Fatigue can have many causes, including lack of sleep, physical or psychological stress, medical conditions, an unbalanced diet, or external factors such as poor indoor air quality, excess weight, or prolonged heat.

Iron deficiency is particularly often linked to fatigue and exhaustion. Iron is required to produce hemoglobin, which transports oxygen in the blood. A deficiency in vitamin B12 or folic acid can also contribute to fatigue and reduced performance.

However, fatigue alone does not prove a nutrient deficiency. If you are constantly tired and exhausted, a medical examination can be useful to clarify potential causes and, if necessary, check specific nutrient levels.

Feeling tired and exhausted can indicate that your body is lacking certain nutrients. The following examples show which vitamins and minerals may play a role:

Iron is one of the most essential nutrients when it comes to fatigue and exhaustion. Among other functions, the body needs iron to produce hemoglobin, a component of red blood cells that plays a vital role in transporting oxygen. The risk of iron deficiency can be elevated, particularly with regular blood loss, such as from heavy menstrual periods.

A severe iron deficiency can lead to anemia. Possible symptoms include fatigue, exhaustion, and reduced physical performance. Concentration problems, headaches, dizziness, paleness, shortness of breath during exertion, or heart palpitations may also occur. In addition, brittle nails or hair loss can become noticeable.

Vitamin B12 performs various crucial tasks in the body and is needed, among other things, for blood formation and the normal functioning of the nervous system. A vitamin B12 deficiency can manifest as fatigue and exhaustion. Additional symptoms can include concentration problems or neurological complaints such as tingling sensations and numbness.

An increased risk of vitamin B12 deficiency can exist with a vegan diet if B12 is not sufficiently consumed through fortified foods or supplements. Certain medical conditions or medications can also affect the absorption of vitamin B12.

Folic acid belongs to the B-vitamin family and plays an important role in cell division and blood formation. A severe folic acid deficiency can lead to a specific form of anemia. Possible complaints include fatigue, exhaustion, and reduced performance.

Folic acid is found in green leafy vegetables, legumes, and various other foods. An increased demand occurs, for example, during pregnancy.

Vitamin D is essential for the normal function of muscles and the immune system, as well as for maintaining normal bones. The body can produce vitamin D itself with the help of sunlight. However, during months with low sunlight, the body's own production can drop. A low vitamin D status can be accompanied by various complaints, including fatigue.

Magnesium contributes, among other things, to normal energy-yielding metabolism and the normal functioning of the muscles and nervous system. A severe magnesium deficiency can therefore be accompanied by fatigue and exhaustion, as well as symptoms like muscle cramps. Magnesium is found in nuts, seeds, whole grains, and legumes, among other foods.

Zinc is required for numerous processes in the body and contributes to the normal function of the immune system. Good sources of zinc include meat, dairy products, legumes, and nuts. A severe zinc deficiency can impair wound healing and immune function, among other things.

Important: Fatigue and exhaustion alone do not reliably indicate which nutrient your body might be missing. If you feel tired and exhausted over an extended period, a medical evaluation can be useful. A doctor can specifically check whether a nutrient deficiency is present and if appropriate treatment is required.

Even if you get enough sleep, persistent fatigue can have various physical and psychological causes. Potential reasons include:

• Nutrient deficiencies: As previously described, a deficiency in iron, vitamin B12, or vitamin D in particular can be accompanied by fatigue and exhaustion.
• Thyroid and metabolism: An underactive thyroid (hypothyroidism) or glucose metabolism disorders can impair your energy levels and performance.
• Poor sleep quality: Sleep apnea, poor sleep hygiene, or frequent nighttime awakenings can prevent your body from feeling truly rested, despite getting sufficient hours of sleep.
• Psychological stress: Chronic stress, anxiety, or depressive moods can intensify fatigue and exhaustion.
• Medication: Certain medications can cause daytime drowsiness as a side effect.

Occasional fatigue is normal. However, if you are always tired and exhausted and symptoms persist for more than two to four weeks, you should take a closer look.

A medical evaluation is particularly advisable if:

• The exhaustion lasts for several weeks
• You are permanently tired despite getting enough sleep
• Your ability to perform daily tasks decreases significantly
• Dizziness, shortness of breath, or heart palpitations occur as well
• You look unusually pale
• You experience unintentional weight loss
• You increasingly withdraw from daily life due to exhaustion
• You feel inwardly empty and depressed

Psychological stress can also lead to feeling permanently exhausted, tired, and lacking motivation. If your fatigue is accompanied by symptoms such as feeling down, a loss of interest, persistent overthinking, concentration problems, or social withdrawal, you should take these complaints seriously.

Persistent fatigue and exhaustion can also occur as part of depression. Particularly when low mood continues for an extended period, joy and interest in activities fade, or sleep patterns change significantly, an underlying depressive disorder could be present. Sleep changes can manifest as difficulty falling asleep or staying asleep, or as an increased need for sleep.

This does not mean your exhaustion is "just psychological." Physical and mental factors can influence one another. For instance, ongoing stress can make falling asleep harder or make sleep less restful, which in turn increases fatigue during the day. Conversely, persistent exhaustion can impair your mood and mental resilience. It makes sense to seek a medical or psychotherapeutic evaluation to determine whether depression may be present and what support is most helpful.

Eat a Balanced Diet and Drink Enough Water

• A varied diet provides your body with essential vitamins and minerals. Whole grains, vegetables, fruit, legumes, nuts, seeds, and, depending on your diet, animal products can contribute to an adequate nutrient supply. However, a balanced diet is not a replacement for targeted treatment if a deficiency is actually present.
• Insufficient fluid intake can also impair your well-being and performance. Drinking enough water throughout the day is therefore another simple step you can take.

Do Not Take Dietary Supplements on Speculation

• The temptation can be strong to simply take iron, vitamin B12, vitamin D, or other supplements.
• This is not always useful. Not everyone experiencing fatigue has a nutrient deficiency. Furthermore, high-dose dietary supplements can cause adverse side effects or interact with other medications.

Have Potential Deficiencies Medically Evaluated

• If you feel constantly tired and exhausted, your doctors can work with you to decide which diagnostic tests are appropriate.
• Depending on the situation, blood tests can provide indication of whether anemia or a specific nutrient deficiency is present. The specific values tested should be based on your symptoms and individual risk factors.

Focus on Getting Enough Exercise and Daylight

• Regular physical activity can help reduce fatigue and improve overall well-being. Daylight, especially in the morning, also supports your sleep-wake rhythm. Even a daily walk can be a simple way to integrate more movement and natural light into your everyday routine.

Maintain a Regular Sleep Schedule

• Not only sleep duration, but also a regular sleep schedule can be crucial for restful sleep. Keeping consistent bedtimes and wake-up times as much as possible, along with a quiet sleep environment, can support your sleep quality.

Reduce Stress and Mind Your Mental Health

• Chronic stress can leave you feeling permanently tired and exhausted. Make a conscious effort to schedule recovery periods and ensure a healthy balance in your daily life. Relaxation techniques, physical activity, or talking to trusted people can help. If severe psychological stress or depressive moods persist, seeking professional support may be beneficial.

If persistent fatigue and exhaustion are accompanied by depressive symptoms, you should seek support. A medical or psychotherapeutic evaluation can help you better understand your complaints and work together to find suitable treatment options.

One such online therapy option is deprexis. This digital program supports you in addressing your depressive mood, developing helpful strategies for managing stress, and integrating exercises into your daily routine.

deprexis is available free of charge on prescription, the costs are fully covered by your health insurance provider. Your doctor or therapist can prescribe deprexis for you. You can then launch the program using the activation code you receive.