Whilst sweating and tiredness are normal bodily functions, when they become extreme and long-lasting, some may worry about the underlying causes. These can be a giveaway sign of a wide range of different medical conditions, from menopause to mental health issues. Below, we will explore in depth the medical conditions associated with both excessive sweating and chronic tiredness. Understanding the possible causes for these symptoms can help in taking steps towards diagnosis and treatment, and moving towards a better quality of life.
Introduction
Experiencing sweating and tiredness is a normal experience, especially after exercise, a stressful situation or just a long day. When these symptoms become chronic, they can significantly affect overall well-being and daily life. It can be especially frustrating if experiencing these symptoms is unrelated to lifestyle choices, leading many to look into possible underlying medical causes.
Excessive sweating (hyperhidrosis) is a broad symptom, with many possible causes. These include genetics, some medical conditions and as a side effect of certain medications. Chronic tiredness (fatigue) is also a common symptom, usually linked to infections, hormone imbalances and mental health issues. These two symptoms can exist independently; for example, if someone struggles with primary hyperhidrosis (excessive sweating not associated with any other condition), and they experience fatigue from an infection. However, they can also be indicative of an underlying condition.
Understanding excessive sweating and chronic tiredness as symptoms
To explore the possible underlying medical causes of these symptoms, we must first define what we mean by “excessive” sweating and “chronic” tiredness and how they differ from normal.
Excessive sweating
Excessive sweating, or hyperhidrosis, is a common condition, affecting just under 5% of the population. The term “excessive” sweating refers to sweating beyond the amount that is needed physiologically.1
Hyperhidrosis is split into primary hyperhidrosis and secondary hyperhidrosis. Primary hyperhidrosis usually presents itself in childhood or adolescence and is not associated with any other detrimental medical condition, as it is hypothesised to be of genetic origin.2 It is characterised by excessive sweating in certain areas like the hands, feet and underarms.2
The type of hyperhidrosis that we will be discussing in this article is called secondary hyperhidrosis. This is a type of excessive sweating that presents itself in adulthood, seemingly out of nowhere. There are two different subtypes of this type of excessive sweating, which describe the way that it presents itself. These are called focal and generalised secondary hyperhidrosis. Focal secondary hyperhidrosis affects specific body areas like palms, feet and underarms. Generalised secondary hyperhidrosis occurs when sweating affects larger portions of the body.
Chronic tiredness
A one-off sleepless night or fatigue after going to the gym are experiences that everyone has gone through in their life. The problem arises when there is no apparent causing event to the tiredness, and it becomes persistent or chronic. This may happen due to lack of sleep, infections, medications or other medical conditions.3 In cases of chronic tiredness, the symptom does not go away after a good night’s sleep, indicating an underlying medical cause.
Common medical conditions associated with both symptoms
Below is a list of common conditions associated with chronic tiredness and excessive sweating as well as other accompanying symptoms.
Thyroid disorders
Thyroid disorders are relatively common and most prevalent in those who were born female. The thyroid is responsible for releasing hormones that control your body’s metabolism. In thyroid disorders, these hormones are either released too much (hyperthyroidism) or too little (hypothyroidism). Excessive sweating and fatigue have been observed in both conditions.4
Other symptoms for hyperthyroidism include:
- Irritability, anxiety, nervousness and mood swings
- Finding it hard to sit still or concentrate
- Difficulty sleeping
- Heat sensitivity
- Muscle weakness
- Diarrhoea and needing to pee more than usual
- Persistent thirst
Other symptoms for hypothyroidism include:
- Cold sensitivity
- Weight gain
- Constipation
- Psychological symptoms like depression, slow thoughts and lack of libido
- Dry skin, brittle nails and hair
- Muscle aches and weakness
- Irregular or heavy periods
Diabetes
Diabetes is a condition in which the body cannot balance blood sugar levels properly. This is a result of either immune cells targeting and destroying insulin-producing cells (type 1) or a deficit in the production of insulin and insulin resistance (type 2). Chronic tiredness and excessive sweating are seen in both subtypes.
In type 1 diabetes, excessive sweating is usually in the upper body, with decreased sweating in the lower body.5 In both types of diabetes, individuals have an increased risk of gustatory sweating.6 This is characterised as sweating when eating or thinking about food, and arises due to nerve damage in the face.
