(Ask the Doctor) I feel unusually fatigued and weak!

Thank you so much for your advice. We really appreciate it. I am a 26 year old working mother. I always squeeze two hours for the gym everyday and go swimming on the weekend. But for a month now, I have been feeling really fatigued. For someone who was always up by 5am, I don’t want to get out of bed now. My body aches all the time. I get headaches more times than normal and, last week, I even felt a little dizzy from time to time. I spend less time with my daughter because I always want to be in bed undisturbed. What is going on with me? Can you help? Gloria, 26, Kacyiru Dear Gloria, What you are facing now is a common problem, more so with working women. There are multiple reasons for it, the most common being physical and mental stress. Before going to work and coming back, you have to complete and supervise multiple chores. In office too, there may be many commitments waiting to be tackled. There may be a situation which you do not like or are unable to solve as per your liking. All this keeps the mind fully occupied and stressed at times. Running about also leads to physical stress. To top it all off, if one is not able to sleep properly after long working hours or after attending to the baby or domestic chores, it could pile on the stress. Apart from this, neglecting your diet and gradually lacking nutrients can cause early fatigue. This is more likely to happen if you have delivered a baby in the past few months and breastfeeding because the demand for iron and calcium increases with pregnancy and breast feeding. This, if not fulfilled, can cause weakness. Consumption of alcohol also contributes to fatigue due to the depletion of nutrients in the body. You have not specified whether your menstrual cycle is normal or not. If there has been excess bleeding in the past few cycles, you may be having iron deficiency anemia, causing fatigue. Hormonal disorders like diabetes or hypothyroidism (inadequate functioning of the thyroid gland) are also responsible for weakness and sense of fatigue. What you really need to do first is to learn to relax completely. Gym and swimming are fine to maintain fitness. But for complete mental relaxation, yoga and meditation are more useful. If you can learn breathing exercises (pranayam) of yoga and do it regularly, you shall notice improvement in the physical as well as mental stamina. Try not to bring work to home or sleep with it. While sleeping, keep your mind relaxed, and use fresh night clothes over a clean bed. This ensures sound sleep which will keep you fresh for the coming day. However busy you are, take a nutritious diet. This should include fresh fruits, vegetables, nuts, whole grains, cereals, milk products, eggs and fish. If you take alcohol, quit it now while you are young enough to recoup lost health very well. There is nothing to worry about if you are not able to give enough time to your child because this is part of the overall stress or malaise you are undergoing. Start giving some time to the child compulsorily as a duty and gradually, you shall find yourself mentally free at that time, for example, free from worries. The problem should be solved with the above measures; otherwise you need to be investigated for anemia, diabetes or hypothyroidism. Dr Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital.