One of the commonest complaints I see as a GP is that of fatigue; people just feeling tired all the time. Invariably the person tells me they don’t really understand why because they’re sleeping alright, in fact, they may be sleeping a lot, but still they just feel exhausted and are relying on caffeine and sometimes sugary snacks to get them through the day. Mostly people are just fed up of feeling that way but sometimes they’re genuinely worried that there might be something else going on health-wise. Sound familiar?

As runners, we know that running energises us but it can also make us really tired, especially if we’re training for something in particular. So how do you know what’s normal tiredness and what may indicate an underlying health problem? What steps can you take to resolve your tiredness and when do you need to see a doctor?

Quick Self Check
First up, just sit down and have a think about things. Can you find a simple cause for your tiredness? If you’re honest with yourself, you might have the answer right there. Questions to ask yourself are:

  • Have I increased my training load? Am I running further, faster or more frequently than usual?
  • Am I having enough rest days and have I increased my sleep to balance any extra activity?
  • Am I eating sufficient amounts to fuel my exercise? Am I skipping meals and is my food of good enough quality to meet my body’s demands?
  • What else is going on in my life? Is work or home life demanding and using my energy?

The solution to your fatigue may simply lie in trying to correct these factors – easier said than done on the last one! Try going to bed half an hour earlier. Improve your diet by reducing your caffeine intake, eating better quality food, not skipping meals and introducing healthy snacks. Make sure your training plan is sensible and cut it back a bit if you need to. Do what you can to reduce your general stresses; just understanding that you’re human and your resources are not infinite can help you.

Sometimes however, there is something more to it. Let’s look at three common medical conditions that cause tiredness and what might alert you to the fact you need to see a doctor.

Your thyroid is a gland in your neck and it produces thyroid hormones which help to control your metabolism. If it’s not producing enough hormones, then your metabolism slows down. Symptoms you might experience include:

  • Fatigue
  • Weight gain
  • Constipation
  • Dry skin
  • Feeling cold all the time
  • Slow thinking

Hypothyroidism is ten times more common in women than men. The commonest cause in the developed world is an auto-immune condition which means for an unknown reason the body starts rejecting its own thyroid. Having a family member with hypothyroidism increases your chance of getting it as it can be hereditary. It’s diagnosed by simple blood testing and treatment usually involves taking tablets to replace the thyroid hormones.

Your blood carries oxygen around your body attached to red blood cells. If there aren’t enough red blood cells then you can start to feel the effects, symptoms include:

  • Fatigue
  • Shortness of breath
  • Palpitations
  • Light headedness
  • A dip in your running performance

The commonest cause is anaemia due to iron deficiency because iron is needed to make red blood cells. This is often due to inadequate iron in your diet and also heavy menstrual bleeding in women, but if iron deficiency is detected on blood tests, your GP will discuss with you whether any further investigations are needed. Treatment for diet related iron deficiency involves eating iron rich food and topping up your iron levels and stores with iron supplements.

In the self-check list above I mentioned that life’s stresses and strains can cause tiredness by affecting your mental health but sometimes simply reducing these is not enough and a more serious mental health problem underlies it. Depression is a common cause of fatigue and it’s not always easy to recognise or admit to in the early stages. You might experience:

  • Fatigue
  • Low mood
  • Poor sleep or excessive sleep
  • Reduced concentration and forgetfulness
  • Low self esteem
  • Fear of leaving the house and feeling unsociable
  • Feeling overwhelmed and unable to see a way forward

Anyone at all can get depressed, it’s no reflection on your intelligence or resilience. Chemical imbalances in the brain trigger the symptoms listed above. Treatment includes support, exercise, talking therapies and medication. If you think you may be depressed then please seek help, there is plenty there if you ask for it (which is not always easy).

Other warning signs
Other symptoms that might potentially indicate another cause for your tiredness also include:

  • Unexplained weight gain or weight loss
  • Excessive thirst or passing lots more urine than normal
  • A persistent cough
  • Night sweats (that aren’t associated with the menopause)
  • A change in your bowel habit or blood in your stools
  • Swollen glands in your neck, arm pits or groin

The causes of tiredness often lie in day to day lifestyle but if you address these and things don’t improve or you have any of the symptoms of hypothyroidism, anaemia, depression or the other warning signs then make an appointment with your GP.

This topic is covered in more detail in my new book Sorted: The Active Woman’s Guide to Health published by Bloomsbury. UKRunChat readers can use the discount code UKRUNCHAT to get 20% off the book price when purchasing via this link: