What causes fatigue?
Fatigue can be due to many different things and is very common in our society. The causes of fatigue can range from having a simple cold/flu, to hypothyroidism, iron deficiency, stress or nutrient absorption problems. Our Naturopathic Doctors can help you determine what the source of your fatigue is to help you feel better!
Signs that your level of fatigue is unusual and would benefit from treatment:
- You rely on coffee to get going in the morning
- You rely on nicotine to keep you going
- You work more than 8 hours per day, 5 days per week
- You need to sleep more than 8 hours per night on the weekend
- You don’t socialize with your friends/family because of the effort that entails
- You need a nap when you get home from work
- You find it difficult to get up in the morning after at least 7 hours of sleep
What is the underlying cause of fatigue?
Fatigue can often be helped by investigating a few areas such as:
- Diet – as the saying goes, “you are what you eat”, so your diet plays a role in fatigue. Perhaps you have a food allergy or you may not be absorbing nutrients properly due to problems in your stomach or your bowels. Most people have mild food allergies that are not obvious to them, but can create ongoing chronic fatigue. How can you find out? There is a blood test for the mild food allergies, also called food intolerances, that can by done by naturopathic doctors. Information about that test is listed here.
- Sleep – are you getting enough sleep and are you waking feeling refreshed? If you don’t feel refreshed after at least 7 hours of sleep, there is a problem (such as food sensitivities, poor adrenal function, low iron or low thyroid) that needs to be addressed.
- Stress – physical or emotional stress can be exhausting, particularly if it goes on for an extended period of time. Our naturopathic doctors can help by supporting the brain, the nervous system and the adrenal glands to help mitigate the effects of stress, help you regain your energy and prevent chronic disease due to stress.
- Allergies – allergies are hypersensitivity of the immune system to substances that should not be considered an immune threat: dust, pollen, dander, foods etc. If your immune system is on high alert against something commonly encountered like foods, then it is working overtime all the time, which can be exhausting. While most of us don’t have the serious IgE mediated food allergies, like a peanut or shellfish allergy, we often do have milder, non-life threatening food sensitivities that we may not be aware of but that do consume a fair bit of your energy day in and day out. Dairy is a common food sensitivity along with gluten, pineapple, almonds, beans and eggs. Sometimes a 3 week strict elimination of these common sensitivities will unearth the source of your fatigue. If not, there is food sensitivity blood testing that can be done to determine what your exact food sensitivities are.
- Underactive thyroid – your thyroid may not be working well, but not yet bad enough to warrant medication from your doctor. This is a prime opportunity to correct it. Knowing exact thyroid levels (TSH) is necessary to determine if your thyroid is mildly underactive. Optimal TSH is less than 2.00, while your doctor will still consider normal until it is greater than 5.00.
- Low iron – iron deficiency is a common cause of fatigue and hair loss. This is easily checked via a blood test as well, but whether your ferritin level is considered normal or deficient will depend on which lab you go to. We use Gamma Dynacare for our conventional lab tests, the other two commonly used medical labs are CML and Life Labs.
According to Gamma, a normal ferritin level is 80-300. According to CML and Life Labs, it’s about 11-190. Quite a difference right? If you went to Gamma to have your ferritin done and it was 11 you would be told you are iron deficient, if you go to CML you would be told it was normal. I find patients don’t feel normal if their ferritin is less than 40 and optimal is above 60. To properly address low iron, you need to assess why it’s low in the first place and fix that. If you’re female perhaps your periods are excessively heavy and you lose too much each month, maybe your iron absorption is poor because your gut is unhealthy, maybe you just don’t consume enough iron rich foods or maybe you do but there are so many foods in your diet like dairy products and whole grains that inhibit iron absorption that you just don’t take in what you are consuming. Most iron supplements from a drug store are a high dose of poorly absorbed iron. This causes GI side effects like nausea or constipation, so patients find it hard to stick with them long enough to get their iron level up. I tend to prescribe a much lower dose of much better absorbed iron.
- Adrenal fatigue. If the thyroid tests are normal, i.e. your TSH is below 2.00 (check this number!), and ferritin is ok, i.e. over 60, then the next place to look if your energy is low is your adrenal glands. Adrenals are two little glands that sit atop your kidneys and perform a wealth of functions, including giving you energy, drive and motivation. They help regulate blood pressure, water and salt balance, blood sugar, hormone balance, and inflammation. If the fatigue set in after a bout of intense stress or after a period of more chronic stress and thyroid and iron are normal, then I would suspect adrenal glands. There are blood tests that can help assess the adrenals, although it’s not as straightforward as TSH and ferritin. Cortisol is a stress hormone produced by the adrenal glands that should peak in the morning and taper off in the evening. To determine whether cortisol is being produced in a healthy fashion, it is best to measure a morning level and and evening level. DHEAs, and testosterone are produced by the adrenal glands, low levels can indicate underfunctioning adrenals. The adrenal glands need Vitamin C, vitamin B5 and B6, magnesium, zinc and potassium to function normally. Due to stress, the demand often exceeds the supply for these vitamins, leading to weak adrenal function.
- Depression – Depression can manifest as an inability or lack of desire to get out of bed in the morning that is similar to fatigue. If you are really struggling with this and experiencing periods of sadness or despair, see your medical doctor to be assessed for depression. Supporting the adrenal glands and enhancing the brain’s ability to produce a healthy balance of neurotransmitters such as dopamine, GABA and serotonin can help increase your sense of well-being and manage depression.
Which natural therapies help fatigue?
- Diet modifications
- Vitamins, minerals
- Good quality sleep
Naturopathic Medicine can be highly effective for fatigue. Your ND will work with you to help you manage your symptoms and help you treat the cause of your fatigue.
Some Natural Medicine & Fatigue Research:
Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome.
Cochrane Database Syst Rev . 2017; 4:CD003200. doi: 10.1002/14651858.CD003200.
● Systematic review of 8 RCTs with 1518 participants, undergoing exercise therapy for 12-26
weeks (eg. Swimming, walking, cycling, dancing, anaerobic exercise) compared to control
(passive relaxation, CBT, pacing, supportive listening, pharmacological treatment). 7 studies
showed reduction in fatigue following exercise therapy at end of treatment – overall findings
suggest exercise therapy had a positive effect on sleep, physical function and self-perceived
Stress Reduction Techniques:
Reduce emotional stress levels by exercising, deep breathing, and meditating.
–Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012
Holy basil (Ocimum tenuiflorum), an aromatic plant native to the Eastern World tropics, was found to strengthen the body against stress.
–Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012