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Couldn’t we all use a little bit more energy? If yours has been lower than you would like recently, please make sure that you or your doctor haven’t overlooked one of the key hidden causes that might just be holding you back. Today, we’ll explore these causes, and I will help put you in a place to succeed with your health moving forward.
There is absolutely nothing worse than wanting to get up and go, and for whatever reason just not feeling up for it. At some point or another, you have felt fatigued – you have had that feeling where your brain might want to jump out the door, but your body just cannot keep up. What if you felt like that all of the time, though?
Let’s look into the 14 hidden causes of fatigue, what they are and what we can do about them, today…
1. Your Adrenal Function
How healthy is your adrenal function? We can think of this as a hidden cause, especially if you are feeling fatigued at certain points throughout the day – and if your blood pressure is unstable, at the same time. How do you know if you are suffering? You can check out the Adrenal Quiz (1), or you can do a salivary cortisol panel.
Key Insight: If you take the Adrenal Quiz today, you will get directions and advice on how to fix your cortisol issues and get your adrenals back to where you need them to be. If they are not working great, it can help you both understand what level you might find yourself in and what you can do about it – starting today.
When we think of sleep apnea, we think of inadequate breathing throughout the night that contributes to a lower quality of overall sleep. If you feel yourself waking up tired, or if you have been sighing or yawning throughout the day, and your sleep is simply not refreshing – apnea could be the culprit.
Where’s a good place to start? Ask your bed partner what they think of your breathing during the night. Do you snore? Do you hold your breath? Get another opinion on how you sleep, and you might be able to uncover whether or not apnea is the culprit behind your fatigue. If you want to know for sure, though, you might want to consider a sleep test. The tests have come along way in the recent past, and now it is as simple as strapping a belt around your waist and sleeping in your very own bed!
What can you do about apnea, here are some options:
- Losing 5 – 10 pounds can make a huge difference
- Some might need a CPAP machine
- Dental appliances have been shown to be helpful
- Deep breathing exercises can get your breathing back on track
This is especially relevant if you have noticed that you have the signature fatigue, but that you also have bouts of dizziness when standing. Or, these symptoms can get a lot worse before, during, or after your menstrual cycle. That’s important because, if you are anemic, the blood loss associated with your cycle can make it a lot worse. This can also apply to:
- Those with malabsorption
How do you know if you have it? Think about some blood tests. There are actually a lot of ways to quantify anemia, which include:
- Red blood cells
- Percent of iron capacity
- Ferritin levels (ideally 70 – 120)
If you are low, some things you can do to treat anemia all revolve around getting more iron into your system. This might involve iron supplements, like iron bisglycinate, and others might do well with intravenous forms of iron (initially). Red meat and plant-based iron are not really that helpful, and do not get the job done the way supplements do in this case.
If you were deficient in B12, you would certainly feel fatigued. But, there would also be some other factors at play, such as:
- Nerve tingling
- Memory loss
We can see this pretty rampantly in vegans, vegetarians and those with nutrient malabsorption. To make sure that you have it, though, there are serum B12 tests which are good for the latter stages of B12 deficiency. There are also methylmalonic acid tests, via blood or urine, which can show slightly early stages.
Key Insight: Your mean cell volume (MCV) can show early stages of B12 deficiency. If you have less than 95, this can be a warning sign for deficiency.
In the diet, we can get B12 exclusively from animal foods. There has been some talk about quantities of B12 in miso, natto or spirulina, but it really has not panned out to where it can be a reliable option moving forward.
Bottom Line: The thing we can do with B12 is get it through supplements. The methyl versions are preferred (1 – 5 milligrams when deficient, 50 – 100 micrograms for maintenance), while some can do sublingual, and there are also B12 shots available which can do a great job of making up for the deficiency.
