12 Reasons You’re So Tired and How to Bounce Back

When people ask you how you are, how do you respond? Do you say you're fine—or tired?

If you were too exhausted even to answer the question, you're not alone: Fatigue is endemic these days. Here are a dozen potential reasons behind that run-down feeling and how you can re-energize yourself.

1. You're bored.

Boredom happens when parts of your life have created a rut of routine, says clinical psychologist Judith Sills, Ph.D. "There's not enough zap in your brain," she says. Sills, author of The Comfort Trap (Viking, 2004), concedes that humans are creatures of habit, so routines are essential for life. But comforting routines and habits can become deadening. That's when lack of zing can translate into fatigue. There's a loss of energy when you have nothing to stimulate you, she says.

The fix: Do something new, Sills suggests. Even small changes, such as a two-day getaway, can be life-affirming. "There's a clear link between our emotions and the anticipation of satisfaction and physical energy," she says. Changing your routine also helps. Try driving down a different road or eating food you haven't tried before. "When you take in new information, your spirit feels a sense of possibility," says Sills. "It's mind food."

2. You have allergies.

Think of allergies as the body's way of fighting unwanted guests. The trouble starts when allergens, such as pollen, certain foods, or animal dander invade the mucous membranes of the eyes and throat, says Lily Pien, M.D., an allergist at The Cleveland Clinic. This triggers the body's antibodies to fight the invaders, causing a release of histamines. The body's reaction to the allergens is often excessive, leading to sneezing, shortness of breath or itching. "It's these reactions that wear you down, especially when they keep you from sleeping." she says.

The fix: "Don't misdiagnose yourself," says Pien, "Most people are allergic to more than one substance." She advises seeing an allergist and getting a skin test to determine the allergens that may be affecting you. Antihistamines and nasal steroid sprays are both typical treatments, she says, and adds that 20 percent of the U.S. population suffers from allergies.

3. You're over-caffeinated.

It seems like a contradiction, but caffeine, a stimulant to the central nervous system, can actually make you tired, says Cheryl Forberg, a registered dietician and the author of Positively Ageless: a 28-Day Plan for a Younger, Slimmer, Sexier You (Rodale Books, 2008). A once-a-day dose in the morning in tea or coffee is fine, she says. But people can create a vicious cycle when they keep ingesting more caffeine to counteract the exhaustion they feel after the previous dose wears off. And, she adds, the cumulative effects of the day's caffeine—such as increased heart rate and a rise in blood pressure—can also keep you from getting a good night's sleep.

The fix: Consider antioxidant-rich green tea, says Forberg. A cup of green tea contains 50 mg of caffeine, compared to coffee's 137 mg and black tea's 65 mg. Not eating or drinking high-caffeine foods and drink—including dark chocolate and certain soft drinks—from late afternoon on is also a step towards restful sleep. Keeping caffeine to a minimum is the best way to go, she says.

4. You're multi-tasking.

Doing one thing at a time is a luxury for most people. But multi-tasking has its downside. "When you multi-task, you need to switch back and forth from one project to another and monitor all the projects simultaneously," says Neal Roese, Ph.D., a professor of psychology at The University of Illinois at Urbana-Champaign. Multi-tasking is a big drain on glucose, which fuels everything the brain does, he says. Not surprisingly, studies show that too much flitting from one task to another ultimately leads to errors and fatigue. Ingesting sugar may keep you going temporarily, but eventually you crash.

The fix: The trick, says Roese, is to keep your projects down to a minimum; he suggests no more than three at a time. Prioritizing your projects and taking the short frequent breaks that allow glucose levels to be restored are also useful strategies.

5. You're anemic.

People with anemia typically don't have enough red blood cells in their body. And, because these blood cells are the body's transportation system for oxygen, fewer of these cells mean less oxygen makes its way to the cells—including that of the brain. "People whose cells get less oxygen may be less able to concentrate and they may feel less energetic, says Alan Greene, M.D., clinical professor of pediatrics at Stanford University and the author of Raising Baby Green (Jossey-Bass, 2007). The most typical type is iron-deficiency anemia, but loss of blood cells through internal bleeding can also be a cause. He says anemia is especially harmful to children, who need the oxygen to fuel their developing bodies and brains.

The fix: Greene advises taking a blood test. On a complete blood count (CBC) test, a low hematocrit indicates anemia (hematocrit measures what proportion of blood volume is made up of red blood cells). Testing serum ferritin, a measure of the body's iron stores, can detect iron deficiency, which can cause symptoms even before full-blown anemia develops. Eating iron-rich foods like lean meat, poultry and beans can help increase the supply, especially when accompanied by foods high in vitamin C. Greene also suggests women and children take supplements that contain iron. Men should speak with their physicians first before taking iron supplements, as their bodies don't easily excrete any excess, and too much of the mineral can also be a cause of fatigue.

