Without question, the most common complaint presented to healthcare providers is fatigue. A quick glance through the Merck Manual, a multi-edition text that details most clinical conditions, notes fatigue as a symptom to most of these. Fatigue has several causes. However, taking steps to narrow down these causes can lead to an accurate diagnosis and good results. Since some causes may be related to each other, it is good to have the appropriate tests to help distinguish which ones are relevant to you. Lastly, a rational treatment approach must be taken that ignores common conceptions about how to deal with fatigue and which may not apply. With these steps, getting a handle on fatigue can become a reality.

So why is fatigue so common? The easy answer is that we are rarely consistent about taking the actions necessary to promote an energetic state. One such cause of fatigue is lack of sleep. Most people when asked consider 5-6 hr of sleep sufficient. This is inaccurate. The old adage of 8 hours of sleep is the amount needed, maybe even a little more. It is not enough to get just 8 hours of sleep, rather you must get 8 hours of sleep during times of darkness. This is important because many hormones are dependent on the circadian, or 24 hour, rhythm. Therefore, ideal sleep is estimated between the times of 10 pm and 6 am. This is the time in which the body is to rest. The energy systems of the body are so efficient during daylight hours at providing us energy for activity. Yet during nighttime hours they support rest and recuperation. If this is not allowed to take place, then the body does not adequately recover from the previous day. When this occurs often enough, the body becomes rundown and fatigue begins to onset. One additional note to consider with sleep is that it needs to be restful. For many, sleep is very light and the deeper stages of sleep are not achieved. Reaching the deeper stages of sleep has proven the most restful and allows for the refreshed feeling in the morning as opposed to waking tired. Attempting to overcome fatigue without quality sleep is a futile effort that will lead to disappointing results.

While lack of sleep can negatively affect the hormones, hormones in their own right when imbalanced can result in fatigue. The most common hormone associated with fatigued states is cortisol. Cortisol is a survival hormone. It is often nicknamed the stress hormone as it is the hormone that has the greatest fluctuation in times of stress. The predominant role of cortisol is to maintain stable glucose levels. Glucose is the primary energy source for the body. Either we have adequate glucose for energy, or we convert other components like fat and protein into glucose for energy. When our glucose levels drop too low in blood, it is cortisol that stimulates release of stored glucose from the liver to provide energy. However, with repetitive stress, the glands that produce cortisol lose the ability to continually manufacture it. When this occurs, there is not enough glucose available to continually fuel the cells with energy. This is like trying to run your car without gas. This state is most commonly noted by episodes of hypoglycemia. Examples of being hypoglycemic would be less energy in between meals, roughly mid-morning or afternoon and/or irritability if you go too long without food. This is a problematic scenario since being hypoglycemic taxes the cortisol producing adrenal gland over time making it more difficult to respond to low states of glucose. If this scenario progress long enough or often enough, the cells become less responsive even when glucose is present. Correction of cortisol dysfunction to address low energy is dependent on reducing stress and balancing glucose levels throughout the day.

Another common cause of fatigue is nutrient deficiencies. Nutrient deficiencies were once thought to be rare, however valid clinical testing now allows us to see that the average person has 4-5 nutrient deficiencies, sometimes many more. Even those that are taking supplemental vitamins and minerals are not immune from deficient states. This can be related to poor forms of nutrients, improper combinations of nutrients and lack of assimilation after taking. Vitamins and minerals are most analogous to spark plugs in your care. They are not the main source of energy, but they keep all the cylinders firing. Vitamins and minerals don’t supply energy to the body. That is the role of glucose and oxygen. What vitamins and minerals do among there many functions is to act as cofactors to support the metabolic workings of the body. They allow glucose to go through all the energy production cycles of the body so that it may be used for energy, but they don’t give you energy. This is a false assumption. The only way a vitamin or minerals can provide energy is by making the pathways of the body that generate energy more efficient. Likewise, vitamins and minerals are also needed to produce healthy red blood cells, which transport oxygen. Without oxygen, energy cannot be made. In fact all of the energy production cycles can run effectively, but if you cannot supply oxygen, you will not produce energy. Making sure that you have adequate supplies of nutrient on a daily depends on several factors, but some of the most important include a quality diet that focuses on Paleolithic principles as well as targeted nutritional supplementation to address your specific needs as identified through testing.

While these are by no means all the causes of fatigue, they are without question the most common. Addressing fatigue in a systematic manner allows you a better understanding of what your needs might be as well as how to overcome them. Unfortunately, many individuals unnecessarily deal with fatigue related issues simply because they have many times not had their basic needs meet as detailed above.