As you get older, you might find yourself asking more frequently, “Why am I so tired?” Having low energy can feel worrisome, but it can be completely normal. As you get older, your muscles naturally lose some strength, your reaction time slows a bit, and can take longer to recover from activity.
“Most people notice as they get older that they don’t bounce back quite as fast as they used to, says Susan Leonard, MD, a UCLA geriatrician. “You might walk a little more slowly, need an extra day after gardening to feel recovered, or choose the elevator over the stairs more often. Those shifts are a normal reflection of an aging body, not a personal failing.”
However, not all low energy is just “normal aging,” so it deserves attention. For example, it’s normal to feel a little tired if you stayed up late or exerted yourself more than usual. But if you’re always tired, or when fatigue is new, more intense than you would expect, or begins to interfere with everyday activities, it can be a sign of an underlying health problem rather than simply slowing down.
So, don’t ignore or brush aside persistent low energy. Dr. Leonard advises, “Paying attention to changes in your energy level—and speaking up about them—can help you and your doctor catch medical issues earlier, treat them more effectively, and protect your ability to stay active and independent.”
What Is Fatigue?
Fatigue, or low energy is more than feeling sleepy or having an off day. It is a lasting sense of weariness, lack of energy, or feeling “wiped out” that does not fully improve with rest. “If you’re so drained that getting dressed, making breakfast, or walking across the room leaves you wiped out day after day, that’s not just ‘getting older,’” Dr. Leonard cautions. “That’s a symptom worth bringing to your doctor.”
Low energy can arise from many overlapping issues, including chronic diseases such as heart or lung disease, kidney or liver problems, diabetes, thyroid disorders, and chronic obstructive pulmonary disease (COPD). These conditions can reduce oxygen delivery, upset metabolism, or strain the body so that even simple tasks feel exhausting.
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POSSIBLE CAUSE |
WHAT IT MIGHT LOOK LIKE |
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Heart or lung disease |
Getting winded walking across a room, chest discomfort, swelling in legs or ankles |
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Anemia or blood loss |
Pale skin, dizziness, rapid heartbeat, shortness of breath with mild exertion |
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Thyroid problems |
Feeling cold, weight changes, hair loss, constipation or jitteriness |
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Sleep apnea or poor sleep |
Loud snoring, gasping at night, morning headaches, daytime sleepiness |
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Depression or anxiety |
Low mood, loss of interest, poor sleep or appetite, a general “slowed down” feeling |
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Medication side effects |
New fatigue after a medication change, dizziness, brain fog, daytime drowsiness |
When Fatigue Is an Urgent Warning
Sometimes, low energy comes on suddenly or is paired with symptoms that suggest an emergency. Sudden, extreme fatigue along with chest pain, new or severe shortness of breath, confusion, trouble speaking, weakness on one side, or black, bloody, or heavy bleeding needs immediate medical attention (call emergency services). These can be signs of a heart attack, stroke, severe anemia, or other life-threatening conditions.
Even when symptoms are less dramatic, new fatigue should not go unexamined. Guidelines from organizations like the National Institute on Aging advise calling your clinician if low energy lasts more than a couple of weeks, keeps you from your usual activities, or has no clear explanation.
“If fatigue is starting to limit the activities that normally bring you joy, that’s a reasonable moment to reach out to your doctor,” Dr. Leonard advises. “You don’t need to wait until it becomes severe.”
Some Cause of Low Energy
Poor sleep is one of the most common and under-recognized drivers of low energy in older adults. Insomnia, restless legs syndrome, pain at night, and disrupted sleep-wake cycles can leave you feeling drained, even if you are in bed for eight hours.
Medications are another big factor. Many drugs used for allergies, pain, mood, blood pressure, or bladder problems can cause drowsiness, fogginess, or drop your blood pressure so much that you feel wiped out when you stand. Dr. Leonard emphasizes, “Any time a patient tells me, ‘I felt fine until my pills changed,’ my first step is to go through that medication list line by line and see if there are drug-drug interactions, side effects or anything we can adjust.”
Mood and stress matter, too. Depression, anxiety, grief, and chronic stress are strongly tied to fatigue in older adults. You might feel “slowed down,” have trouble motivating yourself, or lose interest in activities. Those emotional symptoms may show up before sadness becomes obvious to you or your family members.
Evaluating Low Energy
A fatigue evaluation starts with a methodical conversation. Your clinician will usually ask when the fatigue began, what makes it better or worse, how it affects your daily life, your sleep patterns, appetite, mood, and any recent illnesses or medication changes. Dr. Leonard encourages patients to come prepared: “Bring a written list of your medications, including over-the-counter pills and supplements, and jot down a few examples of when you feel especially tired. That makes our detective work much easier.”
Next, expect a physical exam and some basic tests such as blood work to check for anemia, thyroid problems, infections, kidney and liver dysfunction, and vitamin levels. Depending on your symptoms, your clinician may also order heart tests, imaging, or a sleep study, or refer you to a cardiologist, pulmonologist, sleep specialist, or mental health professional.
Overcome Chronic Fatigue
You can do a lot in your everyday life to support your energy. Gently increasing physical activity, especially walking and simple strength exercises, has been shown to lower fatigue over time, even in people with chronic illness. Start small (e.g., a five- or 10-minute walk once or twice a day, using the wall or a chair for balance exercises, if needed), and build up as you feel able, with your clinician’s guidance.
Nutrition also plays a key role. Eating regular, balanced meals with enough protein, fruits, vegetables, and fluids helps stabilize blood sugar and prevent the midday “crash.” If you have lost weight without trying, have trouble chewing, or rely heavily on snacks instead of meals, ask about seeing a registered dietitian for tailored support.
Dr. Leonard often suggests a “daily energy audit” rather than pushing harder through the day. “Notice which activities give you a little lift—maybe a short walk, time with a friend, or music—and which ones drain you,” she says. “Then, strategically pace the draining tasks, build in recovery breaks, and be sure to protect time for the things that actually recharge you.” Prioritizing meaningful activities, planning rest between chores, and keeping a consistent sleep-wake schedule can all reduce that end-of-day crash.
As a general rule, contact a health-care provider if low energy lasts more than a couple of weeks, gets in the way of usual activities, or does not improve with better sleep and self-care. It is especially important to make an appointment if fatigue is getting worse, is accompanied by weight loss, fever, new pain, shortness of breath, or changes in thinking or mood.
“You know your body and your routines,” she says. “If your energy changes in a way that doesn’t make sense to you, let your doctor know. Fatigue is your body’s way of asking for help, and you deserve to feel as strong and engaged as possible at every age.”