6. You have poor posture.

Standing up straight looks impressive and, it turns out, has health benefits. If you hunch your shoulders forward, don't equally distribute your weight on both feet, or create an inward curve in your lower back, you're setting yourself up for fatigue, says Kathleen Koch, an exercise physiologist at The Cleveland Clinic. That's because it's harder for blood to nourish muscles that are being held in inefficient positions typical of bad posture. "Reduced blood flow means your heart and lungs have to work harder, and this makes you tired," she says. Sitting improperly and even running with poor form has the same effect.

The fix: Koch suggests strength and core training to address poor posture. For example, she says to correct slouched shoulders—a sign that the chest muscles are disproportionately stronger—you need to strengthen the muscles in the upper back. Because poor posture is a good indicator of muscle imbalance, it's important to train all muscle groups equally, she says.

 7. You have an underactive thyroid.

One of the top medical reasons for a slow metabolism and low energy is hypothyroidism, says Nunilo Rubio Jr., M.D., assistant professor of endocrinology at The University of Texas Medical School at Houston. Women are more predisposed to the condition, which is from the thyroid gland's secreting less of its hormones. This, in turn, causes fatigue, as well as weight gain, intolerance to cold, and dry hair and skin. Rubio calls it the "turtle effect." Unfortunately, in most cases, it's the body's own autoimmune response that's to blame. The antibodies involved gradually can damage and, in some cases, destroy the thyroid, a condition known as Hashimoto's thyroiditis. In severe cases, says Rubio, metabolism slows down so dramatically that the patient usually requires an intravenously administered dose of thyroid hormones.

The fix: Rubio suggests those suffering from fatigue ask their physician for a blood workup to determine the level of thyroid- hormone activity. If you're diagnosed as having hypothyroidism, a doctor will typically start thyroid-hormone replacement therapy. Once thyroid-hormone levels are restored, energy usually returns to previous levels. (Although iodine deficiency is often linked to hypothyroidism, most people in the U.S. get adequate amounts by using iodized salt and eating iodine-containing food.)

8. You have undiagnosed heart disease.

A heart that's unable to pump blood efficiently has to work harder to transport oxygen throughout the body. Fatigue is the result, says Nieca Goldberg, M.D., cardiologist and author of Dr. Nieca Goldberg's Complete Guide to Women's Health (Ballantine Books, 2008). Several conditions can cause the heart to overexert itself, including clogged arteries, high blood pressure and heart-valve problems. Typically, fatigue due to undiagnosed cardiovascular condition manifests after exertion.

The fix: If you've ruled out anemia, hypothyroidism and infection, and you still feel tired, it's important to get diagnosed for potential heart problems, says Goldberg. Tests typically include an echocardiogram to see how the blood is pumped through the heart, and a stress test to reveal arterial blockages. Not pinpointing heart disease as early as possible can mean more severe symptoms over time, such as shortness of breath and fluid build-up.

9. You're not exercising enough.

It seems counterintuitive that doing nothing can make you fatigued, but it's true. "If you move, you'll feel less tired," says Dr. Koch of The Cleveland Clinic. When you're sedentary, she says, your metabolic rate decreases and you burn fewer calories, so you feel exhausted. Exercise gets that metabolic rate up, which means more energy, and not only the physical kind. People who say they're tired are often depressed, says Koch. Exercise increases the production of dopamine, a hormone that's a mood enhancer.

The fix: Literally, start with small steps. Koch says that research confirms that even a 10- to 15- minute daily walk provides cardiovascular health benefits But, she advises, don't forget to include strength training in the mix, which helps build lean muscle mass. Overall, increasing your amount of weekly exercise means you'll be able to burn even more calories, she says. And that means even more energy at your disposal.

10. You're dehydrated.

At least half of our bodies and 92 percent of our blood consist of water. "Water serves as a medium for the body to perform its life-sustaining functions, such as regulating body temperature and eliminating waste," says Toby Amidor, a registered dietician in New York City. "If you don't ingest enough water to help these metabolic reactions occur, you'll become tired or lightheaded."

The fix: At the first sign of thirst or dizziness, all you need is a small amount of liquid, as little as half a cup or water or fruit juice, says Amidor. Although many people drink huge quantities of water daily as a matter of course, she says many experts now suggest that people simply heed the body's signals for hydration. The water in fruits and vegetables also count as part of your intake, says Amidor. The caveat, though, is that older people often lose their sense of thirst and need to be reminded to hydrate on a more regular basis. For the rest of us, making sure we have access to water as needed—in portable non-plastic containers—is a good option.

