Tackling Fatigue


We all get tired from time to time.

Late nights, long work hours or the kids keeping you up at night – can all leave you feeling temporarily worn out.

But this is not the only form of tiredness impacting the inhabitants of the modern world.

Fatigue, sometimes called TATT (tired all the time), is the type that lingers, no matter how much rest or sleep is undertaken, leaving its victims struggling to get through, let alone enjoy, each day.

The good news is that there is a lot that can be done to overcome that feeling of jetlag, without the holiday. To tackle fatigue and to claim your energy back.

Tiredness and Fatigue

The Oxford dictionary defines tiredness as “the state of wishing for sleep or rest; weariness” and fatigue as “extreme tiredness resulting from mental or physical exertion or illness”.

Whilst there is seemingly an endless array of ways to be tired and fatigued, let’s explore

3 principal types – ‘General Tiredness and Fatigue’, ‘Prolonged Fatigue’ and ‘Chronic Fatigue Syndrome’.

General Tiredness and Fatigue

As human beings we are designed to be awake and functioning for around two thirds of each 24-hour period. Each night we are likely to feel tired, from how we have used that time, and will want to sleep for around the other third.

There will be periods where life has challenged us, we’ve overdone things or we’re recovering from illness. Here we may need extra rest and sleep to recover.

This may see us needing to put our feet up, crash for the weekend, increase self-care or take a much-needed holiday. Given a short spell of the right conditions, recover we will.

Prolonged Fatigue

For some, days that are too much can roll into weeks, and weeks can roll into months, of overdoing and under recovering.

The term ‘adrenal fatigue’ was coined by Dr James L Wilson and describes below optimal functioning of the adrenal glands, which he both details and addresses in his book ‘Adrenal Fatigue: The 21st Century Stress Syndrome’.

Located above the kidneys, the adrenal glands are intrinsically linked to the stress response – the body’s natural defence mechanism against real or perceived danger. Their primary role is to produce stress hormones, including cortisol, in response to stress.

Cortisol isn’t just needed to help fight or flight you out of danger though. It helps to get you out of bed in the morning, maintain steady energy throughout the day and then falls away to let you sleep at night. This is known as the diurnal rhythm.

Run your adrenals with your foot flat on the accelerator for too long and your cortisol production can become sporadic, leaving you with no energy when you need it, and too much when you are trying to rest and sleep. Your diurnal rhythm is out of whack.

  • An inability to get out bed in the morning

  • Exhaustion

  • Brain fog

  • Extreme sugar or salt cravings

  • Unexplained aches and pains

  • Lower back pain

  • Unexplained weight gain, particularly around the mid-section

  • A diminished ability to deal with stress

  • Sleep challenges/Insomnia

  • Decreased libido

  • Anxiety and depression

  • Burnout

… just some of the potential symptoms of prolonged or adrenal fatigue.

Here the road back to diurnal rhythm equilibrium is not a short one, and you are likely to have ‘destination prolonged fatigue’ saved in your internal satnav - should you choose to run your system too fast and for too long in the future.

Functioning of the adrenal glands can be tested via blood, urine, or saliva, with the latter more readily used.

However, adrenal fatigue is not widely accepted by the medical profession, with some preferring to centre investigations around more scientifically accepted diseases such as adrenal insufficiency, thyroid or pituitary diseases. Equally, it can be overly diagnosed in the health and wellbeing world, without a formal diagnosis.

Chronic Fatigue Syndrome or Myalgic Encephalomyelitis (CFS/ME)

Growing up in the eighties, I can remember the emergence of what was deemed as yuppie flu. A fashionable form of fatigue that preyed on young middle-class professionals striving their way up the career and cultural ladder. A perceived copout for those that couldn’t keep pace with the high life.

CFS/ME, as it is now known, is absolutely no joke. It can be a life altering and debilitating condition that can see some sufferers housebound and unable to function or cope with life.

