead of, like, literally falling asleep during the day, I'm feeling weirdly at fault for this. Like if I go to the doctor she will say that a) this isn't all that bad, everyone is tired and doesn't want to work, so stop whining, and b) this isn't a physical thing, it's a problem with you being undisciplined, you need to manage your life/energy levels better.
I kind of know that I am not thinking about this rationally but I can't shake this feeling that I am being a whiny imposter. Can you help give me some perspective on whether this is major enough to talk to my doctor about? If I do talk to her, any tips for how to frame it?
Best answer: Hi, I’m a primary care doctor. To answer your question about putting it in perspective: I get a patient with this complaint about once or twice a week.
posted by amy.g.dala at 9:06 AM on October 24, 2018 [18 favorites]
posted by amy.g.dala at 9:06 AM on October 24, 2018 [18 favorites]
Best answer: This is called fatigue. It’s a symptom of a variety of physical conditions/ailments as well as depression. You are not a doctor (it’s not Impostor Syndrome if you are pretending to be your own doctor, silly) and any physical trait that adversely impacts your quality of life should be checked out by a medical professional. Scoot!
posted by The Wrong Kind of Cheese at 9:08 AM on October 24, 2018
posted by The Wrong Kind of Cheese at 9:08 AM on October 24, 2018
Best answer: Can you help give me some perspective on whether this is major enough to talk to my doctor about?
Unless there’s a significant financial strain involved (and I mean even then, honestly) you generally want to be at the doctor before whatever is going on has progressed to “major.” You don’t gain anything by toughing it out and waiting until you feel completely awful to see a doctor, you’re just taking an unecessary risk with your health if it turns out there actually is something medically wrong with you.
posted by griphus at 9:16 AM on October 24, 2018 [8 favorites]
Unless there’s a significant financial strain involved (and I mean even then, honestly) you generally want to be at the doctor before whatever is going on has progressed to “major.” You don’t gain anything by toughing it out and waiting until you feel completely awful to see a doctor, you’re just taking an unecessary risk with your health if it turns out there actually is something medically wrong with you.
posted by griphus at 9:16 AM on October 24, 2018 [8 favorites]
Best answer: What you've described is definitely a good reason to go to the doctor.
I am like you in that I'm often unsure of whether my problems are "serious" enough to go to the doctor. Also, I'm a woman and (due to what I suspect is sexism) have had doctors downplay or dismiss my very real health issues, so even when I know I need to go, I'm afraid I'll be dismissed or seen as a hypochondriac.
Someone once told me when describing an issue to a doctor, it's effective to emphasize that 1) the symptoms are a change from what is normal FOR YOU, and that 2) they're affecting your ability to function normally in daily life. I've tried this approach and it seems to work pretty well. I've had to be assertive sometimes, but in the end it does get me taken seriously.
Good luck! I hope your doc can get to the bottom of it so you can get your normal functioning back.
posted by hurdy gurdy girl at 9:17 AM on October 24, 2018 [8 favorites]
I am like you in that I'm often unsure of whether my problems are "serious" enough to go to the doctor. Also, I'm a woman and (due to what I suspect is sexism) have had doctors downplay or dismiss my very real health issues, so even when I know I need to go, I'm afraid I'll be dismissed or seen as a hypochondriac.
Someone once told me when describing an issue to a doctor, it's effective to emphasize that 1) the symptoms are a change from what is normal FOR YOU, and that 2) they're affecting your ability to function normally in daily life. I've tried this approach and it seems to work pretty well. I've had to be assertive sometimes, but in the end it does get me taken seriously.
Good luck! I hope your doc can get to the bottom of it so you can get your normal functioning back.
posted by hurdy gurdy girl at 9:17 AM on October 24, 2018 [8 favorites]
Best answer: Think about it this way: maybe the first visit is to establish a baseline (and if you haven't had bloodwork lately, to get that ordered and then wait for the results to come back). You may only get a mild recommendation to make some minor changes and then come back in X interval if the situation doesn't improve or if the bloodwork has something actionable.
That's STILL important to do, if just to establish parameters. If we all had good accessible healthcare, this would be a normal thing to do, rather than waiting until a limb falls off seeming like a normal thing to do.
posted by Lyn Never at 9:20 AM on October 24, 2018 [3 favorites]
That's STILL important to do, if just to establish parameters. If we all had good accessible healthcare, this would be a normal thing to do, rather than waiting until a limb falls off seeming like a normal thing to do.
posted by Lyn Never at 9:20 AM on October 24, 2018 [3 favorites]
Best answer: Common wisdom says that you should go to a doctor if you notice a persistent change from your normal. You sound impressively self-aware about how your body operates and what it needs (much more than I am!). Because of that, I'd say you have good reason to go.
posted by yawper at 9:21 AM on October 24, 2018 [2 favorites]
posted by yawper at 9:21 AM on October 24, 2018 [2 favorites]
Definitely go to the doctor. The fact that you think these symptoms can make you seem a "whiny imposter" signals to me that you've either been emotionally abused in your youth to the point that you questioned yourself (Did you have a parent that called you names and told you to suck it up when you suffered ailments as a child?) or that you've had experience with doctors that did not take you seriously. Both of these are bad things and not your fault.
Your symptoms remind me of my sister's when she was pregnant and didn't know it. They also remind me of mine when I was severely lacking in vitamin D and didn't know it (until I got blood tested). But there are so many vitamin deficiencies, conditions and variables that can be causing this so rather than guessing for yourself definitely go to a doctor.
posted by fantasticness at 9:43 AM on October 24, 2018 [1 favorite]
Your symptoms remind me of my sister's when she was pregnant and didn't know it. They also remind me of mine when I was severely lacking in vitamin D and didn't know it (until I got blood tested). But there are so many vitamin deficiencies, conditions and variables that can be causing this so rather than guessing for yourself definitely go to a doctor.
posted by fantasticness at 9:43 AM on October 24, 2018 [1 favorite]
Best answer: These are great indicators to have your thyroid, B12, Vitamin D, iron, etc. checked by your GP.
posted by DarlingBri at 9:59 AM on October 24, 2018 [2 favorites]
posted by DarlingBri at 9:59 AM on October 24, 2018 [2 favorites]
Best answer: I did. My thyroid had crapped out. I have meds now, I feel better, no one laughed at me for being silly and coming in.
posted by charmedimsure at 10:11 AM on October 24, 2018
posted by charmedimsure at 10:11 AM on October 24, 2018
Best answer: Yes. I went to the doctor with this exact same symptom years ago. I could sleep 9, 10 hours a night and would still be exhausted. Was sent for a sleep study and it turned out I have a sleep disorder, which was easily fixed with medication. Don't suffer!
posted by Automocar at 10:21 AM on October 24, 2018 [2 favorites]
posted by Automocar at 10:21 AM on October 24, 2018 [2 favorites]
Best answer: Please take care of yourself and don't hesitate to go to the doctor about anything that's affecting your quality of life or is a change from what's normal for you.
To add an anecdote, I delayed going to a doctor about fatigue for months because I figured I was just lazy and needed to push through it. After a blood test, I got a call from an endocrinologist telling me that my doctor had made an urgent referral and they'd booked me an appointment for that week because my thyroid hormone levels were through the roof. A few weeks later, they dropped down to basically zero. Apparently my thyroid had basically decided to dump all of its hormones into my body at once. It turned out not to be a medical emergency, but the doctors were all "well, of course you're exhausted!", and even before the blood test my doctor took my symptoms as a serious sign that something might be off.
Any good doctor will thoroughly investigate this, but if you're concerned you won't be taken seriously, I'll echo hurdy gurdy girl that you should emphasize (1) you're sleeping 9 hours and still tired, which is not normal for you, and (2) the fatigue is seriously impacting your quality of life.
You may be tempted to downplay your symptoms with the doctor. Please don't. If any doctor tells you to stop whining, find a new doctor - the problem would be them, not you.
posted by ersatzhuman at 10:22 AM on October 24, 2018
To add an anecdote, I delayed going to a doctor about fatigue for months because I figured I was just lazy and needed to push through it. After a blood test, I got a call from an endocrinologist telling me that my doctor had made an urgent referral and they'd booked me an appointment for that week because my thyroid hormone levels were through the roof. A few weeks later, they dropped down to basically zero. Apparently my thyroid had basically decided to dump all of its hormones into my body at once. It turned out not to be a medical emergency, but the doctors were all "well, of course you're exhausted!", and even before the blood test my doctor took my symptoms as a serious sign that something might be off.
Any good doctor will thoroughly investigate this, but if you're concerned you won't be taken seriously, I'll echo hurdy gurdy girl that you should emphasize (1) you're sleeping 9 hours and still tired, which is not normal for you, and (2) the fatigue is seriously impacting your quality of life.
