“I’m Exhausted” — How to Investigate When You Have No Energy (An Open Thread)

exhausted-no-energySomething I hear more and more these days is that people are exhausted and have no energy.  You can say what you want about information overload, device mania, etc — to say nothing for those of us with small kids, where it’s generally accepted that exhaustion is par for the course — but the fact is that for some people, there are actually things that medicine can do to help.  But even when you admit to yourself that it’s time to seek help, there are a million different routes to go down — and for friends I’ve seen seek help, it seems like doctors often need to be convinced there’s a medically-related problem. I thought it might be helpful to have a discussion for those of you who’ve gone down the huge topic that is energy and exhaustion — what did you research, what tests did you take, what doctors did you see?  Did you find resolution? How did you function at work and in life in the meantime?

For example, I know any of these could be possible answers to a constant exhaustion:

  • thyroid
  • vitamin imbalance (possibly related to genetic issues like MTHFR mutations)
  • depression
  • cancer
  • sleep apnea / other sleep problems
  • food intolerance
  • hormone problem/ peri-menopause
  • autoimmune disease

I’ve had many friends go to their doctor as a first step who ran their bloodwork (which hopefully can cross things like thyroid/cancer off the list) — but if the bloodwork comes back normal, for many doctors the inquiry ends there and friends are left to pursue their own answers and educate themselves, sometimes at great expense when things like sleep clinics and private genetic testing get into the mix. Even if you do eventually find the right “answer,” it can take a while to get used to the solution, whether it’s a new drug, a cocktail of drugs, or even just a CPAP machine or whatnot (for those with sleep apnea).

So I’m curious, ladies — have you sought help for low energy/exhaustion? How did you know you didn’t just need more coffee or sleep?  What resources were helpful to you when you began your research and started to digest this huge topic? More importantly, once you found “the answer,” how long until you felt better?  

Pictured: Morning coffee, originally uploaded to Flickr by Vesselin Dochkov

Psst: in case it’s helpful, here’s our last discussion on how to nap at the office, as well as our discussion on how to deal with hormone/mood problems.


  1. Marshmallow :

    This happened to me towards the end of high school. I had recurring colds and bronchitis and was always tired, but a few months after finishing up antibiotics for one illness I’d be sick with something else. Finally my doctor ran blood tests, and I tested positive for both mono and Fifths’ Disease. Fifths causes rashes in kids, but in adults can cause low immunity and extreme exhaustion. It was a bizarre result and we still don’t know how I got it, but once we cleared it up my health improved markedly.

    • I had Fifths Disease as a child. Had totally forgotten about that. It was mostly a strange rash on my face, if I recall correctly. Such a strange disease.

    • Awful Velocipedestrienne :

      I got mono at age 29, a bad case that took months to recover from. It took four months to get diagnosed, because neither the doctor nor I were expecting someone my age to get it.

  2. Another possiblity is walking pneumonia. I had it for months and was tired, tired, tired, and depressed, too. Once I got the right diagnosis and antibx, it was light night and day.

    • LIKE night and day.

      • Anonymous :

        If you’re suffering any kind of pain with the exhaustion, it is worth speaking to your doctor, and possibly to a rheumatologist. After my daughter was born, I had extreme exhaustion (no kidding), but I kept waiting for it to get better and it never did (even after she was sleeping through the night) — _and_ I had significant aching in my muscles and tendons. It turns out that the pregnancy knocked both my thyroid levels and my immune system for a loop (fibromyalgia), but once we sorted that out and began treatment, I improved rapidly. I just offer that in case anyone out there reads this and thinks “Hey, that sounds familiar!”

  3. Anonymous :

    Sorry for threadjack… but am seeking some oddly specific fashion advice from those less color-impaired than I am, and couldn’t find anyone writing about this situation anywhere else on the internet.

    I had podiatric surgery last week and am in a soft cast with my toes sticking out. Planning to go back into the office on crutches later this week. What color polish should I use to distract from slight to moderate bruising in the toe area? I’m normally fair-skinned but my toes are kind of a dull purple right now, and would not be surprised if they turn greenish at some point in the future. Not pretty.

