Can constant fatigue be a sign of an underlying health condition?

Yes, constant fatigue can absolutely be a sign of an underlying health condition. While occasional tiredness is normal, persistent fatigue that does not improve with rest may indicate a medical issue that requires evaluation. At Serenity Choice Health, our women’s primary care providers can help identify the root cause of your fatigue and develop a treatment plan tailored to your needs.

What Is Normal Fatigue vs. Concerning Fatigue

Normal fatigue is temporary and improves with rest, sleep, and good nutrition. You feel tired after a long day, a poor night’s sleep, or intense physical activity, but you recover within a day or two.

Concerning fatigue (sometimes called “chronic fatigue”) lasts for weeks or months, does not improve with rest, interferes with your daily activities, and may be accompanied by other symptoms. If you have been feeling exhausted for more than two weeks despite getting adequate sleep, it is time to see a provider.

Common Medical Causes of Constant Fatigue in Women

Iron deficiency anemia

Anemia is one of the most common causes of fatigue in women, especially those with heavy menstrual periods. When your body does not have enough healthy red blood cells to carry oxygen to your tissues, you feel exhausted. Other symptoms include pale skin, shortness of breath, dizziness, cold hands and feet, and brittle nails.

Anemia is easily diagnosed with a simple blood test (complete blood count) and is highly treatable with iron supplements, dietary changes, or treatment of the underlying cause (such as heavy periods). Read about can anemia affect abortion pill safety.

Thyroid disorders

Your thyroid gland controls your metabolism. When it is underactive (hypothyroidism), your body slows down, causing fatigue, weight gain, feeling cold, dry skin, hair thinning, constipation, and depression. Hypothyroidism is very common in women, especially as they age.

Thyroid disorders are diagnosed with a simple blood test (TSH, T3, T4) and are highly treatable with daily thyroid hormone replacement medication. Most people feel significantly better within weeks of starting treatment.

Diabetes and prediabetes

When your body cannot properly use sugar for energy, fatigue results. Other symptoms of diabetes include increased thirst, frequent urination (especially at night), blurred vision, slow-healing cuts or sores, and unexplained weight changes.

Diabetes is diagnosed with blood tests (fasting glucose or hemoglobin A1C). Prediabetes can often be reversed with lifestyle changes, and diabetes can be managed effectively with medication, diet, and exercise.

Depression and anxiety

Mental health conditions are a very common cause of persistent fatigue. Depression often causes low energy, loss of interest in activities, changes in sleep and appetite, difficulty concentrating, and feelings of worthlessness or hopelessness. Anxiety can be mentally and physically exhausting, leaving you feeling drained even after minimal activity.

Both conditions are treatable with therapy, medication (antidepressants or anti-anxiety medications), or a combination of both. Your primary care provider can screen for depression and anxiety during a routine visit. Read about can I take abortion pills if I have anxiety or panic attacks.

Sleep disorders

Even if you think you are sleeping enough, you may not be getting quality sleep. Obstructive sleep apnea causes you to stop breathing briefly many times during the night, disrupting your sleep cycle and leaving you exhausted during the day. Other signs include loud snoring, gasping or choking during sleep, morning headaches, and daytime sleepiness.

Other sleep disorders include insomnia (trouble falling or staying asleep) and restless leg syndrome (uncomfortable sensations in your legs that worsen at night). These conditions can be diagnosed through sleep studies and are treatable with various interventions.

Chronic fatigue syndrome (myalgic encephalomyelitis)

Chronic fatigue syndrome is a complex disorder characterized by extreme fatigue that lasts for at least six months and does not improve with rest. Other symptoms include worsening of fatigue after physical or mental activity (called “post-exertional malaise”), unrefreshing sleep, cognitive difficulties (“brain fog”), dizziness when standing up, and muscle or joint pain.

Diagnosis requires ruling out other medical conditions first. Treatment focuses on symptom management.

Autoimmune conditions

Autoimmune diseases occur when your immune system attacks your own body. Common autoimmune conditions that cause fatigue include lupus (joint pain, skin rashes, fatigue), rheumatoid arthritis (joint pain and swelling), Sjögren’s syndrome (dry eyes, dry mouth, fatigue), and multiple sclerosis (neurological symptoms).

These conditions are diagnosed through blood tests, physical examination, and sometimes imaging. Treatment depends on the specific condition and may include immunosuppressive medications.