Whilst it has been linked to stress and to viral infections, the causes of CFS/ME are not entirely known. It is generally characterised by extreme fatigue lasting over 6 months, along with an inability to function in daily life, that can’t be attributed to a medical condition.

Symptoms may include:

  • Extreme or persistent fatigue that worsens with physical or mental activity but doesn’t improve with rest.

  • Feeling unrefreshed following adequate sleep.

  • Musculoskeletal weakness, dizziness, and issues with balance.

  • Challenges with memory, focus and concentration.

  • Enlarged lymph nodes in the neck or armpits.

There is no mechanism to diagnose CFS/ME - generally other conditions are ruled out to determine a diagnosis.

The road to recovery is not easy and requires time and a lot of support. Most people see symptoms improve, some continue to have flare-ups and others make a full recovery.

An individualised treatment plan is usually devised, under the guidance of a doctor or specialist, supported by close family and/or friends.

Pandemic Fatigue

Okay so I said three, but I can’t write a blog on fatigue, at this time, without mentioning covid-19.

It has now been over a year since this relatively unheard-of virus began to plague our planet. Bringing with it a roller coaster ride of, amongst other things, hardships and restrictions - setting the stage for life to become increasingly challenging and decreasingly enjoyable.

The term ‘pandemic fatigue’ was devised by the World Health Organisation (WHO) and refers to a natural response to a prolonged global health crisis. In their pandemic fatigue report, WHO detail some of the known impacts and their recommendations.

Unsurprisingly this prolonged period is taking its toll on physical and mental health, with many saying they are feeling worn down by the year behind us, and the uncertainty of what lies ahead.

Whilst there is light at the end of this tunnel, there is much to be learnt about what will be left in covid-19’s wake.

Know Your Starting Point

Before we journey into solution mode, it’s worth considering your current position. What the underlying cause, or causes, of fatigue may be – the problem you are trying to fix.

I recommend you pull over for a moment and get clear on exactly where you are:

1. Consider your current situation or any challenges, that may be contributing to fatigue?

2. What is the impact to your health and wellbeing, and the level of fatigue you may be


3. What are you doing about it, if anything - positive or negative?!

It is worth pointing out that fatigue is not a condition in its own right, rather a symptom of something else - namely a medical condition, a lifestyle factor or both.

Medical Conditions

If something isn’t running as it should, like any good mechanic, the first step is to take a look under the covers.

There are many conditions that can cause, or significantly contribute to, fatigue, including:

  • Anaemia

  • Thyroid disfunction

  • Coeliac Disease

  • Fibromyalgia

  • Insulin Resistance

  • Diabetes

  • Adrenal Insufficiency

  • Anxiety and Depression

  • Obesity

  • Glandular Fever

  • Menopause

  • Deficiencies such as Iron, Vitamin D, B12

  • Food Sensitivities

  • Sleep conditions such as Sleep Apnoea and Insomnia

  • Covid-19

  • Emphysema

  • Chronic Inflammation or Infection

  • Certain Medications

And more…

I advise working with your Doctor to first rule out or tackle any health concerns directly. If your Doctor falls into the camp of not recognising fatigue, then I would recommend finding one with a more integrative approach to medicine.

Lifestyle Factors

Fatigue is not always the result of a medical condition, rather life-style factors, or a combination of both. Again, those that contribute to fatigue can be wide ranging:

  • Relationship issues

  • Financial worries

  • Too much or too little sleep

  • Work related stress

  • A young family

  • Over or under exercising

  • Shift or on-call work

  • Alcohol or drug use

  • Unhealthy eating habits

  • Life events – weddings, house moves etc

The good news is that, if no medical conditions are identified, you are likely to be healthy.

The not so good news is that, if lifestyle factors are causing or a contributing to fatigue, these will need to change - if you genuinely want to get your mojo back.

Tackling Fatigue

Each of us is moving through life in a different vehicle, that we use in a different way and on a unique journey.

So, whilst there are some generic steps we can take in tackling fatigue, our approach to getting and keeping our vehicle running optimally is likely to be unique to us.