Doctor, I am sleeping well and eating well but always feeling tired, Help Me:


Fatemeh Aghanasiri

MD, G.P. ;M.C.C 

MD, MCC (Canada) 

Obesity and Weight Management specialist

Lifestyle medicine student

Chronic fatigue syndrome is the most common cause of chronic fatigue;

Fatigue occurs most often as part of a symptom complex, but even when it is the sole or main presenting symptom, fatigue is one of the most common symptoms. Fatigue is difficulty initiating and sustaining activity due to a lack of energy and accompanied by a desire to rest. Fatigue is normal after physical exertion, prolonged stress, and sleep deprivation.

Fatigue is a desire to rest that reflects exhaustion. It differs from weakness, inability to move, and reluctance to move because of pain with movement. Fatigue may reflect activity of a systemic inflammatory disorder.

The most common disorders manifesting predominantly as recent fatigue (lasting lest than 1 month) are

  • * Drug adverse effects
  • * Anemia
  • * Stress and/or depression


The most common causes manifesting predominantly as prolonged fatigue (lasting 1 to 6 months) are

  • * Diabetes
  • * Hypothyroidism
  • * Sleep disturbances (eg, sleep apnea)
  • * Cancer

The most common causes manifesting predominantly as chronic fatigue (lasting more than 6 months) are

  • – Chronic fatigue syndrome
  • – Mood changes (eg, depression)
  • – Drugs
  • – Chronic weight loss
  • – Chronic fever or night sweating
  • – Generalized lymphadenopathy
  • – Muscle weakness or pain
  • Serious non-fatigue symptoms (blood loss, Sever breathing problem, liver diseases , change of level of conciousness, suicidal ideation)
  • Involvement of more than 1 organ system (eg, skin rashes plus joints pain)

  • New or different headache or loss of vision, particularly with muscle pains, in an older adult
  • Older age (eg, > 65 yr)