What Causes Tiredness & Fatigue? – Part 2


In the first of this 2-part discussion (which can be found here), we learnt about general conditions and diseases that cause tiredness. In terms of specific organs or systems, what causes tiredness / fatigue? This is what we are going to explore in this second part.

Kindly note: these articles on tiredness and fatigue are for information and guidance. They cannot replace the thorough assessment of a Healthcare professional.

Tiredness and fatigue can be symptoms of serious underlying conditions. It is therefore strongly recommended that you visit your nearest or routine Health centre for workup and management.

At this point, let us present items that can be acquired online. They help to treat or even prevent specified causes of tiredness. These are items that every person should have readily available, or be able to acquire easily, e.g. by clicking on the links.

DISCLOSURE: This post contains affiliate link(s). An affiliate link means the Author may earn a small commission if you make a purchase through such a link. This is at no cost to You, Esteemed Reader. Read full Disclosure Statement


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The heart and connected blood vessels are one of most important systems in our bodies. It is through this cardiovascular system that blood, the carrier of nutrients and oxygen as discussed in the first article, is transported throughout the body. It is therefore understandable that cardiovascular disease can cause tiredness and fatigue.

Many cardiovascular disorders can cause tiredness and fatigue. But here we will only discuss three of the commonest:

  • heart failure
  • hypertension
  • ischaemic heart disease

In heart failure, the heart’s pumping mechanism for various reasons becomes too weak. The heart muscles lose strength and conditioning. The heart enlarges and its output to the body drops, causing symptoms including tiredness and fatigue.

Heart failure is a very common condition worldwide, because it has many causative factors. It is a fatal condition, often preceded by very poor quality of life. Please beware tiredness of new onset, with or without other symptoms of heart failure such as shortness of breath and leg swelling.

Hypertension is an increased circulating blood pressure. It is in the majority of cases, asymptomatic (a silent disease). But it does have among its symptoms, fatigue.

Please have your blood pressure checked as part of the investigations, if you have unexplained tiredness. This could save you from irreversible end-organ damage or decreased longevity. Hypertension is also one of the commonest causes of heart failure.

Ischaemic heart disease (IHD) is caused by Coronary Artery Disease (CAD), which includes blockage. Coronary arteries are small blood vessels that supply the heart muscles with blood.

The manifestations of IHD are angina chest pain, and “heart attacks” (myocardial infarction). But there are variations, and fatigue may be one of the symptoms, or the only symptom of IHD. Furthermore, IHD causes heart failure, and with heart failure, tiredness and fatigue are much more common.


Kidney disease in general can cause tiredness and fatigue. But more likely to do that, and more troublesome, is chronic kidney diseases. This is because longstanding (chronic) kidney disease has several mechanisms by which it can cause tiredness and fatigue, mechanisms which will be explained.

Kidney disease may reveal itself with changes in the urine, such as frothiness, redness, burning urine, or urinating at night (the most reliable sign). But kidney disease may manifest just with onset of unexplained tiredness and lassitude. Easy and cheap tests such as urine dipsticks, urine microscopy and levels of impurities in the blood, can quickly tell it if you have kidney disease.

In established kidney disease, impurities that are filtered by the kidneys, urea and creatinine, build up in the blood. These impurities, with or without accompanying fluid overload, cause tiredness and fatigue.

Also, in chronic kidney disease, the kidneys lose their ability to manufacture erythropoietin. Thus, there is little or no hormone to stimulate red blood cell production. This causes anaemia and tiredness. 


Oh yes, allergies do cause tiredness! This applies not only to generalised allergic conditions, but also allergies that affect specific organs. Localised allergies include allergic bronchitis, allergic rhinitis (nose), allergic dermatitis (skin), and allergic conjunctivitis (eyes).

Allergic reactions involve the setting into motion of multiple cellular elements and immune mediators. As this all-out war happens in the body, it uses up a lot of energy, and may even generate heat and cause a fever. This causes tiredness and fatigue among other symptoms.

Another important point to bring out, is the fact that the immune system is closely tied with the central nervous system. So when the immune system functions in the aberrant manner that is allergy, it impacts on the central nervous system, causing tiredness, various pains and aches, and depressed mood.


There are many diseases of the abdominal organs that can cause tiredness and fatigue. We will discuss some of the commonest conditions. They can be diseases of the stomach and bowels (GIT), or of the liver and biliary channels.

Celiac disease or celiac sprue is a chronic and quite debilitating condition of the small intestines. It is an allergic reaction to gluten, a component of wheat and related grains. This gluten sensitivity has among its symptoms, fatigue.

But celiac disease also causes other conditions which can secondarily cause fatigue. These include diarrhoea, malabsorption and anaemia.

Successful treatment (not cure) if celiac sprue using a strict gluten free diet and medication, can help reverse the fatigue and other symptoms.

Liver disease, whether acute or chronic, most frequently presents with fatigue. The fatigue is of varying severity, ranging from low grade to severe.


“Tiredness and fatigue surely emanate from the muscles, so why is this system being placed bottom of the list?” That’s an interesting question you are probably asking, dear Reader!

Sports and Exercise scientists have decades ago established that muscles themselves DO NOT get tired! They have innate means by which they replenish their energy. The tiredness that is “felt in the muscles”, is actually in the head (nervous system)!

Fibromyalgia is a common condition that causes fatigue, muscle pain and tender spots all over the body. It has a strong association with disturbed mood.

Multiple sclerosis is another condition that typically causes tiredness among its symptoms. Though it is being mentioned here, it is a neurological condition that causes extensive nerve damage.

There are some relatively rare muscle diseases worth mentioning. One is myasthenia gravis, a condition that causes FATIGUABILITY of muscles. Fatiguability means that as muscles are used repeatedly, they wear down and become unable to contract.


What is adrenal fatigue syndrome? It is a misnomer.

This one is included here just so that it can be dispelled. This is a term that does not belong to us, biomedical practitioners. It is used by our colleagues in the alternative health sphere, and only for the past two decades.

Adrenal fatigue syndrome has not been, and is unlikely to ever be, proven scientifically. It is a term that could end up being used in patients suffering from one or more of the conditions covered by this discussion. And that is detrimental.


There are so many products all over the world that are marketed as “medications for fatigue”. But as can be seen from the foregoing discussions in this and the previous article, the causes of fatigue are numerous and diverse. There can hardly be a medication that can cure or even control fatigue or tiredness of all causation.

The medication might only lessen the feelings of tiredness and fatigue and mask them. But that is not helping the situation and may actually be dangerous.

Addressing the root cause of the tiredness and fatigue is the right approach. And to be able to do that, some searching frequently needs to be done in order to elucidate the underlying condition(s).


Tiredness and fatigue are very common complaints all over the world. They may just be due to your life’s circumstances, short-term or long-term. You may be overworking yourself because of long duty lists, tight schedules, or harsh economic conditions.

Dear Reader you may also be feeling tired because your home, school or work environment is not the best recently, or always. It may be stressing you out and zapping your energy.

But as thrashed out in these articles, your (or your loved one’s) tiredness, could also be due to generalised conditions in their bodies. Or it could be due to a condition or disease in a specific part of the body.

A timely visit to a Healthcare professional will very likely lead to identification of the cause of tiredness and fatigue. And this in turn will lead to management of the underlying cause, which will potentially save life.


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