You sleep 8 hours and still feel tired all the time, and after 35 you get much less deep sleep, even when every test comes back normal.
First a doctor checks the common causes, like low iron, your thyroid, your blood sugar and sleep apnoea. When those come back normal, there is one more thing: from your thirties you get far less deep sleep, which is the part of the night that repairs you.
If you are tired every day even after a full night, start with a doctor, because the most common causes are easy to test for.
- Feeling tired all the time, what doctors call fatigue, means being tired most days for weeks, even after you sleep enough. It is one of the most common reasons people see a doctor.
- The common causes are checked with a blood test and a few questions: low iron, your thyroid, your blood sugar, vitamin D, vitamin B12, low mood, and medicines you take.
- Sleep apnoea is often missed. It means your breathing stops for short moments while you sleep, so you never get a full night's rest. In South Africa, about 22 in every 100 adults are thought to have it.
- Even when every test is normal, the kind of sleep you get changes with age. Deep sleep, the part that repairs you, falls from about 19% of the night at ages 16 to 25 to about 3% at ages 36 to 50.
- Most of the growth hormone your body releases at night comes out during that deep sleep, and it falls as deep sleep falls.
- No study has shown that taking growth hormone as a medicine makes a healthy adult feel less tired. So a doctor starts with your health checks, your sleep and your training, not with a prescription.
Most everyday tiredness has a cause a doctor can test for, so the first step is a blood test and a few questions, not a new supplement.
These causes are common, and most of them are easy to treat once someone finds them. Only when they come back clear is it worth asking what else changed.
Low iron, even when your blood count came back normal
Why it matters: iron carries oxygen in your blood. In South Africa, 31 in 100 women and 17 in 100 men aged 15 and over are anaemic. The part people miss: in studies, people with low iron stores felt less tired after iron treatment even when their blood count was normal.
Your thyroid, blood sugar, vitamin D and B12
Why it matters: a slow thyroid, high blood sugar or a low vitamin can all make you tired every day. The part people miss: about 7 in 100 South African adults have diabetes, and up to 7 in 10 of them do not know it.
Sleep apnoea, low mood, and your medicines
Why it matters: with sleep apnoea your breathing stops for moments through the night, so you wake up tired however long you were in bed. The part people miss: it is not screened for in South Africa's public health service, and common medicines like some blood pressure tablets and antihistamines also cause tiredness.
About 1 in every 5 South African adults is thought to have sleep apnoea, where your breathing keeps stopping or going shallow while you sleep.
It is missed so often because it happens while you are asleep. A partner noticing loud snoring or pauses in your breathing is usually the first clue.
Raine, African Journal of Thoracic and Critical Care Medicine, 2020, using the Benjafield global estimate. The figure is 22 in 100, counting breathing that stops or goes shallow at least 15 times an hour.
Had your bloods done, and they came back normal? Answer a 60-second quiz, then book a once-off R99 call with a registered doctor.
Claim Your Peptide Therapy ConsultationFrom your thirties you get much less deep sleep, so the same eight hours in bed do less repair than they used to.
Almost nobody tells you this part. Researchers have measured it in a sleep lab, it happens to everyone, and it starts in your thirties, not in old age.
You spend the same 8 hours in bed.
Your alarm goes off at the same time it did ten years ago, and you were in bed just as long. So being told to get more sleep does not help you, because you are already in bed long enough.
But much less of that night is deep sleep.
Deep sleep is the heavy part of the night, when you are hardest to wake. In a study of 149 healthy men, it made up about 19% of the night at ages 16 to 25, and only about 3% by ages 36 to 50.
Most of your growth hormone is released in that deep sleep.
Growth hormone is the signal your body uses overnight to repair tissue. In those same men, the amount released fell as deep sleep fell, and the two moved together whatever the man's age.
By your late thirties you get about five times less deep sleep than you did in your early twenties.
Researchers measured this in a sleep lab, in 149 healthy men aged 16 to 83. The drop happens between the twenties and the late thirties and then stays flat, so by 40 or 45 you have been living at the lower number for years. It is the same stretch of life when people start saying they wake up tired, though no study has shown that the one causes the other.
Van Cauter, Leproult and Plat, Journal of the American Medical Association, 2000. Share of the night spent in deep sleep.
You are in bed the same eight hours, but you get far less of the deep sleep that repairs you.
How much of the night was deep sleep, measured in a sleep lab (Van Cauter et al., 2000, 149 healthy men).
Two other things change over the same years, and you cannot feel either one happening. Muscle mass drops by about 3% to 5% every decade from around age 30 if you do nothing about it, and muscle is where a lot of your daily energy is used and made. Training keeps it, and that is the part you control.
Inside your cells, the tiny parts that make energy, called mitochondria, also make less of it as you age. In a study of 146 healthy people aged 18 to 89, the amount of energy their cells could produce fell steadily with age, and the fitter a person was, the more energy their cells made.
And this is South Africa, so there is one more. In a 2026 study of 173 South African adults, sleep scores dropped as load shedding got worse, and sleep satisfaction and length were hit hardest. The authors call it early work, but most people here will recognise it.
