Let’s just start by saying this: you are not lazy.
That foggy, bone-deep exhaustion you feel? That’s not something a strong coffee or a good night’s sleep is going to fix.
Fatigue is one of the most common (and most misunderstood) symptoms I see in clinic. It’s also one of the hardest to explain to other people. It’s not “feeling a bit tired.” It’s struggling to shower, cook, or even concentrate long enough to reply to a message. And it’s rarely about motivation—it’s about biology.
I used to think I knew what fatigue was. I thought I understood what my clients were experiencing when they described feeling exhausted. And to be honest, I probably thought I had a pretty good handle on it. But it turns out—I was wrong.
Since developing POTS (Postural Orthostatic Tachycardia Syndrome), I’ve come to understand fatigue on a whole new level. The kind that isn’t fixed by rest. The kind that makes simple things like standing up, making breakfast, or having a conversation feel like climbing a mountain. It’s been incredibly humbling, and it’s completely changed the way I work with people experiencing fatigue now—because I get it, not just professionally, but personally too.
So today, I want to break this down for you—why you might always feel tired, what could be causing it, and what might actually help.
What Is Fatigue (and What Isn’t It)?
Fatigue is more than tiredness. It’s physical, emotional, and cognitive depletion. It doesn’t resolve with rest, and it often doesn’t have a “reason” that’s easy to see from the outside. It can feel like walking through wet cement, or like your body is a flat phone battery no matter how long you’ve been plugged in.
And here’s something else I’ve noticed—fatigue can play tricks on your mind. When it lingers for days, weeks, or months, it starts to feel like your new normal. You begin second-guessing your own experience. You catch yourself wondering, ‘Am I really fatigued? Or am I just being lazy?’ That internal doubt can be one of the hardest parts. But then—when you have a better day, when the fog lifts even slightly—you remember, ‘Oh. This is what it feels like to have energy’. And you realise it’s never been about laziness. It’s been about your body needing support.
For people living with ongoing symptoms, fatigue is one of the most disruptive—not just because it affects your day-to-day life, but because it’s often dismissed or misunderstood.
Why Am I Always Tired? 5 Common Causes of Fatigue
There isn’t one simple answer—but there are some key physiological processes that help explain why fatigue shows up and stays around. Here are some of the more common root causes I see:
1. Inflammation and Neuroinflammation
Chronic inflammation—present in most chronic conditions and in response to prolonged stress—has been directly linked to fatigue. Inflammatory molecules (called cytokines) can interfere with energy production in your cells and impact brain function, contributing to both physical tiredness and mental fog.
2. Mitochondrial Dysfunction
Think of mitochondria as your body’s energy factories. When chronic illness or ongoing stress affects their function, your body simply can’t produce energy as efficiently. So even if you’ve had enough sleep, your cells aren’t getting the fuel they need.
3. Nutrient Deficiencies
Chronic conditions can impact nutrient absorption or increase the demand for certain vitamins and minerals. Deficiencies in iron, B12, magnesium, and vitamin D are all common (but not the only) culprits when it comes to fatigue. And if you’re dealing with gut issues, you might not be absorbing these nutrients properly—even if your diet is great.
4. Hormonal Imbalances
Your thyroid, adrenal glands and sex hormones all play a role in energy regulation. If any of these are out of balance (which is common in perimenopause, chronic stress, adrenal dysfunction, or autoimmune thyroid conditions), fatigue can show up in a big way.
5. Sleep Disturbances
Poor sleep isn’t just a consequence of fatigue—it can also be a cause. Pain, anxiety, night-time urination, or hormonal changes can all disrupt your ability to get restorative sleep, which then feeds back into the fatigue cycle.
What You’re Feeling Is Real
I want to pause here and just say—if you’ve ever had someone tell you to “push through” or suggest that you’re not doing enough to help yourself… I’m sorry. That’s not helpful, and it’s not true.
You are doing your best with the energy you have. And that counts.
What Might Help When You’re Always Tired
There’s no magic bullet—and if someone tells you there is, they’re probably selling something you don’t need. But there are ways to support your body and gently begin to rebuild energy over time. Here are a few foundational steps I often discuss with clients:
- Reduce inflammation with an anti-inflammatory diet (lots of plants, healthy fats, and minimal processed foods) and targeted supplements.
- Support your mitochondria with nutrients like magnesium, B-vitamins, CoQ10 and iron (if needed).
- Get your nutrient levels tested, especially iron, B12 and vitamin D.
- Prioritise sleep hygiene—create a wind-down routine and aim for a consistent sleep-wake cycle. While sleep doesn’t ‘cure’ fatigue, it can help.
- Pace yourself. This one is so important (and often one of the hardest things to do). Energy management is about recognising your limits and honouring them—not pushing through.
And maybe most importantly?
- Practice self-compassion. Living with fatigue is hard enough without the inner critic making it harder. You are allowed to rest. You are allowed to ask for help. You are allowed to honour your limits.
Final Thoughts
If you’ve been asking yourself, “Why am I always tired?”—please know you’re not alone.
Fatigue is complex, frustrating, and all too real. But it’s also a message. Not a failure. Not a weakness. Just your body’s way of asking for support.
And there are ways to feel better—one gentle, manageable step at a time.
You’re not broken. And you absolutely deserve to feel supported on your healing journey.
Little by little, a little becomes a lot.
“If this post resonated with you, I’d love to hear from you. Feel free to reach out or share this with someone who needs to hear it today.”
