Are you always tired? Look for these four common underlying causes

Question: I’m always tired and need caffeine to get through the day. I never feel rested, even if I get enough sleep.

Answer: Feeling constantly tired is a symptom of an underlying health issue. Many things can be involved but the four most common ones we see in functional medicine are low thyroid activity, blood sugar imbalances, anemia, and adrenal fatigue.

Common causes of feeling tired all the time

  1. Low thyroid activity (hypothyroidism).

If you’re always fatigued it’s important to rule out low thyroid activity, or hypothyroidism. The thyroid gland regulates metabolism and if it’s under functioning you’ll feel run down. Most cases of hypothyroid in the United States are caused by an autoimmune disease called Hashimoto’s, in which the immune system attacks and destroys the thyroid gland. Hashimoto’s should be addressed by managing the immune system, although thyroid hormone medication may still be necessary.

  1. Blood sugar imbalance. Blood sugar imbalances are very common today and a frequent cause of fatigue. Many people struggle with low blood sugar, high blood sugar (insulin resistance), a combination of both, or diabetes. Low blood sugar causes fatigue, lightheadedness, shakiness, and feeling spaced-out. High blood sugar causes insomnia, an inability to feel rested even after sufficient sleep, and sleepiness after meals.

Blood sugar imbalances are caused by consuming too many sweets and processed carbohydrates, skipping meals, relying on coffee or energy drinks in place of meals, and overeating.

When fatigue is an issue it’s important to evaluate your diet and eat in a way that keeps blood sugar stable.

  1. Anemia.Iron-deficiency anemiais a common cause of fatigue because low iron deprives the body of oxygen and hence energy. Poor nutrient absorption due to a damaged gut wall from undiagnosed gluten sensitivity often underlies iron-deficiency anemia. Other common causes of anemia are a B12 deficiency, inflammation, or an autoimmune disease. It’s important to know what type of anemia you have as unnecessarily supplementing with iron can cause toxic levels; too much iron is highly inflammatory and damaging.
  2. Adrenal fatigue. The adrenals are two walnut-sized glands that sit atop each kidney and secrete hormones to help us respond to stress. Many people have exhausted their adrenal function. Common symptoms of adrenal fatigue are constant tiredness, low blood sugar (hypoglycemia), and low blood pressure. Adrenal fatigue is always secondary to something else, such as chronic inflammation, a poor diet, or chronic stress. Lab testing can assess adrenal function.

Fatigue is a symptom of an underlying disorder

These are just a few causes of fatigue. Other possibilities include food intolerances, gut inflammation, hormonal imbalances, brain chemistry imbalances, dehydration, and of course lack of sleep.

For more information on managing your fatigue, contact my office.

Dr. David B. Tuchinsky, D.C., PLLC
St. Augustine Functional Medicine Practitioner, Speaker and Author
(904) 342-2783

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Dr. Tuchinsky

Dr. Tuchinsky has been “health coach” to thousands of local residents. He has been a popular author and lecturer and has been featured in print media and local TV.