Why am I tired all the time?

You’re not just feeling a bit tired, you feel tired all the time. Here we discuss some of the reasons your energy levels are at an all time low.

The NHS guidelines suggest that the following conditions are some of the top causes of fatigue: coeliac disease, anaemia, chronic fatigue syndrome, sleep apnoea and an underactive thyroid. Lifestyle, diet and mental health issues are also contributing factors to constant tiredness. Let’s take a more detailed look at each of these possibilities and what it might mean for you. 


Why am I tired?

Coeliac disease

Coeliac disease can go undiagnosed for years and it is possible that there are many more people affected than we know of. Tiredness is one possible symptom, often there are some signs of digestive dysfunction too (bloating, diarrhoea, stomach cramps), these symptoms can sometimes be mistaken as IBS.

Coeliac disease is not usually diagnosed until there is a significant destruction of the villi in the digestive system, so, there is a chance that in the early stages the disease may not be detected. There is also non-coeliac gluten sensitivity (NCGS) which is a sensitivity to gluten that results in symptoms other than destruction of the villi. The effects of NCGS are not specific to the digestive system. This sensitivity can cause migraines, other neurological symptoms, disrupt thyroid function and leave you feeling tired and lacking concentration. 


Low iron levels can significantly impact on energy levels. Often the supplements prescribed to remedy the anaemia can aggravate digestion and sometimes they need to be given in high doses just to achieve reasonable absorption. Iron supplementation can impact on the uptake of other key minerals that can also make you feel tired.

The best approach is to understand the reason for low iron levels - is it lacking in your diet? Do you have heavy periods? Is there some other blood loss? Or is lack of absorption due to IBS or low stomach acid? Understanding and working on the underlying reason for iron deficiency is the best approach for maintaining good iron levels in the future. 

Chronic fatigue syndrome

There are many different pathways to chronic fatigue syndrome. A diagnosis of chronic fatigue syndrome is arrived upon after ruling out all other possible causes of fatigue. This means that those with a diagnosis could have multiple different causes of their fatigue.

Using a nutritional programme to improve symptoms of chronic fatigue syndrome is a good option, the risk is low and there is the possibility of seeing some real improvements. The approach is different for each individual but as a general guide the focus in a nutrition consultation will be on the following addressing nutrient levels and possible deficiencies, absorption and improved gut function, supporting the immune system and energy production in the cell. 

Sleep apnoea

Sleep apnoea is characterised by loud snoring and gasps for breath whilst sleeping. Chances are it’s your partner who would notice these symptoms whilst you are blissfully unaware of them. You might just notice that you are feeling desperately tired all the time and you might wake up with headaches.

Sleep apnoea is more common in people who are overweight and this is where nutrition can make the difference. It can be difficult to lose weight when you are not getting a restful night’s sleep. Your body adapts to lack of sleep by promoting intake of starchy and sugary foods and prioritising fat storage. Also, the inflammation that is caused by sleep apnoea can make weight loss difficult. This can make adopting a diet that is low in sugar and refined carbs difficult. A nutritionist can help and support you in this process.

Underactive thyroid

Many people show signs of low thyroid function despite having blood test results that suggest their thyroid function is ‘normal’. If you find that you tick a lot of the boxes that suggest thyroid dysfunction it is worth seeing a practitioner for further help. These signs include a low body temperature, constipation, low mood and low energy levels.

Many people with a hypothyroid diagnosis that take medication will still exhibit symptoms of low thyroid function. Often the problem is not fully rectified with medication. Over time, symptoms can get worse because their thyroid function hasn’t been properly restored. If you are on medication and you still have all the typical symptoms of hypothyroidism then you might need some nutrition support.

You can also order more sensitive lab testing through your nutritionist. A test that looks at all the thyroid hormones as well as other important factors like iodine and selenium deficiency and antibodies. Good thyroid function involves key nutrients, which when lacking result in dysfunction or a sub-clinical dysfunction that can affect your energy levels significantly. 

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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Birmingham, B13 8JP
Written by Sarah Hanratty
Birmingham, B13 8JP

Sarah is an experienced practitioner at the Brain Food Nutrition Clinic specialising in the link between gut health and physical and cognitive well-being.

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