You may be tempted to downplay your symptoms with the doctor. Please don't. If any doctor tells you to stop whining, find a new doctor - the problem would be them, not you.
posted by ersatzhuman at 10:22 AM on October 24, 2018
Best answer: Yes. If you're a woman they may try to brush you off, don't let them. Make sure they know how much sleep you're getting & the impact it's having.
Look at it this way I don't know a good doctor that wouldn't rather treat a problem when it's small & easily treated than wait for you to have major symptoms that may well be harder & more expensive to treat.
posted by wwax at 11:02 AM on October 24, 2018 [1 favorite]
Look at it this way I don't know a good doctor that wouldn't rather treat a problem when it's small & easily treated than wait for you to have major symptoms that may well be harder & more expensive to treat.
posted by wwax at 11:02 AM on October 24, 2018 [1 favorite]
Best answer: How long has it been since your last physical? You can certainly have a physical done a little earlier in the schedule if you want. Bring up the tiredness and ask if you may have vitamin deficiencies, thyroid issues, or other possible causes.
posted by acidnova at 11:44 AM on October 24, 2018
posted by acidnova at 11:44 AM on October 24, 2018
Best answer: Like if I go to the doctor she will say that a) this isn't all that bad, everyone is tired and doesn't want to work, so stop whining, and b) this isn't a physical thing, it's a problem with you being undisciplined, you need to manage your life/energy levels better.
the doctor's not your mom and it's not her place to say any of this even if she thinks it. remember that just in case she does say it. doctors get confused about the kind of authority figures they are as much as patients do. but she is only an authority with respect to her professional knowledge and in her workplace hierarchy; she is not a personal authority over you. assessing your character is not part of her job.
tell her you are experiencing unusual and prolonged fatigue and that you haven't skipped or stopped your usual medication. if she does suspect that it isn't a dangerous physical thing, she can and probably will order a bunch of tests to rule out thyroid issues and vitamin deficiencies (B12, D, iron). it almost never is those things but you can rule them out. this isn't a lot of work for a doctor to order and can't hurt you to check, so don't feel bad about asking specifically for those tests if she doesn't mention it.
sometimes doctors have weird ideas of their own. mentioning tiredness and headaches got me tested both for Lyme disease and giant cell something or other. I do not have them, never thought I did, had no other symptoms suggesting either thing, and was correct that I did not have them. but I like taking tests so I went along with it. maybe your doctor will have some personal testing obsession of her own that will lead to a surprise diagnosis, you never know.
if you're underplaying your fatigue and malaise, get tested for mono. it probably isn't. but if you're depressed you will get told to get out of bed and get more sun and exercise, and if it's mono, you need to stay in bed for a month being nice to your organs.
posted by queenofbithynia at 11:45 AM on October 24, 2018
the doctor's not your mom and it's not her place to say any of this even if she thinks it. remember that just in case she does say it. doctors get confused about the kind of authority figures they are as much as patients do. but she is only an authority with respect to her professional knowledge and in her workplace hierarchy; she is not a personal authority over you. assessing your character is not part of her job.
tell her you are experiencing unusual and prolonged fatigue and that you haven't skipped or stopped your usual medication. if she does suspect that it isn't a dangerous physical thing, she can and probably will order a bunch of tests to rule out thyroid issues and vitamin deficiencies (B12, D, iron). it almost never is those things but you can rule them out. this isn't a lot of work for a doctor to order and can't hurt you to check, so don't feel bad about asking specifically for those tests if she doesn't mention it.
sometimes doctors have weird ideas of their own. mentioning tiredness and headaches got me tested both for Lyme disease and giant cell something or other. I do not have them, never thought I did, had no other symptoms suggesting either thing, and was correct that I did not have them. but I like taking tests so I went along with it. maybe your doctor will have some personal testing obsession of her own that will lead to a surprise diagnosis, you never know.
if you're underplaying your fatigue and malaise, get tested for mono. it probably isn't. but if you're depressed you will get told to get out of bed and get more sun and exercise, and if it's mono, you need to stay in bed for a month being nice to your organs.
posted by queenofbithynia at 11:45 AM on October 24, 2018
Best answer: It's not "almost never" thyroid or vitamin deficiencies. These are very common.
A good thing to ask is what is your thyroid level as shown by the blood tests, when they come back, because often doctors will say it's normal when in fact it is borderline. Under-prescribing can be as big a problem as over-prescribing, with some doctors.
