Fatigue is unfortunately one of the most popular symptoms reported by patients in my practice. If it is not the main reason a patient is coming to see me, it is very commonly on the list of signs and symptoms they would like addressed. Below are my top 10 reasons for fatigue, and frequent causes of each.
1. Not Enough Good Quality Sleep
Getting adequate, good quality sleep is of utmost importance to your health. Sleep is when you repair and regenerate your body. Most people need 7-9 hours of sleep per night in order to wake up feeling rested. Of course there are several reasons for not being able to fall asleep or stay asleep, and can range from anxiety or depression, to frequent nighttime urination, pain, or sleep apnea (snoring and/or stopping breathing) for example. Sleep apnea is a very serious cause of sleep disturbance that needs to be evaluated by a physician right away. For more information on proper sleep hygiene, click here.
2. Poor Nutrition
The typical SAD (Standard American Diet) high in sugar, artificial sweeteners, colors, preservatives, poor quality fasts, pesticides, genetically modified foods, and a general lack of plant foods in the diet is a major contributor to lack of energy. As a very first step in treating fatigue, removal of all of the former is necessary, and I commonly recommend a 30-day elimination diet, to really dig in to see if any of the top food intolerances are culprits. In addition, adding 10 servings per day of plant foods to ensure adequate phytonutrients and antioxidants, and enough good quality water (about half of your body weight in ounces, more if it is hot, or with exercise). Sugar, gluten, dairy, corn, soy, and eggs, are frequently culprits of food intolerances, and also legumes and other grains may be to blame as well. The truth is everyone is different, and has the possibility of having food intolerance to ANYTHING…the only way to find out is to eliminate it from the diet for at least 3 weeks, preferably 30 days and track how you feel. For tips on how to get started with healthy eating, click here.
3. High Stress
Stress is a HUGE contributor to disease that is too often overlooked. Getting control of the stress in your life is crucial to your health. Many of you may be thinking, “ I have a stressful job that I can’t change”, or stressful home life, or some other stress in life that is out of your control. Remember, stress starts with your own perception, which is something you can control and change. A daily relaxation practice, especially meditation, can positively change your reactions and responses to stress significantly, as evidenced by a large body scientific research. I explain this in more detail in my blog article on stress, click here (please put link to blog article)
4. Lack of Exercise and Movement
It may seem counterintuitive to expend more energy exercising in order to gain more energy, however that is exactly what happens! Getting 10, 000 or more steps per day in, and at least 3 days per week of regular exercise that you enjoy are key factors in changing your energy metabolism for the better. Of course if you have a medical disease or infection affecting energy production, or your adrenals are not healthy, too much high intensity exercise may make fatigue worse. Consult your physician before starting any exercise program, as there is not one size fits all!
5. Nutrient Deficiencies and Blood Sugar Abnormalities
There are several nutrients that are key in supplying energy to your body, in many different ways. For example, nutrients like iron, B12, and folate are needed to make healthy red blood cells. Red blood cells carry oxygen to your tissues to use, so if there are not enough properly formed and healthy red blood cells around, you are likely to get tired easily. A whole host of nutrients, like riboflavin, niacin, CoQ10, and fatty acids are needed to help supply your mitochondria (the powerhouses of our cells) with the necessary tools to make energy. In addition, both highs and lows in blood sugar can also cause disturbances in energy, as your brain needs glucose to function (unless you are totally ketogenic/fat adapted).
6. Chronic Infections and Autoimmune Disease
If an infection is hanging around, your body will busy mounting a response to it, thus using more energy, in addition to the infection itself causing fatigue. Viral, fungal, and bacterial infections can all be culprits. Epstein Barr and Lyme’s disease are two common infections known to contribute to fatigue. Autoimmune disease of any kind may contribute to fatigue, as there is a dysfunction in the immune system, which may cause symptoms on it’s own, and also makes you more susceptible to infections.
7. Thyroid Dysfunction
Thyroid disease is also a major contributor to fatigue! You can have a low functioning thyroid due to nutrient deficiencies, such as iodine, magnesium, zinc, and selenium to name a few. Autoimmune thyroid conditions may also be the cause, such as Hashimoto’s Thyroiditis, or Grave’s Disease.
8. Hormone Dysfunction
When adrenal (stress) and sex hormones are out balance, your energy can be affected significantly. Long-term stress of any kind, physical, emotional, or environmental, is disruptive to the production and balance of hormones. High stress over a long period of time can cause a rise in cortisol, one of your body’s main stress hormones. If the stress continues, next DHEA will drop, which causes progesterone and testosterone to drop, then ultimately cortisol and estrogen drop if the stress is severe and prolonged, causing significant fatigue.
Toxins of any kind can contribute to fatigue. What do I mean by a toxin? Obvious things like chemicals, pollutants, smokes, preservatives, pesticides, and infections, but other things like heavy metals, molds, and volatile organic compounds fit in as toxins too. Also, let’s not forget food! Especially highly processed, packaged, preserved, GMO, and/or pesticide containing foods. Toxins can be dangerous themselves and cause damage to the body, starve your cells of the necessary nutrients it needs, or the immune system response to the toxin itself can also cause fatigue, among many other symptoms that are often difficult to figure out.
Not surprisingly, there is a very large list of medications with fatigue as a side effect. Medications for pain, sleep, high blood pressure, high cholesterol and seizures, to name a few, commonly cause fatigue. The mechanisms that cause fatigue are different for each medication. For example, we know the statin class of medications to treat high cholesterol causes CoQ10 to decrease, which is an important antioxidant for cardiovascular health and energy production at the cellular level. We also know that beta-blockers for high blood pressure can deplete B vitamins, which are also important for energy production. And of course there are many many more!
This list consists of the most common reasons for fatigue I am seeing in my practice that are highly treatable. There are of course many other causes to consider as well. If you are suffering from fatigue, don’t wait, get to your functional medicine physician to find and treat your root cause!