Tired all the time: when should you see a doctor?

When does tiredness stop being normal?

When it has lasted a few weeks and you cannot say why. That is the NHS benchmark, with a second test alongside it: the tiredness is affecting your daily life. Being worn out after exam week, a house move or nights broken by a newborn has an explanation. Failing to recover despite rest needs checking.

The common causes are well known: too little sleep, stress, bereavement, a new baby, the hormonal shifts of pregnancy or the menopause, the aftermath of an infection. None of them is shameful, and none says anything about your willpower. But tiredness with no explanation that does not improve is sometimes a sign of a medical condition. Only a consultation will settle it.

Which signs should worry me on top of the tiredness?

The ones that come with it and point somewhere. Low energy with noticeable heartbeats, shortness of breath and paler skin suggests iron deficiency anaemia. Feeling very tired and very thirsty, and needing to pass urine more often, particularly at night, points towards diabetes. Loud snoring and gasping or snorting noises that someone else notices suggest sleep apnoea.

Anaemia deserves particular attention. It affects 30% of women aged 15 to 49 worldwide, according to the World Health Organization, including 106 million in its African region. The causes vary: iron deficiency, heavy periods, malaria, inherited blood disorders. When anaemia is marked, paleness also shows inside the mouth and under the fingernails. These clues are not a diagnosis. Write them down and show them to the doctor.

Should I stop training when I’m exhausted?

Not automatically, because a little movement often restores energy. The NHS points out that regular exercise makes you less tired in the long run and that a single 15-minute walk can give you a boost. Its advice is to start small and build up over weeks and months towards the recommended two and a half hours a week.

Two simple adjustments go with that gentle restart. Drink first: mild dehydration is enough to make you tired, especially after exercise. Then sleep, with regular times for going to bed and getting up. If the tiredness is overwhelming, though, and neither rest nor sleep relieves it, do not look for the answer in training. The doctor comes before the session.

What will the doctor look for?

A cause, first of all, through your answers and often a blood test. The tests check for anaemia, diabetes or a thyroid problem. Depending on the result, what follows ranges from advice on sleep and lifestyle to treatment matched to the cause, or a referral to a specialist if nothing shows up.

You will save time by arriving with facts. How long have you been tired? Are your periods long or heavy? How many hours do you sleep? Has your routine, your job or your training changed? Note what you have noticed as well: breathlessness on the stairs, weight loss, low mood. The NHS is blunt on this point: do not self-diagnose. Your job is to describe, the doctor’s is to conclude.