Dear NOA: "Why Am I So Tired All the Time?" What Your Exhaustion Might Be Telling You

There is an important distinction worth making here. Normal tiredness is what you feel after a late night, a long week or a period of high stress. It responds to rest. You sleep, you recover, you feel better.

Fatigue is different. It is persistent, often disproportionate to how much you have done, and it does not resolve with sleep alone. You might wake up after eight hours and still feel unrefreshed. You might hit a wall by mid-afternoon every day regardless of what you eat or how early you went to bed. If that sounds familiar, it is worth paying attention.

Not all fatigue is the same, and understanding the type can help point you in the right direction. Perimenopause and menopause fatigue is driven by fluctuating oestrogen and progesterone, which affect sleep quality, energy metabolism and mood. It often appears before other perimenopause symptoms, which is why it can catch women off guard.

Muscle fatigue, a persistent heaviness or weakness in the muscles, can be a sign of low iron, vitamin D deficiency or thyroid issues, rather than simply overdoing it.

Adrenal fatigue is a widely searched term, often used to describe a feeling of being simultaneously wired and exhausted, with poor stress recovery and crashing energy. It is not a recognised medical diagnosis, but the symptoms people describe are real and worth exploring properly. Fatigue in pregnancy is extremely common, particularly in the first and third trimesters, driven by significant hormonal and physiological changes.

For women in their late thirties and forties, a few things tend to converge. Alongside hormonal shifts, these are the areas that come up most frequently.

• Iron and ferritin: Low iron is one of the most overlooked causes of fatigue in women, particularly if periods are heavy. Symptoms can include dizziness, nausea, breathlessness and difficulty concentrating, and are often mistakenly attributed to stress.
• Vitamin D, vitamin B12 and other nutrient deficiencies: Vitamin D deficiency is extremely common in the UK and a well-documented cause of persistent tiredness, low mood and muscle weakness. B12 is another frequently missed factor, particularly in women who eat less meat or have digestive issues that affect absorption.
• Thyroid function: An underactive thyroid is one of the most common hormonal conditions in women, and fatigue is often the first sign, sometimes alongside weight changes, low mood or dry skin.

 

Low iron and low ferritin are common causes of persistent fatigue, particularly for women who experience heavy periods. Other iron deficiency symptoms can include breathlessness, dizziness, headaches, heart palpitations, pale skin and difficulty concentrating.

An iron supplement may be recommended if a blood test confirms that your levels are low. Options include iron tablets, capsules, liquids and iron spray products. However, the best iron tablets for you will depend on your test results, dietary needs and how well you tolerate different forms of iron. It’s also advised to avoid taking iron without first checking your levels, as too much can be harmful.

There is a broad category of energy support supplements that can play a genuinely useful role, but it is important to test before you supplement. Taking iron when your levels are already sufficient, for example, can cause problems rather than solving them. Knowing what your body actually needs means any supplementation is targeted rather than a shot in the dark.

Once you have that picture, there are some products worth considering. Electrolytes, which include key minerals like magnesium, potassium and calcium, support hydration and normal muscle function. The KIKI Health Ionic Electrolytes Liquid Concentrate is a simple way to add these into your daily routine, using 100% natural minerals in a highly bioavailable liquid form. For cognitive fatigue specifically, some women find functional mushrooms useful as part of their wider routine. The Sixways Focus + Elevate Mushroom Blend contains lion's mane mushroom, which is widely used to support concentration and mental clarity.

Poor-quality sleep can leave you feeling exhausted even when you appear to be spending enough time in bed. Magnesium supports normal muscle function and the nervous system, which is why a magnesium supplement is often included in evening wellbeing routines.

Magnesium glycinate is a popular form because it is generally considered gentle on the digestive system. Some people take magnesium glycinate for sleep, relaxation and stress support, although supplements should be considered alongside your wider sleep routine rather than as a replacement for it.

The trouble with fatigue is that the causes overlap so much. Low iron can feel a lot like a thyroid issue, which can feel a lot like a hormonal shift, which can feel a lot like simply being run down. This is exactly why so many women end up trying everything without ever finding out what is actually driving it.

The most effective starting point is information. A blood test that looks at markers including vitamin D, a full iron panel, B12, thyroid function, reproductive hormones and blood sugar gives you a clear picture of what is contributing to your fatigue, rather than leaving you to piece it together from search results and social media.

At NOA, our blood test checks 26 key markers across iron status, vitamins, thyroid function and hormones, paired with a nutritionist consultation to talk through your results in plain English and build a plan around what your body actually needs. No guesswork, just clarity.

Alongside targeted supplementation, the rituals that bookend your day can make a real difference to how energy levels feel in practice. Starting the morning with the NEOM Super Shower Power Body Cleanser, which uses spearmint, rosemary and eucalyptus essential oils, is a small but genuinely invigorating way to wake up the body and mind. In the evening, a wind-down routine that supports sleep is just as important. The BetterYou Magnesium Bath Flakes offer a relaxing soak that supports muscle recovery and calm before bed, and the NEOM Real Luxury Magnesium Body Butter, blended with lavender, jasmine and sandalwood, is a lovely way to create a moment of calm and nourish skin as part of your evening routine.

Feeling tired all the time should not be something you simply learn to live with. Understanding whether your exhaustion is connected to nutrient levels, hormonal changes, sleep or another underlying factor can help you make more informed decisions about your health.

Book your NOA Now Plan today!