Feeling tired all the time? It may signal underlying problems like cancer, diabetes or mental health issues

CNA

14 hours ago

You know how it's like when you've had a late night. The following day, your battery just can't seem to last past lunchtime. By 2pm, you're ready to tap out. But those tired days can usually be remedied with a nap or a few nights' good sleep.
The situation is different when you consistently wake up to your body and mind saying 'no, thank you' and 'can we stay in bed?'.
'In medical terms, fatigue is usually a more prolonged and persistent state of physical, mental, or emotional exhaustion,' said Dr Sky Koh, an associate consultant and family physician with National University Polyclinics. 'Fatigue also affects your ability to perform daily activities and may not be relieved by rest or sleep.'
And Singaporeans are fatigued. 'I see cases of fatigue quite frequently, about two or three out of 100 patients,' said Dr Koh.
But before you chalk up your low-energy situation to age, a lack of sleep and/or work stress, there may be medical issues involved that affect you physically and mentally. Here's a look at some of them.
ISN'T EVERYONE FEELING FATIGUED? WHY SHOULD I BE WORRIED?
'Feeling tired all the time is not normal!' emphasised Dr Koh. 'It is essential to educate people about the importance of feeling refreshed and energised after adequate sleep.'
And there are some very good reasons to put down your devices and get some shuteye. 'Quality sleep is essential for your body to heal and repair its muscles, organs and other cells, said Elizabeth Eu, a psychologist with Geylang Polyclinic. 'Sleep is also important for lowering your risk of cardiovascular complications and difficulties in weight management.'
Your mental health is dependent on sleep as well. 'Sleep disorders may increase the risk of mood disorders (such as anxiety and depression), lead to a decline in cognitive functioning, and could affect your ability to regulate emotions effectively,' said Eu.
WHAT ARE THE COMMON SIGNS OF FATIGUE?
They include long-term tiredness, excessive sleepiness despite rest, recurring headaches, dizziness, muscle aches and weakness, a general lack of motivation or interest in activities, and affected emotional wellbeing, explained Dr Koh.
'However, patients often don't walk in saying, 'I'm feeling fatigued'. Instead, they typically present with symptoms like persistent tiredness, lack of energy or excessive sleepiness that interfere with their daily life, relationships with friends, colleagues and family, and overall well-being.'
WHAT OTHER HEALTH ISSUES CAN CAUSE FATIGUE?
Fatigue may be one of the signs of the following illnesses, to name a few. But it doesn't mean that you definitely have cancer, diabetes or lupus if you're constantly feeling drained. Here's a look at how these diseases can sap your energy level:
1. CANCER
Your healthy cells have to compete against the tumour cells for nutrients. On top of that, your body is wasting energy to produce chronic inflammation caused by the cancer, said Dr Koh.
In fact, cancer fatigue (yes, there is a term for it) affects 80 per cent to 100 per cent of people with cancer, according to Cleveland Clinic. 'With cancer fatigue, you may feel exhausted for no clear reason. People who experience cancer fatigue describe it as paralyzing tiredness that doesn't go away no matter how much rest or sleep they get,' noted the website.
Some cancers may be more energy draining than others. For instance, breast and prostate cancers can alter the hormone levels in your body, which can lead to a number of side effects, including fatigue, according to Cancer Research UK.
Certain blood cancers as well as pancreatic and colorectal cancers can produce cytokines – a group of proteins that play an important function in boosting the immune system. And these cytokines can cause fatigue, noted the same website.
Other cancers, noted Cancer Research UK, may secrete substances that make your body stop utilising nutrients such as calcium and potassium to keep your heart and muscles working. As a result, you start to feel sleepy and fatigued.
2. DIABETES
When you eat, food is digested into blood sugar or glucose. Then, your pancreas secretes insulin to enable your body to use this blood sugar for energy. In diabetics, their bodies can't produce enough insulin to utilise the blood sugar. Without this energy source, the cells in their bodies weaken or get fatigued.
'Low blood sugar can also cause fatigue, especially in people who have frequent episodes and do not get enough warning that their blood sugar levels are dropping,' reported Medical News Today. 'A person can still feel fatigued even after treatment for low blood sugar.'
And that's just the glucose part. The website also reported that excessive thirst and frequent urination, though not directly linked to fatigue, can result in patients losing sleep at night.
'Biological factors such as inflammation, organ damage and hormonal imbalances can also cause fatigue,' said Dr Koh.
3. AUTOIMMUNE DISEASE
There may be more than 100 different autoimmune diseases (lupus, rheumatoid arthritis and multiple sclerosis are some) but they all do one thing: Causing the immune system to attack the body instead of invaders such as bacteria, viruses or toxins.
As you can imagine, the body's persistent full-on attack on itself as well as the need to fend off its own attack require vast amounts of energy – which probably explains why patients often feel exhausted.
Furthermore, autoimmune diseases may also directly or indirectly affect the central nervous system. When this happens, it can disrupt neurotransmitter signalling and brain function, and contribute to fatigue.
4. SLEEP DISORDER
A sleep disorder, such as obstructive sleep apnoea (OSA), is probably the top reason that pops into your mind – and you aren't wrong to think that. In fact, there are 10 distinct types of sleep disorders, according to Eu.
'They range from difficulties in falling or maintaining sleep, to excessive daytime sleepiness, disrupted circadian rhythm (sleep-wake cycle) and various physiological conditions such as OSA that affect sleep quality,' she said.
'Sleep disorders may disrupt your body's natural sleep-wake cycle, interfering with the deep sleep needed for physical and mental recovery,' said Eu. 'Individuals affected by these conditions often experience persistent tiredness and struggle to maintain their energy levels throughout the day.'
5. MENTAL HEALTH ISSUES
You know that stress, anxiety and depression can disrupt your sleep and drain your energy levels. Your mind is never 'off' from the minute you wake up. You're constantly fighting the thoughts that bombard your mind and cause anxiety to spike. There's no reprieve at night either; you have difficulty switching off. It's no wonder you're exhausted.
And sometimes, stress, anxiety and depression can be a sign of emotional exhaustion, according to Mayo Clinic, caused by the continuous stress from challenging events in your life. When your body detects stress, it interprets it as a threat to survival and releases stress hormones. But what the hormones do is further contribute to your experience of emotional exhaustion, noted the website.
WHEN SHOULD YOU GO SEE A DOCTOR FOR YOUR FATIGUE?
According to Dr Koh, the timeframe varies from person to person 'as individuals know their bodies best'. 'It's crucial to encourage self-reflection and identify the underlying causes of fatigue, which may include sleep disorders, nutrition issues or mental health conditions,' he said.
'Generally, if you've identified the potential cause of fatigue, made the necessary lifestyle changes (such as improving nutrition, sleep and stress management) and still experience persistent fatigue after two to four weeks, it's worth consulting a healthcare professional,' said Dr Koh.
'However, if fatigue significantly impacts daily activities, functioning or relationships, or if you have a pre-existing medical condition, it's best to seek help sooner,' advised Dr Koh. The same applies if you experience sudden onset fatigue, severe symptoms, or suspect an underlying condition, he added.