If you can’t seem to shake the sluggishness, you may have one of these medical conditions.

In our busy modern world, a common complaint doctors hear is that their patients are frequently tired. If that’s the case for you, the first step is to look at your lifestyle. Healthy eating should supply you with all the nutrients you need; but if you have a poor diet, the lack of nutrition might have your body scrambling for sources of energy. Exercise can ramp up and strengthen your body’s systems, and it releases feel-good hormones called endorphins, which can give you a boost. But if you are sedentary, overweight or obese, your body might be struggling to function optimally. Finally, good sleep is crucial for your body to rest and repair; not enough of it can leave you drained.

If you’ve addressed all the lifestyle factors you can control and are still dealing with fatigue that doesn’t seem to go away, your tiredness could have a medical cause, including:

Anemia

Iron-deficiency anemia is marked by a lack of iron in the blood, which prevents red blood cells from functioning properly and leads to tiredness. Women who menstruate, especially if they have heavy periods, and pregnant women are particularly at risk, although postmenopausal women] as well as men can have it, too. A simple blood test can measure your iron levels, and supplementation is available over the counter. In addition, you can eat more natural sources of iron including meat and dark green, leafy vegetables to help correct the problem.

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Thyroid disease

Because your thyroid gland controls your metabolism, which in turn affects your energy levels, an underactive thyroid can cause you to feel tired. Called hypothyroidism, it affects mainly women and older adults, and has no cure. Fortunately, though, it’s easily diagnosed with a blood test to measure your level of thyroid hormone. Taking thyroid medication can restore your thyroid to its normal function, although you’ll need to take it for your lifetime.

Diabetes

One of the first signs of diabetes can be tiredness because you aren’t processing and absorbing glucose, which properly fuels your body. Diabetes is a serious health condition that can lead to damage to your eyes, kidneys, nerves and heart, so it’s best to get diagnosed as soon as possible. Blood tests can help identify diabetes, and you can keep it under control through diet, exercise and often medication.

Depression or anxiety

Mental health problems are intimately connected with your entire body and can have physical symptoms as well. With conditions such as depression and anxiety, small tasks can be overwhelming and draining, and this lack of energy may make you feel tired. Medications and counseling can help. But even in people without a mental health condition, stress can lead to fatigue as the body stays on high alert (the “flight or fight” response). In this case, relaxation and stress management techniques such as meditation or yoga may release the energy-zapping tension you feel.

Sleep apnea

Sleep is commonly considered one of the pillars of health, just like diet and exercise. Even if you think you’re getting a full night’s sleep, a condition called obstructive sleep apnea may leave you tired because blockage of breathing in your throat can be waking you up repeatedly during the night. If you think you might have sleep apnea (maybe because your partner says you snore), the next step is a sleep study to determine whether you are suffering from this disorder. Lifestyle changes such as weight loss can help, as can breathing devices like CPAP (continuous positive air pressure) machines or surgery.

According to Eric J. Kezirian, MD, MPH, professor of sleep medicine at the Keck School of Medicine of USC and the director of the USC Center for Sleep Apnea and Snoring Surgery Center at Keck Medicine of USC, “Sleep apnea is a common problem that can affect your health, social relationships and the ability to get restful, refreshing sleep. There are so many people who have sleep apnea but do not know it, and there are also others who have received CPAP to treat their sleep apnea but are not comfortable wearing it through the night. If you think you have sleep apnea or have sleep apnea but cannot tolerate CPAP, visit an otolaryngologist who specializes in sleep.”

Autoimmune disease

There are over 80 types of autoimmune disease, such as rheumatoid arthritis, lupus, multiple sclerosis, Sjogren’s syndrome and celiac disease, in which the body mistakenly attacks its own cells. Unfortunately, autoimmune disease isn’t easy to diagnose. In addition, fibromyalgia and chronic fatigue syndrome, which are not classified as autoimmune diseases but often act like one, are other conditions your doctor may consider in making a diagnosis. Although the reason fatigue is coupled with these conditions is not totally clear, and medications and lifestyle adjustments can help you manage your tiredness while coping with your chronic illness.

Heart disease

You might not associate fatigue with heart disease, but it can be a sign of the condition, especially if you have other symptoms like shortness of breath, dizziness or chest pain. Your heart is working extra hard, and your blood is not flowing to your organs and tissues properly, which leads to tiredness. If you think you might have a problem with your heart, see your doctor immediately, as your condition may be life-threatening.

By Tina Donvito

If you think you may have one of these conditions, make an appointment with one of our specialists at Keck Medicine at USC. If you are in the Los Angeles area, schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting keckmedicine.org/request-an-appointment.