Tiredness

Advised

• Iron

  A mineral found in red meat, beans, nuts, dried fruit and fortified breakfast cereals.

  • NHS: Tiredness can be a symptom; a GP will usually check with a blood test.
  • NHS: Iron tablets are recommended if the test shows a low red blood cell count.

  Also covered by NHS and NICE.

  What iron is, and the forms it comes in

• Vitamin B12

  A vitamin found almost only in animal foods, and added to some plant drinks and breakfast cereals.

  • NHS: See a GP if you suspect a deficiency; diagnosis uses symptoms and a blood test.
  • NHS: Injections usually come first, then B12 tablets between meals if the cause is diet.

  Also covered by NICE.

  What vitamin B12 is, and the forms it comes in

• Vitamin D

  A vitamin the body makes when skin is in sunlight. Oily fish, eggs and fortified foods have some; supplements come as D3 or D2.

  • NHS: Everyone should consider 10 micrograms a day in autumn and winter.
  • NICE: GPs assessing tiredness may check vitamin D if someone is at risk of deficiency.

  Also covered by NICE.

  What vitamin D is, and the forms it comes in

Limited evidence

• Ginseng

  The root of the Asian ginseng plant, Panax ginseng, sold as red or white ginseng.

  • NCCIH: Most trials are small and short; research on fatigue does not all agree.
  • NCCIH: Appears safe short term, up to 6 months; trouble sleeping is the commonest side effect.

• Rhodiola

  A plant that grows in cold regions and at high altitudes, sold as a herbal remedy.

  • NCCIH: Not enough reliable evidence to say whether it is useful for any health purpose.
  • NCCIH: Possibly safe for up to 12 weeks; an interaction with losartan has been reported.

• Multivitamins

  A tablet, capsule or gummy with several vitamins and minerals together, often including vitamin D.

  • NICE: Not enough evidence for routine vitamin and mineral supplements to manage ME/CFS symptoms.

  Also covered by NHS.

Advised against

• Caffeine

  A stimulant found in coffee, tea, cola and energy drinks, and sold as tablets and powders.

  • NHS: Cut out caffeine: it can disrupt sleep, leading to daytime tiredness.
  • NHS: Avoid caffeine in the couple of hours before sleep.

Things to check

• NHS: See a GP if you've felt tired for a few weeks without knowing why, or it affects daily life.
• NHS: Do not self-diagnose; see a GP if you're worried.
• NHS: Keep iron tablets out of children's reach: an overdose of iron in a young child can be fatal.
• NHS: 17mg or less a day of iron supplements is unlikely to cause harm; take more only if a GP advises.
• NHS: Do not take more than 100 micrograms (4,000 IU) of vitamin D a day.
• British Dietetic Association: If a multivitamin already contains vitamin D, do not take extra vitamin D unless a health professional advises it.
• NCCIH: Ginseng might lower blood sugar: with diabetes, check with a doctor first. It may also interfere with blood clotting.
• NHS: To cut out caffeine, cut down gradually: stopping suddenly can cause insomnia and headaches.

If you take medication, are pregnant, or have a health condition, check with a pharmacist or GP first.