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Why am I so tired all the time? An expert weighs in

Why am I so tired all the time? An expert weighs in


by Melanie Morris
20th Sep 2024

Why do so many women, of different ages, feel so completely exhausted? From hormones and vitamin deficiencies to diet and fatigue, Melanie Morris investigates.

Life is busy at the moment, and really while we’d all like to claim the Covid years taught us the benefits of slower living, we’ve actually gone and done the opposite. The reality is, that in 2024 we’re trying to juggle more than ever before – hybrid working is playing havoc with routine, work calls for out-of-hours attention, children need constant ferrying, and somehow we still have to make time for a social life and/or “date night”. It’s no wonder that weekends are either spent at the other end of a wine bottle, or under the duvet. And when we do get out, the latest competitive sport is comparing levels of exhaustion.

Sometimes it’s the little things that chip, chip, chip away… a week of poor eating and late nights; an anxious time where stress levels have been mounting and unrelenting; coming out of a long, dark winter without suitable vitamin D supplementation, and/or the realities of being human and having a body that just won’t keep up with the demands we put on it.

Whatever the cause, the outcome of fatigue is that we’re feeling lousy, and when we try to address it, we think we’re being too soft on ourselves. No, we just need to (wo)man up and push through. However, the converse side of this strategy is that the negative aggressors can compound and make the long-term effects worse, rather than being a simple hump in the road that we tell ourselves just needs to be navigated.

In her best-selling book, It’s Probably Your Hormones, endocrinologist Dr Mary Ryan examines the role of hormones in our overall health, with many of the symptoms of dysregulation resulting in profound fatigue, exhaustion and burnout.

Before we dig deeper, a little explanation on hormones and why they are relevant to the story. “Hormones are the chemicals that control every muscle and organ in the body,” says Dr Ryan. “They dictate our daily rhythms, stabilise our immune system, regulate body temperature, appetite, fertility and brain function.” And once hormones go out of whack, there’s a price to pay because they control how our body works, how we feel, and as a result, how much energy we have to tackle life.”

“From the moment women start having periods, we battle a continuous energy flux as our hormones ebb and surge through the month,” says Dr Ryan. “Then, when peri, and menopause occurs, our hormone levels alter again, with associated changes across our health and behaviour.”

When it comes to feeling exhausted, one of the first culprits can be an underactive thyroid, something according to the American Thyroid Association that’s five to eight times more likely to happen with women than men; while one-in-eight women will develop thyroid problems during their lifetime. Dr Ryan can attest to this.

The thyroid gland, and its hormones, regulates the body’s metabolic rate, growth and development. It controls heart, muscle and digestive function. It’s also the hormone centre that gets badly affected by fatigue and burnout. The system gets exhausted, and the immune system starts to attack the body in a condition known as Hashimoto’s thyroiditis. “I see so many new mothers and menopausal women with this, or hypothyroidism which, unfortunately, is irreversible and needs to be treated with medication on a long-term basis.”

“To avoid getting in this trap, I tell my patients to ask for help”, says Dr Ryan. “None of us are Superwomen and realistically, we can’t stay on the hamster wheel of multiple school runs, managing our children’s social, school and sports diaries, looking after elderly family members, keeping a home and managing our own working lives. Whether you have someone to lean on, or if you can pay for assistance, seek it wherever you can, and get children involved in helping; tweens and teens are well able to sort out their laundry, prepare their own lunches etc, it shouldn’t always be up to the mother.”

Stress hormones in overdrive, or firing at inappropriate times can also bring negative, exhausting side-effects. “Cortisol is our normal stress hormone, and it’s necessary to get us up and moving every day. We have plenty in the morning and it should tail off as the day goes on, so I always recommend vigorous exercise at the start of the day, or by lunch time. There’s no point getting charged up in the evening or exercising when you are tired as it can lead to injury or trigger illness through lowered immunity.”

Dr Ryan also points out that coffee first thing in the morning isn’t the best idea. “While we all think we can lean on an Americano to get us going, it can actually shut off that natural circadian rhythm, giving a false boost instead. I’m not against coffee at all, but suggest starting the day with something like ginger tea which will pep up the system without overstimulating it. And then have that first coffee at least an hour after waking. Limit to a maximum of three a day and stop drinking coffee by lunchtime.”

Good sleep is the game-changer when it comes to energy. By that, Dr Ryan doesn’t mean we take to the bed for hours on end, but rather “Get to bed early, get up at a consistent time, and don’t while away extra hours dozing or scrolling”. Equally, don’t push the later nights by watching one more episode of something. Good quality sleep is essential to refresh the brain and for releasing lots of beneficial growth hormones to repair and revive the body.

When you’re tired, try to look to meditation, yoga and taking a break rather than Red Bull, coffee and sugar. Naps are an invaluable way to recharge if you’re someone that can do so, but don’t rest for longer than 30 minutes to prevent your body from going into full sleep mode, which only makes us more tired.

While the role of a good diet with possible supplementation is obvious when it comes to keeping energy levels up, a lot of the time it’s easier said than done. Fatigue brings a craving for sweet, processed food with it, because it’s far easier for the body to digest than complex carbs, fibre and protein. Equally, we are all far too familiar with the crash that comes with milling high-sugar, low-nutrient choices, so learning a little about how the body creates energy may just power you through to making that little bit of extra effort.

In order to feed the cell’s mitochondria – its power source – the body processes a number of nutrients in a complicated sequence known as the Krebs cycle. Diets, or supplementation high in B vitamins, iron and CoQ10 can be especially handy in bolstering energy as they are essential in the creation of ATP, the final metabolite needed to create energy in the mitochondria. In recent times, there’s been a lot of coverage about NAD+ supplementation (by self-injection, under the skin) as it’s another essential part of the Krebs cycle. And while many hailed these shots to be a game-changer in anti-aging and exhausted mitochondrial activity, and have reported an energy uplift, it’s worth pointing out these injections have not been thoroughly studied or approved, particularly in the context of home use. There hangs a question around them and the development of fatty liver disease, a condition characterised by the accumulation of fat in the liver cells which NAD+ is associated with. Proceed with caution and perhaps try GP-administered B12 injections instead.

Overall, don’t think the solution to exhaustion is a week off work or on holidays. It didn’t take such a short amount of time to wear ourselves out, so recovery will also be a process. Get help. Start with a GP visit to run a full blood text, add a food tolerance or kinesiology test if you think there could be allergies weighing you down. Consider acupuncture. But don’t outsource the problem. The issue could be much closer to home and reveal themselves in your diary, your bedtime routine or the number of dependents in your life. But in the immortal words, nothing changes unless you do, so take the time to see how and where you need help. Do something now, and reap the benefits of a better, more restful life.

This article originally appeared in the Summer 2024 issue of IMAGE Magazine.

IMAGE Autumn 2024

IMAGE Autumn 2024

The Autumn issue of IMAGE is here, and we’re looking forward to the cool, crisp days as a chance to reset our routine. From new-season looks to inspiring women to glean wisdom from, we’re embracing that “New Year” feeling. Plus: * Sleek style * Grandad dressing * In studio with Irish designer Cleo Prickett * Adaptive fashion * The Irish at fashion month * Inspiring the next generation * Rethinking end of life planning * Regenerative farming * Bobs are back * Navigating antidepressants * The future of Irish food * Group stays * and so much more…

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