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Dr Sarah Jarvis

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I have COPD, diabetes and pernicious anaemia – will I always feel so tired?

I am female, 67 years old and I have COPD, diabetes and pernicious anaemia. I had my B12 jab last Friday but still feel very tired. I am having an hour’s sleep midday as I cannot last the day without that extra sleep. Will I always feel tired or is it a combination of illnesses? Thank you.

- Pat, UK


Tiredness is a very common symptom in the average GP’s practice – so common, in fact, that is has its very own acronym. It’s known as TATT or Tired All The Time. There are literally hundreds of causes of tiredness. Often no underlying physical cause is found, and it’s often related to stress or depression. Almost everyone suffers from short-term tiredness (for a week or two at a time) at some point, and this is often due to an infection (everything from a nasty cold to a urine infection can cause tiredness).

However, if you’ve just been diagnosed with pernicious anaemia, you may well still be anaemic. Pernicious anaemia is an autoimmune condition, in which your body’s own immune system (which usually helps you fight off infection) turns on itself. It stops your body from being able to absorb vitamin B12 properly, and this in turn leads to anaemia and with it tiredness and sometimes dizziness and shortness of breath. Pernicious anaemia is treated with regular injections of vitamin B12 for life. However, even after you’ve had your first injection, it can take some weeks for your haemoglobin (this is what’s low when you have anaemia) to rise.

COPD is a chronic lung condition that causes shortness of breath and repeated chest infections, but it can also cause tiredness. It can’t be cured, but stopping smoking is absolutely key to slowing down its progression. It can also be treated with inhalers and sometimes tablets as well (or, in severe cases, oxygen as well). Tiredness is a particular issue when you’re suffering from a chest infection, which is a very common complication of COPD.

Likewise, if you have diabetes, poorly controlled blood sugar can cause significant tiredness. In fact, many people are diagnosed with type 2 diabetes when they come in complaining of vague tiredness. However, once your blood sugar is well-controlled, it’s less likely to result in tiredness. You don’t say if you have type 1 or type 2 diabetes; in many respects these are very different conditions. In particular as far as your question is concerned, type 1 diabetes is much more likely to cause dangerously high blood sugar and a condition called ketoacidosis.

Other conditions which can cause tiredness include underactive thyroid gland and problems with the liver or kidneys. A simple blood test can usually rule these out. If your tiredness is persistent, if it hasn’t been looked into to exclude physical causes or if it becomes very severe, see your GP.

Dr. Sarah Jarvis
Healthcare Professional

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