Fatigue becomes worrisome when it lasts over a couple of weeks without relief, disrupts daily life (work, activities), isn't explained by lifestyle, or comes with "red flag" symptoms like unexplained weight loss, shortness of breath, fever, severe headaches, unusual bleeding, or chest pain, signaling a need for a doctor's visit or emergency care. It's concerning if rest doesn't help, you feel constantly run-down, or if it's accompanied by mental health struggles like suicidal thoughts.
Fatigue symptoms can be physical, mental and emotional and may include:
You should also call your provider if: Your fatigue lasts longer than a few days. You're having a hard time going to work or performing daily activities. There isn't a clear reason (such as a recent illness) for your fatigue.
Red Flags That Fatigue Might Be Something More
You've had persistent low energy for more than two weeks. Your mood, memory, or motivation has changed noticeably. You feel dizzy, weak, or lightheaded regularly. You're noticing unexplained aches, or frequent headaches.
The four Ps are problem solving, planning, prioritising and pacing. The aim is to think of the four Ps at the beginning of each day or week to help you manage your energy levels.
Most people with a terminal illness feel extreme or constant tiredness (fatigue). Try to pace yourself and save your energy for the activities that are most important to you. An occupational therapist may be able to help with equipment at home to reduce the energy needed for daily activities such as showering.
Fatigue indicators to include: time of incident, number of days into shift pattern, number of hours into shift, number of rest days in previous 14 day period, rest in previous 24 hours, amount of sleep in previous 72 hours, work activity, commute time.
Exhaustion that doesn't let up might be a sign of:
Vitamin and mineral deficiencies, including B2, B3, B5, B6, B9, B12, C, D, iron, and magnesium, are among the most common causes of unexplained fatigue. Vitamin D deficiencies affect over 50% of the global population, and approximately 12.5% have iron deficiency anemia.
Get emergency help if you have fatigue and any of the following: Chest pain. Shortness of breath. Irregular or fast heartbeat.
See a GP if:
you feel tired and have other symptoms, such as weight loss or mood changes, or you've been told you're making gasping, snorting or choking noises when you're asleep.
A Complete Blood Count (CBC) is a comprehensive blood test that measures various components of your blood, including red blood cells, white blood cells, and platelets. This test is crucial for detecting conditions like anemia, which can cause extreme fatigue.
Adrenal fatigue is a term used by some alternative health practitioners to explain tiredness and other symptoms. They believe these symptoms are caused by chronic (long-term) exposure to stressful situations. Many studies have failed to prove that adrenal fatigue is a medical condition.
Even a week of feeling more tired than usual is not uncommon. Yet most people can tell when their fatigue feels like something more serious. If that's the case, or your fatigue gets worse or lasts longer than a week or two, it's time to see your doctor.
Pace, plan and prioritise (the 'three Ps')
Think about the 'three Ps' to help you learn to manage your fatigue. Fatigue can follow a pattern. Learning to understand this can help you make the most of your energy.
Patients experiencing chronic fatigue related to autoimmune conditions often describe their symptoms as more than just feeling tired during the day. This is significant exhaustion that impacts quality of life and makes it difficult to function on a normal basis.
Individuals experiencing a deficiency often report feeling unusually tired or weak, even after adequate sleep. This symptom arises because a lack of B12 impairs the production of red blood cells, leading to fewer cells to transport oxygen throughout the body.
The right combination of vitamins can address both types of low energy levels. Certain vitamins like B12, iron, magnesium and Vitamin D directly impact parts of the energy production cycle. Deficiencies in these vitamins can cause symptoms like fatigue, weakness and low energy.
Common Low Vitamin D Symptoms
Fatigue and exhaustion: This is one of the most common complaints. You might feel persistent tiredness that doesn't improve with rest. Even simple tasks feel draining. Bone and muscle pain: Aching bones, muscle weakness, or generalized body pain often signal low vitamin D.
A wide range of medical problems and decompensation processes of underlying diseases can cause fatigue. Sleep disorders, sleep-related respiratory disorders, depression, and psychosocial stress are the main causes of persistent fatigue.
When trying to cope with fatigue, a simple rule is to remember The Five P's: Plan, Prioritise, Pace, Position and Permission. Plan and organise your time. Plan your day ahead with periods of rest and periods of activity.
About 1 in 10 people who get infected by Epstein-Barr virus, Ross River virus, or Coxiella burnetti later develop an illness like ME/CFS. This is especially true if they had severe symptoms of these infections. But not all people with ME/CFS have had these infections.
Fatigue is regarded as having an impact on work performance. Government of Alberta, Labour* reports that most incidents occur when people are more likely to want sleep - between midnight and 6 am, and between 1 to 3 pm.
Thankfully, there are ways you can help manage, or work around your fatigue. The Four P's reminds us of some ways to help conserve and save energy for the things that are most important. The Four P's are Problem solving, Planning, Prioritising, and Pacing.
The FSS is a self-administered questionnaire with 9 items (questions) investigating the severity of fatigue in different situations during the past week. Grading of each item ranges from 1 to 7, where 1 indicates strong disagreement and 7 strong agreement, and the final score represents the mean value of the 9 items.