5. Caffeine Toxicity
When might you suspect this one? You might have fatigue, but it is especially worse before you have your caffeine. Along with that, we might be able to see:
- Poor sleep quality
- Memory disturbances
If you are trying to determine whether or not you have caffeine toxicity, you might need to try to stop your caffeine intake altogether. Do a three-week test, where you stop all consumption of tea, coffee, and chocolate, just see how that affects your symptoms. If they do not change, it probably was not the caffeine, but you should at least try it first.
Do you feel like you “need” your cup of coffee every single day, just to feel normal? That should raise a red flag right there. If the idea of taking a few weeks off scares you, then that definitely means you are the type of person who should seriously consider it.
Bottom Line: For some, mentioning “caffeine” might feel like a dirty word – you do not want to get rid of it, and you would do anything but. At the same time, this could be the kind of decision that changes your life. Consider cutting down, or cutting it out altogether, and see how you feel.
Hydration seems like a simple thing, but you would be surprised at how many do not stay hydrated enough throughout the day. This is the same sort of routine fatigue that you might feel, but there might also be dizziness or muscle pain at the same time.
There’s an easy way to tell if hydration is a problem for you: your urine is dark. Your urine is a very good indicator of your hydration levels, and when you do not get enough it runs darker.
Bottom Line: If you are not sure whether or not this is you, try and track your water intake. Try and get 3 – 4 quarts of water, each day, for three weeks. The most interesting thing about this is that the more you drink, the stronger your thirst response gets – you drink more, and then you want to drink more.
What’s distinct about fatigue brought on by depression? You might also feel:
- Body pains
- Withdrawal from social activities
- Digestive symptoms
- Numbness or tingling in the extremities
Key Insight: If you are concerned that you might be depressed, there are some great quizzes that you can take to assess whether or not you are suffering from it (2). Speaking with a good health professional or mental health professional can also work wonders.
If you think you might be depressed, there are also some concrete actions steps that you can take right away. They are:
- Screen thyroid function
- Consider cognitive behavioral therapy
- Try journalling
- Avoid caffeine and alcohol
- Manage your blood sugar
- Try exercising daily (outdoors)
- Get omega-3 fats in your diet (from fish and flax)
8. Epstein-Barr Virus (EBV)
First, you have the fatigue. What you might also have is a random sore throat, odd fevers that come and go, or you might be the kind of person who gets sick all of the time and just cannot seem to shake these random illnesses. This might be a case of EBV (3).
The thing about EBV is that you have got to test for it. There are some great tests that screen for it, such as:
One of my favorite treatments for EBV is intravenous vitamin C treatments. This can make a really big difference.
9. Food Intolerances
The nuance here is that while you might experience fatigue, it is most likely going to be coupled with gas and bloating, rashes and joint pain. If you are wondering if you have it, you can easily see these symptoms come and go if you are fasting. If you have done food elimination for about three weeks, and the response is noticeable, you might have just uncovered the root cause of your fatigue.
Testing can help a great deal, and learning more about food intolerances is easy – in fact, I just recently wrote the “Ultimate Guide To Food Intolerance” (4) so, please, check that out when you get the chance.
10. Heart Disease
If you are feeling fatigued from heart disease, you will often notice that it is after you have been physically active in some way, shape or form. If you go up a flight of stairs, and you are just plain exhausted, this is typically a pretty good indication.
Getting to the heart of it is easy, it just requires vigilance. Please stay on top of your:
- Blood pressure – ideally it will be under 110/70.
- Watch your resting heart rate in the morning – it will hopefully be less than 70.
- Keep tabs on your LDL levels – try and keep them under 90.
- Also be aware of advanced markers – LDL-P, hs-CRP, fibrinogen.
This is another case where I am just a big fan of testing, especially when it comes to something as important as your heart. Try and get a coronary artery CT, a stress test, and know if there is any dysfunction going on in there. Even if it is there, it is treatable – the only problem is when we ignore it, then problems start to crop up for us.
