Q. Why am I so tired?

A. This is one of the most common concerns a woman presents to her doctor. I consider fatigue to be usually related to 3 factors.

The first factor is a medical problem. Such diseases as hypothyroidism (a low thyroid level), hepatitis, anemia, and some infections can cause fatigue, even chronic fatigue. These illnesses are easy to detect with a physical examination and some simple blood tests. Thus, a visit to your health care provider can provide insights into these diseases.

The second factor is a lack of sleep. While a lack of sleep can be caused by other factors, here I refer to the person to is "burning the candle at both ends" and not getting enough sleep each night. How much sleep each person needs is different, but if you find that you have a hard time getting up in the morning and you consistently get less than 7 or 8 hours a night, you may not be getting enough sleep. Of course, sleep deprivation may be a problem even if you are asleep long enough. This can occur if your sleep in not sound. There are many problems than can cause a person to not sleep well. You can check out http://www.sleepnet.com/ (it has many useful links...you can visit its site at http://www.sleepnet.com/disorder.htm for an overview of many sleep disorders) or visit your doctor.

Finally, there are psychological reasons for fatigue. Stress is the number one cause of fatigue in my practice. Many patients who are fatigued are depressed. (Stress and mild depression often occur together.) It is sometimes a vicious cycle: you get a bit fatigued from lack of sleep, this makes in harder for your to cope with normal day to day stresses, this trouble coping causes sleep problems, which increases your sense of stress. Breaking the cycle (often by getting a few good nights sleep) can work wonders.

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