The Real Reason You are Tired All the Time

By: Cat Ebeling, RN, MSN-PHN, co-author of the best-sellers:  The Fat Burning KitchenThe Top 101 Foods that Fight Aging & The Diabetes Fix

One of the biggest complaints that many people mention is fatigue. So many of us complain of being tired all the time. No matter how common it seems, feeling exhausted all the time is just not normal or healthy. It’s a sign that something is not right.

It seems to go hand in hand with aging and can sometimes get worse before it gets better. When fatigue begins to interfere with your normal DAILY routine, it’s time to look into why and see if you can remedy the situation.

There are many factors that contribute to fatigue, and the good news is that many of these things are easily ‘fixable’. In addition, many of these health and lifestyle changes affect your overall health for the better, prevent chronic disease and help you feel mentally better as well.

Let’s take a look at some of the hidden (and not so hidden) causes of fatigue:

Sleep Issues


We have all experienced some sleepless nights, for a multitude of reasons. When sleep problems persist, we end up exhausted, dragging through the day, irritable and moody. Poor sleep can lower immunity, raise cortisol levels, cause weight gain, and reduce our ability to think clearly.

There are quite a number of things that can cause poor sleep but let’s consider a few factors:

  • Sleep timing — It’s important to do your best to get on a good sleep schedule. Our bodies have something called a ‘circadian’ rhythm that helps us to be sleepy at night when it’s dark and wakeful during daylight.

Going to bed early some nights, interspersed with staying up late will definitely cause problems in your sleep cycle. Our bodies tend to develop a ‘sleep rhythm’ where we tend to get tired around the same time every night. If you ignore this sleep rhythm on a regular basis, it will wreak havoc with your natural sleep cycle of REM sleep and deep sleep.

Traveling through different time zones can often temporarily disrupt sleep cycles. This is where the supplement melatonin comes in, helping you re-regulate your sleep periods.

  • Hormones — Hormones can have a huge effect on sleep quality. For women in perimenopause (the ten years or so preceding menopause), plummeting levels of progesterone can cause anxiety, agitation, and loss of sound sleep. Sometimes, just an over-the-counter natural progesterone cream can help women struggling with hormonally based insomnia.

Men too, can have sleep issues due to dropping hormone levels. While loss of sleep is linked to causing lower testosterone, naturally declining levels of testosterone can also affect a man’s sleep quality with fewer deep sleep cycles.

As testosterone levels begin to gradually drop when a man reaches his forties or so, cortisol (our stress hormone) increases. Cortisol contributes to the usual stress response, even during sleep. Increased cortisol can cause more wakefulness, tossing and turning, a faster heart rate and shallower breathing. So for men, feeling tired and fatigued is often a symptom of low testosterone, according to the American Urological Association.blank

  • Sleep Apnea — Many men and women (often another sign of aging) can have sleep apnea. This is where, for a number of reasons, breathing stops for short periods of time. This can be a potentially serious sleep disorder. When the CO2 levels begin to build up in the blood, the sleeper will wake up, take a deep breath, and most likely go back to sleep. Sleep apnea is often tied to loud snoring.

Many people don’t even realize they have sleep apnea, but just complain of feeling tired all the time. Other signs of sleep apnea include awakening with a dry mouth, a morning headache, and difficulty staying asleep.

If this is the case, it’s best to have it checked out by a sleep specialist or a doctor. Sleep apnea can increase the risk of high blood pressure, heart disease, high blood sugar, liver dysfunction and mood problems. And you may have a sleep partner who is being deprived of sleep as well.

  • Other health and lifestyle factors — Other factors that interfere with sleep and contribute to overall fatigue include: poor diet, stress, drinking too much alcohol, medications, depression or anxiety disorders, and being too sedentary.

Thyroid Dysfunctionthyroid anatomy

Thyroid disease is more common than many of us realize. An estimated 20 million people suffer from thyroid disease and up to 60% of those don’t even realize they have a thyroid problem. Thyroid disease occurs more often in women and aging adults.

