Why am I tired all the time? Nutritional causes worth checking.
If you have ever typed "why do I feel tired and fatigued all the time" into a search bar, please know you are in very good company. Tiredness is one of the most common reasons women come to see me, and it is rarely as simple as "I just need an early night".
The good news is that there is often a lot we can look at first. Blood sugar balance, iron, thyroid health, hormone shifts and long-term stress can all have a big influence on how energetic you feel, and many of them can be explored through simple food and lifestyle habits and standard GP blood tests.
This article is general information, not medical advice, and it cannot tell you what is behind your own tiredness. Think of it as a guide to the questions worth asking.
First, what kind of tired are you?
When someone says "I am so tired all the time, why?", the pattern matters just as much as the feeling. Which of these sounds most like you?
Waking up unrefreshed. You sleep (or at least you are in bed for long enough) but you wake feeling as though you have not rested at all.
Hitting the wall mid-afternoon. You are fine until about 2 or 3pm, then your focus fades and you are reaching for something sugary or another coffee.
Running on fumes. You have been busy, stretched and "coping" for months or even years, and now you feel completely drained.
Wired but tired. You are exhausted all day, then suddenly alert at 10pm when you should be winding down.
Many of us are a mixture of two or three. Noticing your pattern gives you useful clues, and it is something I always ask about in clinic.
Blood sugar balance: the energy rollercoaster
One of the first things I look at with tired clients is how steady their energy is across the day.
When meals are built mainly around refined carbohydrates, such as a breakfast of toast or cereal, a sandwich at your desk, or a biscuit with your tea, blood sugar can rise quickly and then fall just as fast. That dip is often felt as a crash in energy, a foggy head, irritability or a sudden craving for something sweet.
Things that tend to support steadier energy include:
Eating a proper breakfast that includes protein, rather than skipping it or relying on coffee alone
Pairing carbohydrates with protein, healthy fats and fibre rather than eating them on their own
Not leaving very long gaps between meals if you notice you crash when you do
Having a balanced plate at lunch, so the afternoon does not become a battle
These are simple changes, but for many women they make a noticeable difference within a few weeks.
Iron and other nutrients your energy relies on
Your body needs a good supply of certain nutrients to make energy, and iron is a big one. It helps carry oxygen around the body, so low levels can leave you feeling flat, breathless on stairs, pale or unusually cold.
Women can be more vulnerable to low iron for a number of reasons, including heavy or long periods, pregnancy and the postnatal months, and eating little or no red meat. Other nutrients, including B vitamins and vitamin D, also play a part in how energetic you feel.
From a food point of view, iron-rich foods include red meat, poultry, eggs, lentils, beans, pumpkin seeds and dark leafy greens. Having vitamin C-rich foods alongside plant-based sources, such as peppers with your lentils, can help your body absorb more.
Iron is not something to guess at, though. If you suspect your levels might be low, it is well worth asking your GP about checking them first.
Thyroid health
Your thyroid acts a bit like a thermostat for your metabolism, so when it is not working as it should, tiredness is often one of the first things people notice. Other things that may show up alongside it include feeling cold, changes in weight, dry skin, thinning hair and low mood.
Thyroid concerns are more common in women, and they often become more noticeable around times of hormonal change such as the postnatal period and perimenopause.
I cannot diagnose a thyroid problem, and nor would I try. What I can say is that if several of these signs sound familiar, it is a very good reason to ask your GP about thyroid blood tests. From a nutritional point of view, I can then support you with eating well for your thyroid, including getting enough protein and a variety of whole foods.
Female hormones and energy
Hormones and energy are closely linked. Fluctuations in oestrogen and progesterone can affect your sleep, your blood sugar response, your mood and, of course, how much get-up-and-go you have.
You might notice your tiredness is worse:
In the week or so before your period
During or after heavy periods
In the months after having a baby
During perimenopause, when sleep can become broken and energy can feel unpredictable, sometimes years before periods change
If your tiredness seems to follow a pattern like this, make a note of it. Tracking your symptoms alongside your cycle for a couple of months can give you something very concrete to take to a health professional, and helps me tailor food and lifestyle support to you.
Stress, cortisol and feeling drained
If you have been running on stress for a long time, it can feel as though your battery simply will not recharge. Cortisol is one of your body's main stress hormones, and it normally follows a daily rhythm: higher in the morning to help you get going, and lower in the evening so you can wind down.
When life is demanding for long periods, with work pressure, family responsibilities, poor sleep and little time to switch off, many people feel that rhythm is out of step. That might look like struggling to get up, flagging in the afternoon and then feeling wired at night.
Cortisol testing is available and can help provide answers for some people. You can read more about how it works on my cortisol testing page. However, I always say there is plenty that can be explored first through standard GP blood tests, and through nutrition and lifestyle habits. Testing is not the first step for everyone.
Simple changes to start this week
If you are hoping for a quick fix, I understand. Many of the women I work with cannot afford to slow down, and they want small changes that fit into a busy life. While there is no magic switch, these are good places to begin:
Eat breakfast with protein. Eggs, Greek yoghurt with nuts and seeds, or porridge with nut butter will keep you going longer than something sugary.
Build balanced meals. Aim for protein, colourful vegetables, some healthy fats and slow-release carbohydrates at most meals.
Have a lighter touch with caffeine. Try having your last cup before midday and notice what happens to your afternoon and your sleep.
Drink enough water. Even mild dehydration can leave you feeling sluggish.
Get outside in the morning. Natural daylight helps to set your body clock.
Protect your wind-down time. Dim the lights, put the phone down earlier and give yourself a gentle bedtime routine.
Move in a way that restores you. A brisk walk often does more for energy than a punishing workout when you are already depleted.
Give changes like these a few weeks before judging how they are working, and try not to change everything at once.
When tiredness needs a closer look
I would love to promise that a few tweaks to your diet will sort everything out, but I would not be doing my job if I did. Persistent tiredness deserves proper attention, and it is not something to simply push through.
Please speak to your GP if your tiredness is severe, has lasted for weeks without improving, is getting worse, or comes with other symptoms that worry you, such as unexplained weight change, very heavy bleeding, dizziness or shortness of breath. A GP can arrange appropriate tests and check for causes that sit outside my area of practice.
Where I come in is helping you build the food and lifestyle foundations alongside that, so your body has the best possible support.
Ready to get to the bottom of your tiredness?
If you are tired of being tired, you do not have to work it out alone. In an energy and fatigue consultation, we will look closely at your symptoms, your eating patterns, your stress load, your sleep and your cycle, and build a practical plan that fits the life you actually have.
Book an energy & fatigue consultation and let's start getting your energy back.
Put yourself back on the priority list. x
This article is for general information only and does not replace advice from your GP or another healthcare professional.
