Are you exhausted? Top tips on reviving your va-va-voom 
 

Do you wake up groggy, rely on caffeine and sugar to get you through the day and feel like you’re running on empty? then help is at hand..

Are you repeatedly hitting the snooze button on your alarm clock, drinking coffee all morning, craving sugary treats all afternoon and feeling bloated and constantly shattered? If so, you’re not alone.
Dr Frank Lipman, autor of Revive: End Exhaustion and Feel Great Again, claims a whole generation of overworked women are suffering from ‘exhaustion epidemic’.
“Modern life is burning them out,” says Dr Lipman, who counts Gwyneth Paltrow amongst his clients.
As well as Hollywood stars, Dr Lipman sees many regular women in his New York clinic who are simply worn out by the demands of raising a family, holding down a job and running a home.
“They put everybody else first and their energy levels are paying the price,” he says.
“They grab processed food on the go, they don’t sleep properly, they rarely find time to relax, they have long to-do lists and they’re glued to their mobile phones or laptops.
"All of these things are draining them of energy.”
Here, he reveals why we’re so tired all the time and offers easy advice on becoming slimmer, happier and brimming with energy.

Are you exhausted?

● Do you wake up tired most days, regardless of how much sleep you’ve had?
● Do you need caffeine (i.e. tea or coffee) to get you going in the morning?
● Do you have trouble concentrating and often get distracted during tasks?
● Do you regularly crave something sweet after your meals and in the evening?
● Do you find it hard to unwind at the end of the day?
● Do you tend to suffer from bloating or constipation?
● Do you have trouble falling asleep at night, even though you’ve felt tired all day?
Under his definition, Dr Lipman says that you are exhausted if you answered ‘Yes’ to three or more of these questions.

Do you wake up tired most days?

Sort out your digestion

Before he gets started with new clients, Dr Lipman asks them about their digestion.
“Most of us don’t realise our digestive systems aren’t working properly,” he explains.
“We’ve become so used to mild indigestion, constipation, irritable bowels and bloating that we think it’s normal.
“But it really isn’t normal and if you sort out your digestion, other problems, such as tiredness and sluggishness, will sort themselves out.
“No matter how healthy your food is, if your digestive system isn’t working properly you won’t reap the rewards of all that healthy food, which can lead to a weakened immune system and more tiredness.”
Dr Lipman advises avoiding sugar and alcohol, as both can affect your digestion.
“Most of us eat too quickly and don’t take the time to properly chew our food, which leads to bad digestion and poorly digested food sitting in the gut, which causes bloating,” he says.
He also suggests clients take probiotic and ginseng supplements because both can help improve your digestion.
“You’ll be amazed at the improvement you’ll see in your energy levels when you improve your digestion,” he says.
Try Vitabiotics Ultra Ginkgo & Ginseng (available nationwide, £9.95 for 60 capsules) and Boots Pharmaceuticals Probiotic Multivitamin (£3.49 for 30 capsules).
And the most simple tip of all? “Sit up straight — it really helps your digestion,” he says.

Log off

Switch off your laptop well before bedtime

Dr Lipman believes people who over-use technology risk running out of steam. “In today’s world, many of us literally can’t switch off,” he says.
“We’re glued to our computers during the day, our phones on the way to and from work, and our laptops in the evening.
"Then there’s TV. All of these are stimulants and they can disturb your quality of sleep.”
Dr Lipman advises all his clients to switch off their laptops, TVs and mobile phones an hour — preferably two — before bed.
“Exposure to electromagnetic fields too close to bedtime stops the sleep hormone melatonin from being secreted as you fall asleep, which means you never reach the deep, restorative type of sleep we all need,” he says.
“This type of sleep leaves you feeling fully refreshed after seven or eight hours, plus it keeps your immune system strong.”
Dr Lipman suggests his patients wear an eye mask in bed: “Total darkness helps you fall into a deep restorative sleep.”
"Or invest in blackout blinds for their bedroom. Try a Moulded Blackout Eye Mask from M&S (£5).

Clean out your diet

Dr Lipman believes an overly-processed diet and too much sugar are two of the main culprits of exhaustion.
“You should get back to the most natural and pure foods,” he says.
“As well as avoiding processed foods such as junk food, tinned food and ready meals, don’t buy foods that contain trans fats — they can increase your risk of heart disease and they’re found in some margarines and baked goods like biscuits.”
Refined sugar is a no-no, so avoid cakes, sweets, fizzy drinks and seemingly healthy products like cereal bars, low-fat yoghurts and some sauces (check the label for the sugar content).
“Your body processes sugar rapidly, which is why it gives you an instant burst of energy,” says Dr Lipman.
“Then your blood sugar levels drop so the energy surge vanishes.
"This process causes the body to crave more sugar so you eat more to get another hit of energy. Then a vicious circle begins.”
Dr Lipman says overwhelming your body with sugar puts stress on it, wearing you out and leading to weight gain.
He advises clients to eat wholesome natural foods (such as chicken, fish, vegetables, fruit, nuts, some wholemeal carbs such as brown pasta and rice).

