• Iron deficiency is usually thought of by most doctors as being unimportant unless it produces anaemia. This is not so. Iron-deficiency fatigue can occur in people who have normal blood levels of the iron-containing red-blood-cell pigment called hemoglobin. Anaemia definitely makes people tired and easily fatigued and their heartbeats raised to higher levels on exercise than do those of the non-anaemic. Iron deficiency is, of course, caused by a lack of iron but red blood cells need another nutrient too-folic acid.
• Too little folic acid can make a person tired and anaemic. Iron and folic acid given together appear to be more effective than either alone for many people. In a study in which women were given either iron or folate, or the two together, only 26 per cent of those who received a single nutrient had a rise in hemoglobin whilst 96 per cent of those who received both did so. But for folate to be used by the body you need to have enough vitamin B12. In another study, twenty-eight men and women who complained of tiredness yet had no physical problems were given vitamin B12 and asked to evaluate its effect. For many of the twenty-eight the vitamin not only made them feel less fatigued but also improved their appetite, sleep and general well-being.
• Vitamin Ñ too has been found to be of help in those who are always tired. Miners in Czechoslovakia were given 1 g of the vitamin a day and reported less fatigue and faster reaction times. Another study of 400 people found that those whose vitamin Ñ intake was less than 400 mg a day had more fatigue than others who consumed more.
• Poor sleep can be a cause of constant tiredness.
• Although it might seem strange, increasing the level of exercise you take can reduce feelings of tiredness. Many people, who complain of tiredness, even if they are improved by the above regime, will still feel a lot better for having taken exercise. Whether this is because taking strenuous exercise raises endorphins which produce a sense of well-being, or whether it is because most such people have a sense of achievement after doing the exercise is not known. What is certain, though, is that even lethargic and ‘tired’ people who take exercise two or three times a week feel better in themselves and tend to feel less tired.