The Many Faces of Fatigue

Fatigue can present in many ways from waking feeling exhausted or feeling a crash after meals. With so many reasons for fatigue it is important find the root cause rather than reaching for a quick pick me up in the form of caffeine and sugar.

Hormone Imbalances

Thyroid hormone, the metabolism setter. The thyroid hormone is responsible for setting the energy pace of the body. While your labs may not reveal  overt hypothyroidism, there can be indications in specific thyroid tests that can indicate dysfunction which can often be the crux of fatigue.

Cortisol, the stress hormone. Produced by the adrenal glands, small glands that sit on top of the kidneys. Stress in any form, from inadequate nights sleep to family stress, the body cannot differentiate. Naturally, cortisol is higher in the morning to wake you and improve vitality and to be lowest at night to allow for a restful night sleep. Often this circadian rhythm is flip flopped, causing low energy in the morning and a spike of energy before bed, making sleep disrupted and causing daytime energy to be low. Assessing and balancing cortisol can play a major role in improving energy.

Testosterone is more than a male hormone. It is essential in both men and women for energy support in addition to muscle building and bone density preservation. Often, due to lifestyle stress, testosterone can become depleted and affect energy levels.


Rollercoaster blood sugar is a key cause for energy crashes in the day, especially after eating. Foods high in sugar will spike blood sugar causing an energy surge followed by a rapid crash in blood sugar followed by a drop in energy. This up and down blood sugar can be a major cause of daytime fatigue. Navigating food choices to better support energy is essential.

Caffeine, while tempting, can be detrimental to long term energy improvement. While small amounts of caffeine can be tolerated by some, it can create an artificial energy spike, much like sugar, followed by a crash. Avoiding band-aids like caffeine for artificial energy is a must for a stable energy supply.

Sleep Quality

Sleep apnea can affect anyone of any age and body size. Apnea, meaning breath holding causing low oxygen status, will send signals to the brain there is a lack of oxygen. This sends an alert to wake up and breathe. Restless nights sleep, snoring, morning headaches and fatigue could be due to sleep apnea. It is important to speak with your physician about your risk and if a sleep study is appropriate.

Sleep hygiene may seem trivial but holds more merit than you may think. Keeping electronics including televisions, computers and mobile phones out of the sleeping space can reduce stimulation at night. Reducing light pollution via black out shades or again, keeping electronics out of the room, help improve melatonin production, a hormone in the brain that is responsible for sleepiness. Reduce alcohol, sugar and food consumption prior to bed, all which increase risk of sleep disruption.


Several medications can contribute to energy lulls in the day. From blood pressure medications to allergy medications can cause drowsiness. Finding natural alternatives when appropriate that do not cause lethargy can make marked differences in energy.

Sleep medications, while appropriate for short-term use, when relied upon on a consistent basis can become habit forming, making sleep without them almost impossible. Rather than strong sleep aids, using nutrients that naturally induce sleep could be a better alternative.


Lack of exercise can contribute to fatigue. Sedentary lifestyles, sitting at a desk all day, have been shown to induce fatigue. Exercise simulates blood flow to the brain and muscles can increase focus stamina. Exercise also boosts positive endorphins, mood booster, further improving energy.


Iron helps to carry oxygen to vital organs including the brain. Hypoxia, lack of oxygen, especially in the brain, will cause a decrease in energy. The body needs iron for energy and often specific measures of iron are overlooked.

B-vitamins are water-soluble vitamins that feed the nervous system. Not only do they play a role as a cofactor in the manufacture of positive mood boosting neurotransmitters in the brain, but it also helps to support energy. B-vitamins can be finicky for absorption, making testing and supplementation when necessary appropriate.

Vitamin D is a commonly deficient vitamin the further you are from the equator. The lack of sunshine for months in the north can affect vitamin D absorption and deficiency has been linked to many health ailments including energy deficit. Supplementation is important if deficiency is suspected.

Focusing on your specific needs is essential to fighting fatigue. Testing and supplementation recommendations are as unique as each person. While everyone endures stress in life, our reactions to it and ways we manage will differ depending on our hormone balance, diet, sleep quality, environmental influences, exercise and nutrition. Naturopathic physicians are equip with an array advanced testing, nutrient supplementation, lifestyle counseling suggestions to balance your precise causes of fatigue.

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