# Chronic Fatigue: Causes and How to Regain Energy

> Chronic fatigue: common causes of persistent weakness, symptoms of anemia and thyroid disorders, which tests to take, and how to restore your energy.

- URL: https://celitel.online/en/blog/hronicheskaya-ustalost/
- Author: Dr. Boris Wydoff — https://celitel.online/en/about/
- Published: 2026-11-13
- Language: en

Chronic fatigue often calls for checking three important causes: **anemia, hypothyroidism, and lack of sleep**. With anemia, the body may not have enough iron to produce hemoglobin properly. With hypothyroidism, the thyroid gland is underactive, while chronic sleep deprivation means the body does not have enough time to recover. In addition, persistent weakness can be linked to diabetes, depression, the aftereffects of infections, stress, medication use, and sleep disorders, including sleep apnea.

If you have been waking up exhausted for weeks, struggling with everyday tasks, and feeling no better after resting, don't simply put it down to age. It's important to understand why the weakness has appeared, look at any accompanying symptoms, and discuss the necessary tests with your doctor. At the same time, it's worth reviewing your sleep habits, diet, and daily activity.

## Why Am I Always Tired, Even When I Don't Seem to Do Anything?

Ordinary tiredness occurs after physical or mental exertion and usually improves with rest. It's different when you wake up already exhausted, struggle with everyday tasks, and still don't feel rested after a full night's sleep. This condition deserves attention, especially if it continues for several weeks.

Chronic fatigue can show up in different ways. Some people complain of constant sleepiness, while others experience a lack of energy, irritability, and difficulty concentrating. Sometimes it becomes hard to read, remember information, hold a conversation, or manage familiar household tasks.

Doctors also recognize myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS). This is a long-term condition that affects different systems in the body. It is characterized by severe exhaustion that does not go away with ordinary rest.

One of the characteristic signs of ME/CFS is feeling worse after physical or mental activity. The effects of exertion can last a long time, sometimes for several weeks. Other possible symptoms include sleep disturbances, muscle and joint pain, headaches, and flu-like feelings.

If you have less energy than before, don't try to make up for it by pushing yourself harder. Write down when the changes began, how much you sleep, which medications you take, and which activities leave you feeling worse. Also note whether your condition deteriorates not immediately, but some time after being active. These observations can help your doctor understand the nature of your symptoms.

## What Could Be Behind Persistent Weakness?

The causes of chronic fatigue are varied. Sometimes a person doesn't get enough sleep, organizes their working day poorly, or lives under constant stress. In other cases, the lack of energy is caused by an illness that cannot be identified on your own.

Three causes are particularly important to check:

- **Anemia.** With iron-deficiency anemia, hemoglobin levels may fall. Possible symptoms include pale skin, shortness of breath, a rapid heartbeat, and low energy.
- **Hypothyroidism.** An underactive thyroid gland can cause weakness, fatigue, and changes in overall well-being. Your doctor may order a TSH test to check thyroid function.
- **Lack of sleep.** Going to bed late, waking frequently, insomnia, and breathing problems during sleep can prevent proper rest. You may wake up tired and feel sleepy during the day.

There are also other common causes:

- **An unbalanced diet.** Not getting enough essential nutrients can be accompanied by reduced energy.
- **Physical inactivity.** A lack of regular physical activity can affect your overall well-being.
- **Prolonged stress.** Constant worry and emotional strain can leave you feeling drained.
- **Depression.** It can be accompanied by low energy, sleep disturbances, and mood changes.
- **Diabetes.** Sometimes excessive thirst, frequent urination, and weight loss occur alongside persistent weakness.
- **Previous infections.** For example, fatigue sometimes lingers after COVID-19 or infectious mononucleosis.
- **Hormonal changes.** In women, these can occur during pregnancy, menopause, and other periods of change in the body.
- **Medications and medical procedures.** Some medications and treatments, including chemotherapy, can cause fatigue.

Sleep apnea deserves special attention. With this condition, breathing is repeatedly interrupted during sleep. A person may snore loudly, wake up feeling as though they are choking, and experience daytime sleepiness.

