Full transcript of “THIS Is Why You Feel So Tired All The Time”. Click a timestamp to open the video at that moment. Need another video? Use the YouTube transcript generator.
0:00 We're all exhausted. All of us. Not just people working 100-hour weeks. Not just new parents. All of us. And then there are people, maybe you, who are so exhausted they can't keep up with life at all. And I know this better than most because as a GP I've seen hundreds, if not thousands of patients come into my clinic with the same problem. A symptom so common, so debilitating, we have a name for it. TAT. Tired all the time. People like you looking for answers, looking for a solution, some way to get their life back. And I can explain it using this. But you might not like the answer. I think this is how most of us imagine
0:46 energy works. We wake up in the morning with a full bottle, and throughout the day we slowly use it up. We get dressed, we make breakfast, walk the dog, answer emails, play with the grandchildren, cook dinner. Even little things cost us a little bit of energy. And by bedtime, there's not much left. We go to sleep, the bottle fills back up, and tomorrow we do it all again. Simple. Except that's not how it actually works. And once you see this, I think exhaustion suddenly starts making a lot more sense. Because there are two things we've almost completely ignored. The first is that some things don't just use energy while you're doing them, they quietly drain it all day long. Things
1:33 like worry, financial pressure, chronic pain, looking after someone you love, poor sleep, and medical conditions. Real common medical problems that quietly drain your reserve constantly. We'll come back to those in a moment because they're incredibly important. The point is, these things don't just cost you energy once, they keep taking it hour after hour, day after day, whether you notice them or not. But, there's a second thing we've all been ignoring. We've all been staring at the water level, the amount of energy we've got, when all along the thing that's quietly changing is the size of the bottle itself, your
2:18 reserve. The amount your body can cope with before it finally says, "Enough." And once that reserve becomes smaller, simply pouring more energy back in often isn't enough. You can sleep in, have a relaxing weekend, go on holiday, feel better after a few days, then life starts again, and somehow you're right back where you started, exhausted. So, perhaps we've been asking the wrong question, not how do I get more energy, but where am I leaking energy? Why has my reserve become smaller? And how do I fix [clears throat] it? Now, here's the good news, bottles don't usually develop holes for no reason, which means if we can work out what's causing the leak, we've got a much better chance of fixing it. And after years of seeing exhausted
3:04 patients, I found that most medical causes fall into just a few groups, not hundreds, just a few. And as we go through them, I want you to think about yourself. Don't just listen to the explanation, ask yourself, "Does this sound like me?" Because by the end of this, I want you to have a much better idea where your exhaustion might be coming from. Just a quick one. If you enjoy these videos, I'm sure you'll enjoy my newsletter, too. It's called Three Apples. It's interesting, it's useful, and it's free. Link down below for subscribing if you're interested. So, let's start looking for the leak. The first group are conditions that stop the bottle filling properly. We've all had a bad night's sleep. You wake up feeling like somebody forgot to refill the bottle overnight. Sometimes that's
3:49 simply because you're not sleeping enough. But, sometimes you sleep for 8 hours and you still wake up exhausted. Sleep apnea is one of the commonest examples I see. Your breathing repeatedly stops while you're asleep, often without you ever knowing it. So, although you spend all night in bed, your body never really gets a chance to recover. So, let me ask you a question. Do you wake up feeling refreshed or do you wake up feeling as though you could quite happily go straight back to sleep? If it's the second, that might be a clue. Discuss it with your doctor. The second group creates leaks. We've already spoke about some of them already, things like pain, stress, anxiety, the stress of caring for someone who's unwell, but illnesses can
4:35 do exactly the same thing. Inflammatory conditions, autoimmune diseases, cancer, chronic infections, and it became extremely common after the COVID-19 pandemic where people suffered with long COVID for months or even longer afterwards, intense fatigue. All different diseases, exactly the same effect, really. Your body is quietly spending energy in the background all day long. So, ask yourself, is there something your body has been quietly fighting for months without you really thinking about it? The third group is a little different. Here, the bottle isn't leaking, it's the water that's changed. Imagine filling this bottle up with squash, watered down squash instead of water. It still would look full, but it doesn't do the same job type of energy and you
5:22 can't run properly on it. And that's a bit like iron deficiency, anemia, B12 deficiency, or an underactive thyroid. The tricky part is your test can come back normal and the water is still watered down squash. A ferritin of 18 is technically fine, a TSH of 4.1 is technically fine, but fine sometimes isn't enough. Your body simply can't produce the same amount of useful energy from what it's got. Which is why blood tests matter because these are things we can often diagnose and usually treat. And for men, I need to bring up something specifically. There's one more, testosterone. Not the gym version, the quiet decline in your 60s that changes how well every cell in
6:08 your body converts fuel to energy. It belongs in this group, too. Just like menopause. Then there's the final group. These don't create leaks. They don't stop the bottle from filling. They change the bottle itself. Heart failure, lung disease, frailty, loss of muscle as we get older, weeks, sometimes months of inactivity after illness. Suddenly the same walk, the same flight of stairs, even carrying on shopping feels so much harder than it used to be. Not because life became harder, because your reserve quietly became smaller. So, think back 5 years. Could you do more then than you can now? Not because you've chosen not to, but because you genuinely feel you've got less in the tank, a smaller tank. That