A thyroid disorder can manifest with many differing symptoms. The thyroid gland is considered a primary gland one that secretes hormones that affect almost every function in the body. For example, thyroid is responsible for regulating body temperature, the rate of your heartbeat, respiration, production of protein, and your metabolism and energy levels.

  • Hyperthyroid Conditions – Thyroid dysfunction can be either ‘hyper-’ or ‘hypo-’. When thyroid dysfunction is hyper, metabolism is sped up, the heart races and it becomes difficult to sleep or relax. Even with the excessive amounts of nervous energy from hyperthyroid conditions, the lack of sleep can become very problematic.
  • Hypothyroid – More common is the hypothyroid condition. This is where there is not enough thyroid hormone or the body has difficulty in converting the thyroid hormone T4, into the usable T3. A low thyroid means metabolism is slowed, energy is low and fatigue sets in, sometimes extreme fatigue. Other hypothyroid condition shows up as brain fog, depression, and weight gain.
  • Hormones — Women are often more likely to have a low thyroid than men (although men can have thyroid problems as well). Low thyroid can easily escape a diagnosis.

Many doctors use the standard and very basic TSH test (thyroid stimulating hormone). While this can help with some thyroid disorder, it doesn’t give the full picture. It’s important to have a full “thyroid panel” done to see T3 and T4 levels, free T3, free T4 and thyroid peroxidase (TPO) which detects antibodies against the thyroid.

For women, declining hormones in the mid-forties and fifties can affect thyroid function as well. As progesterone declines, the hormonal imbalance can negatively affect the body’s ability to convert thyroid hormone into the usable T3. So, while this creates a condition of hypothyroid, the basic thyroid test will not show this. Research shows that adding progesterone can help improve thyroid function.


Everyone can benefit from supporting the thyroid, which is the key to optimal function and energy. If you haven’t had a full thyroid panel, ask your doctor for one. An undiagnosed thyroid condition can be the reason for your fatigue.

Supplements can certainly help thyroid function. These include selenium, which supports our body’s ability to create thyroid hormones. Selenium also reduces levels of thyroid antibodies. Zinc also plays an important role in thyroid hormone conversion, as well as being a great nutrient for skin health and immune health. B vitamins are also essential for people with slow thyroids. B vitamins have many interactions with thyroid function, energy levels and hormone regulation.

Other help for the thyroid includes avoiding gluten, soy, and dairy. These foods can interfere with effective thyroid function.


While you may not make a connection between what you eat and your energy levels, diet has a huge effect on fatigue, energy–and even your sleep quality and your moods. A poor diet can not only make you feel fatigued all the time, it can bring on insomnia, foggy thinking, irritability, anxiety and depression.

  • Sugar and Carbohydrates — We’ve probably all heard that too much sugar causes a crash. Yes, this is true, but even too many carbohydrates—especially in the form of refined flours and processed foods will also cause a crash. So while you may not be actually eating sugar, carbohydrates turn into sugar (glucose) once eaten.

This results in a release of insulin in response to the high levels of glucose in the blood, which then lowers blood sugar. Once this happens, sleepiness and fatigue set in. Many people then reach for more high carbohydrate or sugary snacks. This creates a vicious cycle for fatigue and weight gain.

Of course, the best thing is to avoid sugar of all kinds and avoid most carbohydrates, especially grain-based carbohydrates. This means avoiding consumption of chips, crackers, cookies, and even so-called ‘healthy’ foods like pasta, bread, rice, and potatoes.

Eating healthy carbohydrates like fresh veggies and small amounts of fruit, is far better for your health, your weight, and your energy. You also want to be sure you are getting adequate amounts of healthy proteins like meat, fish, and poultry to balance blood sugar and create more sustained energy.

A diet high in carbs and sugar depletes certain vitamins and minerals. It especially depletes vitamin B1(thiamine). A B1 deficiency causes fatigue. People who have trouble controlling their blood sugar or those who are diabetic, often complain of fatigue and are most likely B1-deficient. Note: B1 also needs magnesium to work in the body. As an added benefit, B1 also helps to reduce anxiety, night sweats, and GERD.blank

  • Food Sensitivities — Food sensitivities tend to increase with aging, especially for women during perimenopause and menopause. Many food sensitivities or true allergies can cause obvious symptoms like rashes, digestive problems, runny nose or headaches. But fatigue is a big symptom that’s often overlooked as a reaction to food. And many times, fatigue is the only symptom of a food sensitivity.

