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Why Am I Always Tired?
Here’s What Could Be Behind Your Constant Exhaustion
Feeling constantly tired despite a full night’s sleep? You’re not alone. Many young professionals struggle with persistent fatigue that interferes with productivity, focus, and overall quality of life. As a medical doctor, I often see patients in their 20s and 30s who wonder if their tiredness is “normal” or a sign of something deeper. The truth is, fatigue can stem from a wide range of causes—some benign, others more serious. Here's what you need to know.
1. Lifestyle Factors:
The Common (and Overlooked) Culprits
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Sleep Deprivation & Poor Sleep Hygiene
Working late, scrolling late into the night, or sleeping irregular hours can all lead to inadequate rest. Even mild, ongoing sleep deprivation has a cumulative effect on mental clarity and physical energy.​
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Poor Diet & Nutrient Deficiencies
Skipping meals, eating mostly processed foods, or following restrictive diets may result in low iron, B12, magnesium, or vitamin D—which are all linked to fatigue.​
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Sedentary Lifestyle
Ironically, being inactive can make you feel more exhausted. Regular physical activity boosts baseline energy levels also improve sleep quality, circulation, and overall stress regulation.
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​Dehydration
Even mild dehydration can lead to lethargy, poor concentration, and mood changes.
2. Psychological Causes
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Stress & Burnout
High-pressure jobs, strict deadlines, and long working hours without proper recovery can lead to mental exhaustion or burnout. This can feel like physical fatigue, even when sleep is adequate.
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Anxiety & Depression
Mood disorders often present with fatigue as a major symptom. Anxiety can disrupt sleep, and depression may lower motivation, energy, and overall vitality.
3. Medical Conditions That Can Cause Fatigue
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Anemia
Low iron levels (especially in young women), B12 deficiency, or chronic disease-related anemia can all lead to low energy and brain fog.
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Thyroid Disorders
Hypothyroidism is a common, often underdiagnosed cause of fatigue in young adults. Symptoms include tiredness, cold intolerance, weight gain, and dry skin.
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Diabetes and Blood Sugar Imbalance
Both high and low blood sugar can cause tiredness. Early type 2 diabetes or insulin resistance often flies under the radar in younger people.
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Sleep Disorders
Conditions like insomnia, obstructive sleep apnea, and restless leg syndrome are frequently missed in young adults, especially if they're fit or slim. Additionally, individuals with jaw structure anomalies or nasal obstructions may be affected. These can all severely disrupt restful sleep.
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Infections (Acute or Chronic)
Post-viral syndromes (including long COVID), mononucleosis, hepatitis, or even undiagnosed Lyme disease can leave even young people feeling drained.
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Autoimmune Diseases
Lupus, rheumatoid arthritis, and other autoimmune conditions often begin in young adulthood and include fatigue as an early symptom.
4. Hormonal Imbalances
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“Adrenal Fatigue”? Not Exactly.
Although “adrenal fatigue” isn’t recognized as a formal diagnosis, dysregulation in adrenal hormones can lead to symptoms like fatigue, low stress tolerance, and mood changes—especially in those under chronic stress.
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Sex Hormone Imbalances
Low testosterone in men, or estrogen/progesterone imbalance in women (e.g., PCOS, perimenopause), can lead to tiredness and lack of motivation.
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Chronic Inflammation & Gut Health
Not necessarily a hormonal issue, but emerging evidence suggests that gut microbiome imbalance or low-grade chronic inflammation (e.g., from IBS or food sensitivities) may also contribute to fatigue.
5. Other Factors
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Substance Use
Recreational substances including alcohol an cannabis can all contribute to drowsiness or disrupt sleep architecture.
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Medications
Antihistamines, over the counter sleep medications, among others, may also contribute to fatigue.
When to See a Doctor
If your fatigue persists for more than 2–4 weeks, affects your functioning, or is accompanied by other symptoms like weight changes, night sweats, mood swings, or brain fog, it’s worth seeking a medical evaluation. A simple workup including blood tests, a sleep assessment, a lifestyle and mental health review can often uncover the cause, and help you feel better faster.
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Ultimately, fatigue is not a one-size-fits-all symptom. As a doctor, I encourage you not to dismiss your tiredness as “just stress” or “part of adulthood/getting older.” Your body might be signaling something important. The good news? Most causes of fatigue are identifiable and treatable.
