Is Extreme Fatigue Normal in the Third Trimester?

While fatigue is a common and expected pregnancy symptom, extreme fatigue is not considered normal. Concerning causes of fatigue in pregnancy include gestational diabetes, anemia, thyroid problems, prenatal depression, and chronic fatigue syndrome.

Fatigue is a common symptom throughout pregnancy and is most common during the first and third trimesters. However, extreme fatigue is not normal and may be a sign of an underlying health condition. 

See your doctor if your fatigue is:

• Severe 
• Persistent
• Lasts throughout the entire pregnancy

Causes of fatigue that may be of concern include: 

• Gestational diabetes
  • The body becomes resistant to insulin during pregnancy which may cause fatigue
  • Other symptoms of gestational diabetes include unusual thirst and frequent urination in large amounts
• Anemia
  • This is a low red blood cell count, which may occur after week 20, when blood volume increases and can deplete the body’s stores of iron
  • Other symptoms of anemia include weakness, pale skin, shortness of breath, and lightheadedness/fainting
• Thyroid problems
  • Having too little (hypothyroidism) or too much (hyperthyroidism) thyroid hormone can cause fatigue
  • Other symptoms of thyroid problems include sudden weight changes, temperature sensitivity, depression, and irritability
• Prenatal depression
  • Being more tired than normal for pregnancy can be a sign of prenatal depression
  • Other symptoms of prenatal depression include sadness, apathy, wanting to sleep all the time or not at all, wanting to eat all the time or not at all
  • If symptoms persist more than two weeks, tell your doctor 
  • Depression during pregnancy can affect both the mother and her unborn baby
• Chronic fatigue syndrome
  • Rarely, extreme fatigue during pregnancy can be a sign of chronic fatigue syndrome
  • This may be linked to a serious form of morning sickness known as hyperemesis gravidarum

All of these causes of fatigue during pregnancy can be managed and treated, so talk to your doctor if you experience any symptoms that concern you.