There is no single universal cause of chronic fatigue. Two people with similar complaints may have completely different underlying problems. That's why you shouldn't start taking iron, vitamins, or other supplements on your own based solely on feeling low on energy.

## How Can You Tell It's More Than Ordinary Overexertion?

Pay attention not only to how intense your fatigue is, but also to how long it lasts, what it feels like, and how it affects your everyday life.

With ordinary overexertion, a person gradually returns to their usual level of activity after resting. But if weakness persists, sleep brings no relief, and your ability to function keeps declining, it's worth looking for an explanation.

When assessing chronic fatigue syndrome, doctors look for several characteristic symptoms:

- severe exhaustion that interferes with ordinary daily activities;
- sleep that leaves you feeling unrefreshed;
- problems with concentration, memory, and thinking;
- a noticeable worsening of symptoms after mental or physical exertion;
- sometimes, muscle and joint pain, headaches, and flu-like symptoms.

Feeling worse after exertion is particularly telling. For example, a person may feel relatively well during a walk but notice a sharp increase in weakness some time later. This is not ordinary post-workout tiredness that you should necessarily try to overcome with another workout. When symptoms follow this pattern, it's important not to force yourself to keep going.

However, this sign alone is not enough to establish a diagnosis. ME/CFS symptoms resemble those of other conditions. There is no single specific test that confirms chronic fatigue syndrome. A doctor makes the diagnosis after assessing your symptoms and medical history, conducting an examination, and ruling out other possible causes of your condition.

## What Do I Recommend for Chronic Fatigue?

Over my years of practice, I've come to believe that people experiencing low energy need to review not only their diet but their entire daily routine. I associate chronic fatigue with a lack of fresh air, movement, and proper sleep, as well as excessive strain on the digestive system.

My approach includes several principles that I recommend putting into practice in everyday life.

**First — don't spend the entire day sitting in a chair in front of a screen.**

I believe that prolonged sitting, sustained eye strain, and stuffy indoor air are particularly unfavorable for the body. In my books, I associate inactivity with poor blood circulation and prolonged screen work with constant strain on the nervous system. In my view, the brain is especially sensitive to a lack of oxygen.

That's why I recommend organizing your working day so that you don't put off movement until the evening. Get up from your desk, walk around the room from time to time, do a few gentle movements, and air out the room. If you feel well enough, make time for a walk at a comfortable pace. Don't turn it into an endurance test: if physical activity causes a significant worsening of symptoms, you need to discuss the appropriate level of activity with your doctor.

**Second — rethink how much sugar and processed food you eat.**

In my books, I associate persistent low energy with excess sugar, white flour, and processed foods. According to my theory, this kind of food places an additional burden on the body's internal environment, and energy that could be used for everyday activities is instead spent processing unsuitable foods.

I recommend gradually simplifying your diet: include more vegetables, leafy greens, and fresh foods, and reduce sweets and products made with white flour. You don't need to change your entire menu in one day. Start by observing what you eat during an ordinary week and pay attention to how many sugary and heavily processed foods you consume.

I favor an approach in which people avoid overloading their digestive system and pay attention to food combinations. In particular, I follow the principle of food combining. In my books, I write that eating protein and carbohydrate foods together places an unnecessary burden on digestion. This is one of the distinctive principles of my approach, not an established medical cause of chronic fatigue.

**Third — maintain a balance between work and rest.**

I believe you cannot keep using up your energy without leaving yourself time to recover. In my practice, I recommend a daily routine that alternates mental work, physical activity, and rest.

In the morning, I suggest starting the day calmly, without rushing, and including some light exercise if your condition allows. In the evening, it's important to leave time for relaxation rather than continuing to work right up until bedtime.

Doctors recommend maintaining a regular sleep schedule and aiming for around 6–9 hours of sleep each night. It's helpful to go to bed and get up at roughly the same time. An hour before bedtime, it's best to put away your smartphone and other screens, dim the lights, and create a peaceful bedroom environment.

