Why Am I So Tired?

Q. I am in my early 50s, and for the last six months have felt quite lethargic. At times it is an effort just to go for a walk. I have been a vegetarian for 12 years and until now have been in very good health, never needing a doctor or any kind of medication.

Is it possible that my iron intake needs to be increased? Do women in my age group need to look more closely at what vitamins and minerals they are taking? And if I do need more iron, is it true that this should not be taken with whole grains?

A. Being a vegetarian doesn't mean you are not getting enough iron in your diet especially since things have been fine for 12 years. A blood test can determine if you are anemic, and if the anemia is due to a deficiency of B12, iron, or other mineral. That can cause tiredness, shortness of breath, and even confusion.

If you are no longer menstruating and not losing any blood, then you need to look further for an answer. My recommendation is that you go see your doctor and get a work-up including a test for thyroid disease or heart disease. Both of these diseases could also be the cause your symptoms. Doctors sometimes miss these diagnoses since fatigue and a decrease in exercise ability are often attributed to "aging."

Finally, start a relationship with a doctor. At this point in your life it is more important than ever.