Cracking the Code on Fatigue

Without a doubt, fatigue is by far one of the most common symptoms we see in clinic, affecting everyone from boys and girls, to men and women in their 80s and 90s. Whether it’s termed ‘fatigue’, ‘tiredness’, ‘low energy’, ‘lethargy’ or something else entirely, fatigue is systemic in our modern society – but why? Whilst there are some well known causes, like inadequate sleep, iron deficiency and stress, there are many other factors that may also contribute to low energy and persistent fatigue. More often than not, we find there are multiple factors that are contributing to a patient’s fatigue, and addressing all of these factors holistically is the most effective way to ensure they feel vibrant and energised again.

Of course, two of the major causes of fatigue we see in today’s world are insufficient sleep and iron deficiency. In this article today though, we’ll be taking a more comprehensive look at some of the other, lesser well-known factors that might be at play. These include:

Poor Blood Sugar Management

Every time we eat, our food is broken down into sugars and absorbed into the blood stream. A hormone called insulin then comes along, picks up the blood sugar and delivers it to our cells where it can be used as energy. When this system is working well, our blood sugars remain balanced throughout the day and our cells receive a steady supply of energy. Unfortunately, certain foods and eating habits can compromise how well we manage our blood sugar and insulin levels, resulting in peaks and crashes in our energy levels and moods.

For example, if we constantly eat foods that cause big spikes in blood sugar, we are constantly calling upon insulin to deal with all that extra glucose. As a result of this constant exposure to insulin, our cells can become desensitised to its effects. Eventually, if blood sugars remain too high for too long (due to this loss in insulin sensitivity), insulin does its second job, which is to store sugar as fat around the abdomen. This results in weight gain around the mid-section, and because that sugar is being stored as fat instead of used as fuel, we end up feeling tired and fatigued. This is why fatigue so often goes hand-in-hand with central weight gain.

Chronic Stress

Chronic stress has a number of detrimental effects on the body, one of which is fatigue. When the body has been under stress for prolonged periods of time (whether that stress is emotional, physical or situational in nature), a number of adaptations can take place that can contribute to fatigue. Not only does prolonged stress affect our production of hormones like cortisol and adrenaline, it also affects our appetite, sleep depth, digestion, cardiovascular health and more. Prolonged stress also increases our requirements for certain nutrients, such as zinc, magnesium and B vitamins.

Whilst various terms have been used to describe this relationship between chronic stress and fatigue (such as adrenal insufficiency, adrenal fatigue and general adaptation syndrome), there is no doubt that prolonged stress can have a major impact on our general wellbeing, energy levels and vitality. In such cases, it is therefore essential to address the cause of stress, whilst also supporting the body with plentiful sleep, beautiful nutrition and other important aspects of health, such as sunshine, rest, relaxation and regular exercise.

Medication Side Effects

Various medications have been linked with the side effect of fatigue, including certain anti-depressants, anti-histamines, anti-psychotics, beta-blockers, sleeping medications and more. In such cases, it’s important to discuss the fatigue with your doctor and if necessary, work with your healthcare provider to explore potential alternatives.

Thyroid Disorders

The thyroid is a butterfly-shaped gland that sits in the neck and influences everything from our metabolic rate, to our energy levels, appetite, growth, temperature, mood, heart rate and more. Sometimes, for various reasons, the thyroid can become either over- or under-active, and in both cases, fatigue is a major presenting symptom. For this reason, when patients present with unexplained fatigue, we often assess their thyroid function via a blood test, to see how well this major gland is functioning. If you’d like to know more about the thyroid, you can read some of our other articles on the topic HERE and HERE.


Humans are approximately 60-70% water, meaning hydration is essential to good health and energy levels. When we are dehydrated, cellular processes are compromised and our energy levels can be affected as a result. Dehydration can also reduce our blood pressure, reducing blood flow to the brain and causing sleepiness. Other signs of dehydration can include thirst, headaches, low blood pressure, dark or infrequent urine, dry skin, dizziness and more. According to Australian guidelines, the average adult should aim for 2.1-2.6 L of fluid per day, but this amount can be affected by various factors, such as weather, exercise, pregnancy, breast-feeding, alterations in kidney function, certain medications and more. If you’re unsure whether you’re drinking enough for your personal circumstances, speak to your naturopath or GP, who can provide some guidance on the topic.

Lifestyle Factors

Whilst we all recognise the importance of adequate sleep to prevent fatigue, there are many other lifestyle factors that also influence our general energy levels. In addition to inadequate sleep quality or quantity, these include insufficient sunshine, lack of exercise, too much exercise, excessive alcohol consumption, excessive caffeine, drug use and more. In all cases, we work with our patients to identify potential lifestyle factors that may be contributing to fatigue, so they can implement habits more conducive to good health and vitality.

Sex Hormones

Our bodies are regulated by around 50 different hormones, of which our sex hormones are a major category. This includes hormones like oestrogen, testosterone and progesterone. In addition to regulating our reproductive function, these hormones also influence our mood, energy levels, vitality, metabolism and more. In some cases, imbalances in our reproductive hormones can contribute to low energy and fatigue. For example, low testosterone in men is commonly associated with fatigue, depression, low motivation and low energy levels. In such cases, identifying and addressing the cause of the hormonal imbalance is essential to implementing an appropriate treatment plan and addressing the issue at the cause.

Nutritional Factors

Of course, one of the major factors that can contribute to fatigue is poor nutrition. Not only does poor nutrition affect our blood sugar levels (as discussed above), but it can also contribute to nutritional deficiencies that compromise cellular energy production. Key nutritional deficiencies commonly associated with fatigue include deficiencies in iron, zinc, magnesium and various B vitamins (such as B3, B6, B9 and B12). All of these nutrients contribute to energy production and maintenance in more ways than one, highlighting just how important it is to consume a nutrient-dense diet rich in vitamins, minerals, antioxidants, polyphenols and more.

The Take Home

To sum up, there are MANY factors that can cause or contribute to feelings of fatigue, and this list is just the beginning. Whilst fatigue and low energy levels are symptoms we see every day in practice, more often than not there is more than one reason for a patient’s fatigue, and for that reason it’s essential to understand and investigate the underlying cause to ensure an appropriate treatment approach can be implemented.

histamine intolerance