Exploring fatigue from a functional medicine perspective
One of the most common symptoms we hear from new patients at our functional medicine practice in Denver, Colorado, is fatigue. Fatigue can manifest in various ways: some people struggle to get up in the morning, others experience afternoon energy dips—reaching for that 2 PM cup of coffee or tea—and still others feel a constant sense of lethargy or malaise.
You may be wondering:
Why is fatigue so common?
What are its root causes?
How can we support our energy levels and combat fatigue?
Root Causes of Fatigue:
Sleep issues: Interrupted sleep, sleep apnea, insufficient REM or deep sleep
High stress: Dysregulated daily cortisol patterns
Mood disorders: Depression and anxiety can contribute to fatigue
Nutrient deficiencies: Low levels of iron, CoQ10, vitamin B12, and vitamin D3
Hormonal imbalances: Low or suboptimal testosterone
Thyroid dysfunction: Hypothyroidism, characterized by high TSH and/or low free T3
Toxic exposures: Molds/mycotoxins, heavy metals, PCBs
Blood sugar issues: Fluctuations in blood sugar levels, causing spikes and drops
How to Support Your Energy Levels:
Track your sleep: A great first step is investing in a sleep tracker. I personally recommend the Oura ring, as it offers valuable insights into sleep patterns, including deep sleep, REM sleep, and light sleep.
Consider a home sleep study: These are often covered by insurance, and even if you don’t suspect sleep apnea, a home study can provide useful information. Petite women, in particular, can be overlooked for sleep apnea due to smaller airways.
Reduce alcohol consumption: While alcohol might help you fall asleep, it disrupts sleep as it metabolizes, leading to poor sleep quality and low energy the next day.
Manage stress: Dysfunctional cortisol patterns can be assessed through a salivary cortisol test, which provides a 24-hour profile of your stress hormones. Based on the results, your functional medicine provider can recommend adaptogenic herbs to balance your cortisol. Additionally, addressing the underlying causes of stress through meditation, breathing exercises, therapy, or improving work-life balance is crucial.
Test your nutrient levels: Work with your functional medicine provider to assess key nutritional markers. For example, many people feel significantly better with a B12 level of around 700, which is considered optimal in functional medicine, compared to the conventional "above 250" standard.
Consider hormone balance: Low or suboptimal testosterone can affect energy levels. It’s also important to thoroughly assess thyroid function—beyond just TSH—by looking at free T3, free T4, reverse T3, and thyroid antibodies.
Support detox pathways: Regular sweating (via exercise or sauna), bowel movements, and eating clean, pesticide-free foods are key to detoxing. Clean your home environment by investing in air purifiers, using filtered water, and switching to chemical-free cleaning and beauty products.
Balance blood sugar: Stabilize your blood sugar by including protein and healthy fats with every meal or snack. Avoiding excessive sugar and refined carbs helps maintain steady energy throughout the day.
Conclusion:
Fatigue is a common and complex symptom, but understanding its root causes can empower you to make changes that lead to lasting improvements in energy. Whether the issue stems from poor sleep, hormonal imbalances, nutrient deficiencies, or toxic exposures, there are tangible steps you can take to support your body. By addressing underlying factors through functional medicine, you can restore your energy and vitality, allowing you to thrive in daily life.