Foods that are eaten every day are often the worst offenders. The most common foods that cause reactions are gluten, dairy, soy, and corn. That’s not to say these are the only foods but this is a good place to start looking.

The best way to check out foods is to do an elimination diet. Cut out entirely one food at a time for ten days to two weeks. Next, reintroduce that food. Eat it several times, noting how you feel. Keep in mind, it may take up to 24 hours to notice a response. Now go back and try eliminating another food and see what happens.

Gluten may be the best place to start. A majority of people with gluten intolerance and celiac disease often complain of fatigue, as well as those who are diagnosed with chronic fatigue syndrome.blank

  • Not Enough Protein — The vegetarian, vegan trend seems to be gaining popularity as the media tries to tell us this will prevent global warming. (It won’t!) For those of us who may be taking a second look at improving their health, a meatless diet seems to be a healthy choice.

While vegan and vegetarian diets have many redeeming qualities, inadequate protein often becomes a hidden factor adding to blood sugar ups and downs, fatigue, brain fog, and mood changes. The issue is that getting adequate nutrition including B12, essential fatty acids and bioavailable protein becomes increasingly difficult with a meatless or vegan diet.

A lack of protein can lead to a lack in muscle. In one study, older men and women who didn’t eat enough protein were found to have an increased rate of muscle loss.

Protein is a vital component of every cell in your body. Protein is necessary as the raw material used for building and repairing tissues, muscles, bones, and skin. Protein is essential to help produce enzymes that activate metabolism. And, if you are not consuming enough bio-available, high-quality protein, like red meat, your body will have a hard time creating and absorbing essential nutrients such as B vitamins, iron, zinc, and essential fatty acids.

If your body isn’t properly nourished by protein, will not be able to get enough vitamin B-12 and folate. Low levels of these important B vitamins and low iron intake will cause anemia—a condition where your body isn’t able to produce enough red blood cells which transport oxygen around the body. Low protein intake and anemia can most definitely cause low blood pressure, poor immune function, injuries and fatigue.

Eating a high-quality meal with some added protein can go a long way towards helping balance blood sugar, helping you feel more full for longer, and have longer lasting energy with no ‘crash’ after meals.

Consuming high quality protein–especially animal protein—will boost your metabolism and energy far more than any carbohydrates can. In one study, self-reported fatigue levels were significantly lower among college students eating high-protein foods like fish, meat, eggs and beans at least twice a day.blank

Best sources of protein include grass fed red meat, pasture raised chicken and eggs, and wild caught fish and unpasteurized, (full fat) dairy products. Nuts and legumes offer some protein, but it’s not bioavailable, or usable in the body as animal protein. Protein powders can also help.

Next time you feel sleepy and need more energy, grab some beef jerky, a few slices of deli turkey, or have a hard-boiled egg and see how you feel.



You don’t have to run a marathon across a desert to become dehydrated. Anyone can be dehydrated, even in the middle of the winter. Dehydration can be very subtle—some people may never even feel thirst as a symptom of dehydration. As we age, we are less sensitive to the obvious symptoms of dehydration. Often, by the time thirst sets in, you are already dehydrated.

Dehydration can be brought on from vomiting or diarrhea, being at high altitude or dry environments, air travel, being outside (hot or cold weather), exercise, alcohol, too much caffeine, medications, diabetes, and simply not drinking enough water.

  • Water vs Electrolytes — In addition to a lack of water, electrolytes must be in the correct balance in order for fluids to reach our cells. These ions include sodium, potassium, chloride, and bicarbonate. When electrolytes are out of balance, the body does not hold on to water and you urinate most of it out of your body. A person out-of-whack electrolytes can become dehydrated, even if a lot of water is consumed.

