Dear Doctor: 'I'm exhausted all the time for no good reason. How can I get my energy back?'

Dear Doctor,

I feel so tired – All. The. Time. No matter how much sleep I get, or how many lifestyle changes I make, I just can’t seem to get on top of my constant fatigue. It feels endless and, to be honest, it's really getting me down. I'm sick of hearing myself complain about it, especially when I don't have kids or a partner – I don't feel like I have any good reason for how exhausted I feel. My doctor has done several blood tests, and they always come back normal, and show no cause for my symptoms. I am at a complete loss for what to do. I just want some energy back to enjoy life again.

Caroline, 36

*** 

Hi Caroline, 

Blergh. I’m so sorry that you feel so exhausted! This type of pervasive fatigue really does impact on every part of your life. And often medicine has no definite answers for you about the cause of your symptoms. Many women feel dismissed or unheard, leading to frustration and anxiety.

So, what do we do when we’ve explored your symptoms, examined you, run the blood tests and there is no definitive answer found? My answer to this is always the same, and it’s this: we make a plan together through shared decision making.

No two patients will be the same when it comes to fatigue. There are just so many causes and a lot of the time there is more than one reason for this symptom. So I generally schedule a long appointment so we can really nut out what we think might be contributing to your symptoms.

Is it sleep quality? Are mental health issues contributing? Are you suffering from burnout? Are there rarer causes of fatigue we need to consider, such as autoimmune disease? Referrals or further tests may be needed to make sure we cover all bases.

In the meantime, there are a few things that may help get some of your pep back.

1. Sleep routine: Be strict if you can (those with small children or on shift work may have to be a bit more flexible!). Go to bed and get up at the same time every day. 

2. Sleep supplements: There is good evidence to show that magnesium, valerian root and ashwaganda assist in sleep quantity and quality. Melatonin used regularly can also assist those with sleep disturbance.

3. Green noise: A quick search on Spotify will bring up a bunch of different green noise playlists. Emerging evidence shows that this helps people drift off to sleep and stay asleep.

4. Move your body: This is so hard when you feel so exhausted. I recommend starting with just 10 minutes a day of gentle walking or yoga. Moving your body provides endorphins that help with alertness and energy.

5. Reduce alcohol and caffeine: For any of my patients suffering fatigue, I recommend abstaining from alcohol until you feel your energy come back. Caffeine is much harder, as you probably find you need a kick to get through the day. If possible, have one or two cups in the morning and then nothing after midday.

As always, listen to your body and if things don’t feel right, let your GP know – and work together to make a plan.

Dr Rebecca Goadby is a General Practitioner who is passionate about the health of women through every stage of their lives. Her approach is compassionate and holistic, with a focus on preventative medicine and mental health wellbeing.

Information found in this column is not meant to be a substitute for proper medical advice – please contact your doctor or a health professional to discuss your own medical needs.

Do you have a burning question you'd love Dr Rebecca to answer? Send us an email (submissions@mamamia.com.au) with the subject line 'DEAR DOCTOR' for consideration.

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