Take your fatigue seriously, and expect the doctor to, as well. I nearly fell asleep while driving before got my meds up to speed. Mary Shomon has the best and most complete info on thyroid issues, including what levels you should look for.
posted by Enid Lareg at 12:44 PM on October 24, 2018 [2 favorites]
A good thing to ask is what is your thyroid level as shown by the blood tests, when they come back, because often doctors will say it's normal when in fact it is borderline. Under-prescribing can be as big a problem as over-prescribing, with some doctors.
Take your fatigue seriously, and expect the doctor to, as well. I nearly fell asleep while driving before got my meds up to speed. Mary Shomon has the best and most complete info on thyroid issues, including what levels you should look for.
posted by Enid Lareg at 12:44 PM on October 24, 2018 [2 favorites]
Best answer: Absolutely. You aren't proposing to go to the emergency room, you're planning on seeing your primary care physician. They are the appropriate first port of call for anything health related.
posted by kitten magic at 12:44 PM on October 24, 2018 [1 favorite]
posted by kitten magic at 12:44 PM on October 24, 2018 [1 favorite]
Response by poster: Thank you everyone!! This was exactly what I needed to hear. I called and scheduled an appointment for tomorrow with my primary care doc and I feel better already for having done that.
I am reminding myself that she is very nice and has always taken my issues seriously in the past, and there is no reason to think she will react any differently this time. I'll be purposeful tomorrow about not letting myself downplay the symptoms.
posted by aka burlap at 2:08 PM on October 24, 2018 [6 favorites]
I am reminding myself that she is very nice and has always taken my issues seriously in the past, and there is no reason to think she will react any differently this time. I'll be purposeful tomorrow about not letting myself downplay the symptoms.
posted by aka burlap at 2:08 PM on October 24, 2018 [6 favorites]
As far as thyroid goes, if you can afford it get your tpo antibodies checked. My thyroid levels were always well within normal, but I had Hashimoto's. Thyroid medication made a world of difference.
posted by Bistyfrass at 2:23 PM on October 24, 2018 [1 favorite]
posted by Bistyfrass at 2:23 PM on October 24, 2018 [1 favorite]
I had fatigue. Turned out I was low on iron.
The doc not only prescribed iron supplements to combat the fatigue, he seeked out the source of the iron depletion - which, in my case, turned out to be a large fibroid. It wanted my blood. It loooooved my blood, and my iron.
One Hysterectomy later, and I have no more fatigue issues. And my Iron levels are back to normal. (Fibroids run in my family and I have no desire for kids, so a Hysto was the way for me to go here.)
posted by spinifex23 at 2:43 PM on October 24, 2018 [1 favorite]
The doc not only prescribed iron supplements to combat the fatigue, he seeked out the source of the iron depletion - which, in my case, turned out to be a large fibroid. It wanted my blood. It loooooved my blood, and my iron.
One Hysterectomy later, and I have no more fatigue issues. And my Iron levels are back to normal. (Fibroids run in my family and I have no desire for kids, so a Hysto was the way for me to go here.)
posted by spinifex23 at 2:43 PM on October 24, 2018 [1 favorite]
Don't forget to pursue the possibility of a sleep study. Sleep apnea yields the same sort of symptoms you're talking about.
posted by Tell Me No Lies at 4:08 PM on October 24, 2018
posted by Tell Me No Lies at 4:08 PM on October 24, 2018
I have eleventy-pepsi medical things going on, so I put off "I'm really fucking tired all the time" for a couple of years. Turned out I had low vitamin D, low iron, and both kinds of sleep apnea. (I've always been an overachiever.)
I'm really glad you're seeing your doc tomorrow. Sleep is too important to ignore.
posted by The Almighty Mommy Goddess at 8:59 PM on October 24, 2018
I'm really glad you're seeing your doc tomorrow. Sleep is too important to ignore.
posted by The Almighty Mommy Goddess at 8:59 PM on October 24, 2018
Response by poster: Update: Turns out I had low iron and low B12! I'm now taking supplements and getting weekly B12 shots to get both levels back up to normal. A few weeks in and I'm feeling better and more like my normal self. The doctor was very nice and took my complaints seriously; I didn't have to push to get tested at all. Thank you everyone for your encouragement! It was exactly what I needed to hear.
Future readers experiencing fatigue: go to the doctor!
posted by aka burlap at 2:46 PM on November 11, 2018 [2 favorites]
Future readers experiencing fatigue: go to the doctor!
posted by aka burlap at 2:46 PM on November 11, 2018 [2 favorites]
This thread is closed to new comments.
posted by tipsyBumblebee at 9:04 AM on October 24, 2018 [9 favorites]