Fatigue is a common presenting complaint for so many patients. Frankly, primary care doctors just don’t have the time to properly evaluate people for fatigue. Why you ask? Simple – there simply isn’t enough time. Most primary care doctors have to see a patient about every seven minutes in order to make a profit. That’s possible if the primary complaint is a simple cold, but fatigue requires a much more in-depth assessment. Our Functional Medicine experts can certainly do the comprehensive workup that is necessary to uncover the root cause of your fatigue.
Simple causes of fatigue will likely be discovered with routine blood work done by your primary care doctor. These may include anemia, diabetes, electrolyte imbalances, or obvious thyroid disease. That said, starting with your primary care doctor to rule out these obvious causes is a great idea.
But what about those people who complain of fatigue and have been to the primary care doctor and still don’t have an answer? Some of these patients have been to multiple specialists and still have no answers. This is the perfect case for a Functional Medicine expert.
If the above obvious causes have not been ruled out, we will certainly order tests for these. But we will also look for more subtle causes of fatigue. Probably the most common cause I see in my practice is chronic stress. Most people probably don’t even know that you can measure the effects of chronic stress on the body. We do this with a salivary cortisol test that measures your cortisol levels four times throughout the day. This is your “stress hormone” and chronic stress will often result in adrenal fatigue or hypocortisolism. This takes a long time to correct, but identifying the cause is the first step. People who suffer from stage 3 adrenal fatigue will often have hypofunctioning thyroid glands as well. The dysfunction may not be obvious and you may have been told that your thyroid is normal, but subtle changes can still result in problems. And you may not have obvious diabetes, but this chronic stress may also affect your body’s sensitivity to insulin. This is called insulin resistance and we stage this into three stages as well. We can usually correct these factors with diet changes, stress-reduction techniques, and targeted supplements/herbs.
Another common cause of fatigue is hormonal imbalance. We discussed cortisol, thyroid and insulin, but here we’re talking about sex hormones (estrogen, progesterone, testosterone, etc). When these critical hormones are suboptimal or out of balance, a common complaint is fatigue. Testing for these hormone levels is simple and correcting imbalances often involves diet changes and bioidentical hormone restoration.
Less common causes for fatigue involve toxic exposures (heavy metals, plastics, etc) and chronic infections (Lyme disease and chronic viral infections).
Most causes of fatigue can be uncovered with a detailed history and laboratory assessment. Do not accept a diagnosis of chronic fatigue syndrome without first doing this comprehensive assessment. Ask to see myself or my partner, Joseph Jimenez, when scheduling your appointment. Our Functional Medicine expertise will certainly prove invaluable to you in your endeavor to feel well again.