My principle is simple: movement should help you stay alert, while rest should give your body a chance to recover. If your condition noticeably worsens after activities, don't increase your workload just to meet an arbitrary target.

**Fourth — pay attention to how your digestive system is working.**

In my books, I place great importance on regular bowel movements and associate problems with intestinal function with general weakness. I consider healthy digestion one of the foundations of good well-being.

That's why I recommend paying attention to regular meals, dietary variety, and changes in digestion. If you develop persistent bowel problems, pain, or other new symptoms, don't limit yourself to changing your menu. Tell your doctor about them.

At the same time, chronic fatigue cannot be explained solely by the condition of your intestines. A medical assessment should take other possible causes into account as well.

## How Do Diet and Lifestyle Affect Your Energy Levels?

Diet and everyday habits really do matter for your overall well-being. However, changing your menu will not automatically resolve anemia, hypothyroidism, diabetes, sleep apnea, or other medical conditions.

To start, it's helpful to take a look at your typical day. Are you getting enough sleep? Does your diet include a variety of foods? Do you spend a lot of time indoors? Do you constantly have to work without breaks? Have you noticed feeling worse after certain activities?

Physical activity should match your condition. If you feel significantly worse after exertion, you shouldn't try to overcome your weakness through willpower alone. If ME/CFS is suspected, it's particularly important to respect your individual energy limits and avoid activities that trigger a worsening of symptoms.

Caffeine, physical exercise, and heavy meals immediately before bedtime can interfere with falling asleep. Alcohol and smoking are also not healthy habits for maintaining your well-being. If you often wake up during the night, pay attention to your sleeping environment and tell your doctor about any possible breathing problems.

In my books, I also emphasize the importance of fresh air, simple food, and a sensible balance between work and rest. These principles can be part of everyday self-care, but they should not replace the search for a medical explanation for prolonged weakness.

## How Can You Learn More About This Topic?

If you'd like to explore the naturopathic approach to nutrition, restoring energy, and organizing everyday life in greater depth, take a look at the [Academy of Natural Healing](/academy/) program. The first stage includes my books, including *The ABCs of Health* and *A Handbook for the Healthy and the Sick*. The second stage covers lectures on nutrition and cleansing, including *The Psychology and Physiology of Nutrition* and *Healing the Digestive System*. The third stage focuses on illnesses and practical methods, followed by seminars and audio recordings. To learn more about fatigue, you can start with the sections on nutrition, rest, and lifestyle in my books.

## When to See a Doctor

**When do you need emergency medical help?**

If you experience sudden pressure or squeezing pain in your chest, shortness of breath, cold sweats, nausea, or severe weakness, especially if the pain spreads to your arm, back, neck, or jaw, call emergency services immediately. Don't wait for the symptoms to pass on their own, and don't try to drive yourself to the hospital. These symptoms may indicate a heart attack, which requires urgent medical attention.

**When should you make a routine appointment?**

Don't put off seeing a doctor if your fatigue has lasted several weeks and you don't understand what's causing it. An examination is particularly important if weakness interferes with your everyday life or is accompanied by other changes in your health.

Other reasons to consult a doctor include:

- unexplained weight loss;
- mood changes;
- excessive thirst and frequent urination;
- shortness of breath, noticeable palpitations, or pale skin;
- loud snoring and episodes of waking up feeling as though you're choking;
- prolonged sleep disturbances;
- problems with memory and concentration;
- feeling worse after physical or mental exertion.

**Which Tests Should You Have for Chronic Fatigue?**

There is no single set of tests that everyone needs. Your doctor will first ask about your symptoms, previous illnesses, medications, and medical history. They will then decide which tests are necessary in your particular case.

To begin investigating the causes of weakness, you can discuss the following laboratory tests with your doctor:

- **Complete blood count (CBC).** This helps assess blood parameters and identify signs of anemia. Special fasting is usually not required for this test, but you should follow your laboratory's instructions.
- **Ferritin.** This shows how much iron your body has stored. The result is assessed alongside your complete blood count and other tests as recommended by your doctor. You should not start taking iron supplements on your own before the cause has been established.
- **TSH (thyroid-stimulating hormone).** This is used to assess thyroid function and check for possible hypothyroidism. Your doctor will decide whether additional tests are needed.
- **Fasting blood glucose.** This helps check for problems with carbohydrate metabolism, including possible diabetes. For this test, blood is taken after a period of fasting, usually at least eight hours. Check the exact preparation instructions with your laboratory.

