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The best way to identify the cause of this fatigue

This kind of fatigue can creep up on you so slowly, you almost don’t even notice until you feel really awful. And its severity can range from very mild general fatigue to a heaviness in your limbs that makes you just not want to move or do anything. What is it?


Anemia. The most common kinds of anemia are iron deficient anemia, and B12 deficient anemia. And I can say that I have had both at the same time. And it can really make you desperate for nothing to do. Everything feels like a chore. And sleep, the thing you want most when you’re tired can even be a challenge when you’re really iron deficient.

Common symptoms of iron deficiency:

  • Extreme fatigue
  • Weakness
  • Pale skin
  • Chest pain, fast heartbeat or shortness of breath
  • Headache, dizziness or lightheadedness
  • Cold hands and feet
  • Inflammation or soreness of your tongue
  • Brittle nails

More common in women, but it can happen to anyone. The most common cause for women is after a heavy period. And the reason it can sneak up on you so slowly is that every month is an opportunity for it to get worse. The best way to identify it is to have your ferritin checked. I consider optimal ferritin 70-100 ng/ml. You’ve got to stay on top of this if it’s an issue for you. The reason you check the ferritin is that true lab anemia often does not show up unless it’s really severe. And you don’t want to wait that long!

B12 deficient anemia has some similar symptoms:

  • Extreme tiredness
  • A lack of energy
  • Pins and needles
  • A sore and red tongue
  • Mouth ulcers
  • Muscle weakness
  • Problems with your vision
  • Psychological problems, which can range from mild depression or anxiety to confusion and dementia

I consider optimal B12 to be around 900 pg/ml. B12 is commonly deficient in vegetarians, and especially vegans. The deficiency increases over time if not addressed. But you don’t have to be vegan or vegetarian to become deficient. Another common cause is infections or general inflammation. When we have inflammation it’s more difficult for us to absorb nutrients. 

Getting these two markers checked if you are tired needs to be part of your process in figuring out your fatigue. Next time I’ll write about reason number 3 – and if you missed reason number 1, read my blog from last week!