    So I’m just looking to make the bruise color not appear as severe and make my toes slightly less gross. Office is business casual; any solid color would be fine. Something darker than the bruise? Navy (sort of the same color family but darker)? Coral-red or cherry-red (opposite color family)? I’m at a loss…


    • I used a bright cherry pinky-red when I was in a walking cast. No one could see them, but *I* felt better about minimizing the ick factor around my bruised, swollen, painful foot.

    • twinkletoes :

      I’d stay away from reds since it will probably make redness in your foot more obvious. How about a metallic, perhaps gold or chrome? Sally Hansen’s “Gilty Pleasure” might be nice (I went looking for Gilty Pleasure and ended up with a very nice gold metallic from Essie, but can’t remember the name.)

    • Blue Family :

      My skin is pretty ruddy. To stand out against my coloring, I recommend a dark blue / dark turquiose / navy / very dark teal. Also the old Chanel Vamp color (also Essie Wicked). You need high contrast with something dark or different than red.

    • I have to disagree with the suggestions to go for blues/metallic/greens. You said your foot is in that color family, and I think adding to it will make your foot look more necrotic. If the goal is to make it look like you are actually healthy and this is something that is going to heal, I’d go with a red. Then it will look like you are taking care of your feet and making an effort to pretty up what is a temporary issue.

    • Aunt Jamesina :

      I think your best bet is giving yourself a pedicure so that your feet and toes appear as neat, moisturized, and clean as possible, and either leave them bare or going for a very light natural shade that gives a bit of sheen. Any added color is just going to attract more attention to your feet. I agree that blues/greens/metallics might just add more to the bruised effect, but while red might balance it out, it also draws attention to your toes.

    • chilled coyote :

      You should totally paint your toes a color that makes you happy, but I would also recommend putting a sock on for wearing to the office. When my foot was in a soft cast, the toes felt very exposed without some kind of sock-like covering. Helps prevent cold / cover up swelling and discoloration. Feel better soon!

    • Anonymous :

      Wow, thank you all! Lots of good ideas :) maybe I will even decide I feel like changing out the color as the bruise changes color…

  4. Sydney Bristow :

    The times in my life that I’ve been most exhausted were when I had mono or when I was severely depressed. Mono was easily diagnosed with a blood test after my strep test came back negative. The depression was diagnosed and treated once I finally reached out for help.

    My doctor wants to test me for sleep apnea but when I was in last they had run out of the take home kits. She didn’t seem super concerned though and didn’t ask me to come back to get one later so I’ll bring it up the next time I’m in. I do have risk factors (overweight and heavy snoring) and I do always feel like I need more sleep. I’m just not sure whether it’s from my schedule (7-7.5 hours a night during the week). I sleep 10ish hours a night most weekends and often take a nap as well. I’m not walking around feeling exhausted, I just never feel like I really got a restful nights sleep.

    • I need to get more sleep also, b/c I am on call 24/7, between my MACBOOK AIR, my IPAD and My Iphone, I can NOT get away from work. It is no wonder I am tired, and have NO husband to go food shopping or cook for me, either! DOUBEL FOOEY! Once I get MARRIED, I will retire from work PERMANENTLEY!!! YAY!!!!

    • I would follow up on it sooner rather than later. I got tested in the fall of 2015 and now use a CPAP. It made a world of difference. I felt like I could never get enough sleep as well.

    • I had to wait 3 months to get in to the sleep specialist. Just did the home sleep study and hoping to get the C-Pap. I am tired much of the time and snore terribly. I am starting to slur words and having memory lapse at times. Am so afraid I fall asleep sometimes and don’t know it. Can’t wait to get this resolved!

  5. Anonymous :

    My biggest problem is insomnia that gets worse when I’m stressed! If I can get 8 hours, I feel great, but that only happens once in a while, usually I’m stuck working with 5-6 hours.

    • This + a few other things for me. I have been a long-time sufferer of depression and anxiety and even when properly medicated, the only time I do not feel exhausted is when I get the appropriate amount of sleep for me (at LEAST 7 uninterrupted hours, although 8 is best), am exercising regularly, and am eating properly.

  6. Fashion threadjack: I’m looking for ivory tights or leggings that look like knitted lace or crochet, with an open weave. Googling/Amazon gets me either boot socks or legwarmers, or the ONE pair of Ivory Hue sweatertights that I’ve found in person. What search terms should I be using and/or can anyone recommend some?