Chronic infections

Long-standing infections can cause persistent fatigue even without obvious acute symptoms. These include mononucleosis (EBV), Lyme disease, long COVID (persistent symptoms after COVID-19 infection), and HIV. Diagnosis requires specific blood tests based on your risk factors and symptoms.

Vitamin deficiencies

Deficiencies in certain vitamins and minerals can cause fatigue, including vitamin D deficiency (extremely common, especially in northern climates), vitamin B12 deficiency (more common in vegetarians, vegans, and older adults), and folate deficiency.

These deficiencies are diagnosed with blood tests and are easily treated with supplements or dietary changes.

Perimenopause and menopause

Hormonal changes during the transition to menopause can cause severe fatigue in many women. Declining estrogen and progesterone levels disrupt sleep (due to night sweats and hot flashes), affect mood (contributing to depression or anxiety), and directly impact energy levels.

Hormone therapy, lifestyle changes, and other treatments can significantly improve fatigue during this life stage.

Other potential causes of constant fatigue

• Chronic kidney disease: Fatigue from waste buildup in the blood

• Liver disease: Fatigue from impaired liver function

• Heart failure: Fatigue because your heart cannot pump enough oxygen-rich blood to your tissues

• Fibromyalgia: Widespread pain accompanied by severe fatigue and sleep disturbances

• Medication side effects: Beta-blockers, antihistamines, antidepressants, and other medications can cause fatigue

• Long COVID: Persistent fatigue lasting weeks or months after COVID-19 infection

Lifestyle Factors That Can Contribute to Fatigue

Before assuming a medical condition, your provider will also evaluate lifestyle factors that may be causing or worsening your fatigue:

Poor sleep hygiene: Irregular sleep schedules, screen time before bed, caffeine or alcohol close to bedtime, and an uncomfortable sleep environment can all disrupt sleep quality.

Poor nutrition: Skipping meals, eating highly processed foods, insufficient protein, and dehydration can all cause energy crashes.

Lack of physical activity: Ironically, being sedentary can make fatigue worse. Regular moderate exercise often improves energy levels.

Chronic stress: Ongoing work, family, or financial stress is mentally and physically exhausting.

Caffeine dependence: While caffeine provides temporary energy, dependence can lead to crashes and disrupted sleep.

Alcohol use: Even moderate alcohol consumption disrupts sleep quality, leaving you tired the next day.

When to See a Provider for Fatigue

You should schedule an appointment with a primary care provider if:

• Your fatigue has lasted for two weeks or longer despite getting adequate rest

• Your fatigue interferes with your ability to work, care for your family, or enjoy your life

• You have other symptoms such as fever, unexplained weight changes, pain, shortness of breath, or changes in your periods

• You feel sad, anxious, or hopeless in addition to being tired

• You have a family history of thyroid disease, diabetes, or autoimmune conditions

What to Expect During Your Appointment

When you see a provider for fatigue, they will:

1. Take a detailed history including when your fatigue started, how it has progressed, what makes it better or worse, and any other symptoms you have noticed

2. Review your medications because many common medications cause fatigue as a side effect

3. Ask about your sleep, diet, exercise, stress, and alcohol or caffeine use

4. Perform a physical examination including checking your thyroid, listening to your heart and lungs, and looking for signs of anemia or other conditions

5. Order blood tests based on your symptoms and history, which may include complete blood count (CBC), thyroid function tests (TSH, T3, T4), iron studies, vitamin B12 and vitamin D levels, blood sugar (glucose) and hemoglobin A1C, and screening for autoimmune conditions if indicated

Questions to Ask Your Provider About Fatigue

• “What tests do I need to determine the cause of my fatigue?”

• “Could my fatigue be caused by anemia, thyroid problems, or diabetes?”

• “Are any of my medications causing fatigue as a side effect?”

• “What lifestyle changes could improve my energy levels?”

• “When should I expect to feel better after starting treatment?”

Treatment Options Depending on the Cause

Treatment for fatigue depends entirely on the underlying cause:

Support at Serenity Choice Health

At Serenity Choice Health, our women’s primary care providers can help identify the root cause of your constant fatigue and develop a treatment plan tailored to your needs. We offer comprehensive women’s primary care services including annual wellness exams, chronic disease management, and diagnostic testing. We also provide STI STD testing, birth control contraceptive services, and abortion pill treatment. Do you have questions about fatigue or want to schedule an appointment to evaluate your symptoms? Contact our medical team or book a confidential appointment today.