Relax

Dr Lipman believes we must put aside some time to unwind. “Whether it’s breathing before bed or relaxing exercises, taking a bit of time out each day will help calm down a racing mind and leave you feeling  restored and relaxed,” he says.
Before bed, try the following: find a quiet space and sit down (in a chair or on the floor) in a comfortable position. Close your eyes and place your hands in your lap.
Spend five minutes inhaling through your nose and exhaling through your nose.
Or try this neck and shoulder release: Lie on your back with your knees bent and feet hip-width apart.
Place two tennis balls at the top of your shoulder blades, side by side, in the area where you would have a shoulder massage.
Slowly lower your head and shoulders. Place a pillow behind your head if your neck is uncomfortable.
Lift your arms to the ceiling, then move them slowly toward your knees and then toward the wall behind you.

Feeling constantly tired? You're exhausted

Always tired? Feel like you're running on empty? Join the club - increasing numbers of us are suffering from constant fatigue. Jane Feinmann reveals how to tell if there's a medical cause - or if it's just modern life wearing you out 

If you're almost too exhausted to make it to your doctor for a check-up, be consoled: at least you're not alone. More people are tired today than ever before. On any day, one in five of us is feeling unusually fatigued, while one in 10 has persistent low energy, sufficient to undermine quality of life and day-to-day functioning.

It's an epidemic that worries sufferers and frustrates their doctors. "It's a very disabling condition, and it's perhaps not surprising that people come to see us desperately looking for a quick fix for a problem that is ruining their lives," says Dr Sarah Jarvis, a GP in west London.

Yet being tired all the time has been adopted as a bitter shorthand by Britain's doctors, who use the term TATT to describe the condition that they most dread walking through their consulting-room door.

"Unfortunately, nine times out of 10 there's absolutely nothing we can do about it beyond ordering a batch of blood tests to eliminate the usual suspects," says Jarvis, a spokesperson for the Royal College of General Practitioners.

The vast majority of weary people suffer because of the way they choose to live, says Professor Fred Zijlstra of Surrey University. "People work ever-longer hours and then take files home or check their e-mails in the evening. New technology means they're on call 24/7. With double burden of being a working parent, there's a constant feeling of never getting things finished. It's this that can be so tiring."

Even so, fatigue is a symptom in a wide range of physical and psychological problems. If exhaustion is now a way of life, you could be one of the "lucky" ones with a "real", or at least treatable, condition. If not, it may be time to ask yourself some difficult questions.

ANAEMIA

Unusual tiredness is the main symptom of anaemia, a group of disorders in which insufficient red blood cells are produced to carry adequate supplies of oxygen throughout the body.

The most common type is iron deficiency anaemia, normally the result of losing blood faster than the body can make it. Around one in seven menstruating women suffers iron deficiency anaemia. It is also common during pregnancy when there is extra demand for iron.

Two other types are: vitamin B12 deficiency anaemia, which mostly affects vegetarians and vegans (B12 is only found in animal fats, meat, fish, eggs and milk); and folic acid deficiency anaemia, which occurs in pregnancy and as a result of high alcohol consumption or a poor diet, particularly in the elderly.

What to do

A blood test can diagnose anaemia, and doctors will normally recommend supplements along with dietary advice. If your blood count is at the low end of normal, but not anaemic, boosting your iron intake could make you feel better.

CHRONIC FATIGUE SYNDROME

Overwhelming exhaustion, made worse by activity and not helped by rest, could be CFS (or ME, myalgic encephalomyelitis). One in 100 people, usually in their twenties or thirties, is affected, with three times as many women sufferers as men. CFS appears to be triggered by an infection, even a minor one. It can be worsened by stress. Symptoms include muscle pain, sore throat, an inability to start or sustain activity, and finding that any increase in activity requires a prolonged recovery time.

What to do

Take as much information about your symptoms to your GP as possible. Diagnosis is tricky, and frequently involves excluding other conditions. Training in the form of graded exercise can help mild CFS. Cognitive behavioural therapy, along with a supervised lifestyle management programme, is effective in severe cases.

COELIAC DISEASE

Extreme fatigue, with bowel symptoms such as diarrhoea and bloating, can indicate a flare-up of this lifelong inflammatory condition of the small gut in response to gluten, a substance found in wheat, barley and rye. Most commonly diagnosed in people aged 30 to 45, it can come out of the blue or occur in people with a history of stomach upsets. As many as one in 100 people are thought to be affected, and as many as nine out of 10 remain undiagnosed, on some estimates.

What to do

A blood test can pick up antibodies, and the diagnosis can be confirmed by an investigation of the lining of the small bowel, normally carried out at the endoscopy unit of the local hospital. A gluten-free diet can bring real improvement in less than a week.

DEPRESSION

Severe tiredness and loss of energy that persists for most of the day, nearly every day, for more than two weeks is one of the clearest signals of clinical depression. This is suffered by up to one in 10 of the population at any one time. A GP will suspect depression when fatigue is experienced with symptoms such as loss of confidence; inability to enjoy things that are usually pleasurable; a desire to avoid people, including friends; irritability; and feeling like a "waste of space".

