Fatigue

Fatigue

Feeling tired is a given at certain times—when you’ve walked more than usual, worked long hours in the garden, or taken a long-distance flight. But fatigue can come from unexpected sources, too. In the hustle, bustle, and travel of a Christmas visit to see your children and grandchildren in another state, you can end up pretty exhausted by the time Christmas morning dawns.

On a smaller scale, if your coffeemaker breaks down and you don’t get your morning cup, fatigue can come along about midmorning. Even the glare of a computer screen—forcing you to squint—can be fatiguing.

One of the things older people have a difficult time recognizing about fatigue is its relationship to stress, says Maria Simonson, Sc.D., Ph.D., director of the health, weight, and stress clinic and professor emeritus at Johns Hopkins Medical Institutions in Baltimore. “They try to find physical causes. If they have something go wrong with them, it must be with their bodies. They forget the psychological aspects of their minds.”

True, your body is changing and there are physical developments during aging that contribute to fatigue. The older you are, the more sleep problems you have and the more sedentary you might be. And maybe you’re less likely to eat balanced, healthful meals. These and other factors can leave you feeling sluggish during the day.

But fatigue is not an inevitable part of aging. You have the power to change many of the factors that cause that rundown feeling, says Stephen Langer, M.D., specialist in thyroid problems and chronic fatigue in Berkeley, California, and author of Solved: The Riddle of Illness.

Perk yourself up with these tips.

Try This First

Get moving. Exercise and physical movement are sure ways of beating back fatigue. For four to six hours after you exercise, your body’s metabolism and temperature remain up, leaving you feeling more alert and awake. And it doesn’t take a lot to keep your body rhythms on course and give you a charge of energy. “If you can walk 20 to 40 minutes three or four times a week, it’s perfect,” Dr. Langer says. Remember to concentrate on doing what you like to do. And do the exercise when it is convenient. That way you will be more likely to stick to it.

Other Wise Ways

Socialize. No one knows exactly why, but increased social interaction seems to help people feel less fatigued. “One theory holds that increasing mental activity—just like increasing physical activity—increases blood flow to the brain,” says Phyllis Zee, M.D., Ph.D., director of the sleep disorders center and associate professor of neurology at Northwestern University Medical School in Chicago. “And we find that not only does it improve deep sleep in older people but also their mental ability increases during the day.”

Find something useful to do. Loneliness and boredom contribute to fatigue, Dr. Simonson says. Doing some volunteer work or joining a hobby group might seem like a small thing to do. But once you start doing it, you may find that participation puts a whole new incentive in your daily life. “Make yourself valuable to people,” advises Dr. Simonson.

Eat right. A diet that is 60 percent carbohydrates, 20 percent protein, and 20 percent fat is the optimum to maintain energy, Dr. Langer says. Most of us rely on refined foods such as pasta, white rice, white bread, and packaged food products, which are less nutrient-dense than their whole-food counterparts. If you can shift your diet to include more whole grains, fruits, and vegetables, you’ll probably see a bit of change. All these foods are sources of energy that are also packed with nutrients.

Treat constipation with C. Constipation can interfere with the body’s ability to absorb key nutrients, leading to potential deficiencies in vitamins and minerals, says Dr. Langer. (For more information, see Constipation on page 118.) Start taking a vitamin C supplement, which helps loosen the stool as well as provide antioxidants, he advises. He recommends a powdered form of C that will be less irritating to the stomach. Dr. Langer suggests beginning with 1,000 milligrams (usually one-quarter teaspoon) three to four times a day and slowly increasing your intake to your own personal level of bowel tolerance. Powdered vitamin C is available at health food stores.

Go for some ginseng. The herbal remedy ginseng has been used by people for centuries to put a little spring in their steps. When you’re picking a ginseng product, examine the label to make sure it has at least 4 percent ginsenosides, suggests Varro Tyler, Ph.D., distinguished professor emeritus at Purdue University in West Lafayette, Indiana, and author of The Honest Herbal. Dr. Tyler recommends taking two 100-milligram capsules a day. Make sure to get American ginseng or Asian ginseng, which tend to be more effective, says Dr. Tyler, who cautions that Siberian ginseng is not as well-tested. (Ginseng may cause irritability if taken with caffeine or other stimulants, and it should not be taken by people with high blood pressure.)

Pick up some ginkgo biloba. You may want to try ginkgo biloba if you feel that you’re in a mental fog. This herb helps fend off mental fatigue by improving circulation to your extremities and your brain, Dr. Langer says. Try taking 120 milligrams of it a day.

Do not use this herb with antidepressant MAO inhibitor drugs such as phenelzine sulfate (Nardil) or tranylcypromine (Parnate), aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), or blood-thinning medications such as warfarin (Coumadin).

Write it down. stress and worry can add to fatigue, especially if you let your problems plague you in the night, says Lauren Broch, Ph.D., director of education and training at the sleep-wake disorders center at New York Hospital–Cornell Medical Center in White Plains, New York. You can’t make worries vanish, of course, but there’s an organizing trick that can outfox the worrywart part of your brain.

Make a list of all the things that are bothering you, suggests Dr. Broch. Do it sometime late in the day or early in the evening to help you feel more in control of your problems so you can stop worrying before you try to rest. For every item on the list, think of a potential resolution. Then put the list away and use the rest of your time leading up to bedtime to relax.