Bloods normal, and you are still tired every day? Answer a 60-second quiz, then book a once-off R99 call with a registered doctor.
Claim Your Peptide Therapy ConsultationOnce your health checks are clear, sleep and training come first, and only then may a doctor talk to you about a peptide that works with your own growth hormone.
A peptide is a tiny piece of protein. Your body makes thousands of them, and each one carries a signal to the cells it fits. The ones below ask your body to release more of its own growth hormone, instead of putting growth hormone in from outside.
It travels through your blood
Once it is in your body, the peptide is carried by your blood to every part of your body.
It fits the cells it was made for
It only fits into a "lock" on certain cells, like a key fits one lock, so only those cells get its signal.
Those cells answer the signal
With these peptides, the cells that answer sit in a small gland at the base of your brain, which releases growth hormone.
Two peptides a doctor may talk to you about, and only your doctor decides which one, if any, suits you.
Ipamorelin
Ipamorelin may ask the gland at the base of your brain to release a short burst of your own growth hormone. It is the simpler of the two. Only your doctor decides which one, if any, suits you.
Learn More About IpamorelinAsk About Ipamorelin
Ipamorelin + CJC-1295
CJC-1295 is a copy of your body's own "make growth hormone" signal. In two placebo-controlled trials with 42 healthy adults, a long-acting version of it raised their own growth hormone for six days or more (Teichman et al., 2006). The pen a doctor may prescribe uses the short-acting version, and the two peptides are often paired, though the pair itself has never been tested in a trial.
Learn More About Ipamorelin + CJC-1295Ask About Ipamorelin + CJC-1295Not growth hormone itself
Growth hormone itself was tested as an anti-ageing treatment in healthy older adults. A review of 31 published reports, covering 18 groups of people and 220 who were treated, found small changes in body fat and muscle, more side effects like swelling, joint pain and painful, tingling hands, and concluded it cannot be recommended for anti-ageing. These peptides work differently: they ask your own body to release its own.
Not a fix for tiredness
No study has shown that these peptides make a healthy adult feel less tired. What is shown in people is that CJC-1295 raises your own growth hormone. Ipamorelin's growth hormone pulse is mostly shown in lab and animal work. Anyone who promises you more energy is promising more than the studies show.
Not for everyone
A doctor says no if you have cancer or had it, if you are pregnant or breastfeeding, or if your blood sugar is too high and has to be treated first. Both peptides are also banned in competitive sport, so they are not for athletes who get drug tested. These are prescription medicines and they have side effects, and the doctor goes through them with you on the call.
Peptide therapy is legal in South Africa if you can answer yes to both of the questions below.
In South Africa these peptides count as medicines, not supplements. Ask these two questions about any peptide you have been offered.
A doctor registered with the Health Professions Council of South Africa (HPCSA) checked your health before prescribing it, and a pharmacy licensed by the South African Pharmacy Council (SAPC) made it to the standard for medicine that goes into people. This is how Clarve works.
You can get peptide therapy the legal way. It starts with a 60-second quiz and one call with a registered doctor.
Claim Your Peptide Therapy ConsultationGet your peptides legally in five easy steps.
The legal way to get these peptides in South Africa is a prescription from a registered doctor, made up by a licensed pharmacy. Clarve gives you both.
Answer a few quick health questions so we can check whether this therapy is suitable for you before you pay anything.
Complete a quick checkout for the R99 consultation fee. You can add other peptides to your consult here if you'd like the doctor to assess them too. R99 is all you pay to start. Your therapy is priced separately once prescribed.
A registered doctor reviews your information in a short online consultation to assess what's right for you.
Based on the consult, the doctor writes your prescription and confirms the price of your therapy.
Once you settle the invoice, your therapy is compounded and dispatched to you.
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Before you book a doctor, check what is worth testing first.
Is it normal to sleep 8 hours and still be tired?
It is common, and it is worth checking. Being tired most days for more than two or three weeks, even after enough sleep, is a reason to see a doctor. The usual causes are low iron, your thyroid, your blood sugar, vitamin D or B12, low mood, sleep apnoea and medicines you take.
Why am I never refreshed after sleep?
Because the hours you sleep and the kind of sleep you get are two different things. Sleep apnoea, alcohol late at night, a hot or noisy room and some medicines all cut your deep sleep. Deep sleep also falls a lot on its own between your twenties and your late thirties.
At what age do you start feeling more tired?
For most people the change starts in the thirties, not in old age. In a sleep lab study of 149 healthy men, deep sleep fell from about 19% of the night at ages 16 to 25 to about 3% by ages 36 to 50, and barely changed after that.
What is my body lacking if I am always tired?
Most often iron, vitamin D or vitamin B12, or it is your thyroid or your blood sugar. You cannot tell which one from how you feel, which is why a doctor tests rather than guesses. Taking supplements you do not need does not help, and some can harm you.
What are the warning signs that tiredness is something serious?
