Are you just really tired or is it a sign of a larger issue?

While being tired 24/7 is a bitter part of adulthood, at what point does it indicate a more serious issue? There are many factors that affect your sleeping habits, but sometimes you’re more than fatigued.

You should be aiming to get in the around seven to nine hours of sleep a night to be fully rested. Most people struggle to make the minimum hours. Your pre-bedtime habits can affect how you sleep; these denominators could make the eight hours a night you sleep, feel like four. However, it’s not normal to feel persistently fatigued for more than a week, according to Jenepher Piper, M.S.N., a certified registered nurse practitioner tells SELF.

Eating before bed, exercising right before bed, your phone and mattress can all factor into the fatigue you feel the next day. On the other end of the scale, going to bed hungry and not exercising enough can also impact your sleep negatively.

There are many ways in which you could be sabotaging your sleep with, leaving you tired the next day.

In some cases you need to flag your fatigue to your doctor, but when? And what could your fatigue be a sign of?

“Sleepiness is simply the drive to sleep. Falling asleep during concerts, sales meetings, or intercourse are sure signs of excessive sleepiness,” board-certified sleep medicine doctor and neurologist W. Christopher Winter, M.D, of Charlottesville Neurology and Sleep Medicine, says.

And, of course, you could also feel wiped even though you know you got enough sleep. This is when you should consider you may just be more than tired.

Your excessive fatigue could be caused by something as minor as PMS, in female’s cases, or getting over a virus. Your immune system works hard to fend off an infection and can leave you feeling fatigued after being sick. Another cause of fatigue could be allergies. Feeling winded, coughing, and a runny nose are all common signs of allergies, but your immune system is kicked into high gear fighting off allergens and can leave you feeling worn out.

Clinical psychologist Alicia H. Clark, Psy.D, confirms your mental health can take a toll on your energy too. Feelings of hopelessness and helplessness associated with depression can drain you.  Clarks added: “If you aren’t sleeping well then you may be more tired, and in turn have more trouble sleeping,”

“Insomnia and mental health challenges are closely related and can exacerbate each other.”

According to Clark “anxiety in particular can be draining” and leave you just as fatigued. If you suspect you’re suffering from these symptoms, you should reach out to your mental health care professional.

If you suffer from diarrhoea, gas, and vomiting once you ingest gluten, or if you don’t feel well after having wheat, barley, or rye products, you talk to your doctor about getting tested for celiac disease. Feeling weak or fatigued, even without other symptoms, could also be a sign of celiac disease, according to the Mayo Clinic.

Extreme fatigue could also indicate Chronic fatigue syndrome– a disorder that causes extreme and unexplained fatigue. It gets worse with physical activity but doesn’t get better once you rest. Another condition that would leave you feeling fatigued, is anemia. Other symptoms can include pale or yellowish skin, shortness of breath, and cold hands and feet. Anemia can be determined by your doctor and resolved by taking an iron supplement.

Fatigue can also be a sign of a Thyroid problem. Your thyroid helps impact several important functions of your body and an under-active thyroid, known as hypothyroidism, can slow down your bodily functions and leave you feeling tired.

Hyperthyroidism on the other hand, a thyroid condition when your thyroid is overactive, speeds everything up and can cause insomnia and an inner restlessness.

Aging can affect the quality of your sleep, as you get older you may wake up more often and have a less consistent sleep pattern. If your fatigue is coupled with other symptoms or disrupts your daily life, it’s best to speak to your GP.

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