Tired All The Time

Do you feel TATT?
High on coffee, multivitamins, energy drinks? You are not alone. Every few days a patient comes to me requesting blood tests to find out why (s)he is always tired. Whenever I call one of my very good friends and ask, “How are you doing?” He always replies, “I’m knackered!” He too is a busy man and regularly works round the clock promising to slow down very soon.

Why am I tired?
There are four main reasons why we get tired or fatigued:
  1. A lifestyle of headlines, deadlines,  long days and late nights
  2. Physical activity: work-related or pleasurable
  3. Medical problems e.g. anaemia, nutritional deficiencies, underactive thyroid, diabetes, heart failure, chronic fatigue, cancers, coeliac and other chronic diseases, sleep apnoea
  4. Psychological problems such as anxiety, depression, insomnia, chronic stress
What to do if TATT
There’s an old saying that the common things are the most common. How is your lifestyle? Do you need to make a few changes in these areas?
  • Hours of sleep
  • Water intake
  • Physical activity
  • Dietary sugar, salt, fat consumption
  • Vegetables and fruit
  • Alcohol and/or smoking
  • Work-life balance
Do you snore?
As many as 4 in 10 people aged 40 and over snore. One half of many couples have been banished to different bedrooms because of snoring. Even children with enlarged adenoids and tonsils are plagued by snoring, some of them too tired to concentrate at school.
British Snoring and Sleep Apnoea Association have excellent tools on their website which are highly recommended.
  1. People who snore can do a mouth, nose or tongue test by following this link:
  2. Snoring can be a cause of daytime sleepiness. How likely are you to doze off during the day? Find out here:
 Have you considered Sleep Apnoea?
One of the medical causes of TATT which many at-risk people are not aware of is Sleep Apnoea. Take this final test. The STOPBang Questionnaire – it may save your life.
When we are awake, the tone of the muscles of the tongue and upper airway is sufficient to keep the airway patent so that air we breathe flows into our lungs. For some of us, the situation changes when we sleep. As one slips into deeper sleep (Stage 2 or later), the muscles relax, the tongue falls backwards and blocks the airway. This obstruction ceases air entry into our lungs and we stop breathing momentarily (apnoea). Our brains then wake us up (to Stage 1 sleep), the muscles contract and the airway opens up again. We go through repeated cycles of snoring, apnoea, gasps, wake up and back to sleep. When we finally get up in the morning, we may have slept all night but in reality we never really slept.
The result is excessive daytime sleepiness. If untreated, Obstructive Sleep Apnoea (OSA) which goes from mild to severe, can lead to hypertension, heart disease, weight gain, Type 2 Diabetes, acid reflux, adult-onset asthma, loss of libido, forgetfulness and irritability. Moving vehicle traffic accident can result from nodding off behind the wheel!How to manage TATT
Your doctor can take a detailed history to identify the possible lifestyle, physical, medical and/or psychological causes of your tiredness followed by physical examination
A ‘TATT screen’ – focused blood tests can identify conditions such as iron deficiency anaemia, thyroid problems, vitamin deficiency, diabetes, coeliac disease, liver or kidney disease, infections.
Management will depend on the findings. As you can imagine, there is NO MAGIC PILL to correct a self-destructive lifestyle. However, if you have self-checked via the links above and identified snoring or sleepiness problems, these can be further investigated and treated.

It’s time to shake off the tiredness, get your life back and live on natural energy boosters.

Doctor Hector
KayHector Consulting Ltd

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