Tired all the time? Think about this, before you see a Doctor

Ok so I'm new to this, but I feel like I want to start by saying THIS IS NOT MEDICAL ADVICE. If you think you are sick, make an appointment to see your GP.

Now that's out the way, and no-one can sue me, I wanted to write this little piece as I honestly think it'll be helpful. TATT (tired all the time) is a common reason patients will come and see me and the reason I feel comfortable writing this piece with such a sensational headline is because most of the time, doctors are not the best people to figure out why you are TATT. And by TATT I mean, TATT as your only symptom. No weight loss, no night sweats, no constant severe pain, no fevers, no change in bowel habit etc. As a junior doctor I used to struggle with these consultations because in order to understand why someone may be TATT you need to ask very basic questions that I thought weren't the remit of a super scientific academic :

"did you eat well today, did you sleep well last night? are you happy? do you suffer from anxiety? do you work shifts? are you working too much? are you not working enough? do you do things for fun?  what's your caffeine intake? what's your alcohol intake? do you smoke? do you regularly exercise? do you exercise too much? do you get enough sunlight? have you had a recent mild self limiting cold/ illness"

Often patients expecting a full body scan and blood tests may be disappointed by this line of seemingly simplistic questioning (some even offended that the answer would be so simple)  

The truth is 99% of the time (I've made this stat up so don't sue me), the answer lies in this arena and not in some esoteric diagnosis. The issue is, you really need to analyse each of these areas in forensic detail. It takes time, way more than the 10 (or 15 if you are lucky!) minutes you have with an NHS GP to identify the patterns that are driving how you feel, which is why it's easier to default to medical investigations (also the fear of getting sued for missing the tiny fraction of illness that presents non specifically). The recent blood bottle shortage sharply brings into focus an additional reason why targeted medical investigation is a better approach than "checking for everything" - but this is a big topic for another day perhaps. (There are also even more compelling reasons I would like to add, but again, another time).

There is one exception to this rule that I would like to highlight and that is if you are having heavy periods. If you are experiencing heavy periods (and it's remarkable the amount of people who bleed heavily and just get on with things) there is every chance you may be anaemic, in which case definitely please go and see a doctor!  

Keeping a diary is really useful, when trying to think off the top of your head if you really ate right, if you slept right etc. it's often easy to omit the times you did do something that would actively promote tiredness (especially if you have convinced yourself you have a disease). Keeping a diary for a couple of weeks, noting all of the above, and correlating it with your energy levels will be revealing, and even if it's not, it's a good asset to have if your tiredness persists and you do end up having to consult a doctor. The above list of questions is not exhaustive, and you may be able to come up with some questions for yourself that are unique to your life - that may be be affecting your energy levels.

Feeling tired is often a normal body response and there isn't a simple "tonic" you can take to combat it. As much as the supplement industry would love to take your money there is still very little evidence that taking an expensive combination of multivitamins is beneficial (Vitamin D excluded). A healthy balanced diet will provide you with all the nutrition you need and again, doctors aren't the best source of information on this. Additionally in our always on society now, with our constant "grind to 5" mentality many people are burning out. Social media presents everything in a warped best light and this can be draining. It was the inspiration for my song "Do Less", a song that many people found helpful and a concept we are embracing more as a society

Take the signal your body is giving you and really delve deep into your day to day and more often than not you will find the key to restoring your energy levels.