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Why am I so tired? – Functional Medicine Speaks To Common Causes Of Fatigue
An increasing number of my new patients are suffering from fatigue and exhaustion. They often state that they just don’t have the energy they used to. For many, it does not matter how much sleep they get, they just feel run down, tired, and not motivated.
There are many reasons that a person may experience fatigue. Causes include, but are not limited to nutrient deficiencies, dietary choices, hormone imbalances, inflammation, and adrenal gland fatigue.
The most diagnosed medical causes for fatigue include iron deficiency anemia and low thyroid function (hypothyroidism). These 2 conditions are routinely evaluated and diagnosed in traditional medicine. However, if you are not anemic or suffering from low thyroid hormone levels, then traditional medicine does not offer you much in the way of answers.
Common Causes of Fatigue
The root cause of fatigue may be found in the following:
Low Iron
Serum (blood) iron levels can go up and down on a regular basis. Serum iron, along with a Complete Blood Count (CBC) are the main ways most doctors evaluate whether a person has low iron. In addition to this, I also like to test for ferritin levels (your iron reserves), TIBC (Total iron-binding capacity and Iron Saturation to determine optimal levels of iron in the body. TIBC measures how well iron attaches to transferrin and other proteins in the blood. You will become low in iron before you become anemic. When you don’t have enough iron, your red blood cells can’t carry oxygen to your cells. Your cells need this oxygen so they can make energy. Even before you become anemic, you may start to experience fatigue symptoms.
What causes low iron and anemia?
There are a number of causes for low iron. Common causes include blood loss (ex: menstrual or traumatic) or internal bleeding (ex: ulcer), low iron consumption (vegetarian/vegan diet), and impaired digestion/absorption. Since iron is required for red blood cells to transport oxygen to the cells, low iron can lead to anemia if not addressed.
How serious is iron-deficiency anemia?
This condition, if untreated, can ultimately lead to heart failure, where the heart is unable to pump enough blood around the body at the right pressure.
Low Vitamin B12
Weakness and fatigue are common symptoms of vitamin B12 deficiency. This may result from inadequate consumption or impaired absorption of B12. Problems with absorption of B12 may be due to poor digestion or perhaps an autoimmune condition. One of the autoimmune conditions is called pernicious anemia and this is when the body is not producing any (or enough) intrinsic factor. This is a protein that is required for the body to absorb B12. Another autoimmune condition which can affect the absorption of B12 is Irritable Bowel Disease (IBD), consisting of Crohn’s disease and Ulcerative Colitis. Both of these conditions may impact the area of the intestines where B12 is absorbed and thus impair the ability of B12 to get into the body.
How does low B12 cause fatigue and exhaustion?
When your body doesn’t have enough vitamin B12, it is unable to make a sufficient amount of red blood cells (RBC). RBCs transport oxygen throughout your body. When this function is impaired, you are unable to efficiently transport oxygen to your body’s cells, which results in a condition called B12 anemia.
Low thyroid function
Low thyroid means I am tired?
If your thyroid is producing an insufficient amount of thyroid hormone, you may experience fatigue and exhaustion. There are other symptoms that may occur as well, including: cold sensitivity, weight gain, constipation, muscle aches and weakness, depression and muscle cramps, to name a few.’
Low thyroid function is treated with medication, but even when medicated, you can still experience fatigue. There are many causes for this. Please see my other blogs on thyroid function for more information on this subject.
Why doesn’t my thyroid produce hormones?
A low functioning thyroid may be related to the brain signaling to the thyroid or it may be the result of an auto-immune condition called Hashimoto’s Disease. Hashimoto’s disease and hypothyroidism often occur together. But not everyone with Hashimoto’s will develop hypothyroidism and not all cases of hypothyroidism are due to Hashimoto’s.
Hashimoto’s disease
This is an autoimmune condition where the immune system attacks the thyroid gland. (1)
Can Hashimoto’s cause extreme fatigue?
Many individuals with Hashimoto’s still suffer from fatigue, even while taking thyroid medication. Why? Because the fatigue is often due to inflammation from the disease and not due to a lack of thyroid hormones.
Adrenal fatigue
The condition referred to as ‘adrenal fatigue’ is not an accepted medical diagnosis. It is a lay term that applies to a collection of symptoms that relate to the impact of unmanaged stress. These symptoms may include the following: fatigue, nervousness, body aches, sleep disturbances, and digestive problems.
What are adrenal glands?
You have 2 adrenal glands, one sitting on each of your kidneys. They are triangular and measure approximately 5cm by 2cm in size. They are responsible for producing hormones which help to regulate your metabolism, immune system, blood pressure, response to stress and other essential functions.
‘Adrenal fatigue’ seems to be a stress related response that is strongly influenced by circulating cortisol levels. Even though it is not an accepted medical diagnosis, adrenal fatigue has appeared in the medical literature by various names for over 100 years, its prevalence is only recently coming to the forefront.
Your adrenal glands help keep you from feeling fatigued by producing hormones and stimulants such as cortisol, dopamine, norepinephrine, and epinephrine. They also make large amounts of an important hormone called DHEA…this is the most abundant hormone in the human body.
“A number of studies have found that DHEA supplements may help people with depression, obesity, and adrenal insufficiency. DHEA may also improve skin in older people and help treat osteoporosis, vaginal atrophy, erectile dysfunction, and some psychological conditions.”
https://www.webmd.com/a-to-z-guides/dhea#1
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating medical condition characterized by profound fatigue that is not relieved by rest and is accompanied by a range of other symptoms. These symptoms often include unrefreshing sleep, cognitive impairment (often referred to as “brain fog“), muscle and joint pain, headaches, sore throat, tender lymph nodes, and post-exertional malaise (worsening of symptoms after physical or mental exertion). The exact cause of CFS/ME is unknown, but it is believed to involve a combination of factors including viral infections, immune system dysfunction, hormonal imbalances, and genetic predisposition. Diagnosis can be challenging due to the diverse and fluctuating nature of symptoms, and there are currently no specific diagnostic tests for CFS/ME. Treatment typically focuses on managing symptoms through a combination of lifestyle modifications, medications to alleviate symptoms, cognitive-behavioral therapy, and graded exercise therapy.