This is not a mandatory list for everyone, nor is it a way to diagnose yourself. Your doctor may select only some of these tests or expand the examination to include urine tests and other investigations, depending on your symptoms.

Before having your tests, check the preparation requirements with the laboratory. Don't stop taking prescribed medication on your own. Tell your doctor about all the medications and supplements you use, as this may matter when interpreting the results.

If chronic fatigue syndrome is suspected, the diagnosis is based on the combination of symptoms and made after other conditions have been ruled out. No single laboratory result is sufficient to confirm this syndrome.

**How Is Chronic Fatigue Treated?**

The treatment approach depends on the underlying cause. If a medical condition is identified, treatment is directed at that condition. For ME/CFS, approaches may include energy management, cognitive behavioral therapy, and medications to control individual symptoms, such as pain and sleep disturbances.

For ordinary fatigue, your doctor may recommend improving your sleep, making lifestyle changes, and using psychological support. If the cause cannot be established on your own, a specialist will refer you for further examinations.

Don't stop taking prescribed medications on your own or replace medical care with diets, vegetable juices, or other natural methods.

You can read more about how I approach this topic on the [Youth and Longevity](/health/dolgoletie/) page.

## From the Editors

This article is based on the books of Boris Wydoff and medical reference materials about chronic fatigue, its symptoms, possible causes, and evaluation. The doctor's views reflect his naturopathic approach, are not proven medical recommendations, and do not replace consultation with a physician.

Medical information: [NHS (UK National Health Service)](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/), [NHS (UK National Health Service)](https://www.nhs.uk/conditions/tiredness-and-fatigue/).

## FAQ

**Q: Why do I feel tired all the time?**
A: Possible causes include lack of sleep, anemia, hypothyroidism, stress, an unbalanced diet, previous infections, medications, or other medical conditions. If weakness persists for several weeks, it's worth seeing a doctor to find out what's causing it.

**Q: What are the symptoms of chronic fatigue?**
A: Common symptoms include persistent weakness, not feeling rested after sleep, and difficulty with memory and concentration. With chronic fatigue syndrome, symptoms may worsen after physical or mental activity.

**Q: Chronic fatigue — what should I do when I have no energy?**
A: Don't try to make up for your lack of energy with excessive exercise. Review your sleep, diet, and daily activities. If your symptoms continue for several weeks, see a doctor.

**Q: Which tests should I have if I feel sleepy all the time?**
A: Your doctor may order a complete blood count, ferritin, TSH, and fasting blood glucose. Preparation depends on the test: for glucose, you usually need to fast for at least eight hours. Your doctor will determine the final list.

**Q: What is my body lacking if I'm constantly tired?**
A: Sometimes low energy is linked to anemia or an unbalanced diet, but a lack of nutrients is not always the cause. It's important to check other possible explanations, including sleep disorders and thyroid problems.

**Q: What should I drink for chronic fatigue?**
A: Choose drinks that suit you and help maintain your usual fluid intake. Freshly squeezed vegetable juices can be part of your diet, but there is no proven evidence that they treat chronic fatigue. They do not replace medical evaluation or prescribed treatment.

**Q: Can I get rid of chronic fatigue by changing my diet?**
A: Diet can be part of supporting your health, but the results depend on what's causing your symptoms. If your weakness is due to anemia, hypothyroidism, diabetes, or another medical condition, changing your diet alone will not be enough.

**Q: How is chronic fatigue different from ordinary overexertion?**
A: Ordinary tiredness usually improves with rest. With prolonged exhaustion, sleep may bring no relief, and everyday activities become much more difficult. ME/CFS is also characterized by a worsening of symptoms after activity.


_Educational content; it does not replace medical advice._