Fatigue

Fatigue can cause a wide range of symptoms. These might include: 

• feeling tired or sleepy all the time
• headache
• poor concentration
• slow reflexes
• blurry vision
• impaired judgement and difficulty making decisions
• feeling moody or irritable
• clumsiness or poor hand-eye coordination
• muscle pain
• feeling weak
• loss of appetite
• low motivation or general lack of interest
• seeing things that aren’t there (hallucinations).

Many different things can cause fatigue. These can be medical, lifestyle-related, workplace-related and/or emotional.

Medical causes of fatigue

Fatigue can be a symptom of many medical conditions including: 

• flu
• COVID-19 and long COVID
• glandular fever
• myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
• coeliac disease
• heart disease
• diabetes
• thyroid disorders
• anaemia
• pregnancy
• going through menopause
• pain
• multiple sclerosis
• cancer or cancer treatment
• medication or a combination of medicines
• having a disturbed sleep pattern, eg, sleep apnoea, getting up in the night with an overactive bladder or prostate issue

Lifestyle causes of fatigue

Lifestyle causes can include:

• drinking too much alcohol or taking drugs
• poor sleep hygiene (external link)(eg, going to bed at irregular hours, too much noise or light)
• too much caffeine
• lack of exercise
• poor diet (eg, junk food)

Work related causes of fatigue

These could be:

• shift work (read more about sleep and shift work)
• poor workplace practices or environment (eg, long hours, hard physical labour, unsuitable environment)
• workplace stress, bullying, conflict or job insecurity
• unemployment.

Image credit: Canva

Emotional causes of fatigue

Emotional causes of fatigue are common. It’s not unusual to feel fatigued if you’re experiencing:

• anxiety
• grief or emotional shock
• stress 
• depression.

The good news is there are practical things you can do to boost your energy levels and manage tiredness. However, if you have ongoing fatigue that isn’t improved with rest and sleep or is interfering with your life, talk to your healthcare provider. See ‘When should I see my healthcare provider?’ below.

Here are some tips that may help:

• Eat well – read more about healthy eating basics
• Get moving – read more about how physical activity can improve your life
• Lose weight to gain energy – read more about weight loss
• Manage stress – this page has some ways to reduce stress, including videos.
• Balance rest and activity.
• Cut out caffeine – learn more about the effects of caffeine.
• Cut back on or quit alcohol and/or drugs. Read more about alcohol, including alcohol and mental health, alcohol and harmful drinking and addiction.
• Drink more water – learn more about the benefits of water.

Talking to whānau or an understanding friend can often help if you’re experiencing fatigue or tiredness – they might offer support, eg looking after your tamariki, or picking up your groceries. You might also find it helpful to join a support group and talk with others who are experiencing fatigue.

Healthify's Te Kete Haerenga and fatigue toolkit has some advice and worksheets you may find helpful.

Apps reviewed by Healthify

You may find it useful to look at some Nutrition, exercise and weight management apps, Sleep and snoring apps, and Mental health and wellbeing apps.

Fatigue is a common symptom of COVID-19 infection. While you’re recovering, it can continue for weeks to months after the infection has cleared. Learn more about long COVID.

Helpful tips for managing COVID-related tiredness and fatigue

There’s no clear reason why some people feel more fatigued or tired than others. Different things contribute to the tiredness and make it last a long time. For example, a disturbed daily routine, poor sleep patterns, carer responsibilities, low mood, anxiety and stress can all make your fatigue worse.

While there's no one solution to fit everyone's needs, here are some general tips that you can use to manage fatigue.

Pace yourself and plan your activities

Pacing is an important strategy to help you to work within the limits of your fatigue. Overdoing it can make you feel more exhausted. You should develop an activity plan that is flexible depending on how you are feeling that day. Stay within your current ability, and slowly progress your activity levels as you feel able to do so.

Try to think about when you feel most fatigued; this might be in the afternoon or in the morning. Plan your tasks around your tiredness, and break up tasks throughout the week. For example, instead of cleaning the house in one day, do one room or part of that room each day. Take as many rest periods as you need throughout the day to recharge. If you're too tired to continue, that’s OK. Take a rest and try again tomorrow.

Prioritise your activities

Think about what activities are important to you. Focus on doing these, and consider asking somebody for help, or doing other tasks at a different time of the day.

Let others help you

It's OK to ask for help and allow others to help. Things like caring for children, shopping, preparing meals, or driving may be difficult. Accept offers of support and let people know what they can help you with. Services that can help with activities, such as shopping or cooking, may also be useful while you are still recovering.

Return to exercise slowly and safely

See returning to physical activity and exercise after COVID-19 for some tips on returning to exercise and improving your strength and fitness.

Image credit: Canva

If you have long COVID (lasting more than 12 weeks) the long COVID page has information about how to get support (link).

See your healthcare provider if you have fatigue plus any of the following symptoms:

• Weight change (loss or gain).
• Ongoing fevers.
• Heavy periods.
• Black tarry stools (poo) or blood in your stool.
• A change in bowel habits.
• Trouble staying awake during the day.
• Hair loss.
• Extreme thirst.
• Any other symptoms concerning you.

These may be signs of an underlying medical problem. Your healthcare provider might do tests (eg, blood tests, urine tests) and other investigations to check for signs of illness or disease.

Other healthcare professionals like a physiotherapist, mental health professional or occupational therapist might be able to help.