Our electrolytes help your body run on electricity the keeps your heart pumping, your brain working, and your nervous system and muscles working properly. Being dehydrated will actually make your blood thicker, causing your heart to pound as it pumps harder to move the thick blood around your body.blank

  • Medications — Many prescribed and over-the-counter medications can actually cause dehydration. Allergy and cold medications often work to dry up nasal secretions and can often be a cause of dehydration. Blood pressure medications sometimes include a diuretic which works to decrease fluids in the body. In addition, these medications often upset electrolyte balance, further increasing the risk of dehydration.
  • The Wrong Kind of Fluids — Alcohol, tea and coffee are diuretics and can easily contribute to dehydration. Any excess of these types of beverages will cause excessive urination that will lead to dehydration. Even drinking too much plain water without enough electrolyte intake can lead to being ‘overhydrated’, a condition that is just as bad and dehydration. People have been known to overhydrate with too much water and actually die from it.
  • Age — As we age, we lose our ability to sense thirst as well. Older people are definitely more susceptible to dehydration than younger people. Older people don’t always have a good sodium/water balance. Many older people also have various impairments and disabilities or even a lack of access to good drinking water. Aging people tend to be on more medications which may also contribute to dehydration.

Dehydration can cause symptoms like brain fog, confusion, sleepiness and lethargy, inability to concentrate, and weakness. Dehydration can also cause insomnia, further increasing your fatigue.

To prevent dehydration, be sure to get adequate amounts of water, vegetables and fruit (good sources of potassium), and salt in your diet. Don’t wait until you feel thirsty!blank

Natural thirst-quenching foods and drinks include lemon water, coconut water, celery, watermelon, cucumbers, bell peppers, pineapple and cantaloupe. In addition, mineral water contains important electrolytes like magnesium, calcium and chloride. Adding a sprinkle of sea salt or Himalayan salt to your water can help your body retain this vital fluid—especially if you’ve been sweating.

Underlying Health Conditions and Fatigue

Persistent fatigue that seems to have none of the above causes can be related to an undiagnosed health condition. These include:

  • Anemia, either from a lack of iron or lack of proper B vitamins
  • Type 1 or type 2 diabetes
  • Heart disease or heart failure
  • Hormonal issues—cortisol, testosterone, progesterone, thyroid
  • Depression, anxiety
  • Cancer
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Viral or bacterial infection
  • Recovering from surgery or a physical trauma
  • Seasonal allergies

It’s important to let your health professional know you are experiencing ongoing fatigue—especially if you have eliminated the above causes.

How often you experience fatigue, whether it interferes with your day-to-day activities and the type of fatigue is important to note. Is your fatigue related to weakness or sleepiness? Does your fatigue cause brain fog? Are you taking a lot of naps? Do you feel like you just don’t have enough energy to make it through the day? How is your sleep at night? Is it constant or just occasional?

It’s important to discuss with your doctor other symptoms you may be experiencing, even if they seem unrelated. A health professional may want to order extra lab work, look over any medications you are taking, and evaluate if you need any further testing.

Nutrient Deficiencies


Nutrient deficiencies are a key factor in fatigue. There are many nutrients that can contribute to fatigue including deficiencies in: B vitamins—especially B1, B6, and B9; vitamin D, iron, magnesium, potassium and certain antioxidants, including glutathione.

Some people do not possess adequate digestive enzymes to fully extract nutrients from the foods they eat, while others may have inflammation in the digestive system, from food intolerances or allergies that makes it difficult to absorb nutrients from food.blank

  • B vitamins — The B vitamins are B1 (thiamine), B2 (riboflavin), B3 B5 (pantothenic acid), B6, B12, B9 (folate) and biotin. B vitamins are vital to supplying energy for every part of the body, including the brain and nervous system. All the B vitamins are involved in the energy-production system within the cells. When you are lacking in any of the B vitamins, your cells’ mitochondria will not be able to generate energy well and your red blood cells won’t be very efficient getting oxygen to all parts of your body.

A deficiency in just one of the B vitamins can slow down an entire sequence of biochemical reactions necessary for converting food into energy, this results in a loss of energy and fatigue.