Get enough quality sleep. Are you able to sleep soundly each night? Even though you may be spending enough time in bed, it’s quality that really counts, says Margaret Moline, Ph.D., director of the sleep-wake disorders center at New York Presbyterian Hospital–Cornell Medical Center in White Plains, New York. When older patients complain about fatigue, she finds, the real problem can often be a sleep disorder that impacts the quality of their sleep. “If you spend eight hours in bed every night and still don’t feel refreshed in the morning, talk with your doctor,” advises Dr. Moline.

Rise and shine the same time each day. Varying sleep patterns can often leave people with a jet-lag feeling even if they’ve never left home. Go to bed at the same time each night, and try to rise at the same hour each morning. The regular sleep time ensures that your body will sleep efficiently, says Dr. Zee.

Monitor sleeping pill use. If you take an over-the-counter sleeping pill right before bedtime every night, you may still experience its lingering effects when you try to wake up the next morning, says Melanie Cupp, Pharm.D., clinical assistant professor of pharmacy and a drug information specialist at the West Virginia University School of Pharmacy in Morgantown. Dr. Cupp says that sleeping pills can have a carry-over, almost hangover, effect the next day, causing drowsiness that can be so bad that it impairs driving.

Brighten your world. Colors can have an amazing effect on how people feel, says Dr. Simonson. The colors on the warm end of the spectrum—yellows, oranges, and reds—are the higher energy, stimulating colors. But don’t go repainting your whole house in magenta yet. She suggests that you use these colors strategically in every room of your house, in objets d’art, rugs, and other accessories. Place these colors where the eye will linger. In the bedroom, carefully limit the use of energizing colors, but make sure to have one particular object that will help rouse you in the morning. “This has an instant, energizing effect,” Dr. Simonson says.

Power nap. If you take a nap, for how long do you nap? If you nap for more than a half-hour, your body goes into its deep-sleep phases and you feel very groggy when you are wakened. As long as you nap in the early part of the afternoon and limit the nap to a half-hour, you probably will feel more refreshed for the rest of the day, says Sonia Ancoli-Israel, Ph.D., director of the sleep disorders clinic at the Veteran’s Affairs Health Care System in San Diego, professor of psychiatry at the University of California, San Diego, and author of All I Want Is a Good Night’s Sleep.

Treat your blues. Feeling depressed affects your sleep and your energy levels. “Depression will affect sleep. It might make you sleep more, it might make you sleep less, but it will generally make you feel more fatigued,” Dr. Broch says. If you suspect that the blues are making you feel blah, consult with your doctor.

Caffeinate or decaffeinate your life. The stimulant caffeine and fatigue have an intimate and conflicting relationship, says Roland Griffiths, Ph.D., professor in the departments of psychiatry and neuroscience at Johns Hopkins School of Medicine in Baltimore. On a short-term basis, caffeine can work. If you don’t have it regularly and you need something to keep yourself awake during an important meeting or event, drinking a caffeinated beverage will help boost your feelings of wakefulness and well-being. That dose of caffeine can also increase your ability to concentrate. So caffeinated coffee, tea, soda, or even chocolate may help you get by in the short term.

But the watchwords here are “short term.” If you start using caffeine habitually, you’ll start to feel fatigued whenever you don’t get enough. So to maximize the benefits of your caffeine intake, use it either intermittently (about every third day) or minimally (less than 75 milligrams a day), says Dr. Griffith. That’s about a half-cup of coffee or two six-ounce cups of tea.

Take care of your eyes. If you have an eyeglass prescription that’s not up-to-date or you’re doing a lot of close-up work such as reading, the strain on your eye muscles will make you feel tired, says Stephen Miller, O.D., executive director of the College of Optometrists in Vision Development in St. Louis.

In addition to your eye muscles tiring, if you can’t see something well, you may move closer or hunch over so you can see. That’s certainly true if you’re doing anything that requires viewing at a close distance all day long, such as reading, sewing, or other detail-oriented hobbies, says Dr. Miller. All that hunching over can lead to muscle fatigue and strain in your back, neck, and shoulders.

So take a break every 15 minutes or so, look away, or perform another task. Do anything that allows your eyes to relax and helps you avoid fatigue.

If you’re experiencing eyestrain regularly, be sure to call your eye doctor for an appointment. Your prescription may need adjusting or you may have to start wearing some type of corrective lenses. Dr. Miller recommends an annual eye exam for older adults.

Halt the hunching. Be sure that hunching over doesn’t become a habit, says Dr. Miller. If you’re using a computer, adjust your seat position so you can sit erect about 20 to 26 inches away from the screen. You should be looking down slightly at about a 15- to 20-degree angle when viewing the screen. Keep your feet flat on the floor and your arms bent at about a 90-degree angle when using the keyboard. And if you do a lot of reading, position the book so you don’t strain your shoulders. Sit upright and hold your reading material about 14 to 18 inches from your eyes. Use good lighting that doesn’t glare or cast shadows. Frequent breaks from work—taking time to walk or stretch—can help keep your neck-area muscles loosened up.

Do like birds of a feather. Some people get up at the crack of dawn. Others don’t get going until the afternoon and are most productive in the wee hours of the morning. Sleep specialists call people with these predilections larks and owls. If you’re an owl trying to fit into a lark’s schedule, you’re going to end up tired. If possible, consider changing your routine, maybe even your job, to fit your pattern. “For people who are constitutionally one way or another, it helps to find a lifestyle that matches their constitutions,” says Patricia Prinz, Ph.D., professor of behavioral nursing and adjunct professor of psychiatry and behavior sciences at the University of Washington in Seattle.