Dear Dr. Mo: I feel tired and my legs feel tired and not just in the morning but sometimes during the day and in the evening. What could be causing me to feel low like that?
Dear reader: Feeling tired, sleepy and lacking energy is called fatigue and all these symptoms are our body’s response to something we call Low Energy State.
Weakness is usually one of the first symptoms of any medical condition (as 90% of them are tied to Low Energy State) and it should not be ignored. Together with shortness of breath these two are the most common first presentation of majority of illnesses.
If weakness/fatigue doesn’t go away after enough sleep, good nutrition and reduced stress a doctor should check it out.
Tiredness in legs can commonly be just a result of too much walking, standing or running but if it doesn’t go away or keeps coming back even without excessive physical exertion then you may be in a Low Energy State for some reason that you should discover and correct asap.
Now, a whole variety of reasons exist that result in Low Energy State, which then goes on to cause weakness, fatigue and more specifically, tired legs among other symptoms. These can include:
Lifestyle reasons – feelings of fatigue are most commonly caused by (before we jump to illnesses) sleep deprivation and other sleep disorders (like apnea), overwork (or working in shifts), sedentary behavior (lack of exercise) or unhealthy habits (like smoking, alcohol consumption, drug abuse, skipping meals and inappropriate dieting);
Medical reasons – unrelenting weakness may signal an underlying illness, such as a thyroid dysfunction (hypothyroidism), heart disease, diabetes, cancer, anemia, infection etc. All these deprive us of energy for cells’ functioning and cause exhaustion and fatigue;
Emotional reasons (worry and stress) – fatigue is a common symptom of mental health problems, such as grief and depression, burnout at work and chronic anxiety and may be accompanied by other signs and symptoms, including irritability and lack of motivation. Note that all these too drive us into a Low Energy State in which our bodily needs for energy are unmet.
Of course, these 3 categories can and often do work in combination and diagnosis can be difficult at first.
To understand how a Low Energy State relates to an illness, which then causes us to feel weak just think of Diabetes for instance: in it, cells cannot get the glucose they need for energy because of either lack of or resistance to Insulin. No glucose – no energy – no cellular processes. First thing that happens is cellular swelling and that’s why you’ll sometimes notice that feet (and possibly other parts of the body) are swollen (this happens across the board, not just in Diabetes). The first symptom of Diabetes is always weakness and the first sign is shortness of breath (again, the two indicators of Low Energy State) – all the other signs and symptoms you hear about come later..
Most other diseases too deprive cells of nutrients needed for energy and the same mechanism takes place. Take Hypothyroidism as another example, lack of Thyroid hormones affects metabolic rate, cellular development, heat generation etc. tuning it all down and driving us into a Low Energy State and the rest is the same: weakness, fatigue, shortness of breath etc.
It is important to understand that our legs do get tired often but, if this is persistent and doesn’t go away after lifestyle modifications and especially if it’s coupled with shortness of breath, some underlying problem is causing a Low Energy State, which warrants our attention and a visit to a doctor – many of the causes are both treatable and preventable or at least manageable.
Yours in health,