How many times have you thought this over the years. And now that you’re older, and hopefully taking a bit – or a lot- of time out for yourself, are you still feeling that way? Should you be? Is it normal? How do you know when the fatigue is simply from doing too much and when it indicates a serious illness?

This is a question that comes up a lot in both our practices, especially from women. And though you’d think that women younger than us would have less of a problem with fatigue, and that we midlife women are entitled to be chronically tired, that isn’t the case. To illustrate this, I’m sure you know of one (or many) women in midlife and older who have so much energy that they almost never need to rest. I certainly know women like this in their 70s, 80s and even 90s. So, by that fact alone – ie, that there are some women who never slow down no matter their age – we know that humans are not necessarily programmed to lose energy and be more easily tired as we age.

In fact, what it boils down to is what is normal for you, and whether or not there has been a change in your fatigue levels over a short period of time. (This is true of virtually any symptom that you get too.) To know if your fatigue is abnormal and indicative of an underlying illness, such as thyroid dysfunction or anemia or a low-grade infection, ask yourself these questions:

Am I needing more sleep on a regular basis than I ever did in the past?

Do I never feel rested or energized no matter how much sleep/rest I get?

Do I feel incapacitated by the fatigue?

Am I having to change my exercise routine because I now get tired doing the same amount that I’ve done for ages?

Does any exercise, or any physical activity, make the fatigue symptoms immediately worse?

Am I taking more “time outs” or rest periods during my day, and not able to keep up my usual schedule?

Am I getting less done because of my increased need to sleep or rest?

Am I turning down activities in the evenings that I used to do regularly because of  fatigue?

Am I drinking more caffeinated fluids or taking “pep” pills just to get through the day?

Is there an element of physical fatigue to how I feel, or is that I “just don’t feel like getting up and going”, but feel physically ok?

Once you’ve asked yourself these questions, take a look at your daily calendar for this month and compare it to the past several months. Are there many less activities planned?

Most illnesses that start with fatigue do so over a fairly long period of time; that is, weeks to months rather than days to weeks.  If you notice that you are unusually tired for longer than a month or two, you should see your primary healthcare practitioner. One very common cause of fatigue is depression, for which there are  good treatments available. 

If the incapacitating fatigue goes on for 6 months or longer, with no other illness being found as an explanation for it, you may have Chronic Fatigue Syndrome, or CFS (sometimes also known as Chronic Fatigue and Immune Dysfunction Syndrome). This is an illness that has a very specific definition; the diagnosis of CFS cannot be made unless your symptoms meet that definition.  For more information on CFS, visit here: http://www.cdc.gov/CFS/

In my experience, most women who are unusually fatigued do not have CFS, but rather another illness or explanation for their symptoms. Most of the time, this symptom is correctable. The important point is that you recognize what amount of fatigue is abnormal for you, and take action to get medical help for it. Remember that the earlier an illness is diagnosed, the quicker and more easily it can be treated. Don’t ignore fatigue, or think “it goes with the territory” of aging. It doesn’t.