What to do

Consult your GP with a list of symptoms and work with him or her to decide the best treatment. This can include psychotherapy or counselling, along with medication.

TYPE 2 DIABETES

Extreme tiredness that develops slowly, with constant thirst, a need to urinate and episodes of thrush, could be type 2 diabetes. People with the disease have problems converting food into energy because the insulin, a hormone that muscle, liver and fat cells use for this, becomes ineffective, often due to obesity. While these cells are starved of energy, blood glucose levels remain high, eventually damaging nerves and blood vessels and leading to serious complications. Type 2 diabetes usually occurs in people over 40, although children as young as seven have been diagnosed. It is three times more common in Asians and West Indians.

What to do

A simple blood test will diagnose the disease and, if picked up at an early stage, changes such as weight loss, a healthy diet and exercise can prevent further deterioration.

GLANDULAR FEVER

Severe fatigue, accompanied by feverish symptoms such aching muscles, loss of appetite and swollen lymph glands in the groin, suggests the "kissing disease". The infection is most common in the teens and early twenties; by their late twenties, most people have developed immunity to the Epstein-Barr virus, which is spread in saliva via kisses, coughs or sneezes. The tiredness frequently persists for weeks or even months after the other symptoms have disappeared.

What to do

Diagnosis by symptoms can be confirmed by a blood test. Antibiotics will not help; rest is the best treatment.

LYME DISEASE

Flu-like symptoms including tiredness could be a sign of this relatively rare tick-borne infection, which can affect walkers and cyclists who fail to tuck their trousers into socks in long grass and heathland in parts of UK.

What to do

Ideally, take the tick with its identifiable bite-mark and surrounding rash to your GP. Otherwise, diagnosis is by exclusion or by a blood test around eight weeks after infection, which can be quickly cleared up with antibiotics.

SLEEP APNOEA

Severe daytime sleepiness is the most obvious symptom of sleep apnoea, where sleep is disrupted by snoring. The disorder, which actually halts breathing, sometimes hundreds of times a night, causes a brief awakening each time as the body senses what is happening and acts to prevent suffocation.

What to do

Diagnosis requires an overnight stay in hospital, although a home test is being developed. Wearing a gumshield and avoiding alcohol after 6pm can reduce snoring. Severe cases are best treated with a pump that blows air gently through the nose. It's cum- bersome, but most sufferers decide to use the machine at home every night, says the Sleep Apnoea Trust.

UNDERACTIVE THYROID (HYPOTHYROIDISM)

Tiredness and excess sleep, with symptoms including constipation, sensitivity to cold and weight gain, may be a sign of an underactive thyroid. This disorder, which is caused by the body failing to produce sufficient thyroxine hormone, thereby slowing the metabolism, is most common in older people, affecting one in 50 women and one in 1,000 men at some time in their lives.

What to do

A risk of developing the condition can be detected with a blood test to measure TSH (thyroid stimulating hormone), which is raised when the thyroid gland is not producing sufficient thyroid hormone. A further test can then measure T4, the actual level of thyroxine. A condition known as sub-clinical hypothyroidism exists when levels of TSH are raised but thyroxine levels are normal. Some doctors decide to offer thyroxine treatment to see if it works: others prefer to wait and see whether the metabolism continues to slow.

Is your life too tiring?

Do you demand too much of yourself?

If yes: try to manage stress; learn to say no; set priorities; pace yourself. Take time each day to simply relax, perhaps using a tape or relaxation class. Consider whether there is a good balance of work and play in your life and what you can do about it. If necessary, you may want to reconsider what you want from life.

Have you been affected recently by a stressful event?

If yes: Be realistic, and be kind to yourself. Events such as moving house, having a baby, starting a new job, being bereaved or ending an important relationship can be exhausting, especially when you feel you have no control over what's happening. Don't expect to be back to your normal self overnight. Remember; all progress is good, however small or unimportant it may seem to you at the time.

Is regular exercise part of your daily life?

If no: Begin to change that. If you are unfit, start with 10 minutes of moderate physical activity each day and build up to at least 30 minutes. "It may seem counter-intuitive, but aerobic exercise is an excellent way to counter fatigue," says Dr Sarah Jarvis.

Is your diet healthy?

If no: try to begin the day with an energy-packed, low-fat, high-fibre breakfast. Reduce the amount of high-fat and high-sugar foods, which will to make you feel sluggish later on. If you are underweight, gradually increase your portion sizes and calorie intake. If you are overweight, focus on eating less (but don't crash-diet) and being more physically active. There's no good evidence that vitamins, minerals, stimulants or fortified wine will help to combat tiredness.

Are you drinking too much?

If yes: cut down on the booze. It acts as a sedative, and even small amounts can make you tired for hours.

Are you sleeping well?

If no: practice good sleep habits. Avoid eating, reading or watching television while in bed. Keep your bedroom cool, dark and quiet, and set the alarm to get up at the same time each day - a routine will help you to establish a regular schedule. Staying in bed all day will not help.