This is where we might be dealing with bouts of random low blood sugar. Along with the routine fatigue that we have detailed before, you might also feel:
- Foggy in your brain
The thing about hypoglycemia is that food makes it all better – this is typically how we know whether or not we have it. Any symptoms that are just better with food, may be hypoglycemic symptoms. You can do things, like a glucose tolerance test, to be sure, but the best confirmation is typically that “food test.”
Key Insight: I typically suggest glucose tabs for those who are really trying to identify whether or not they suffer from symptoms due to hypoglycemia. This is not a long-term treatment or solution, but it is an easy way to notice whether or not your symptoms are brought on by low blood sugar.
What can you do about it? Well, simply adjust your diet. Some of the things you can do are:
- Avoid caffeine and alcohol
- Enjoy breakfast with 20 grams of protein and more than 5 grams of fiber
- Avoid sugar
- Make sure you’re getting enough good carbohydrates
- Not getting too many saturated fats
- Always getting enough protein
So, when it comes to hypothyroidism, we have a level of fatigue that is pretty consistent throughout the day. We could also see symptoms like:
- Muscle pain
- Hair loss
- Weight gain
- Drier skin
Key Insight: Worried about your thyroid? Take the Thyroid Quiz (5) and learn a little bit more about your thyroid today. Not only will you get a better idea of where you stand, but you will get some clear, concise action steps that will help you make the best possible decisions for your health.
If you are concerned about your thyroid, one of the most important things you can do is test – and don’t guess (6). After that, you can also consider some of the ways to heal Hashimoto’s today (7).
We often overlook how important magnesium is in our bodies (8), but magnesium deficiency can be one of the most well-hidden culprits for fatigue. If you are deficient, you might notice:
- Sugar cravings
- Muscle cramps
- Leg tremors
If your diet is low in legumes, nuts, seeds or greens, you are especially at risk for this type of deficiency. The best way to find out if you are suffering is with an RBC magnesium test, which can give you a really good idea of whether or not you are lacking in magnesium.
Some of the best food sources, to get more magnesium into your diet, would be:
- Adzuki beans
- Pumpkin seeds
Bottom Line: My favorite supplemental version of magnesium is known as di magnesium malate. All it takes is 100 – 300 mg daily, and you can be back to getting the right amount of magnesium into your body, and getting rid of that chronic fatigue troubling you.
14. Urinary Tract Infection (UTI)
Here is what we always think when it comes to UTIs: wouldn’t it hurt when I pee? Wouldn’t I have some sort of burning pain? For men, usually, but for women, the answer is not always. You might have it, and not feel any pain besides fatigue. There could be:
- Back pain
If you are feeling run down, this is one more thing to think about – and it is especially important, because you might not be noticing it at all. Have your doctor do a simple urine test, but also do a urine culture to really get a full idea of where you stand.
Bottom Line: Ultimately, UTIs can be recurrent for women. In those cases, when antibiotics just will not cut it, mannose can be a great way to reverse that.
Bonus: Vitamin D Deficiency
There is actually one more hidden cause for fatigue, and it is vitamin D deficiency. This is where you might experience fatigue, as well as chronic pain and an overall weakened state of immunity. We only really know about this sort of deficiency through testing, where we would normally want to see 40 – 55 nanograms per milliliter (9).
Most do really well on about 5000 units of vitamin D3, every single day. The thing is that the sun can be inconsistent in helping reverse this deficiency, which is why it is so important to test.
Get To The Bottom Of Your Fatigue
Have you been concerned about your fatigue, and have some of these hidden culprits caused you to question whether or not you know about your fatigue? Start with the Adrenal Quiz (10) today, I know we mentioned it earlier but it needs to be repeated. If you feel like you are struggling with your energy levels, you need to do everything you can to get to the bottom of it. Don’t ignore feeling tired ever again, and get to the feeling better starting today!
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, cure diabetes, and regain energy. Learn more about the surprising story that started his quest.