Everybody is tired — that’s just part of being a grownup. But even though it’s easy to dismiss your tiredness as just “one of those things” there comes a point when it’s not. When you’re feeling fatigued all the time, it might mean your body is trying to tell you something.
That’s what actress Mindy Cohn discovered before she was diagnosed with breast cancer. “I was walking around my neighborhood in Los Angeles and I suddenly got so tired,” the Facts of Life star told People. “I just couldn’t go anymore. This was before Uber was really a thing, so I texted my friend Helen Hunt and said, ‘Something’s wrong with me. I need help.'” Cohn saw her doctor and was eventually diagnosed with breast cancer — and fatigue was her first major symptom.
Obviously not every bout of exhaustion should make your mind go to cancer, but when should you check in with a doctor about fatigue?
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It’s important to know the difference between feeling tired and feeling fatigued
Feeling tired or sleepy is when you’re having trouble staying awake and want to nod off, says W. Christopher Winter, M.D., of Charlottesville Neurology and Sleep Medicine, and author of the book, The Sleep Solution: Why Your Sleep is Broken and How to Fix It. Fatigue, on the other hand, is when you’re seriously lacking energy.
“Normal” fatigue gets better when you’re able to rest (think: your arm gets fatigued after you do a bunch of bicep curls, but feels better 10 minutes later), and “normal” sleepiness gets better with more sleep. In most cases, fatigue is your body telling you to slow down, and you should probably listen to it.
But when fatigue regularly keeps you from doing the things you want to do, it’s a problem, Dr. Winter says. “That doesn’t mean ‘I can’t run 38 miles because I get fatigued,’ it’s more like ‘I have trouble getting up and down stairs,’ or ‘a walk from the parking lot to my office exhausts me,’” he says. And if this comes out of nowhere, it’s worth checking in with a doctor.
Many health conditions list fatigue as one of the symptoms
When Dr. Winter sees patients who say they’re tired, he often tries to distinguish whether they’re sleepy or fatigued. “Sleepiness is pretty easy — it’s a defined group of problems,” he says. “But if they’re talking about fatigue, you could make a list a mile long of what could be causing it.” That list includes a deficiency in vitamins B12 or D, multiple sclerosis, type 2 diabetes, and Parkinson’s disease, to name a few.
Other conditions that are associated with fatigue include anemia, a thyroid issue, or even leukemia — all of which can make people feel incredibly rundown, says Yvonne Bohn, M.D., an ob/gyn at Providence Saint John’s Health Center in Santa Monica.
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“My patients definitely talk about being tired,” Dr. Bohn says. When she hears that, she starts asking questions to try to figure out what might be behind it. If there doesn’t seem to be lifestyle factors behind it (like caring for a new baby or training for a marathon), she’ll typically do a blood workup to try to figure out what’s going on. Mental health conditions, including depression, can also make people feel fatigued, Dr. Bohn points out, though they can’t be detected with a blood test.
And, yes, fatigue can be one symptom of cancer, though it’s not typically the first or most obvious sign of disease. “About one in five breast cancer patients experience severe fatigue as a symptom of breast cancer,” Heather Jim, Ph.D., an assistant member of the Health Outcomes & Behavior Program at Moffitt Cancer Center who studies fatigue and cancer, tells SELF. It’s not totally clear why this happens, but cancer can cause chronic inflammation which has been linked to fatigue, Dr. Jim says.
But fatigue due to cancer is different from “normal” fatigue. “Cancer-related fatigue tends to be severe and does not get better with rest,” Dr. Jim says.
It’s easy to read this and worry that your recent exhaustion is a sign of something serious, but that’s probably not the case
Sure, many health conditions can lead to fatigue, but so can being super overwhelmed for months or going through a big life change that screws with your sleep and stress levels.
If this is exhaustion that comes out of nowhere or doesn’t get better with rest, that’s when you should consider seeing a doctor. Whether it’s an undiagnosed condition or the result of lifestyle factors that could use some tweaking, they may be able to help.
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So if you’re suffering from fatigue, don’t write it off, and don’t let your doctor dismiss it either. “If your doctor can’t figure it out, it’s time to find a new doctor who has a long list of health conditions to investigate,” Dr. Winter says.
Because, just like we shouldn’t glorify being busy and stressed all the time, we certainly shouldn’t settle for being tired all the time.