11. You're pre-diabetic.

Glucose supplies energy to the body and brain. It's not surprising that not enough glucose will make you extremely tired. But the same is true when you ingest too much, says Dr. Greene. Normally, the act of eating signals the body to produce insulin which, in turn, fuels the cells with energy. But, says Greene, when you're pre-diabetic, your body can become insulin-resistant—overeating or ingesting too many simple carbs is often a factor. The result is all that excess glucose doesn't get into the cells, but rather it gets stored as fat or spills into the urine, and you grow tired.

The fix: A fasting blood sugar test will determine if you're pre-diabetic, says Greene. If you fall into that category, consider it a wake-up call to change your eating and exercise habits. Greene recommends a Mediterranean-type diet, consisting of whole grains, lots of fruits and vegetables and moderate amounts of healthy fats.

12. You have sleep apnea.

Many people with sleep apnea don't even know they have it, says Michael Breus, Ph.D., a clinical psychologist in private practice whose specialty is sleep disorders. Sleep apnea, which is typically caused by anatomical problems, impels the sleeper to stop breathing, sometimes as many as 150 times an hour. When breathing shuts down, even for only a couple of seconds, there's less oxygen supplied to the brain. The body senses the danger and wakes you to breathe. "In severe cases, this constant waking is comparable to total sleep deprivation," says Breus, who's author of Beauty Sleep: Look Younger, Lose Weight and Feel Great through Better Sleep (Plume, 2007).

The fix: See a medical professional who's certified in sleep medicine or clinical sleep disorders, says Breus. You'll be referred to a sleep center for diagnosis. The most popular form of treatment is a continuous positive airway pressure machine (CPAP), which shoots air through the nasal passages and throat while you're asleep. Other solutions include using nose filters, dental appliances to help correct jaw displacement, or surgery to remove excess throat tissue which tends to accumulate in overweight people. Weight loss may eliminate the condition entirely in some cases, says Breus.

 

Source: Coeli Carr for MSN Health & Fitness

South Beach Diet

 

Definition

The South Beach diet is a three-phase, carbohydrate-restrictive diet. It emphasizes foods that are low on the glycemic index (GI) and low in saturated fat, such as lean meats, vegetables, cheeses, nuts, and eggs. Unlike other carbohydrate-restrictive diets, such as the Atkins and Zone diets, the South Beach diet promotes "good" carbohydrates, such as whole grains and fruit.

Origins

The creator of the South Beach diet, Dr. Arthur Agatston, is considered a leading cardiologist and is the director of the Mount Sinai Cardiac Prevention Center in Miami Beach. Originally, he had intended to design an eating plan to improve the cholesterol and insulin levels of his patients. However, Dr. Agatston soon discovered that his patients also lost weight on his plan. After further research, he approached Marie Almon, R.D., chief clinical dietician at the hospital, to help develop the eating plan into an effective diet. The results became the South Beach diet. Having sold more than a million copies since its publication in April 2003, The South Beach Diet book has remained on the New York Times bestseller list for over a year.

Benefits

The primary benefit of the South Beach diet is considered by many to be its initial rapid and significant weight loss—8–13 lb (4–6 kg) in the first two weeks. After the first two weeks, weight loss continues at a slower rate, averaging 1–2 lb (0.4–1 kg) weekly. In addition to weight loss, the diet reduces cholesterol and insulin levels, thus reducing the risks of diabetes and heart disease. It is claimed that the diet is easy to follow because it is designed to eliminate cravings and has more flexible food options after the first two weeks.

Description

In his book, The South Beach Diet, Dr. Agatston states that "this diet is not low-carb. Nor is it low-fat." Instead, the diet focuses on eating the "good" carbohydrates (fruits, vegetables, and whole grains) and "good" fats (olive oil and nuts) rather than eliminating them from the diet entirely.

Dr. Agatston based the core of his dietary plan around the glycemic index –the increase in blood sugar levels by foods containing carbohydrates during a set amount of time.

After consumption, food is metabolized into sugars and promotes the release of the hormone insulin. When the blood contains excess sugar, insulin removes it from the blood stream by storing it in cells, including fat cells. High-glycemic carbohydrates (greater than 70 GI) are metabolized rapidly, which causes elevated insulin production. High levels of insulin result in more blood sugar being stored as fat, thus causing weight gain. This pattern induces craving for more carbohydrates, thus leading to the consumption of more high-GI foods. Low to moderate-GI foods, however, raise insulin levels more slowly and sugars are metabolized more effectively, thus reducing the amount of blood sugar stored as fat. Cravings for more food is reduced. In addition, by eating these low-GI foods, the risk of insulin resistance that can lead to atherosclerosis and diabetes is reduced. As such, Dr. Agatston designed the South Beach diet to promote foods low on the GI and eliminate the body’s craving for high-GI foods.