People who eat high carb/high sugar diets or those who have trouble controlling their blood sugar (diabetics or those with metabolic syndrome) may feel extreme fatigue. This is due to a shortage of vitamin B1.

Low levels of B9, B12 or B6 are key B vitamins that can cause tiredness and fatigue. A folate deficiency for example (B9), causes a type of anemia called ‘macrocytic’ anemia, whereas people low in B12 have another type of anemia called ‘pernicious’ anemia.

It’s thought that 10 to 15 percent of aging adults have a B12 deficiency, often due to low levels of intrinsic factor which allows B12 absorption. In addition to fatigue, low levels of B12 can cause brain fog, confusion and even dementia. Many vegetarians and vegans are low on this essential nutrient, because B12 is from animal-based sources of food only.

Low levels of B vitamins can cause fatigue, anxiety, numbness and tingling in extremities, a swollen red tongue, irritability and brain fog.

You can try supplementing with a quality multi-B vitamin supplement for a couple of weeks to see how you feel. It’s always better to take the whole B vitamin family, because taking just one type of B vitamin can upset the delicate synergy between all the B vitamins.

Due to a certain genetic defect of the MTHFR gene, some people may not be able to properly metabolize folate and B12, so as a precaution, be sure you are taking B vitamins that include methylfolate (B9) and methylcobalamin (B12).blank

  • Vitamin D — This vitamin is crucial for bone health, immune function, and—surprise—to prevent fatigue—among its many other benefits. The symptoms of vitamin D deficiency can be difficult to pinpoint, but they are fatigue, bone pain, depression, and muscle aches and weakness.

If you cannot get outside in the midday sun, or if you live in a northern latitude, you may need to supplement with vitamin D. According to the NIH, most adults need a minimum of 15-20 micrograms (mcg) of vitamin D3 each day, and adults older than 70 need 20 mcg. Best source of vitamin D comes from the sun. Your doctor can include vitamin D levels in your lab work and it’s a good idea to see where you are at. Optimal levels are 40-60+ ng/mL.blank

  • Magnesium — Magnesium is a very powerful mineral. It not only supports bone health, moods, and blood sugar regulation, but it is vital for assistance in energy production. Many people (about 80%) are low in this essential mineral, so it is a good idea to add magnesium supplements to your daily routine. Not only will it assist in energy production, but it aids in sound sleep too—so you attack fatigue from both angles.

Low levels of magnesium can cause loss of appetite, fatigue, weakness, muscle cramps, irregular heartbeat, nervousness and anxiety. Recommended amounts of magnesium are 250-400 mg a day.blank

  • Iron — Deficiencies in iron can be fairly common. Iron deficiency anemia is very common especially for those who do not eat red meat. Iron is necessary for red blood cells to transport oxygen throughout the body.

Iron-deficiency anemia will cause weakness and fatigue, shortness of breath, pale skin, a fast heartbeat, lowered immune status, and a swollen tongue. Often iron-deficiency anemia is accompanied by B vitamin shortages as well, further increasing fatigue and weakness symptoms.

Iron-deficiency anemia will cause weakness and fatigue, shortness of breath, pale skin, a fast heartbeat, lowered immune status, and a swollen tongue. Often iron-deficiency anemia is accompanied by B vitamin shortages as well, further increasing fatigue and weakness symptoms.

  • Potassium — Potassium is a vital electrolyte and mineral that assists the heart, nerves, and muscles to work properly. Plus, it’s also an important nutrient that helps balance sodium in the body. Most people get adequate amounts of potassium in their diet if they include vegetables and fruit on a regular basis.

However, in cases of vomiting or diarrhea, excessive sweating, laxatives, diuretics, or kidney disease, potassium can run low. Symptoms include dizziness, fatigue, muscle twitching or cramps, tingling, numbness and abnormal heartbeat.

Potassium is relatively easy to replace with diet—bananas, most all vegetables and fruit, squash, and legumes provide plenty of potassium to replace lost stores. blank

  • AntioxidantsAntioxidants prevent oxidative stress and fatigue in our bodies. Oxidation results from many things related to lifestyle. A poor diet, high in sugar and processed foods contributes, as does excessive exercise, environmental toxins, smoking cigarettes, alcohol, stress and many other unavoidable things.