    It’s for my wedding in, er, two weeks where I’ll be wearing a green dress and knee high brown boots. I didn’t get them in advance because it seemed like they were everywhere this winter, right up until I started looking for them.


    • N.C. anon :

      Urban Outfitters tends to have a lot of knitted/crochet tights and socks. Try their accessories section.

    • Anonymous :

      American Apparel usually has a wide selection of tights. e.g.

    • stickyrice :

      Sock Dreams has some promising options:

  7. I’ve never needed treatment but I generally need 9 hours of sleep/night to feel well rested. I get about 7.5-8 on most weekdays, which I know a lot of people would love to have, but I still feel tired with that. It’s frustrating because I feel like people don’t take me seriously when I say I am too tired to wake up early, i.e., to work out. Yes, others may function fine on 6-7 hours of sleep but I just don’t and I don’t know how to ‘fix’ that. I’m thinking about TTC in the next year or so and I’m a little bit terrified (ok a lot terrified) of the exhaustion of children considering what I’m like now.

    • Anonymous :

      I’m the same way. Being honest with myself about how much sleep I need and being strict about bedtimes really makes me feel better rested, happier and more productive. I can get by on 6-7 hours but I’m much happier with at least 9 hours.

    • Anonymous :

      I’m in the same boat. I really need 9 hours of sleep to feel “normal.” I’ve been like that my whole life. I’m also terrified about TTC for this reason. The pregnancy exhaustion actually scares me the most, since I don’t plan to work full-time when I have young kids and DH can’t help out when the baby is still inside me.

    • Yes I have to get 8-9 hours or I feel sick, am unfocused, and very irritable. About to have a baby so really excited to see how I handle the sleep deprivation.

    • Anonymous :

      I am also someone who generally needs 8-9 hours a night and was worried about what this would mean when I had kids. I now have an almost 3-year-old who isn’t a great sleeper. I’m not going to lie – it has been difficult, as he still wakes up once a night most of the times (sometimes sleeps through the night and sometimes up two times a night). I have just accepted that I am going to feel very tired all the time. My husband often wakes up with our son on the weekends and I get an extra hour or two. But, this has simply become the new normal for me. The one thing I’ll say is that you shouldn’t underestimate the power of being a mom and what you can get through. I never thought I’d be able to survive on less sleep. But, especially when my guy was little, I just thought to myself every time I woke up with him “I am proving to him how much I love him.” Take it one day at a time and try not think “I’m not going to sleep for 2 years.”

    • This is funny, since I CAN get 6-7 hours to feel rested and I’m pregnant to I need more like 8 now. My DH b*itches on all weekends because now that I need 8 hours, he can’t have them because someone has to get up with our daughter. He really does need 8-9 hours or he’s a bear so I have to weigh my tiredness vs dealing with him. He really does mean well but drives me nuts when I’m pregnant!!!

    • I seriously could have written this.

      I havent tried a sleep study or sleep apnea test though so I might try those…

    • Anon Sleeper :

      +1 for needing more sleep than a lot of other people. So jealous of (and annoyed with) the people who can feel great on 6 or 7 hours :(

    • Same here, I need 7.5-9 hours of sleep to feel fully rested. I do get up early most mornings to work out, but I’m in bed by 8:30 or 9 if that’s the case so I can get enough sleep. I feel like I have plenty of energy when I’m up, so it doesn’t concern me to be honest. And I generally have no trouble getting in enough hours of sleep, I don’t have kids and don’t generally need to work long hours.

      My hats are off to parents, I don’t know how y’all do it all.

  8. I’ve had low energy at various points throughout my life. Lots of bloodwork for iron deficiency and thyroid problems that have always returned normal. A few things that I think have helped:

    1. My husband and I have been TTC and I think taking prenatal vitamins has correlated with greater energy.
    2. Also related to TTC, I cut back on caffeine a great deal. Now I drink about one cup a day, half-caff. My tolerance for caffeine is a lot lower, which lets me indulge in something full strength when I need a pick-me-up.
    3. Exercise.

