Why So Tired ?

You're overbooked and overworked. Between your job, your family, your fitness routine and all the to-dos on your list, it's no wonder you're tired sometimes (or, um, all the time). But if you feel as if you're running on empty most days and find that getting more sleep hasn't helped, you may have an underlying health problem, says Molly Cooke, MD, the president of the American College of Physicians. Here, six surprising conditions that can leave you drained. By Hallie Levine Sklar Where's My Mojo? You need more vitamin D. Up to 40 percent of us are deficient in D, the vitamin that protects against osteoporosis and several autoimmune diseases and may also help fight cancer and high blood pressure. "You have vitamin D receptors in your muscles and in almost every organ of your body, including your heart and brain," explains Sue Penckofer, PhD, a professor at the School of Nursing at Loyola University in Chicago. If you're low in it, you may have no energy. Another sign of a deficiency: a dull pain in your bones or muscles that persists even when you're not working out, says Michal Melamed, MD, an associate professor of medicine at Albert Einstein College of Medicine in New York City. The Rx: Ask your primary care doc to run the 25-hydroxy vitamin D blood test to measure your level of D, which should be between 20 and 40 nanograms per milliliter. If yours is less than that, your physician may suggest supplements that contain more than the 600 to 800 international units found in most multivitamins. Patients treated with vitamin D reported less muscle weakness and fatigue, according to a study presented at the Society of Endocrinology's annual meeting last year. You're stuffed up all the time. Chronic sinusitis affects about 12 percent of adults -- or almost 30 million people -- according to the Centers for Disease Control and Prevention. "Your sinuses become inflamed and swollen over a period of weeks, which causes mucus to build up," explains Scott Stringer, MD, the chairman of the Department of Otolaryngology at the University of Mississippi Medical Center in Jackson. Symptoms include fatigue; congestion; pain and tenderness around the eyes, cheeks and nose; a reduced sense of smell and taste; and bad breath. Fighting sinusitis leaves you too exhausted to do much of anything else. The Rx: A saline nose spray or a neti pot can help flush out your sinuses. If symptoms persist, your primary care doc can prescribe a steroid nasal spray to shrink nose and sinus membranes. If that doesn't help, go to an ear, nose, and throat specialist, Dr. Stringer suggests. She will look up your nose with a thin tubular device called an endoscope to see what's going on and then prescribe a treatment: antibiotics for an infection, antihistamines or a nasal steroid for an allergy-related condition, or oral steroids for nasal polyps (tissue growths in the nose), which are common among adults. You've got gluten problems. More than 2 million people in the United States have celiac disease, and about 70 percent are women, according to the National Foundation for Celiac Awareness. If you're among them, eating anything with gluten -- which is found in wheat, rye and barley, triggers an immune response in your small intestine, producing inflammation that prevents the absorption of nutrients and leaves you malnourished and with an upset stomach. As a result, you don't have the fuel to get through the day, says Peter Green, MD, the director of the Celiac Disease Center at Columbia University Medical Center in New York City. Sensitivity to gluten, which affects another 18 million people, can also trigger fatigue. Diarrhea and weight loss are the classic signs of gluten problems, but most sufferers have symptoms that are more subtle, says Alessio Fasano, MD, the director of the Center for Celiac Research at MassGeneral Hospital for Children in Boston. "They include fatigue, bloating, body aches, chronic headaches, and short-term memory loss." The Rx: Your GP can order a blood test to look for elevated levels of antibodies that indicate celiac disease. If the result is positive, you'll need to consult a GI specialist to check for damage to the lining of your small intestine, Dr. Green says. Steroids may help relieve symptoms, but they can have significant side effects. To treat celiac, follow a gluten-free diet: Eat fresh fruits and vegetables, lean meats, fish, beans, and nuts as well as naturally gluten-free grains like quinoa and rice. If your blood test is negative but you suspect you have gluten sensitivity, avoid foods containing the substance for a month to see if you notice a difference, Dr. Fasano advises.