A buildup of free radicals and oxidative stress contributes to tiredness, fatigue and an inability to recover from strenuous exercise. Low levels of antioxidants can contribute to muscle atrophy and fatigue.

Inadequate levels of important antioxidants also increase age-related loss of muscle mass (sarcopenia), weakening the body, increasing fatigue, and causing more susceptibility to injuries. This creates a vicious circle of fatigue, inactivity and further health decline.

There are particular antioxidants that may be the most valuable to supplement. These include glutathione (the master antioxidant), coenzyme Q10, vitamin E, vitamin C, lipoic acid and carotenoids.

Glutathione helps strengthen immunity, and neutralizes free radicals while removing toxins. It also helps to fortify and activate other antioxidants in the body.

CoQ10 supports the heart and cardiovascular function. CoQ10 aids in 95% of the body’s energy and supports the mitochondria in our cells. Mitochondria function as our cells’ energy powerhouse.

And Alpha lipoic acid is a multipurpose nutrient that has powerful antioxidant and blood sugar management actions. ALA increase glucose uptake in the muscles, resulting in increases in muscle energy.

Antioxidants can be found in ample amounts in a variety of fruits and vegetables. Eating a diet high in colorful, nutritious vegetables full of vitamin C and carotenoids will go a long ways towards supplying the antioxidants you need. Organ meats also include large amounts of the valuable antioxidants, CoQ10. There are also many supplement combinations that supply antioxidants for energy and free radical protection.

As you can see from the above, there are many contributing factors that cause fatigue. And often, it is not just one thing but a combination of factors, health conditions, diet and lifestyle that all go together to cause fatigue. Taking a step-by-step approach–beginning with diet and lifestyle, is important.

First, look at diet and remove possible foods that may be causing inflammation, intolerances or sensitivities. Then begin building up a healthy diet that includes lots of organic, fresh, colorful vegetables, a little bit of fruit, naturally raised meats/fish/poultry, and healthy fats. Eliminate gluten, corn and dairy from your diet as these foods often contribute to sensitivities and fatigue.blank

Be sure to optimize your sleep to get as restful as possible sleep. Stay well hydrated, get outside during daylight hours to get exercise and sunlight, and do your best to eliminate stress.

If necessary, ask for extra lab work and testing from your doctor.

Supplement as needed. I highly recommend starting with a good multi vitamin/mineral supplement, B vitamins with methlyfolate and methylcobalamin, and magnesium.

While it may seem like a daunting task, taking the above steps will most definitely get you moving in the direction of feeling great and having more energy. I can almost guarantee it!

If you found this article interesting and helpful, and you are over the age of 40, take a look at how you can regain that lost energy and start feeling like yourself again….

According to the best-selling author and world-renowned heart surgeon, Dr. Steven Gundry, there’s one fruit people over 40 should never eat.

This fruit can disrupt your hormones. Both sapping you of energy and forcing your body to create “sticky” fat cells that can NOT be “burned off” with normal diet and exercise.

Do you know the fruit I’m talking about? Make sure you do by clicking the one below you think it is, and get the answer from Dr. Gundry himself on the next page:

>> Blueberries

>> Strawberries

>> Goji Berries



About The Watchdog

Mike Geary has been a Certified Nutrition Specialist and Certified Personal Trainer for over 15 years now. He has been studying nutrition and exercise for almost 25 years, ever since being a young teenager. Mike is originally from Pennsylvania, but has fallen in love with mountain life and now resides in the picturesque mountains of Utah. Mike is an avid adventurist and when he’s not spending his time skiing, mountain biking, hiking, or paddleboarding on the lake, he has enjoyed skydiving, whitewater rafting, piloting an Italian fighter plane (seriously), scuba diving, heli-skiing, and traveling all around the world, enjoying learning about different cultures. At the age of 40, Mike now feels healthier, stronger, and more energetic than when he was 20... All because of a healthy lifestyle and great nutrition!

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  1. Very informative I think its a great article Thank you

  2. Very informative

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