By naturopath Margaret Jasinska

Feeling tired all the time is a sad reality for a large number of people. Long term fatigue is one of the most common reasons people book in to see a naturopath. The problem is, fatigue is a symptom of so many different health problems. So getting to the bottom of the cause of fatigue can be very difficult.

Autoimmune disease and chronic infections typically cause long standing fatigue that takes a long time to resolve. Luckily some causes of fatigue are easily fixed; nutrient deficiencies and gut problems are fairly easy to remedy, and our patients start feeling better quickly.

Chronic fatigue syndrome (CFS) is fatigue on an entirely different level. It means that fatigue is consistent and severe enough to reduce normal daily activities by at least 50 percent, for a minimum of six months. This type of fatigue is not resolved after a night’s sleep.

There are typically other symptoms associated with CFS, including sore throat, significant post-exercise or exertional pain; poor memory, foggy head, sleep disturbances, muscle pain, and tender lymph nodes. Sadly, the majority of patients with CFS remain functionally impaired for many years.

What are the most common causes of fatigue?

These are the things we check for in our fatigued patients:

Overwhelmingly, I find that patients with digestive problems experience fatigue. This makes sense because the health of your digestive organs determines how well you absorb the nutrients from your meals, and also how well you eliminate wastes and toxins. Improving gut health is vital for increasing energy. There is so much helpful information in Dr Cabot’s book Healthy Bowel, Healthy Body.

Nutritional deficiencies. Iron deficiency in menstruating women is the most common. This can be detected via a blood test for iron studies, particularly looking at ferritin levels. A level below 50 is associated with fatigue. The most common causes of low iron are heavy menstrual bleeding; being a vegetarian or vegan, malabsorption due to digestive problems (such as small intestinal bacterial overgrowth), or the loss of blood from an area of the body (eg. Bleeding bowel polyps). Other common nutritional deficiencies include vitamin B12 (common in vegetarians, vegans and people with digestive problems), vitamin D, magnesium and iodine.

Chronic infections in the body – these can be bacterial such as Lyme Disease from tick bites, streptococcus, staphylococcus, or viral such as the herpes viruses, including glandular fever and herpes virus 6, which is strongly associated with chronic fatigue syndrome.

Autoimmune disease is a very common cause of fatigue. There are more than 80 different autoimmune diseases. Their symptoms vary depending on which part of the body is affected. Two symptoms they all have in common is chronic fatigue and unrefreshing sleep. A lot of autoimmune diseases cause chronic pain, and this has a very draining effect on a person’s energy level. For more information see our book titled Healing Autoimmune Disease: A plan to help your immune system and reduce inflammation.

Leaky gut is strongly associated with fatigue. This is because if the gut lining is inflamed, the absorption of nutrients is impaired. Unfortunately it also means that high levels of bowel wastes and toxins are absorbed into the bloodstream. They travel to the liver and increase its workload. Since leaky gut is a feature of all autoimmune disease, there is a large section about how to overcome it in our book  Healing Autoimmune Disease: A plan to help your immune system and reduce inflammation. Removing food allergens and inflammatory foods from the diet, and taking glutamine to heal the gut lining are critical.

Adrenal gland exhaustion is a very common cause of fatigue in people who have suffered long term stress, or illness or insomnia.

Fatty liver can cause unstable blood sugar levels, poor detoxification capability and sluggish metabolism. As a result, the breakdown of toxic chemicals from the environment, food and water is compromised and general body toxin load increases. This will inevitably cause fatigue.

Inactivity and a sedentary lifestyle results in poor circulation of blood and mental sluggishness.

Insomnia and/or chronic stress. Insomnia can be tricky to overcome, because it can be caused by a variety of factors. Ensuring you get enough magnesium in your diet is important. If you have trouble falling asleep, the natural hormone melatonin can help. It requires a doctor’s prescription.

Thyroid problems, which often remain undetected can cause fatigue. Sometimes thyroid hormones are borderline; they aren’t abnormal enough for the average doctor to treat, yet the abnormality is significant enough to cause low energy, inability to lose weight, depression and other symptoms. For solutions, see our book Your Thyroid Problems Solved.

Selenium assists with thyroid hormone production.

Low levels of testosterone in men and women. Low testosterone is associated with depression, low motivation and drive.

There are many other causes of fatigue; some of which are obvious, but some are hard to detect and that is why it is vital to see a medical practitioner who is thorough.