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normal weight can all be affected. Never judge.

Running and daily life

Q I love running, but I’m generally just so tired all the time and don’t have enough energy for it. Should I go to the doctor?

A Feeling tired all the time is one of the most common reasons people see their GP. It’s most definitely a sign of the times, with huge pressures and expectations being put on us from both society and ourselves. While there are medical conditions that cause fatigue, the diagnosis more often than not comes down to lifestyle. Being anaemic (having low numbers of red blood cells) and hypothyroidism (an underactive thyroid) are the two most common medical causes of fatigue, particularly in women. These can be diagnosed by a blood test so if you suspect that your fatigue may be down to more than just a hectic life or you have any of the following symptoms, then you should see your GP:

• You’re passing more urine than normal or are constantly thirsty.

• You’re losing or gaining weight without a change in your diet.

• You have night sweats (and aren’t menopausal).

• You have any lumps in your armpits, groin or neck.

• You’ve had a change in your normal bowel habit or blood in your stools.

• You’re more out of breath than usual.

• You’ve been getting palpitations, dizzy spells or chest pains.

• You have heavy periods.

• You’re excessively tired every day and aren’t able to function normally.

If there’s no underlying medical condition then it’s helpful to know that even if you don’t feel you have the energy for a run, it might be just the thing you need. Yes, sometimes a rest is best, but running can give you an energy boost. It may be that some time away from life, either solo or with running friends, will refresh you and give you a feeling of wellbeing. It’s also important to do what you can to ensure you’re sleeping as well as possible and eating high-quality foods in enough quantity to fuel your daily life and running. Stress is exhausting too. It may not be one overwhelming issue, just a long-term, low-level stress that is sapping your energy (see here). Trying to get the right balance in life isn’t always easy, but it’s essential to prioritise yourself sometimes.

Q I know that running is supposed to help sleep. I run regularly, but I still can’t sleep.

A People who exercise generally sleep better than those who don’t. But, we’re all different and insomnia is thought to be a problem for around one third of the UK population. It’s particularly difficult if you’re a shift worker or have children who can be little sleep thieves. With respect to running, if you exercise late in the day it might be worth changing the time you run. While some studies show that evening exercise doesn’t affect sleep, there are certainly people who find that the surge of adrenalin produced by high intensity exercise makes it hard for them to unwind and get off to sleep. Other things that you should avoid before bed are heavy meals (allow a couple of hours for digestion), looking at a screen (have at least an hour screen-free before sleep) and caffeine (it’s best not to have any after 4pm). Alcohol can also affect both the quality and quantity of your sleep.

To try and help you sleep, make sure your bedroom is dark and cool; that it’s not cluttered with things that will make you think about all the things you need to do the next day; and that you’ve had a period of winding down doing something relaxing, such as a bath or reading. Relaxation is key – you need to quieten your thoughts. There are lots of relaxation apps you can try, including ones that play the sound of the sea or rain to act as white noise and help you drift off.

Practise sleep hygiene, which means going to bed and getting up at the same time every day to get your body into a healthy rhythm and habit. Avoid napping in the day, even if the urge is strong! If you can’t sleep or you wake in the night and can’t get back to sleep, then try to stay calm. Worrying about not sleeping will make it worse. Lie quietly and do some relaxation. If half an hour has passed and you’re still not asleep, then get up. Don’t do what so many patients over the years told me they did – make a cup of tea! You need to avoid stimulation and caffeine, so do something you dislike and find boring, such as ironing. You don’t want to reward yourself. Return to bed after a while and repeat the relaxation techniques.

Sleep disturbance is common and usually short-lived. It’s often related to life events, but it’s worth knowing that there may be a long lag between the event and the sleep issues. Having a longer-term sleep problem is dreadful and can have a huge impact on your life. There are sometimes other health conditions underlying poor sleep. The hormonal fluctuations around the time of the menopause (see here) can cause restless nights for women and an over-active bladder (see here) can mean many night-time wakings. Mood disorders and medication side-effects may also be to blame. See your doctor if this is the case. Remember too that it’s entirely normal to hardly sleep a wink before an important race!

Did you know?

Exercise is a powerful anti-ageing tool. As we get older, our telomeres (the little caps on the end of our chromosomes which protect the genetic material inside) shorten. Exercise has been shown to slow down the rate the telomeres shorten, so our DNA is protected for longer and we age more slowly.

Q I hate running when it’s hot. I sweat so much and get tired really quickly. I’m running a marathon this summer. Do you have any tips?

A Some of us tolerate running in the heat better than others. You’ll

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