  9. anonymeows :

    For some time last year I was very tired — like falling-asleep-in-the-middle-of-the-day tired — and I asked my OB/Gyn about it at my annual exam. She said that if the blood tests didn’t show anything, a sleep study might be a good idea, but luckily I didn’t have to do that. The blood tests showed that I had low vitamin D (which had happened the previous year) and low iron. She told me to take iron pills and prescription-strength (50,000 IU!) vitamin D once a week for five weeks. Yay for no more falling asleep in the middle of the day and waking up wondering what happened! It’s also good to have your doctor check your thyroid — not just TSH but T3 and free T4 (and maybe more — I’m not an expert!). I think a lot of doctors dismiss women’s complaints about being tired.

    • Vitamin D makes a huge difference for me. At one point my doctor told me my level was basically zero. A course of Vit D got me back on track and now it is the first thing I turn to when I feel run down.

  10. Anonymous :

    When I started a new birth control, I was taking it in the morning and by about 7 pm I was So.Fricking.Tired. And then got depressed because I didn’t want to do anything when I got home from work. I started taking the in the evening, just before going to bed and I stopped being tired (and stopped being nauseous in the morning, as well as ravenously hungry around lunch).

    So, consider new medications you are taking (or not taking).

  11. Anonymous :

    I have an autoimmune disease (celiac) that has caused extremely low iron (that is what twigged them to check for it).
    Extremely low iron is exhausting.

  12. Diana Barry :

    2 things – (1) thyroid and (2) vitamin D. I don’t need any less sleep, but I do feel less tired now!

  13. I have been trying to solve this “exhaustion” puzzle for the last 5 months! I spent February-November of last year under extreme stress at work. Even after returning to a normal 40 hour work week, I never recovered. Along with exhaustion, I find myself running a low grade fever and experiencing body aches after “overdoing it” on the weekend or at work. I was first tested for a slew of things including, EBV, CMV, Lyme Disease, Celiac, etc. When these things came back negative, my GP tested for thyroid and autoimmune diseases/inflammation before shrugging her shoulders and calling me “healthy.” Only recently did I get any semblance of an answer when I visited an endocrinologist: my cortisol levels are double what is considered normal! I’ve been taking magnesium and vitamin D supplements and they’ve improved my energy levels quite a bit but I still never feel 100%. I have an appointment with a naturopath next week and I’m hoping she will be willing to work with me to find a solution! I’ve realized it’s important to advocate for yourself in these situations. It seems that oftentimes when the answer is not obvious and the symptoms are ambiguous (like exhaustion), even well-meaning doctors can be dismissive.

    • Google “adrenal fatigue.” Sounds like that’s what’s going on with the period of high stress and now the high cortisol that won’t subside.

  14. I was treated for “sleep dilution” by a sleep doctor. Essentially, I was trying to hard to sleep. I never felt rested. I spent a lot of time in bed trying to fall asleep, would awake during the night, and wake up too early. I thought I needed at least 8 hours a night, and maybe more. The doctor gave me a worksheet to fill out for every night. I stayed up later, but went to bed at the same time, and got up at the same time, every day. We eventually we determined that I really needed 6.5 – 7 hours of sleep. So this came down to a matter of sleep hygiene. It was really a surprise to me. The best part is, anyone can try this at home without going to the sleep doctor.

  15. Anonymous :

    My dad was diagnosed with sleep apnea at 55, and he said the breathing machine he uses at night changed his life. It went undiagnosed for most of his life and he Dias the night he got the mask was the first time he woke up feeling rested in over 25 years. he’d always assumed his tiredness was from working long hours with a long commute and only 5-6 hours of sleep, or chasing 3 crazy kids on the weekend , or whatever-never thought he wasn’t sleeping properly!

  16. After becoming pregnant for the first time, I experienced extreme exhaustion and a total inability to regulate my body temperature (to the tune of teeth chattering and uncontrollable, full body shivering at times when anybody else would have maybe felt mildly cold). I was barely able to get to work and stay awake through the day, and once I got home I couldn’t do much besides get in bed with a pile of blankets on top of me. It was severe enough that I wasn’t able to cook or do much else to take care of myself – I think I survived on cold cereal and bananas for the first two months of the pregnancy. Eventually, based on standard pregnancy bloodwork, my doctor diagnosed hypothyroidism (likely exacerbated by the pregnancy, but probably present beforehand), prescribed synthroid – a synthetic replacement for the hormone my thyroid was failing to produce – and sent me to an endocrinologist. I felt better within a week and probably back to relatively normal within a month. I feel really lucky that my doctor identified the problem early – I had no idea that what was happening wasn’t a normal part of early pregnancy and in the midst of a severe disorder like that, it’s often hard to identify how sick you really are.