Other symptoms of type 1 diabetes include:
- Peeing more than usual
- Extreme thirst
- Unintentional and fast weight loss
Other symptoms of type 2 diabetes include:
- Peeing more than usual
- Extreme thirst
- Unintentional and fast weight loss
- Itching around the penis or vagina
- Cuts and wounds taking longer to heal than usual
- Blurred vision
Sleep disorders
Disorders of sleep can disrupt sleep quality and lead to daytime fatigue. Sleep apnoea is a relatively common condition in which the throat closes during sleep, preventing airflow and interrupting normal breathing. This causes the body to wake up, hence disturbs sleep. Sleep apnoea causes tiredness in the daytime, but can also cause night sweats.
Other symptoms of sleep apnoea include:
- Making gasping, choking or snorting noises and snoring in your sleep
- Difficulties concentrating
- Mood swings
- Having a headache when you wake up
Heart conditions
Certain heart conditions can cause both chronic tiredness and sweating. In conditions like congestive heart failure, poor blood circulation may cause fatigue and excessive sweating presents more as facial sweating or drenching sweat.7
Other symptoms of congestive heart failure include:
- Breathlessness
- Swollen ankles or legs
- Feeling lightheaded and fainting
Infections
It is common to sweat excessively and become fatigued when you have a fever, as the temperature of your body rises. Common infections which can cause excessive sweating and fatigue include the flu, COVID-19 or Strep A. Less common infections that may cause both symptoms include tuberculosis and endocarditis (heart infection).
Other signs that you may have an infection include:
- High temperature
- Aching muscles
- Sore throat
- Cough
- Blocked or runny nose
- Headache
- Difficulties sleeping
- Loss of appetite
- Diarrhoea and tummy pains
- Vomiting
Menopause
Menopause is defined as the cessation of periods. Everyone who experiences periods will go through menopause either naturally with age or for other premature reasons like surgeries of the reproductive system, chemotherapy or genetic reasons. Hormonal changes during menopause can be responsible for feelings of tiredness and sweating more than usual. Excessive sweating during menopause presents itself with periods of hot flashes and night sweats. Fatigue can be caused due to difficulties sleeping or due to hormonal changes.
Other symptoms of menopause include:
- Heart palpitations
- Headaches or migraines
- Muscle and joint pains
- Changes in body weight and shape
- Changes in mood, such as mood swings or low mood
- Problems with memory and difficulties concentrating
Mental health disorders
Mental health disorders like anxiety can increase sweating and cause fatigue. In anxiety, the body overly responds to relatively harmless stimuli which results in excessive stress. This means that in periods of increased anxiety, you may find yourself sweating more. This can occur all over the body but it is common to sweat on the hands, feet and underarms.8 Following periods of stress, you may feel more tired than usual, as the body recovers from the stress response.
Other symptoms of anxiety include:
- Feeling tense
- Stomach problems
- Heart palpitations
- Feeling lightheaded and dizzy
- Getting sudden attacks of panic and anxiety in panic disorders
- Fearing a specific thing in phobias
Medications
Certain medications can cause chronic tiredness and excessive sweating. Below is a list of some example medications that may be responsible for these symptoms:
ADHD medications
Incorrect dosage can lead to increased sweating and difficulties sleeping.
Antidepressants
Some selective serotonin reuptake inhibitors and tricyclic antidepressants can cause increased sweating.9 They can also cause drowsiness or difficulties sleeping.
Antipsychotics10
Pain medications
Opioids (used as strong painkillers) can make you drowsy and increase sweat production.11
Drugs for dementia, Parkinson’s disease and Alzheimer’s disease
Specific drugs used in the treatment of cognitive diseases, known as acetylcholinesterase inhibitors, can induce sweating and fatigue.12
When to see a doctor
It is important to see a doctor if symptoms get in the way of your daily life and affect well-being. You should consult a doctor before stopping any prescription medications even if they cause unpleasant side effects.
Summary
Excessive sweating and chronic tiredness are broad symptoms, seen in a variety of common medical conditions. These range from hormonal imbalances caused by menopause or thyroid problems to mental health issues like anxiety. They can also be caused by certain medications.
There are many different mechanisms for both symptoms, hence it can be difficult to figure out the underlying cause. Increased sweating and fatigue are often unpleasant for those suffering from them and can lead to a decrease in life quality and well-being. If this is the case for you, it may help to seek a consultation from a doctor or medical professional.
