Why You're Tired - 5 Common Causes of Fatigue
Do you feel exhausted, although you’re getting adequate sleep? Have you noticed that your mood, memory, concentration, and physical endurance are compromised? Well, you are not alone. Fatigue is actually one of the most common complaints to health care providers, regardless of practice setting or culture.
Getting to the underlying cause of these symptoms is the first step to help you regain your energy. With some simple laboratory testing and thorough history taking through your naturopathic physician, the root cause of your fatigue can be revealed, and strategies for re-balancing can be started to get you feeling your best once again!
Below are 5 common causes of fatigue that I commonly see in my naturopathic practice.
1) Hypothyroidism
It is estimated that approximately 2 in 100 Canadians suffer from overt hypothyroidism. However, subclinical hypothyroidism is estimated to affect up to 15% of the population.
Hypothyroidism or underactive thyroid occurs when our thyroid gland fails to produce adequate amounts thyroid hormones, T3 and T4. The thyroid gland is the master gland of metabolism and energy, and affects almost every cell in the body. Therefore, if your thyroid isn’t working optimally, neither are you!
Symptoms of hypothyroidism include fatigue, depression, constipation, dry skin, brittle nails and hair, muscle aches, poor memory and concentration, cool body temperature, and weight gain.
If you suspect that your thyroid is sluggish, ask your health care provider to order acomprehensive thyroid panel including TSH (thyroid stimulating hormone), fT3 (free T3), fT4 (free T4), and TPO (thyroid peroxidase antibodies). Optimal thyroid levels are achieved when your TSH is below 2.5, TPO is negative, and fT3 and fT4 are in mid-range of the given reference range.
2) Iron Deficiency
Iron deficiency is the most common nutritional deficiency of the world. Individuals who are susceptible are vegans and vegetarians, pregnant women, women with heavy menstrual periods, and individuals with digestive disorders that impede absorption of nutrients.
Symptoms of iron deficiency include fatigue, pale skin, cool body temperature, light-headedness, anxiety or low mood, shortness of breath, thinning of hair, and brittle nails. As you can see a lot of these symptoms overlap with low thyroid function. To diagnose iron deficiency your doctor will order a complete blood count, and ferritin (your body’s iron stores). Optimal iron levels are achieved when your ferritin is above 50ug/L.
3) Vitamin B12 Deficiency
Vitamin B12 is a water-soluble vitamin that is essential for good health. Your body needs vitamin B12 for DNA replication, red blood cell production, and maintaining the health of your nerves.
Vitamin B12 deficiency is associated with a variety of health concerns including anemia and fatigue, dementia, depression, and peripheral neuropathies.
Risk factors for this vitamin deficiency include vegetarian and vegan diets, celiac disease and other digestive disorders that impede absorption, heavy consumption of alcohol, increasing age (ie. the elderly), and long term use of acid-reduction and blood sugar lowering drugs.
Just like iron and thyroid function, vitamin B12 deficiency can be diagnosed with a simple blood test. Optimal vitamin B12 levels are achieved when your levels are above 350 pmol/L.
4) Stress & Adrenal Fatigue
Chronic stress can lead to what is called hypocortisolism or adrenal fatigue. This occurs when your adrenal glands cannot keep up with daily stressors, and business of life, and cortisol (your stress hormone) declines.
Symptoms of suboptimal cortisol levels include fatigue, a stressed-feeling, shakiness if a meal is missed, low blood pressures, dizziness, impaired memory, body aches, and insomnia.
Testing your cortisol involves taking a 4-point salivary hormone test, which can be ordered through your naturopathic doctor (ND). Naturally, cortisol is highest in the morning and declines throughout the day, and should remain low throughout the night while you are sleeping. Your ND will analyze the results, and make treatment recommendations if you fall outside of this normal cortisol curve.
5) Inflammation and Gut Health
Inflammation, or over-reactivity of the immune system has long been known to underlie a wide variety of chronic health disorders - including coronary heart disease, diabetes, and autoimmune disease. More recently, researchers have connected inflammation with fatigue presenting disorders – including depression, anxiety, chronic fatigue syndrome, and fibromyalgia.
It is now clear that the integrity of the gut wall plays a key roll in determining the amount of inflammation that is present in the body. The most integral factor that contributes to gut integrity is the balance and bio-diversity of the microbes that line our intestinal track. These organisms are collectively called the human microbiome, and are tasked with the job of protecting the gut lining from damage, and controlling immune responses in the body. Factors that alter our gut bacteria, and thus contribute to ‘leaky gut’ include the overuse of antibiotics, exposure to environmental toxins, food allergies, and the consumption of diets low in dietary fiber and high in sugar and saturated fat.
If your ND suspects that you have a leaky gut, a variety of laboratory tests may be ordered including - food sensitivity and allergy testing, stool testing, or small intestinal bacteria overgrowth (SIBO) testing. From these results, your ND will recommend an individualized nutritional plan free of food triggers, and a customized gut healing treatment plan.
In health and happiness,
Dr. Meghan van Drimmelen | Naturopath Victoria BC