  17. Meg Murry :

    I went through this after my 2nd son was born and never really got a clear answer despite running a billion medical tests. A few of my hormone levels were low, a few vitamin levels were low but no obvious red flags.

    Basically, I have just adjusted to this level of fogginess and exhaustion being my “new normal” and I’ve scaled back my expectations for myself. When I’m having a good week and remember to take all my vitamins and med, get enough sleep, eat a relatively healthy diet and get some exercise, I almost feel back to “normal” – but still never back to the great I used to feel when younger. As soon as any one thing starts starts to slip though, it’s a giant domino effect and the only thing I can do is take some time off to “reset” – either by taking vacation or sick days to catch up on sleep, or to call in the Grandma calvary to help with the kids over a weekend so I can try to dig myself out of the hole, whether that be sleep deficit, lack of healthy grocery options/meal planning, lack of exercise, etc. Luckily my husband has a flexible schedule and my current job has lots of vacation time.

    I know part of it is simply that I’m just not 22 anymore and never will be again, but I’m still not convinced that I’ve hit on exactly what is going on with me – but I’ve also determined that there may not be a simple medical answer. Another huge part of it for me is probably that I just plain need to lose weight but that is a huge struggle for me and always has been – even on weight watchers or other strict diets weight comes off me suuuuuper slowly. The last ditch option suggested by my endocrinologist is to look at the weight loss drugs approved by the FDA in the past few years (Qsymia is one he recommended a the time, I know there are others now) – but my insurance doesn’t cover them, so that would potentially be thousands of dollars of medical expenses out of pocket.

  18. I come from a family of chronically exhausted women. Some family members have mild to moderate hypothyroidism. I have been tested up one side and down the next – my thyroid is normal and I do not have any antibodies. Vitamin D insufficiency was noted and treated, but did not have a significant effect. I am not at my ideal weight, but I’m not obese either and I regularly work out. Ultimately, I did a multiphasic sleep latency test, and my doctor confirmed I have idiopathic hypersomnia (aka, excessive daytime sleepiness for reasons that doctors do not understand). Not narcolepsy though. I was given an RX for Nuvigil, and after sucking up the mother of all headaches when I started taking it the first four days, I finally have the energy of a normal person without having to drink 7 venti red eyes a day to stay awake even after 8-9h of sleep. I hate having to take a pill everyday to feel normal, but I am just so grateful to actually feel normal that it is totally worth it.

    • I know what you mean – I have mild narcolepsy (with virtually no cataplexy, thankfully) diagnosed as an adult, and I do not like having to take tablets to stay awake, but it’s much better than being the exhausted mess I was before.

      Note for everyone: be specific with your doctors! My narcolepsy took ages to diagnose because I said I felt tired a lot, rather than the precise situation, which is that I was falling asleep all the time, as in ‘only matchsticks would have kept my eyes open’. We were all very frustrated!

  19. Chronic Hives :

    I have chronic hives and I am always exhausted before, during, and after a flare-up.

    I have started to clean up my diet: tons of veggies and healthy foods. I had 3 doctors recommend a plant based diet (vegan) so I stopped eating meat, dairy, and eggs. I was never a real fan of meat and I had to limit my portions because I would feel sick so it was easy for me to do. I feel a lot less tired, have an easier time falling asleep and don’t get the post-meal blahs.

    YMMV, of course.

  20. I have a triple whammy of ailments woohoo!
    1) Multiple sclerosis
    2) Low vitamin D (my doctor asked me “are you a hermit?” after seeing my really low D levels. And he wasn’t kidding.)
    3) Low iron

  21. A complete blood work up showed a type of anemia. I can’t recall the name, but essentially my red blood cells are too big and not very good at their job. A potential cause is insufficient B12 or folate. My folic acid numbers were OK, so my GP suggested I try B12 supplements. They have definitely helped. My allergies have improved, too, to the point of no longer needing Claritin year-round.

