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Worn out and weary, women across the country named fatigue among their top five health concerns of 2010 in WebMD's annual Year in Health survey (the other four were period problems, "super foods" best for nutrition, thyroid conditions, and sex and relationship issues). Here are seven of the biggest reasons you may be dragging, and ways to put the spring back into your step.

Thyroid Problems

The thyroid -- a little butterfly-shaped gland in your neck -- produces the hormones that regulate how your body burns fuel for energy. It can be overactive or underactive, but either way you'll feel sleepy.

Why? "With an underactive thyroid you can't get your engine going. With an overactive thyroid your engine's on overdrive and you start to burn out," says Sandra Fryhofer, MD, clinical associate professor of medicine at the Emory University School of Medicine in Atlanta.

Thyroid problems are more common in women, although doctors aren't sure why. "That's the big mystery. It may be related to genetics or hormones -- we don't know," says Hossein Gharib, MD, professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn.

What to do: Tests can reveal whether you need to take a manmade version of thyroid hormone to rev up an underactive thyroid, or antithyroid medicine to calm down an overactive thyroid.

Heart Disease

"We think it's just a man's disease, but it's not," says Fryhofer. In fact, heart disease is a serious threat to women -- more serious than every type of cancer, including breast cancer, even though many women believe cancer is a bigger concern.  According to the American Heart Association, nearly twice as many American women die of heart disease, stroke, and other cardiovascular diseases as from all forms of cancer.

When your heart isn't pumping efficiently, it can't get enough blood out to your body, and that can make you tired. "Fatigue is one of the most common complaints of women with heart disease," says Annabelle S. Volgman, MD, associate professor of medicine and medical director of the Heart Center for Women at Rush University Medical Center in Chicago.

What to do: If you have heart risk factors such as obesity, high blood pressure, and a family history of heart conditions, you need to have your heart checked out. Measuring your blood pressure and other simple tests such as an electrocardiogram or an echocardiogram can pinpoint whether your heart is the source of your weariness.

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