7 Weird Reasons You're Tired All the Time

You stayed up late binge-watching sex and the city. Then you woke up extra early to beat the boss to the office. Some days, there's no mystery as to why you need an extra shot of espresso (and if you can't sleep no matter what you try, check out these 10 sleep myths and real solutions for better shuteye.)

 But sometimes, the root of your fatigue isn't so obvious, and everything from a hidden health issue to your gym habits could be to blame. "It's like asking a pediatrician why a baby is crying; the answer could be any number of things," says Tanvir Hussain, MD, a preventive cardiologist in Los Angeles.

A challenging puzzle, yes, but your fatigue is a mystery you can solve.

Here are 7 reasons you could be dragging--and how to regain more energy than you ever remember having.


You're dehydrated
Healthy women who failed to replace a mere 1.5% of their water weight experienced mood swings and low energy levels, according to a 2012 study in The Journal of Nutrition. The study authors suspect neurons in your hypothalamus--the brain region responsible for controlling things like hydration and body temperature--send mood-altering messages to the rest of your brain as an early warning to drink more water.

You're low on B12
 Your body needs vitamin B12 to make red blood cells and keep neurons functioning properly. Deficiency decreases the amount of oxygen your blood can carry through your body, leaving you with that sleeping-with-your-eyes-open feeling. As you age, you produce less of a protein called intrinsic factor, which helps you process the nutrient.

You're overwhelmed with stress
 Trying to do it all comes with a huge downside. Normally, your levels of the stress hormone cortisol run highest in the morning and dip down at night, helping you maintain a normal daily rhythm. But chronic stress throws this pattern out of whack in either direction, says Marc Bubbs, ND, CSCS, founder of Naturopathic Sports Medicine in Toronto. If your body remains on constant alert, your cortisol levels may never fall off at night, disrupting your sleep. Or, your adrenal glands may eventually fall behind in cortisol production, leaving you sleepwalking through your morning.

You have hidden heart disease
In a study in the journal Heart & Lung, half of women who had heart attacks said they had trouble sleeping and felt unusually fatigued in the weeks beforehand. Weariness and shortness of breath when you exercise, climb stairs, or otherwise exert yourself should also raise a red flag, Dr. Hussain says. Blocked arteries or a weak heart muscle reduce blood flow, preventing your muscles and tissues from getting the oxygen they need to function properly.

Your iron levels are too low--or too high
 Most women know anemia leads to fatigue. But don't assume popping iron supplements will pep you up. Yes, low iron levels lead to poorly formed red blood cells that deprive your body of refreshing oxygen. However, getting too much iron can wear you down as well. Your body uses vitamins, minerals, and energy to rid your system of the excess, leaving you with little left to run on, says Dr. Sirchio.

You're not working out
 Especially when paired with chronic stress, too much time spent sedentary drains your fuel tank even though you're merely idling, Dr. Bubbs says. Picture it: A stressful day at work cranks up your cortisol and blood glucose levels, triggering your knee jerk reaction to fight or flee. But when you spend your afternoon and evening barely moving between your computer screen and your couch, you never release that energy and tension. This can keep your engine revved and disrupt your sleep at night--or burn out your body's cortisol factory so much that you're dragging the next morning.

You're exercising too much
 On the flip side, you can have too much of a good thing. If you're sweating every day or doing heavy-duty training for an event like a triathlon, fatigue and trouble sleeping can serve as a sign that you're pushing your body beyond its limits. Workouts--and especially endurance sports like long-distance running and cycling--also cause a spike in cortisol. If you're not striking the right balance between activity and rest, you can overload your system with physical stress just as you can with emotional or mental pressure, Dr. Bubbs points out.

You have a urinary tract infection
 If you've had a UTI before, you know the burning urgency that comes when you pee. But about half of women who show up with UTIs also report fatigue and a general sense of illness, and the rate increases among those 40 or older, says Ashley Carroll, MD, an assistant professor of urogynecology at Virginia Commonwealth University. "Basically, it's your body's way of forcing you to rest in order to focus energy on fighting the infection," Dr. Carroll says.