Chronic Fatigue

This is an all-too-common problem.  If you haven’t found this to be a challenge yourself, just ask those around you in your everyday life – most everyone else has.  (Of note, I’m not talking about the official diagnosis of “Chronic Fatigue Syndrome” here.)

There are the common lifestyle contributors to chronic fatigue: inadequate amounts of sleep, being overworked, being overcommitted (to hobbies, organizations, peripheral family), generalized anxiety, and more.  Often times, these conditions subsequently lead to secondary stress, insomnia, and even bonafide medical diagnoses such as high blood pressure, diabetes, ulcers, and more, whether as a direct or indirect (eg through poor dietary habits) result of such longstanding patterns. 

Aside from these lifestyle matters, doctors often will check routine lab tests to help identify other possible causes of persistent fatigue, including assessments for the thyroid, blood salts, glucose, liver, kidneys, red blood cells (the inadequacy of which is called “anemia”), vitamin B12 and folic acid and iron (a deficiency of any of which will lead to various forms of anemia), and nowadays, vitamin D as well.  For select individuals who are at higher risk for certain conditions, additional testing may be suggested to screen for cancer or heart disease, or to better evaluate any sources of pain. 

From my professional experience, there are a large number of individuals who test normally to the lab investigations listed above.  Patients may then be left with categorical responses from their doctors to “get enough sleep, exercise, and eat right”, or “your labs are all normal – I don’t see anything here”, or something else short of getting into the trenches to either help pinpoint the leading cause(s) of the fatigue, or engage with the patient to help change the lifestyle contributions leading to the fatigue. 

Besides lifestyle modification, which obviously is a longstanding and less-than-straightforward process (which we doctors are generally poorly trained at addressing, which in part leads to the lack of engagement in this intervention process), one simple measure is to check the adrenal glands.  These important organs sit atop the kidneys in the abdomen and are responsible for a number of very important hormones which maintain regulation of multiple metabolic processes, ranging from blood salt balances to blood pressure regulation to your energy level.  In our culture, it is all too common for these adrenal glands to be fatigued themselves, having been overworked, attempting to sustain the body’s energy demands through all of life’s activities.  Thankfully, measurement of the function of these glands is available, as are adrenal support supplements for those who test low.  Ultimately, lifestyle modifications usually address the root problems.  But whereby many individuals are either unwilling or feel unable to make such lifestyle changes, testing for adrenal stress (aka adrenal fatigue or adrenal insufficiency) is often warranted and recommended, followed by adrenal support supplements when results are abnormally low.  Comprehensive adrenal function testing is not available though traditional insurance plans and laboratory facilities, but is available through functional medicine labs like Metametrix and Genova, among others.

http://www.womentowomen.com/adrenalfatigue/default.aspx

http://www.drweil.com/drw/u/id/QAA354425

http://www.doctoroz.com/blog/jacob-teitelbaum-md/treating-underactive-adrenal-glands