The Relationship Between Fatigue and Headaches

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Fatigue and headaches often go hand in hand. For most people, headaches and tiredness are occasional nuisances. They may disrupt productivity for a day or cause you to cancel plans for the evening. However, for some people, they can be a chronic, debilitating duo that affects their daily life.

In fact, frequent headaches and fatigue are overlapping symptoms of many chronic health conditions, including anemia, fibromyalgia, migraines, and sleep disorders. They can also be a side effect of certain medications or caused by lifestyle habits.

This article explores the relationship between fatigue and headaches. It explains potential short-term and long-term causes of headaches and fatigue. It also discusses potential treatments for fatigue and headaches and when you should see your healthcare provider.

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What Causes Headaches and Fatigue?

Lifestyle factors, temporary illness, or chronic health conditions can cause a combination of headaches and fatigue.

Lifestyle Factors

Lifestyle factors that can cause fatigue and headaches include:

  • Alcohol use and hangovers
  • Caffeine withdrawal
  • Dehydration
  • Eye strain from looking at digital screens

Headaches and fatigue caused by lifestyle factors can often be resolved by drinking water, taking over-the-counter (OTC) headache relievers, and getting rest.

Long-Term Conditions

Headache and fatigue are present in many chronic health conditions, including:

If you experience chronic headaches and fatigue, talk to your healthcare provider.


Fatigue and headaches can also be side effects of medication. In particular, hypertension drugs like beta-blockers, calcium channel blockers, and vasodilators can cause headaches coupled with fatigue. Other medications that may have this effect include:

  • Antibiotics
  • Anti-depressants
  • Antivirals
  • Chemotherapy drugs
  • Parkinson's medications
  • Statins
  • Sedatives

Headaches and fatigue can also be caused by drug interactions. If you suspect your medications may be causing you problems, talk to your pharmacist or healthcare provider to see if alternatives are available.


Fluctuating levels of estrogen (a female sex hormone) can trigger headaches and fatigue. This can occur right before your period as part of premenstrual syndrome. It is also common during perimenopause, as the menstrual cycle starts to wind down.

Hormones may also be the culprit behind pregnancy-related and postpartum headaches and fatigue.

In addition, hormonal contraceptives and hormone replacement therapy can sometimes trigger headaches and fatigue.

Short-Term Illnesses

Headache and fatigue are also common in many short-term illnesses. These include:

  • COVID-19
  • Influenza
  • Viral upper respiratory infections like the common cold.

What Is Fatigue?

Fatigue is difficult to define, even within the medical profession.

  • Fatigue can be physical, meaning you have difficulty starting or maintaining activity.
  • Fatigue can be mental, meaning you have trouble with concentration, memory, and/or emotional stability.

Many people use terms to describe fatigue interchangeably, including sleepiness, muscle weakness, loss of strength, lack of energy, and loss of interest.

Complicating the problem, even medical researchers don't really know what actually causes fatigue, and that makes it challenging to treat.

When Fatigue is Chronic

Fatigue is considered chronic when it lasts for more than six months. (That's chronic fatigue as a symptom, not the disease called chronic fatigue syndrome.)

Who Gets Fatigue?

Fatigue is one of the most common complaints healthcare providers hear. Everyone is likely to experience some level of fatigue at some point in their lives.

About two-thirds of people who complain of chronic fatigue have an underlying medical condition (like headaches and migraines) or psychiatric condition that's causing it. (Less than 10% of those people have chronic fatigue syndrome.)

The other one-third of people may have lifestyle causes of fatigue, which can include too little sleep, too much stress, nutritional deficiencies, or low activity levels.

How Fatigue Is Evaluated

If you experience a lot of fatigue, it's important to see your healthcare provider so they can determine the source of it. For instance, is your fatigue related to your headache disorder? Another medical or psychiatric condition? Or "idiopathic," meaning no known cause?

Your healthcare provider will ask you questions to better understand what "fatigue" means to you, including:

  • How would you describe your fatigue?
  • When did your fatigue start?
  • With the treatment of your headaches, is your fatigue improving?
  • How long does your fatigue last? Does it occur daily?
  • What makes your fatigue better or worse?
  • How does your fatigue affect your job or your interpersonal relationships?

Your healthcare provider will also inquire about sleep hygiene and any medications or supplements you are taking, as they could be causing or exacerbating your fatigue.

To rule out an underlying medical cause for your fatigue, like cancer or an autoimmune disease, your healthcare provider will perform a thorough physical examination and order laboratory studies.

Finally, to examine the potential role of psychiatric illness in your fatigue, your healthcare provider will screen you for disorders like depression, anxiety, and substance abuse.


If fatigue is secondary to a psychiatric or medical condition such as a headache, your healthcare provider will focus on treating that underlying illness. Even with treatment, though, fatigue can still persist. Some therapies may help you minimize it, including:

  • Cognitive-behavioral therapy (CBT): CBT involves multiple sessions designed to reorient your beliefs surrounding you fatigue, alter behaviors that'll help you gain control over your fatigue, and help you achieve various physical and personal health goals.
  • Graded exercise therapy (GET): GET involves engaging in physical activity slowly and increasing the level of activity gradually over time. Avoiding extremes and stopping before fatigue sets in is critical.

Other treatment options include:

  • Antidepressants
  • Referral to support groups
  • Counseling on sleep hygiene (e.g., avoiding over-sleeping)

A Word From Verywell

Fatigue can be a debilitating symptom, either on its own or as a result of another underlying disease process, including headaches and migraines.

Try not to be discouraged by it. Speak with your healthcare provider, seek out resources, and stay proactive in your health care.

You may not be able to completely eliminate fatigue from your life, but you can strive to minimize it and gain control.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Johns Hopkins Medicine. Headaches and women: What do hormones have to do with it?

  3. Gudipally PR, Sharma GK. Premenstrual syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.

  4. Sader E, Rayhill M. Headache in pregnancy, the puerperium, and menopause. Semin Neurol. 2018;38(6):627–33. doi:10.1055/s-0038-1673681

  5. Negro A, Delaruelle Z, Ivanova TA, et al; European Headache Federation School of Advanced Studies (EHF-SAS). Headache and pregnancy: a systematic review. J Headache Pain. 2017;18(1):106. doi:10.1186/s10194-017-0816-0

  6. Diagnosis of ME/CFS. Centers for Disease Control and Prevention. July 2018.

  7. Larun L, Brurberg KG, Odgaard-jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2019;10:CD003200.  doi:10.1002/14651858.CD003200.pub8

  8. Find a Support Group. American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society.

Additional Reading
  • Fosnocht KM & Ende J. Approach to the adult patient with fatigue.I n: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014.
  • Peres MF, Zukerman E, Young WB, Silberstein SD. Fatigue in chronic migraine patients. Cephalalgia. 2002 Nov;22(9):720-4.
  • Ravindran MK, Zheng Y, Timbol C, Merck SJ, Baraniuk JN.Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.BMC Neurol. 2011 Mar 5;11:30.
  • Solomon S, Lipton RB, Newman LC. Clinical features of chronic daily headache. Headache 1992; 32:325–9.
  • Spierings EL, van Hoof MJ. Fatigue and sleep in chronic headache sufferers: an age- and sex- controlled questionnaire study. Headache. 1997; 37:549–52.

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.