    In researching why I might have trouble absorbing B12 (I eat plenty of red meat), I read about some connection with gluten sensitivity, so I dropped most gluten from my diet (since I’m not actually celiac, it isn’t life-or-death). I have had to add magnesium, as the B12 was giving me Charlie Horses and twitchy muscles.

    Running a few miles a few times a week helps, too. I was never a big fan of exercise, but once I had to do a Girls On the Run 5K (and did the C25K program), I was hooked. I now feel sluggish when weather or health keep me from running for very long.

    Getting 7-8 hours a night is still the elusive goal, but I am doing better with the B12.

    • Huh, that’s interesting! I might try these B-12 and magnesium supplements! Thanks for your story :)

  22. A new mattress helped a lot. I realized several years ago that I was tired and achy at 9:30am. We decided to get a new mattress. It took a couple of months for me to feel better.

  23. Reading all of these comments is really insightful and validating as I have been fighting fatigue since high school!! It all started with depression when I was 16: I would come home from school and just go straight to bed until the next day. I would actually lay my head down in class and sleep! Even through college, I would bring coffee to class and still fight off sleep. When I was 19, I was diagnosed with an autoimmune disease (I was sleeping 18 hrs/day!), but doctors don’t know which one really, they recommended a dairy free, gluten free diet with regular exercise… Also, I’ve been anemic as long as I can remember. Fast forward many years, I’m now almost 28, gluten free, dairy free, regular strength and cardio exercise, same size/weight range as high school, same bed time/wake up time everyday (including weekends) and I still fight sleep in my graduate classes! I just cannot figure it out. I’ve tried it all: paleo diet, no sugar, no caffeine, no alcohol, morning exercise, evening exercise, exercise right before class… People actually make fun of me for it, but I’m honestly worried about the impression it makes when I’m in any situation where I just sit and passively absorb information. Also, it really sucks to be so exhausted all of a sudden and not having my brain all the way ‘on’. I do all the obvious stuff to stay awake: write notes, shake my foot (as annoying as that is), pinch myself, talk a lot in class discussion, ask questions…I just cannot stay awake. Do any of you ladies have an answer? Or a recommendation? Or have the same problem? Oh, and I live in a very sunny environment, so Vitamin D is not an issue. I always get my thyroid checked at the OBGYN and it’s always fine.

    • One of my friends was recently diagnosed with a sleep disorder similar to narcolepsy. Have you ever gotten a sleep study done?

  24. I *had* an endocrinologist. I kept complaining about my exhaustion. He kept telling me I was just depressed.

    It was so irritating to be like, “No, I’m happy. I’m frustrated because I have to time waking up so that I can go out for three hours with my girlfriends because I know that after three hours I’ll be near collapsing.”

    Every woman in my family was already on synthroid, but he didn’t want to put me on it.

    After loads of arguments and unhappy appointments, I was eventually put on a very low-dose of levothyroxine. It did nothing. It was eventually raised to a still low dose. It still did nothing. It was raised again. Two weeks later, I woke up like a normal human being. Literally like none of it had ever happened. Six years later and that’s never happened to me again! Plus, I have a much better endocrinologist.

    Some doctors consider a TSH of under five to be normal. I actually had a doctor tell me, “Well, yeah, it’s not normal for a healthy person, but for someone with hypothyroidism, it’s great!” If I’m already taking medicine for it, shouldn’t I be trying to reach a normal range for normal people?

    I couldn’t get out of bed until my TSH was controlled and under 1. Unfortunately, there are a lot of bad doctors out there. You have to be your own advocate.

  25. Can I add a suggestion for people to get not just their D tested, but their B-12 as well? If you are deficient in B12, you will need shots or supplements (I take Cerefolin with a prescription because I could never get my shots on the right timeframe) and you made need them forever. If you take a PPI, I’m even stronger in my recommendation.

    B-12 is key to our central nervous system, and brain fog / cognition issues are early signs.

  26. I take some medicine that makes me tired, even though I take it at night so that the worst of the side effects happen while I’m sleeping anyway. I’ve recently started taking Brewer’s Yeast to help with energy and have found that to be quite helpful!

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