Headaches and tiredness: what should you know?

A disrupted sleep pattern, dehydration, missed meals, viral illness, eye strain or emotional stress can leave you tired while a headache develops. Anaemia, coeliac disease, chronic kidney disease and COVID-19 are other possible contributors, depending on accompanying symptoms. Burnout may involve exhaustion, reduced concentration and work-related strain. Chronic fatigue syndrome has a more persistent pattern and is not diagnosed from one tired day. Consider whether fatigue is new, present on waking, worsened by activity, or linked with breathlessness, weight change, bowel symptoms, fever or snoring.

Keep a steady sleep and wake routine, drink regularly, eat balanced meals and take screen breaks if reading or computer work worsens the headache. Gentle activity may help if it does not aggravate symptoms; avoid pushing through marked exhaustion. Review alcohol intake and any sedating medicines with a clinician or pharmacist. Keep a simple diary of sleep, meals, headache pattern, energy and menstrual bleeding so an appointment can focus on useful details.

Seek emergency help for a sudden severe headache, new weakness or numbness, confusion, fainting, seizure, stiff neck, repeated vomiting or major vision or speech change. Arrange prompt medical review if fatigue is steadily worsening, limits ordinary activities, follows unexplained weight loss, or occurs with breathlessness, black stools, persistent fever or dehydration. Do not assume prolonged tiredness is simply stress.

Ask whether your sleep, medicines, mood, diet, bleeding pattern or recent infection could explain the symptoms and whether blood or urine tests are appropriate. Mention snoring, bowel changes, alcohol use and any effect of activity on your energy.