Functional Medicine and Chronic Fatigue Syndrome
Functional medicine takes a holistic approach to chronic fatigue syndrome (CFS) by identifying underlying imbalances in the body and aiming to alleviate symptoms while improving overall well-being. Through comprehensive evaluations, integrative medicine practitioners address factors like hormonal imbalances, immune dysfunction, and gut issues, tailoring personalized treatment plans. This approach focuses on addressing root causes such as inflammation, oxidative stress, and mitochondrial dysfunction, while emphasizing nutritional support, gut health optimization, stress management, sleep quality improvement, gradual exercise programs, and patient education and empowerment. By targeting the complex interplay of factors contributing to CFS, functional medicine aims to enhance patients’ quality of life and energy levels.
Brain inflammation
There are many possible causes of increased brain inflammation including food allergies and sensitivities, leaky gut, nutrient deficiencies, autoimmune diseases, emotional stress, head injuries etc. When your brain becomes inflamed, your neurons are not able to work properly. The earliest signs of brain inflammation include: fatigue, brain fog, irritability, insomnia, depression and poor short-term memory. You may experience one or a combination of these symptoms. Long standing brain inflammation is correlated with an increased risk for the development of Parkinson’s disease or Alzheimer’s disease.
“Another possible cause of fatigue is oxidative stress. Oxidative stress is a term used to refer to an imbalance with increased production of free radicals (highly reactive molecules in the body) compared to the compensatory mechanisms that inhibit or repair the damage (antioxidants) that may occur. Molecular mechanisms that protect against cellular stresses may be “fatigue generators” that act on the brain through unknown pathways.” (2)
Adderall and Vyvanse… Drugs that may be pushing a brain that is may be already fatigued…
I am now seeing more patients prescribed drugs like Adderall, Ritalin and Vyvanse and adrenal fatigue. “Adderall is an addictive prescription stimulant with effects similar to meth…”
https://www.addictioncenter.com/stimulants/adderall/
“Brain stimulants…(Ritalin, Vyvanse and Adderall) are used (or at least tried) fairly regularly in chronic fatigue syndrome but few studies have examined their effects.”
Drugs like Vyvanse and Adderall are classified as Schedule II drugs… “both drugs are classified as controlled substances by the United States Drug Enforcement Administration in the Schedule II category, indicating that they are at the highest level of control for drugs that can be obtained by people with a prescription from a physician.”
https://americanaddictioncenters.org/adderall/vs-vyvanse
“Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs include… cocaine, methamphetamine, methadone, oxycodone (OxyContin), fentanyl, Adderall, Vyvanse and Ritalin…”
https://www.dea.gov/drug-scheduling
“Concerns have been voiced that, in addition to neurobiological adaptations, prolonged exposure to amphetamine could damage components of the central nervous system… generally referred to as “neurotoxicity.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/
Are there natural Adderall alternatives? Are there natural Vyvanse alternatives?
There are many reasons for the use of these medications. It is important to be thoroughly evaluated by a medical provider to obtain a proper diagnosis before taking any medication. At Naperville Integrated, we do not prescribe medication. Our goal is to remove the obstacles to health and healing by addressing the root cause of symptoms. Many symptoms may be resolved by supporting weakened systems and reducing inflammation. If you would like to seek a natural approach to your health concerns, reach out to use a NapervilleIntegratedWellness.com.
Summary:
There are many possible causes of fatigue, ranging from key nutrient deficiencies, endocrine gland disorders (thyroid and or adrenal glands) chronic inflammation due to foods and even brain inflammation. If you are suffering from fatigue, then the help of a functional medicine doctor may be your best option. Traditional medicine usually does not look beyond anemia and basic thyroid tests. If they can’t find the cause, you may be given a prescription for psychiatric drugs because you are “depressed” or given drugs belonging to the same group of controlled substances as methamphetamines and cocaine.
We specialize in discovering the root causes of fatigue.
Bibliography
Hahm, J. R. (2012). Autoimmune Thyroid Diseases. Hanyang Medical Reviews, 32(4), 219-226. Retrieved 6 19, 2020, from https://synapse.koreamed.org/synapse/data/pdfdata/0130hmr/hmr-32-219.pdf
Omdal, R. (2015). SP0059 CNS Effects of Inflammation: The Brain and Fatigue. Annals of the Rheumatic Diseases, 74, 16-16. Retrieved 6 19, 2020, from https://ard.bmj.com/content/74/suppl_2/16.3
The purpose of functional medicine is:
Understanding how the body works, knowing how and where to investigate health issues, knowing what to look for, understanding the significance of what is found and creating a plan of action to reverse and correct the root cause the health problems.
My wish for you…health, happiness and a better quality of life!
If you would like more information about functional medicine and integrative medicine or Dr. Sexton go to napervilleintegratedwellness.com
Do your own research, inform yourself and ask lots of questions. When collecting information, you MUST consider the source. There is no shortage of false, misleading, outdated, profit-driven and utterly biased information in healthcare today; even from the most respected sources and organizations.
This approach to healthcare is not intended to diagnose, treat, cure, mitigate, or prevent any disease. This article is for information purposes and is not a substitute professional healthcare services. Contact our office for more information.