The South Beach diet consists of three phases. Phase one is the strictest part of the diet and lasts for two weeks. The purpose of Phase one is to banish the dieter’s cravings for high-GI foods such as bread, rice, potatoes, pasta, and sugar. Alcohol, fruits, cereal, and such vegetables as carrots and corn are also restricted during Phase one. Instead, protein-rich foods are emphasized, such as lean meat, fish, eggs, cheese, nuts, and vegetables. Coffee and tea are also allowed. Three regular-sized meals are eaten each day, supplemented by mid-morning and mid-afternoon snacks as well as dessert. During this period, the body chemistry will change dramatically until cravings for high-GI foods are eliminated and insulin resistance is improved/lowered. In addition, rapid weight loss is typically experienced.

Phase two reintroduces several of the restricted foods and encourages eating from all the dietary food groups, the expected result being that the body will neither crave high-GI foods nor store food as excess fat to the same degree. Such high-fiber carbohydrates as whole-wheat pasta and bread and most fruits are now permitted. Moderation remains the key to success for this phase and low-GI foods are strongly encouraged. Phase two continues until the dieter reaches his or her ideal weight, ideally averaging a loss of one to two pounds per week.

Phase three, the ultimate goal, focuses solely on weight maintenance. Having reached the ideal weight, the dieter now makes the changed eating habits a lifestyle from this point forward. Basic dietary techniques are still maintained. Only the high-GI foods and "bad" fats from the previous two phases continue to be restricted. Altered body chemistry will promote long-term cardiovascular health and reduce the risk of diabetes. Should weight gain occur, Phase one of South Beach diet is reintroduced until the weight goal is achieved.

Preparations

There are no initial preparations required for the South Beach diet. However, as with most diets, it is wise to consult with a physician beforehand. Blood testing for insulin, glucose, and cholesterol levels is suggested. It is strongly recommended that dieters taking medications for medical conditions such as heart disease consult a physician before going on the South Beach diet. Similarly, diabetics on insulin or other medications are advised to have a doctor monitor their blood sugar regularly and determine if they are at risk of kidney impairment while on the diet. It is also recommended that a registered dietitian be consulted to determine the dietary needs of certain medical conditions, such as pregnancy.

Precautions

The South Beach diet is not recommended for people suffering from or at risk of kidney problems. The diet’s high protein content can place increased strain on the kidneys, possibly causing long-term damage as well as kidney stones and bone loss. Additionally, the possibility of ketosis-induced dehydration during Phase one can increase the risk of further kidney impairment. Dehydration occurs when the body experiences water loss with accompanying loss of important blood salts like potassium and sodium. Ketosis occurs when carbohydrates are not available and the body burns an excessive amount of fat, during which some ketones, or fat fragments, are excreted. The restrictive nature of Phase one may also induce mineral and vitamin deficiencies. Remaining in Phase one of the diet for longer than two weeks greatly increases the risk of losing bone and muscle mass. Dieters should remain in Phase one for no longer than three or four weeks.

Some nutrition professionals contend that the South Beach diet menus provided in the book lack important nutritional information and detailed portion sizes as well as specific substitutes for foods the dieter cannot or will not eat. They claim that these aspects, combined with the restrictive nature of the diet, can make sticking with the South Beach diet on a long-term basis difficult for some people. Also, they assert that the diet does not emphasize an exercise regimen and that exercise is vitally important to avoid the loss of muscle and bone mass, especially during Phase one of the diet.

Side Effects

Despite Dr. Agatston’s claims to the contrary, the South Beach diet is both a low carbohydrate and a low fat diet. For this reason, one main concern regarding the diet is the risk of ketosis, especially during Phase one. Ketosis can cause such symptoms as dehydration, dizziness, heart palpitations, fatigue, lightheadedness, and irritability. Hypoglycemia, low blood sugar, headaches, and excessive fluid loss are also commonly associated with this diet. Cramping and tired muscles can be incited by salt depletion. Kidney functions can be impaired, possibly leading to serious health issues. Kidney function can be further impaired by the diet’s high protein requirements. These side effects typically lessen or fade at the beginning of Phase two, when a more balanced diet is undertaken.

Research & General Acceptance

Unlike the majority of low-carbohydrate diets, the medical community generally accepts the South Beach diet. The South Beach diet contains all the major food groups, promotes ingestion of "good" fats for maintaining heart health, and is flexible enough to accommodate most dietary needs.

However, many clinicians and dietitians agree that the rapid initial weight loss results mostly from water loss. Much of this weight can return once the dieter rehydrates.

Another important criticism by medical and nutritional professionals is the lack of evidence to support Dr. Agatston’s claims connecting the consumption of low-GI foods and weight loss. They assert that as of the early 2000s, there is no scientific proof that eating low-GI foods will have any more weight loss effect than eating a normal, calorie-reduced diet that includes carbohydrates; that Dr. Agatston also fails to take into account the interaction of different foods when eaten together, which can dramatically alter glucose metabolism; and that this failure means that utilizing the Glycemic Index as a gauge for what foods to eat is not only confusing but also slightly misleading.