Why Am I Always Tired? 6 Hidden Causes of Fatigue Beyond Just Lack of Sleep

We all experience fatigue from time to time - whether it’s from a late night, a stressful week, or just everyday life. However, if you’re constantly feeling drained despite getting a reasonable amount of sleep, there may be underlying factors contributing to your fatigue. Fatigue can be a signal from your body that something may be out of sync, regardless of how many hours of sleep you clock. It could be linked to hormonal imbalances, gut health issues, thyroid problems, seasonal affective disorder (SAD), poor nutrition, or blood sugar fluctuations. In this month’s blog I’ll be looking into how each of these factors can lead to constant fatigue and what you can do to get yourself back to your lively self!

Hidden Causes of Fatigue: Hormones

Hormones play a critical role in regulating many bodily functions, including energy levels. Imbalances in hormones like cortisol, oestrogen, progesterone, and testosterone can lead to chronic fatigue. Cortisol, the stress hormone, is particularly important in managing our energy throughout the day. When cortisol levels are elevated due to chronic stress or adrenal dysfunction, it can lead to feelings of exhaustion, especially during the afternoon. Why? Because your body has worked all day in ‘fight or flight’ mode, our evolutionary response to fear and stress, so it is puffed out! Unfortunately modern workplaces are not a calm oasis, so many people spend weeks, months and even years in chronic stress.

Oestrogen and progesterone imbalances, particularly during perimenopause or menopause, can also cause fatigue. Fluctuations in these hormones can disrupt sleep patterns, affect mood, and reduce energy levels. Similarly, low testosterone in both men and women can result in persistent tiredness, muscle weakness, and a lack of motivation.

What to do next?

The free and easiest option is to try to work on engaging your parasympathetic nervous system i.e. your body’s calm network. Some quiet time during the day and especially before bed. You can do this however you like - some meditation, journalling, stretching, a walk, tea and a good book. Try to avoid screens during this time too.

The next best option would be to test your hormone levels. There are so many options available ranging from blood to saliva to urine with the purpose of understanding the hormone levels and metabolites in the body.  

What can I do to help hormonal imbalance?

So you’ve been tested and you have a hormonal imbalance -this is where a targeted nutritional, supplemental, herbal and lifestyle protocol would be the most beneficial plan of action. I get the most long lasting and beneficial results with my clients once I am able to understand the root cause of the imbalances (through testing) and can work to improve them naturally without the need for medications, which will come with added side effects and possible more hormonal imbalance!

Gut Health & Fatigue 

Your gut health is crucial for overall wellbeing, and poor gut function is often overlooked as a cause of fatigue. The gut is home to trillions of good and bad bacteria, collectively known as the microbiome, which influence your immune system, nutrient absorption, and even your mood. If the balance of beneficial and harmful bacteria is disrupted (a condition known as gut dysbiosis), it can lead to inflammation and digestive issues like bloating, gas, and constipation, all of which contribute to lack of nutrient absorption and ultimately tiredness.

Moreover, a compromised gut barrier can lead to what’s known as ‘leaky gut’, allowing toxins to enter the bloodstream and trigger immune responses that drain your energy and can cause brain fog, memory loss and headaches. You’re also unable to absorb what good nutrients you are eating as effectively, so people with leaky gut can have deficiencies despite a reasonably healthy diet.

Intestinal parasites, pathogens, overgrowth of bacteria as a result of food poisoning, travel bugs or antibiotics will all lead to gut issues which can manifest in the form of IBS. Having any of these predisposing factors can again lead to digestive insufficiency and ultimately fatigue as well as a poor immunity.

What to do next?

If you suspect gut health issues, taking steps like improving your diet, reducing stress, and adding pre and probiotic rich foods could help restore balance and improve your energy levels. Avoiding ultra processed foods is also really beneficial, as well as introducing a variety of whole foods. If you’re stuck on time PRESS offer some easy solutions such as their Gut Support cleanses, or even the Lean Greens juice to help introduce high nutrient, low cal foods into your diet. 

Just like hormone health, there are some very thorough diagnostic tests available to determine the state of your gut health and microbiome. Unfortunately, these tests (unlike some of the hormone ones) are not available on the NHS. Look for a functional medicine based stool test such as the Ultimate Gut Test kit from Healthpath or the GI Effects from Genova. You will need a Nutritional Therapist or Functional Medicine Doctor to interpret them for you but you will get some pretty life changing results from a thorough microbiome examination.

Thyroid & Fatigue 

The thyroid gland, responsible for regulating metabolism, plays a significant role in controlling energy levels. Hypothyroidism (an underactive thyroid) is a common cause of fatigue. When the thyroid doesn’t produce enough hormones, your body’s metabolism slows down, leading to tiredness, weight gain, and muscle weakness. In some cases, fatigue can be one of the first signs of a thyroid disorder, especially if it’s accompanied by other symptoms like dry skin, hair thinning, and depression.

What to do next?

Thyroid health is incredibly important so if you’ve been struggling with unexplained fatigue, get yourself booked into your GP and request a thyroid panel blood test to rule out hypothyroidism. You want to make sure they test for T3, T4 and TSH to get the full picture. If you do have an underactive thyroid (or even subclinically underactive - meaning it's not enough to medicate you but you still have the symptoms of it), there is so much that can be done nutritionally and with natural supplements to improve thyroid hormone production and ultimately increasing your energy. You can also try eating thyroid loving foods such as figs, spinach, nuts, eggs and wild caught fish.

Seasonal Affective Disorder (SAD)  & Fatigue 

You’ve probably joked about it with your friends during the long weeks of February and March, but SAD is a very real thing! That sense of gloom, feeling sluggish, no energy or desire to socialise is a type of depression mostly found in northernmost countries who have dark long winters and decreased sunlight exposure. SAD can disrupt your sleep-wake cycle, making you feel tired throughout the day. It can also reduce the body’s production of serotonin, a neurotransmitter responsible for regulating mood and energy - the happy hormone!

What to do next?

The lack of sunlight also impacts the production of vitamin D, which is vital for immune function and energy. If you suspect SAD might be affecting you, spending time outdoors during daylight hours without sunglasses on, using a sun lamp therapy light, or supplementing with vitamin D can help alleviate symptoms. 

Diet & Fatigue 

One of the most common but overlooked reasons for fatigue is inadequate nutrition. Not eating enough, or eating the wrong kinds of foods, can lead to dips in energy levels. If you’re not consuming enough nutrient dense calories, your body simply doesn’t have the fuel it needs to function properly. To keep it simple, your car doesn’t run without fuel, or if you put diesel in it instead of petrol. The same is true for us.  Low energy is a common sign of nutrient deficiencies (or blood sugar imbalance - more to come), such as iron or vitamin B12, both of which are crucial for maintaining energy.

Equally important is the quality of your diet. Diets high in processed foods, refined sugars, and unhealthy fats can lead to blood sugar imbalances, which cause fatigue and irritability. On the flip side, a balanced diet rich in whole foods, fibre, lean proteins, and healthy fats can help maintain steady energy levels throughout the day. Also, in case you need reminding, coffee is not food.

What to do next?

This one requires you to take stock of what food you’re choosing to put into your body. If you don’t know where to start here are 3 quick tips for you:

• Include a fistful of protein in each meal. Lean protein is best - grass fed red meat, wild caught fish, tofu, legumes.
  
• Find out the best way to cook for you. Is it batch cooking on Sunday nights? Or getting yourself a slow cooker? Maybe it’s just about outsourcing the problem to PRESS with their meal delivery service?
  
  
• Coffee is not food. Please eat breakfast, and try to avoid caffeine after 2pm.
  

Blood Sugar & Fatigue 

Speaking of blood sugar, imbalances in blood glucose levels can have a significant impact on your energy. If you frequently experience fatigue after eating, it could be a sign of a blood sugar imbalance. After consuming sugary or high-carb foods, your blood sugar spikes, followed by a crash that leaves you feeling drained and sluggish. Think of kids at a birthday party running wild and then crashing 30 minutes later. You’re doing that just at a high-functioning level!

This is a problem as long term it can lead to insulin resistance and put you at risk of diabetes. It also causes chronic inflammation in the body, can damage blood vessels and the latest research is even linking Alzheimer's to high sugar diets. 

What to do next?

To prevent blood sugar swings, try eating balanced meals that include protein, fibre, and healthy fats, and avoid highly processed foods that cause rapid increases in blood sugar. You will honestly notice the difference after a few days that your sugar cravings are reduced and you don’t get the urge for snacks.

How to Improve Sleep Naturally 

That’s a lot of information, but all can be easily resolved. If you're dealing with constant fatigue despite getting enough sleep, it’s worth exploring factors beyond just your bedtime routine. Hormonal imbalances, gut health issues, thyroid dysfunction, seasonal affective disorder, poor nutrition, and blood sugar imbalances can all contribute to feelings of exhaustion, and long term can cause some significant health problems. Paying attention to these areas and consulting with a healthcare professional to help you identify the root cause of your fatigue will ensure you’re feeling your best sooner rather than later.

​​Remember, a well-balanced diet plays a key role in supporting healthy sleep patterns, and incorporating the right nutrients can help you tackle fatigue from the inside out. 

If you’re still feeling stuck and need personalised advice, then please feel free to reach out to one of my clinics for a free consultation!