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Senior Correspondent

Q. I'm 68 years old and I'm tired a lot. What do you think could be causing this?

For starters, I never make a personal diagnosis; I'm not qualified. I'm a journalist, not a physician. If you have persistent fatigue, I recommend you see a doctor for a check-up.

Figuring out why you are fatigued is very difficult because there are so many possible causes. These include: too much exercise, not enough activity, insufficient sleep, alcohol consumption, allergies, caffeine, medications such as antihistamines or blood-pressure drugs, unhealthy eating habits, psychological problems, obesity and diseases.

Among the diseases and conditions know to cause fatigue are cancer, multiple sclerosis, stroke, Parkinson’s disease, fibromyalgia, Lyme disease, Crohn's and lupus.

[Personal note: I suffer from fatigue that I know is caused by seasonal allergies. When the pollen and mold counts are high, I lose energy and doze off during the day.]

There have been studies that indicate allergies cause fatigue. Some researchers say that proteins released by immune cells rushing to protect the body from allergens affect the central nervous system. The proteins release a chemical in the brain that induces lethargy.

In addition, poor sleep caused by allergies can cause fatigue. A study in the Archives of Internal Medicine showed that people with allergic rhinitis were more likely to have sleep problems than people without the condition. In the study, about 35 percent of allergic rhinitis patients reported insomnia.

Fatigue is common, but common fatigue is different from Chronic Fatigue Syndrome (CFS). CFS is a complex disorder characterized by overwhelming fatigue. Patients with CFS also report suffering from other symptoms. In some cases, CFS can persist for years.

The cause or causes of CFS have not been identified and no specific diagnostic tests are available. Therefore, to be diagnosed with chronic fatigue syndrome, a patient must have severe chronic fatigue for at least six months that is not relieved by rest and not caused by medical or psychiatric conditions. 

At the same time, the patient must also have at least four of the following symptoms:

  • Impaired short-term memory or concentration
  • Frequent sore throat
  • Tender lymph nodes
  • Muscle pain
  • Multi-joint pain without swelling or redness
  • Headaches of a new type, pattern, or severity
  • Unrefreshing sleep 
  • Prolonged exhaustion and sickness following physical or mental activity.

How can you cope with fatigue?

  • Take short naps — no longer than an hour — throughout the day rather than resting for one long period.
  • Budget your energy for your most important activities.
  • Stay hydrated by drinking plenty of fluids.
  • Eat a healthy diet.
  • Limit your intake of caffeine and alcohol.
  • Exercise easily to preserve your energy level. 

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