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6 Reasons Why You May Be Feeling More Tired Lately

By: Holly L. Thacker, MD • Posted on November 08, 2021

6 Reasons Why You May Be Feeling More Tired Lately

Feeling more tired lately? Women tend to think that feeling tired is just a normal side effect from being busy or taking on too many responsibilities. However, if you live a healthy lifestyle and are generally healthy, you should not be bothered by daily fatigue. There is often an underlying cause of daily fatigue. Below are the 6 most common causes of fatigue that I see in my female patients as well as ways to help with those problems.

6 Common Causes of Fatigue in Today’s Busy Woman

1. The problem: Vitamin D deficiency.

Vitamin D is not a vitamin, it’s a pro-sterol hormone. It is common to be deficient in the winter (less exposure to the right wavelength from the sun) and to be deficient in latitudes away from the equator. Unless like you eat like an Alaskan (cod liver oil, fresh salmon, and reindeer meat), you cannot get enough vitamin D from your diet in most instances. In the age of COVID-19, you want your 25-OH vitamin D levels OVER 50.

How to fix it:

Sun exposure without sunscreen for 10-15 minutes a day to exposed skin at the right latitude has been found to be maintain adequate levels of vitamin D in young people at the right latitude. The problem for older folks is that our skin doesn't synthesize vitamin D as well as in younger folks - and we are busy putting on sunscreen to protect against aging and skin cancer.

However, if you are not getting the recommended 1,000-2,000 IU of vitamin D daily from the sun or your diet, you should talk with your physician about taking a vitamin D supplement to ensure you are meeting your daily needs. Most people over age 40 who live at northern latitudes need a supplement. Taking your vitamin D supplement with your largest meal of the day will result in better absorption and thus a better blood level for the vitamin. Vitamin D3 supplements (cholecalciferol) are more potent than vitamin D2 (ergocalciferol) - the precursor of D3.

2. The problem: Sleep disorders and sleep deprivation.

Many women tell me they get by on 6 hours of sleep. This is not enough. Prior to electricity, folks slept 10 hours per day. You need at least 8-9 hours of sleep each night.

How to fix it:

If you have difficulty falling asleep or staying asleep, or if you feel sleepy or unenergetic despite a seemingly adequate night of sleep, you may have a sleeping disorder. There are more than 80 disorders of sleep and wakefulness. Talk to your doctor to learn more and see if you are suffering from a sleep disorder.

3. The problem: Vitamin and mineral deficiencies.

B-complex vitamins are water soluble and should be obtained in a healthy diet. Some medications and hormones may accelerate B vitamin metabolism. Certain medications like the PPI antacid stomach medicines may impair the absorption of B12.

B complex vitamins reduce anxiety and improve energy. Zinc helps with mood, energy and hair. Zinc levels should be above 55. Beware of excessive zinc intake which can cause copper deficiency.

How to fix it:

A B50 balanced B-complex vitamin (which combines all the B vitamins) may be helpful to increase energy levels and mood. Magnesium deficiency is very common in women. An oral Magnesium 250-400mg supplement may help with fatigue - as long as kidney function is normal. Magnesium helps vitamin D work in the cells and many times, women just don't get enough magnesium in their diet. Avocado, nuts, seeds and bananas are rich in magnesium.

4. The problem: Medication side effects.

Beta blockers (used for hypertension, heart problems, migraine and other conditions) can cause fatigue. Statins (cholesterol lowering medicines such as Mevacor®, Zocor®, Lipitor®, Pravachol®, Crestor® can cause muscle and nerve symptoms and/or depletion of CoEnzyme Q10.

How to fix it:

Talk to your physician about getting blood tests and discuss if you need to switch your medications.

5. The problem: Female hormone deficiencies.

Many women are happy to stop their menses and go into menopause, however lack of estrogen, progesterone and sometimes testosterone can cause sleep disturbance and/or fatigue as well as less muscle mass.

How to fix it:

Even if you do not have hot flashes, but you have fatigue from perimenopause or postmenopausal onset, you should be evaluated by a Menopause Specialist.

6. The problem: Depression and neurotransmitter imbalance.

Many women come to see me for ‘hormonal imbalance’ with normal menses and what they have is neurotransmitter imbalance of serotonin, dopamine, and norepinephrine. A common cause of unexplained fatigue is untreated depression and/or untreated anxiety disorders. There may or may not be associated mood symptoms. Sometimes fatigue and lack of interest in activities can be the main symptoms.

How to fix it:

If you feel ‘blah’ and tired in the winter with shorter daylight hours, you may have SAD-seasonal affective disorder and this can be helped with bright light providing 10,000 lux of light for 30 minutes each day in the early part of the morning from September through April (in the Northern Hemisphere).

Daily exercise (both aerobic and weightlifting with pre- and post-stretching) and eating a nutritious, heart-healthy Mediterranean diet will boost your energy and concentration and help promote restorative sleep.

Be Strong, Be Healthy, Be in Charge!

-Holly L. Thacker, MD

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Her special interests are menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health. Dr. Thacker is the Executive Director of Speaking of Women’s Health and the author of Women’s Health: Your Body, Your Hormones, Your Choices and Cleveland Clinic Guide to Menopause.



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