See a doctor quickly if your tiredness comes with weight loss you cannot explain, night sweats, a fever, chest pain, or being short of breath when you walk. Also see a doctor if it has lasted more than a few weeks and you do not know why.
Why am I tired all day but can't sleep at night?
This usually points at your body clock, stress or alcohol rather than at a lack of sleep. Late screens, late coffee, a nightcap and a late nap all push it along. If your mind races every night for weeks, tell your doctor, because low mood and anxiety cause exactly this.
Does load shedding affect your sleep?
In one South African study, yes. In a study published in 2026, researchers asked 173 South African adults about their sleep during load shedding in 2023, and sleep scores dropped as load shedding got worse, with sleep satisfaction and length hit hardest. The authors call it early work.
Does low growth hormone make you tired?
Nobody has shown that. What researchers have measured is that deep sleep and the growth hormone released at night fall together as people age. That they go together is not proof that one causes the tiredness you feel.
Can peptide therapy help with tiredness?
No study has shown that it does. What is shown is that these peptides may raise your own growth hormone. A doctor starts with your health checks, your sleep and your training, and only then talks about whether a therapy suits you.
How do I get my energy back after 40?
Get the common causes tested first, then work on your sleep and your strength. Ask your doctor for the usual blood tests, and mention snoring or pauses in your breathing at night. Then protect your sleep and train with weights twice a week, because muscle drops about 3% to 5% every decade from age 30 if you do nothing.
Why am I always tired and have no energy?
Most often it is one of a short list a doctor can test for: low iron, your thyroid, your blood sugar, vitamin D, vitamin B12, low mood, sleep apnoea or a medicine you take. It is the same list for men and for women. You cannot tell which one it is from how you feel, so ask your doctor for the tests rather than guessing.
My blood tests came back normal, so why am I still tired?
Normal tests rule out the common causes, but they do not measure the kind of sleep you get. Sleep apnoea does not show up in a blood test, and nor does the drop in deep sleep that happens from your thirties. Ask your doctor about your sleep, not only your bloods, and mention snoring or pauses in your breathing at night.
Why am I so tired in my 40s?
Because by 40 you have been getting much less deep sleep for years. Deep sleep drops from about 19% of the night at ages 16 to 25 to about 3% at ages 36 to 50, then stays flat. The drop happens in your thirties, so by your forties you are already at the lower number, while work, children and stress all add to it.
Is feeling tired all the time a sign of perimenopause?
It can be. The NHS lists the hormone changes around menopause as a cause of tiredness, and many women notice broken sleep and night sweats in the years before their periods stop. A doctor checks this along with the other causes. Clarve does not treat menopause, so speak to your own doctor about it.
How much does it cost to talk to a doctor?
The doctor consult is a once-off R99. If the doctor prescribes a therapy, you get the exact price before you pay anything more. Our prices are in line with what others charge, so doing it the legal way does not cost you much more.
- Van Cauter E, Leproult R, Plat L. Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. JAMA, 2000;284(7):861-868 (PMID 10938176).
- Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. SLEEP, 2004;27(7):1255-1273 (PMID 15586779).
- Liu H, et al. Systematic review: the safety and efficacy of growth hormone in the healthy elderly. Annals of Internal Medicine, 2007;146(2):104-115 (PMID 17227934).
- Teichman SL, et al. Prolonged stimulation of growth hormone and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GHRH, in healthy adults. Journal of Clinical Endocrinology and Metabolism, 2006 (PMID 16352683).
- Yokoi K, Konomi A. Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials. British Journal of Nutrition, 2017 (PMID 28625177).
- Verdon F, et al. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ, 2003 (PMID 12763985).
- Turawa E, et al. Prevalence of anaemia, iron deficiency and iron deficiency anaemia in women of reproductive age and children under 5 years of age in South Africa (1997-2021): a systematic review. International Journal of Environmental Research and Public Health, 2021 (PMID 34886524).
- South Africa Demographic and Health Survey, 2016 (anaemia in adults).
- International Diabetes Federation. Diabetes Atlas 2025, South Africa.
- Raine R. Can we afford to treat obstructive sleep apnoea? African Journal of Thoracic and Critical Care Medicine, 2020;26(3) (PMID 34240028), citing Benjafield et al., Lancet Respiratory Medicine, 2019.
- Raine R. Obstructive sleep apnoea: diagnosis is all very well, but treatment is necessary. African Journal of Thoracic and Critical Care Medicine, 2019;25(2) (PMID 34286255).
- de Klerk CJ, Mentoor I, Correia JC, Rampf N. Sleep health in the context of energy insecurity: a mixed-methods study of load shedding in South Africa. Sleep Health, 2026;12(2):185-193 (PMID 41571494).
- Short KR, et al. Decline in skeletal muscle mitochondrial function with aging in humans. PNAS, 2005.
- Harvard Health Publishing. Preserve your muscle mass (3% to 5% per decade from age 30).
- World Anti-Doping Agency. Prohibited List, S2 peptide hormones and growth factors.
Last checked 22 September 2026. This article is general information, not medical advice. Only a doctor can tell you what is right for you.
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