Usually, the inertia and overwhelming reluctance we occasionally feel to get up off the sofa and do some exercise (indeed just to put the kettle on sometimes) is a symptom of nothing more serious than a simple case of ‘motivation deficit’, or just the inevitable result of a very busy lifestyle.

But if you are finding that every day is a battle of wills to tackle even the most basic of physical activities, or if you roll out of bed every morning with a groan, feeling no more refreshed than you did the night before, it might be worth visiting your GP. Low energy levels are extremely common, and affect all of us sometimes.

Unfortunately, they do affect some people nearly all the time, which is a cause for concern. Persistent feelings of tiredness can be due to pressing personal stresses and anxieties (mental, emotional and psychological triggers which in turn affect appetite and sleep patterns) or an undiagnosed illness.
Feeling constantly tired is such a common complaint that the NHS websiteeven gives it its very own acronym, ‘TATT’ (Tired All The Time). Below is a list of some of the main causes and diagnoses which often underlie a severe lack of energy. If any of these sound familiar to you, it is worth making an appointment with your doctor to get tested, because all of them can (and should) be identified and treated swiftly:

Chronic Fatigue Syndrome (CFS), sometimes known as ME (myalgic encephalomyelitis), although some people believe these are two distinct conditions, and there remains considerable controversy and medical disagreement over the diagnosis, which often follows a physical, psychological or hormonal disorder or a period of extreme stress.

However, the Department of Health does now accept CFS/ME to be a genuine medical condition. CFS is characterised by a debilitating tiredness, which can be so severe that the individual is unable to find the energy to carry out their job properly or care for their family or even, in extreme cases, to make it out of bed in the morning. It is often accompanied by aches and pains, typically recurrent migraines and/or back pain. Many people with CFS/ME additionally suffer from one of the conditions below. For more information, visit the ME Association website.

Underactive thyroid (hypothyroidism) and other hormonal imbalances, which tend to slow down the metabolism and impact not only on energy levels but also mood and libido. Take a look at our article Do you have an underactive thyroid?, which outlines the causes, symptoms and treatment for this condition, which can affect up to one in 10 people (although it is more prevalent among the elderly and it is very likely that there are many thousands of undiagnosed cases in the UK). It is very common in people with Down’s Syndrome (up to one in three). The most likely cause is autoimmune thyroiditis (your immune system’s antibodies attack your thyroid gland cells).

Lethargy is the most common symptom of anaemia, and the iron deficiency and reduced blood haemoglobin that underlies anaemia can also lead to shortness of breath, dizziness, palpitations, headaches, a pale complexion and brittle hair and nails. Anaemia is sometimes seen in those with coeliac disease (see food intolerances, below).

Food intolerances.
Quite distinct from food allergies, an estimated one in five people in the UK suffer from some form of food intolerance, two of the most common being lactose (most dairy products and many types of prepared and baked goods) and gluten (wheat and most cereals and bakery products). Coeliac disease is an autoimmune disorder which means the sufferer cannot digest gluten. Low energy levels could well indicate a food intolerance, as the digestive system is unable to obtain adequate nutrients from certain foods. If you notice your feelings of tiredness are worse after you have eaten something specific, especially if you are also suffering from stomach cramps and/or diarrhoea, it’s worth getting tested.

Undiagnosed or poorly controlled diabetes.
Prolonged hyperglycaemia (raised blood glucose levels) can seriously wipe you out, but if you have undiagnosed or mismanaged diabetes (‘brittle diabetes’ refers to poorly controlled type one diabetes), the tiredness could be the least of your worries. If tiredness is one symptom among several others that also include any or all of the following: extreme thirst, blurred vision, frequent urination and recurrent thrush infection, see your doctor or pharmacist immediately. There could be in excess of one million cases ofundiagnosed type two diabetes in the UK and if left untreated, it can lead to severe complications, including neuropathy (nerve damage), blindness, organ failure and coma (advanced diabetic ketoacidosis).

Clinical depression.
Although this is primarily a mental illness, and can affect up to 20% of people at some point in their lives, it has many physical symptoms and one of these tends to be total exhaustion. In depression, this lack of energy is usually coupled with social withdrawal and little or no desire to engage in any kind of activity.

It is a rather twisted irony that not exercising enough could well be one of the main reasons for lacking the energy to do any exercise – hence the vicious cycle so many exhausted, demotivated (and typically unfit) people find themselves in. This situation is only only ever exacerbated by too much junk food, caffeine (especially within two hours of bedtime), regular boozing and poor or disturbed sleeping patterns, all of which tend to feature together in the most self-perpetuating of unhealthy lifestyles. Indeed, the modern Western lifestyle does tend to be characterised by an excess of many inadvisable things – bad food, bad habits and sedentary routines. It could well be this very lifestyle that has led to the prevalence of some of the conditions outlined above, in particular type two diabetes.

It is worth remembering that our energy levels provide a crucial clue about our overall health and well-being. You might be tired all the time just because you work too hard and don’t give yourself time to properly relax and wind down. You might feel bombarded by worries that keep you awake at night, or you might have been devastated by a recent bereavement or personal upheaval, which has completely knocked the wind out of your sails. Regardless of whether or not there is an underlying medical (physical or psychological) reason for your tiredness, if you feel it is taking over your life and affecting your health and happiness, you owe it to yourself to get checked over by your GP.

Amanda Hamilton

North Berwick’s Amanda Hamilton is one of the UK’s most popular nutritionists and health gurus, contributing regularly to TV, press, online and public sector. She also runs her own online healthy diet system and healthy holiday company. She’s a member of Whitekirk Leisure Club and will be contributing a weekly post with tips on health and nutrition.