I hear the same thing over and over in my practice – “I just don’t have enough energy!” “I’m so tired all the time.” One of the top five health concerns that I see when new patients arrive in my office is that their energy levels aren’t sufficient enough and often complain of fatigue, especially throughout the day. There are many explanations for continuous fatigue and it is my job as a physician to explore that with each and every patient that walks through my door. So let’s look at a number of common things that I look at as part of a differential diagnosis evaluation.
- Anemia: This one usually tops the list as a common cause of chronic fatigue. There are two common types of anemia that is usually seen – iron deficiency anemia and B12 deficiency. Both can be seen, either separately or concurrently. In order to diagnoses either or both, I usually run a blood panel measuring either ferritin, iron saturation, and/or B12 levels. Iron deficiencies in particular often remain undiagnosed, since the symptoms for iron deficiency anemia include shortness of breath, feeling cold, fatigue, pale skin, dizziness, and even restlessness at night.
- Thyroid Imbalances: Hypothyroidism is also another reason for continuous fatigue, and like iron deficiency anemia, it too is often undiagnosed due to its many symptoms that mimic other issues. Symptoms such as feeling cold, hair thinning or falling out, dry itchy skin, weight gain, moodiness, fatigue, changes in appetite are typical of thyroid deficiencies. Conventionally, TSH or Thyroid Stimulating Hormone is tested. If normal, no further testing is usually done. Unfortunately on its own, TSH does not diagnose a thyroid issue. This is where Naturopathic Doctors go further and run a thyroid panel which include specific thyroid hormones T3 and T4 and even thyroid antibodies such as Anti-TPO. These absolutely will measure the levels of thyroid hormones and check to see if any autoimmune disorders such as Hashimotos or Graves disease are present.
- Adrenal Fatigue: Think of a bear. Now think of you encountering that bear in the woods and it suddenly starts chasing you. Your cortisol (adrenal stress hormone) levels go up, your heart and lung action accelerates, blood pressure goes up, and essentially your body operates based on a ‘fight or flight’ acute stress response. Now imagine that stress threat occurs on a regular basis. Continual high amounts of stress which is pretty common in our society now, wreaks havoc on your adrenal glands, which pump out cortisol regularly in response to it. Over time though, the adrenal glands suffer and burn out. Essentially, the gas tank in the car starts to run on empty, and it needs attention. I will often run salivary cortisol panels in my clinic in order to discern adrenal dysfunction and then treat it accordingly. Use of adaptogenic herbs, diet changes, stress management techniques are all different ways to approach adrenal burnout.
- Dehydration: This is a simple one. Drink more water! The majority of our bodies are made up of water, and we certainly do not consume enough of it. Also, certain medications or excess activities can cause loss of water and electrolytes, and that needs to be addressed. Without proper hydration, nutrients cannot reach the brain, resulting in chronic fatigue, brain ‘fog’, lethargy and moodiness.
- Protein Deficiency and Poor Diet: I see this far too often as well. Skipping breakfast or meals in general, indulging in more simple carbohydrates foods or sugars, eating on the run and essentially not providing the body with an appropriate amount of nutrients and functional building blocks that it needs to remain optimally healthy. Eating good proteins and fats allows your blood sugar to stabilize rather than causing dips during the day thus resulting in drops in energy levels. I always do a seven day nutrition log with all my new patients in order to see exactly what foods are being consumed and when. What you eat and when you eat it really does matter where you fatigue is concerned.
- Emotional Stress: For the same reasons why we often have adrenal fatigue, emotional stresses take a toll on your entire nervous system not to mention, mental and emotional levels. When we are continually stressed, many aspects of our lives are affected, including energy, mood, sleep, and even eating habits and exercise. I address the mind-body connection with all of my patients in order to help them understand how non-tangible events can actually have a powerful effect on the tangible body. Techniques such daily walks, connecting with nature, breath work and journal are excellent ways of combatting daily emotional stresses.
- Leaky Gut Syndrome or Malabsorption: Over time, food sensitivities, prescriptions drugs use, eating processed foods and refined sugars and so forth, can cause the gut lining to became permeable, meaning filled with holes. The lining acts as a barrier that controls what passes through it and what shouldn’t. Once that barrier is damaged, Nutrients that we vitally need for optimal functioning, get lost, resulting in malabsorption, which can decrease energy, contribute to muscle and joint pain, brain fog and memory issues, even weight gain and headaches. I see a lot of ‘Leaky Gut’ in my clinic and will often prescribe specific dietary and lifestyle changes to address it, along with supportive herbal and supplemental medicine to repair the gut lining and restore nutrient levels.
If you are struggling with fatigue issues and don’t know where to start, talk to your Naturopathic Physician. Placing your physical health and wellness is our priority in our practice. Along with proper and customized evaluation, we can help you explore your root causes of your health conditions and how to manage and treat them effectively in ways that are right for you.
To your Health,
Dr. Olena Gill is a Licensed Naturopathic Physician and Registered Acupuncturist (2003). She practices at Indigo Integrative Health/The Mind-Body Connection Centre in Parksville, BC on Vancouver Island.
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Disclaimer: No information given here or in any post or page on this site should be construed as medical advice. Please see your doctor for proper evaluation, diagnosis and treatment.