Canadian Health Network

Send this to a friend Print-friendly version Fatigue Stepping up your physical activity: walking to improve your health Past Articles Subscribe to our Healthlink newsletter

f your fast-paced life is leaving you exhausted at the end of most days, here's what you can do to reclaim your energy and vitality.

Margaret Bream, mother of three, knows all about feeling tired. She figures she's been sleep-deprived for almost 20 years. Oh sure, the kids are older now so she doesn't have to worry about getting up in the middle of the night to deal with nightmares and croup. But she still isn't getting a lot of sleep, thanks to her lucrative job as a night-shift editor at the Toronto Star. While it helps pay for summer camp, ballet lessons, computers and orthodontics, it also means Bream doesn't get to bed much before 2:00 a.m.

"Canadians burn the candle at both ends," says Dr. Cathy MacLean, a Halifax family physician. Women are often the worst offenders, Dr. MacLean adds, because they " tend to put other people's needs above their own and don't always give themselves permission to have some downtime." It's not that men don't suffer from fatigue, notes Dr. MacLean. They do. It's just that men are not as likely to show up in a doctor's office unless encouraged by a woman to do so. "You don't know how many men I see that say, 'I'm here because of my wife, my mother,' " says Dr. MacLean.

Most doctors (many of whom also suffer from exhaustion) agree that not only is fatigue one of the most common complaints heard in a general practitioner's office, but with a bit of probing, patients who come in with other problems—from headaches to dry skin—often admit that fatigue figures prominently in their lives, too. "Everyone I know is exhausted, especially in mid-life," says Bream, who has consulted her own doctor "countless times" to see if iron-deficiency anemia, low blood pressure or an under active thyroid were to blame.

Once a more serious health problem was ruled out, Bream learned that she is suffering from "functional fatigue." The cause? Stress. "This is the tiredness people experience on a day-to-day basis as a result of work, childcare responsibilities or looking after older parents," explains Dr. MacLean.

This kind of stress-related fatigue is not only pervasive in today's fast-paced, multi-tasking society but it can lead to poor lifestyle choices that then perpetuate fatigue. For instance, people who are rushed for time often reach for fast foods and rely on caffeine and sugar to keep going, In turn, these choices can have a negative impact on sleep and digestion, increasing fatigue and decreasing the ability to cope with more stress. "If you're under stress and eat poorly, this increases the stress on your body exponentially," says Leah Hawirko, a registered dietitian/nutritionist and president of Thrive in 5.

			When should you see a doctor?
			If fatigue is interfering with your day-to-day life, having a negative impact on your job or relationships, then check with your doctor. You may need to be tested for: 1. Anemia. This is a condition in which the blood has too few hemoglobin-containing red blood cells. Hemoglobin is the iron-rich compound that carries oxygen from the lungs to other parts of the body. Common symptoms of anemia include: profound fatigue (even showering and getting dressed in the morning can be exhausting) frequent headache loss of sex drive inability to concentrate shortness of breath -often heralded by frequent sighing feelings of being overwhelmed at the thought of carrying out even routine tasks 2. Under active thyroid. Think of the thyroid gland as the body's accelerator. When the thyroid gland produces too little thyroid hormone, all the functions in your body slow down. According to the Thyroid Foundation of Canada, thyroid problems affect 8% of women and only 1% of men. Some symptoms of under-active thyroid include: gut motility slows down, resulting in constipation metabolism slows, resulting in weight gain (even though appetite decreases!) circulation slows, resulting in feeling cold a lot of the time sweat glands produce less, resulting in dry skin brain function slows down, resulting in poor concentration and short-term memory, drowsiness 3. Depression. You wake up with low energy and your fatigue lasts throughout the day. This may be experienced as a feeling of being "slowed down," "leaden" or "empty." You may have difficulty sleeping - either falling asleep or staying asleep - and you may feel irritable and anxious. 4. Chronic illness. There's a long list of ongoing health problems that can result in fatigue. These include congestive heart failure, diabetes, chronic liver or kidney disease, Addison's disease, eating disorders, arthritis, lupus and cancer. Fatigue can also accompany a long-standing infection such as mononucleosis or a parasitic infection. 5. Medication. If you take an anti-histamine for allergies, you may need to switch to a non-drowsy formula. Similarly, drugs for high blood pressure, sleeping pills, steroids and diuretics can cause fatigue.

Bream realized that the only person she could rely on to take care of herself was…herself. As a result, Bream has learned how to "take shortcuts and get help wherever I can. You can't do everything," she says, adding, "It's good advice that's hard to take."

If you suspect your exhaustion is the result of what you're trying to accomplish on a daily basis, the best "cure" is a more reasonable approach to life. Yes, get more sleep, eat better, drink water and get regular exercise. Experts say it's also important that you learn how to de-stress and relax. "My friends who do meditation swear by it," says Bream.

If you've got a relationship issue that's stressing you out, deal with it directly. Pare down the items on your to-do list (something's gotta give!) and for goodness sake, take that vacation that's been on perma-hold. If you can't afford to take a week off, then set up a series of Fridays or Mondays and extend your weekends with an extra day of time just for yourself.

Bream has found that giving herself permission to nap when she can is very restorative. So is her afternoon tea break when her daughter comes back from school. "We talk about the day and what I may be making for dinner. It helps me cope because after dinner, I have to pick up the pace again and drive my kids to all their activities."

Whenever she can, Bream takes a 20-minute walk along the beach near her home. "Watching the waves and listening to the surf is very calming," she says. "Knowing that the water will always be there long after my little problems have come and gone helps me overcome the fatigue that is part of my busy life."

1. Reassess your priorities. It's unrealistic to think you can do everything. Instead, focus on things that really matter when deciding how you are going to spend your energy.

2. Plan ahead. Every week, figure out how you are going to take better care of yourself.

• Schedule time for exercise as you would a meeting or dentist appointment.
• Turn off the TV and go to sleep an hour earlier.
• Plan your lunch each day so you're not tempted to grab any old thing because you're so hungry.

3. Recognize your unhealthy behaviour patterns and change one thing. If your energy tends to fade around 3:00 p.m., take a walk or a nutrition break instead of drinking a coffee. "Going for a walk or drinking herbal tea or water will leave you more alert than a cup of coffee," says Hawirko. "Exercise also will invigorate you and help you sleep better whereas more coffee will just leave you feeling jittery and possibly interfere with your sleep."

4. Focus on good nutrition as part of your support system for yourself that gives the boot to stress-related fatigue.

• Get a healthy cookbook and make one new meal each week. Over time, this small change will add up to big improvements in energy levels and feelings of well-being.
• Choose high-quality, complex carbohydrates in moderate amounts and space them throughout the day. Examples include hummus, chickpeas, brown rice, whole grain cereals, fruits and vegetables. "Unprocessed foods have more vitamins and minerals [than processed foods] and will allow your body to function at its best," says Hawirko. Eating more complex carbohydrates also aids digestion and prevents constipation, which can also make you feel sluggish.