6:54 matters. Now, don't worry if this all sounds overwhelming. Doctors see exhausted patients every single day, all the time. And a targeted blood panel covers the majority of what we've just talked about. And more. Not one test, a whole set designed to catch many of the common medical causes. We've been through some of them. Sometimes we find the answer, and that's brilliant because if you've got iron deficiency, an underactive thyroid, diabetes, vitamin deficiencies, or another treatable condition, that's something we can do something about. But here's the part that bothers me still. Most of the time the blood tests are fine. Those blood tests come back normal, and that's often the moment people lose hope. They think, "So, there's nothing wrong with me." No. That's not what normal blood tests
7:41 mean. It simply means we haven't found a disease that that's explaining your exhaustion. Those are two very different things. And this, I think, is the part you might not like. Because we naturally want there to be an answer. One answer, one blood test, one tablet, one thing to fix it. But I don't think that's how exhaustion really works. Usually works anyway. I think we, as in doctors and patients, often just blame the last thing we noticed. Your vitamin D was a bit low. Your iron had dropped slightly. You had a virus a few weeks ago. And we convince ourselves that's the cause. I don't think it's usually that simple. I think it's the final straw. Let me show you what I mean. Imagine this bottle has been leaking for
8:28 years. You've been under pressure. You're not sleeping brilliantly. Your knees hurt. You're worrying about your partner. You've slowly become less active than you used to be. Nothing really dramatic. Nothing that on its own should flatten you. Then one day your vitamin D Your vitamin D drops below the threshold. Or your iron becomes very slightly low. And suddenly you can't keep up anymore. Was it the vitamin D? Maybe. Was it the iron? Maybe. But I don't think it was the whole story. I think it was simply the thing that tipped the bottle over the edge that was coping brilliantly for years. That's the answer you might not like because there probably isn't just one thing to fix. There's probably several. They've been quietly building for years
9:14 and your body has been compensating until One day it simply can't anymore. Now, I know what some of you might be thinking. That's all very well, but I can't get rid of my arthritis. I can't stop worrying about my partner. I can't magically make life less stressful. And you're absolutely right. Some leaks can't simply be switched off. But that doesn't mean you're powerless. Because although you can't always choose the leaks, you can often build a better bottle. So, how do we do that? Well, the first thing is to realize that your reserve isn't fixed. It can change. That's probably the biggest misconception of all. It can become smaller, but it can also become bigger. And I think that's one of the most hopeful things about exhaustion because it means your future isn't necessarily determined by how exhausted you feel
10:00 today. One of the commonest things I hear is, "Doctor, I'm too exhausted to exercise." And honestly, I completely understand because exercise does use energy up, but that's only half the story. Over time, exercise actually makes the bottle bigger. Your heart becomes stronger. Your muscles become stronger. Your balance improves. Your body becomes more efficient. Eventually, the same walk, the same shopping trip, the the same flight up those stairs has less effect on your reserve. One of the cruel ironies of exhaustion is that one of the best ways of building more energy is to spend a little of it first. That doesn't mean run a marathon. Sometimes it simply means walk a little further today than you managed yesterday because your body rewards the effort
10:47 eventually with capacity. The same principle applies elsewhere. Treating sleep apnea doesn't just stop snoring. It finally allows the bottle to refill properly. Correcting iron deficiency, B12 deficiency, or underactive thyroid doesn't just improve a blood test. It improves the quality of the energy your body can produce. Building muscle gives you more reserve. Treating chronic pain repairs a leak. Looking after your mental health won't remove every worry, but it may slow down some of the leaks that you have quietly had draining you for years. None of these things are magic, but together, they make the system a little bit more resilient. And I think that's the biggest lesson I've learned after years of seeing exhausted patients. The goal isn't to
11:32 create a life with no leaks. None of us get that. Life doesn't work like that. There will always be illness, stress responsibilities unexpected setbacks. The goal is to build enough reserve that when those things happen, you don't immediately run on empty. Your Your body is remarkably good at protecting you. For years, sometimes decades, it is constantly adapting, compensating, keeping you going. Exhaustion isn't your body failing. It's your body telling you, "I can't keep compensating." Now, there is one group of conditions that don't really fit the bottle analogy nicely at all. Things like chronic fatigue syndrome and fibromyalgia, they don't simply create a few leaks and they don't simply stop the bottle filling and they don't just make
12:18 the washer less effective. They seem to affect the whole bottle energy system as a whole. Now, these are some of the most poorly understood conditions in medicine and also some of the most debilitating with the exhaustion they can cause, absolutely very real, terrifying exhaustion. If you want to learn a little bit more about these conditions, ones like fibromyalgia, have a look at this video right here. I hope that was useful and maybe I'll see you over there. Thank you very much for watching. Bye-bye.
