10 diseases that make you tired

Many people are tired and they don't know why. The YOU Pulse team looks at 10 diseases that could make you feel this way.

In 20%-30% of people who feel tired, the cause is a disease of some sort. If you're overly tired, and getting more and more so, it could be that you're suffering from something. And if you feel too weak to go for a walk, go to work, take a bath or get dressed, it may be serious.

1. Depression and melancholy
   One in 10 people suffers from depression at some stage; and depression is a common cause of tiredness. An imbalance in neurotransmitters such as serotonin may cause fatigue, apathy, a fuzzy feeling in the head and headache.
2. Anaemia
   Low iron levels or insufficient red blood cells mean the blood carries much less oxygen; and if the brain, muscles and other tissue don’t get enough oxygen, you will feel tired, especially if you walk or do anything that requires physical effort.
3. Rheumatoid arthritis and other connective tissue (autoimmune) diseases
   In these diseases the body forms antibodies against healthy tissue and causes damage. The attack on the immune system drains the body of energy. Diseases include lupus erythematosus and keratodermia (hardening of the skin).
4. Thyroid problems
   The thyroid secretes hormones that determine the pace of your metabolism. If your thyroid hormone level is too low your metabolism will be slow. You’ll feel tired, your skin and hair will be dry and dull, you may gain weight because your body is slow at burning kilojoules, your feet may swell and your heartbeat may be slower. You may be so exhausted that you become depressed. Up to 10% of women and a slightly lower proportion of men suffer from thyroid problems.
5. Diabetes and insulin resistance
   Whether you suffer from type 1 diabetes (where the body produces no insulin and insulin injections are imperative) or type 2 (where the insulin becomes increasingly inefficient, as often happens when people are overweight), your cells don’t get enough energy to function. Even slight exertion may cause diabetics to feel exhausted.
6. Blood pressure problems
   Both high and low blood pressure may cause fatigue. Some blood pressure tablets cause fatigue as a side effect. Fatigue is also an important symptom of some kidney problems, such as renal failure, that lead to high blood pressure and anaemia, either of which can make you feel tired. Low blood pressure often causes dizziness and apathy.
7. Diseases with fever and infection
   Most infections leave you feeling weak and tired, especially when they go hand in hand with fever. If the disease also affects vital organs such as the lungs, bone marrow or heart muscle, the fatigue may be even worse. Examples of such diseases are endocarditis, myocarditis, asymptomatic pneumonia (especially in older people), HIV (as a result of weight loss, diarrhoea, lung infections and anaemia), tuberculosis and hepatitis.
8. Sleep apnoea and other ear, nose and throat problems
   A chronically blocked nose (as a result of allergies), sinusitis, enlarged tonsils and sleep apnoea may disrupt sleep and reduce the oxygen supply to the body. Eventually you’re perpetually sleepy, exhausted and irritable. Sleep apnoea is caused by a soft, fl accid palate that relaxes during sleep, thereby blocking the air passages. Although you wake up and change position as soon as the body’s carbon dioxide levels become too high, you are mostly unaware of this. Often the only symptom is loud snoring during deep sleep. Some people may wake up as often as 30 times a night.
9. Heart disease
   Fatigue may also be the first sign of cardiac failure, arrhythmia, vascular diseases and a heart attack. According to researchers at Harvard University, 71% of women complain of fatigue a month before a heart attack and 43% during a heart attack. The most important symptom of a heart attack in diabetics is severe shortness of breath and fatigue, not pain.
10. Coeliac disease is a chronic malabsorption disease caused by gluten intolerance. Gluten is present in wheat and rye and to a lesser extent in barley and oats products. Malabsorption of B vitamins in particular can lead to anaemia and fatigue.

Symptoms you should not ignore
Some symptoms combined with the sudden onset of fatigue may indicate serious disease. Alarm bells should start ringing when you experience:

• Chest pain, shortness of breath, dizziness, muscular weakness or suicidal thoughts. These may indicate a heart attack, stroke or an imminent suicide attempt respectively. See a doctor immediately. Shortness of breath, especially when you lie down or during exercise, may indicate cardiac disease such as cardiac failure, as well as lung diseases such as emphysema or asthma.
   
• Sudden unexplained weight loss may indicate cancer, thyroid problems, diabetes or chronic infection.
   
• Fever and night sweats may indicate serious infections such as tuberculosis, HIV, Malta fever or endocarditis.
   
• A pale or yellow skin or yellow eyes could be symptoms of anaemia or hepatitis.
   
• Excessive urinating may indicate diabetes, chronic renal failure or other problems.
   
• Other symptoms such as double or blurred vision, swollen glands in the neck, the armpits and the groin, severe persistent stomachache, a rash on the cheeks, subcutaneal haemorrhage, lack of feeling in the skin, muscular weakness and balance problems also require medical attention.

(Health24, February 2009)

This is an edited extract from an article originally published in the launch edition of YOU Pulse magazine in September 2007. Buy the latest copy, on newsstands now, for more fascinating stories from the world of health and wellness.