Posted on: September 15, 2015 at 5:17 am
Last updated: September 23, 2017 at 12:34 am

This post first appeared on Darou Wellness. Go check out their amazingly informative blog about all things health related with advice from some of the leading Naturopathic Doctors in North America.

Fatigue, or tiredness is the number one complaint that brings people in for naturopathic care. There are many underlying factors to investigate in determining the cause of tiredness. Below is my top 10 list of factors that YOU should look into. Many of these are missed in a conventional medical work-up.

1. Adrenal gland function

We live in a world of stress, where we chronically push ourselves beyond a reasonable capacity and expect our bodies to function well with very little down-time or rest. When we perpetually push too hard, one hormonal system in particular suffers: the adrenal glands. Your adrenal glands produce hormones such as cortisol, DHEA and adrenalin, and they all help our bodies adapt to stress better. Over time with chronic stress, a state called “adrenal fatigue” develops. This is characterized by: tiredness, sugar and salt cravings, poor tolerance for stress (meaning that stressful situations are harder to handle), poor blood sugar regulation, sleep disturbances and lower body temperature. If you suspect your low energy could be due to stress and adrenal gland fatigue, this can be tested most accurately with an “Adrenal Stress Index” (salivary hormone panel), which will give information on how best to bring those adrenal glands back to optimal function.

2. Blood sugar regulation


Many people find that when they track their energy patterns, the are either very low just before or just after eating. If your energy is lowest between meals, or before eating this could indicated hypoglycemia or low blood sugar between meals. In this case, eating regularly through the day (every 3 hours), and minimizing sweet and all-carb meals will help. If on the other hand you are very sleepy and bloated after eating, it could indicate high insulin levels or insulin resistance which is associated with poor blood sugar control. In both cases, a blood test for fasting glucose and fasting insulin is important.

3. Food intolerances

Food intolerances are different from allergies in that they are not life-threatening, and may not cause an immediate reaction. They are associated with many conditions, such as: allergies, eczema, asthma, autoimmune disease, digestive upset, low energy, low mood, and acne for example. In some people, intolerant foods can cause sleepiness, low energy, strong food cravings and fogginess. Elimination of the offending foods will often improve energy levels within one month. Testing is very simply done with a blood test which measures IgG or delayed hypersensitivity reactions to a panel of foods.

4. Thyroid function

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Many women experience thyroid disorders, and they often go undetected and untreated especially those considered “subclinical”. Symptoms of thyroid disorder can include: low energy, difficulty maintaining or losing weight, feeling cold, dry skin and hair, low mood or depression, hair loss and constipation. Testing begins with basic blood testing (for TSH, free T4 and free T3), and may also include taking basal temperatures. There is some controversy as to the normal or reference range with thyroid function, so please discuss your results during your appointment if you suspect an undiagnosed or untreated thyroid condition. A mildly-underactive thyroid, called ‘subclinical hypothyroidism’ can cause significant symptoms, and is often overlooked in the conventional medical system.

5. Low Iron levels

Many women experience iron deficiency anemia due to either low dietary intake of iron, or heavy menstrual cycles. If you have heavy periods and are feeling tired, it is very important to first test for iron deficiency, and if low find a good iron supplement to improve iron stores. Low iron levels can manifest as: fatigue and sleepiness, feeling cold, dizziness, increased in headaches, paleness, dry skin and hair loss.


6. Low vitamin B12 level

When you are deficient in vitamin B12, it causes another form of anemia which can also result in fatigue. Along with tiredness, very low vitamin B12 stores can cause numbness or tingling in the hands and feet, feeling cold, and a very red tongue. Low B12 levels are most often associated with a vegetarian diet, but are also seen with gluten intolerance and celiac disease. (Low B12 levels in a non-vegetarian, is a big red flag for gluten-intolerance!) Testing is quite simply done with a blood test for vitamin B12 levels.

7. Sleep quantity and quality

One basic area that most of us can improve on is increasing the number of hours of sleep. The body runs optimally on approximately 8 hours per night, but many of us reach only 6 on a regular basis. Look at ways to get to sleep earlier so that you are in bed for closer to 8 hours each night – you will feel a difference after 2 weeks! Sleep quality is another factor in how rested you feel in the morning. Are you tossing and turning in the night? Or waking and having difficulty falling asleep again? Some causes of poor sleep quality include: a bedroom that is too light (which inhibits melatonin release in the brain), high stress hormones in the night (very common during and after periods of stress), night-time hypoglycemia from eating too many carbs / sugars or starches before bedtime, caffeine after noon and chocolate latein the day, hormones and hot flashes can certainly interrupt sleep, and of course being woken by children / spouses and pets which are harder factors to control. If you are having trouble staying asleep or feel that it is not restful, please investigate some of the factors above.

8. Caffeine intake

Caffeine intake has a puzzling affect on energy levels in that initially there is a big burst of alertness, but this is always followed by a bigger crash. And caffeine generally affects sleep quality even at low amounts, meaning that you are less rested in the morning. Most people find that when they actually stop drinking coffee, after 1-2 weeks their energy is much higher without it! Give it a try!


9. Yeast overgrowth

If your body has an overgrowth of yeast, it can create symptoms including: fatigue, bloating, gassiness, foggy head, sugar cravings, mood swings, and in some cases recurrent vaginal yeast infections. An intestinal yeast overgrowth occurs from: frequent use of antibiotics (even in the distant past), oral contraceptives, weak immune system function, and high sugar intake (which feeds yeast). If you have taken lots of antibiotics in the past or are on oral contraceptives and have a very strong sweet tooth, a yeast problem may be to blame for your low energy.

10. Low mood or depression

Finally, we can’t ignore depression as a cause of low energy. Depression is sometimes very clear, but other times not as obvious. Signs of depression include: low motivation, difficulty sleeping or sleeping too much, feeling overwhelmed or emotional, either under or over-eating and not receiving pleasure or enjoyment from things that you used to like.  If you think that depression may be the cause of your low energy, please discuss with a health care professional for support and solutions to assist both your emotional and physical state. In naturopathic medicine, a combination of nutrition, exercise, omega-3 fats and sometimes other specific nutritional supplements or herbs have proven to be a safe and effective alternative to antidepressant medications.

If you find yourself frequently saying “I’m tired”, I hope that some of the points above have shown you a potential cause. And, please share this article with anyone in your life who is also too tired. There are many possible causes to investigate!

This article was republished with permission from

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Dr. Shawna Darou
Naturopathic Doctor
Contributor to The Hearty Soul.

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