What is Causing Your Fatigue?
In our last post, we talked about the difference between being tired and truly fatigued. Today, let’s dig deeper into what actually causes fatigue—especially the kind that becomes chronic.
Two Main Types of Fatigue Triggers
There are generally two categories of things that can lead to fatigue:
An acute episode—something sudden or intense that rapidly drains your body’s energy reserves. This could be a viral illness, surgery, major life change, or emotional trauma. For example, we often see this with long COVID or post-viral fatigue syndromes.
Ongoing, low-grade stress or inflammation—a more subtle process that slowly chips away at your energy stores. Over time, these small daily stressors or imbalances can accumulate and leave you feeling chronically drained.
How Do We Figure Out the Root Cause?
To uncover the root cause of fatigue, I often start by asking:
What happened 3–4 months before your symptoms started?
Was there:
A significant life stressor?
A trauma or emotional upheaval?
An infection or illness?
A major change in routine, environment, or work?
Understanding your history can help pinpoint what started the fatigue cycle. Then, we dig deeper into associated symptoms—because fatigue rarely happens in isolation.
A (Not-So-Short) List of Things That Can Contribute to Fatigue
Yes, this might feel a little overwhelming, but it’s important to know how many different systems can influence your energy levels:
Seasonal allergies
Thyroid dysfunction
Vitamin deficiencies (especially B12, D, and iron)
Hormonal imbalances (low estrogen, progesterone, testosterone)
Poor sleep or sleep apnea
Autoimmune conditions
Inadequate nutrition or not eating enough nutrient-dense food
Over-processed foods (which can burden your liver and gut)
Overloaded schedules with no built-in rest
Chronic gut infections (like candida overgrowth)
Insulin resistance or prediabetes (often with no obvious symptoms)
High blood pressure
Skin rashes (can be a clue to inflammation or immune imbalance)
Even seemingly mild or unrelated symptoms can offer important clues.
What Role Does Blood Work Play?
Blood work is incredibly helpful—but only when done intentionally. Here are some key labs we often start with:
CBC (Complete Blood Count): Checks for anemia or blood loss
CMP (Comprehensive Metabolic Panel): Assesses kidney and liver function, electrolytes
Thyroid panel: TSH, free T3, free T4
Vitamin levels: B12 and D are common culprits
hs-CRP: A marker of inflammation
Fasting insulin + Hemoglobin A1c: To assess insulin resistance
Hormones: If symptoms suggest imbalances, we may check estrogen, progesterone, testosterone
Sometimes, autoimmune testing is helpful—but only when we suspect that from the symptoms. I avoid what I call the “shotgun approach”—where we order every test under the sun, hoping something turns up. This often leads to confusing or non-actionable results. For example, someone might have slightly elevated autoimmune markers without symptoms, or hormone levels that are a bit off but not clinically significant.
At the end of the day, we treat the patient, not just the number.
That’s why I prefer targeted testing based on your personal history and symptoms. It keeps our approach focused, thoughtful, and much more likely to uncover meaningful insights.
But What If All My Labs Are “Normal”?
This happens a lot. Just because your lab work looks “normal” doesn’t mean your fatigue is normal. It simply means we may not have a conventional lab marker that explains your experience.
That’s when we turn to symptoms, lifestyle patterns, and deeper investigation. Sometimes, we find that addressing sleep quality, stress, inflammation, blood sugar balance, or gut health—through diet, movement, supplements, and daily rhythms—can make a big difference, even when lab tests don’t give us clear answers.
Next week, we’ll dive into practical, realistic ways you can start recovering from fatigue and restoring your energy balance.
In the meantime, if this blog resonated with you or if you’re wondering whether we can help you figure out your root cause, let’s talk. I’d love to work with you one-on-one and get you on a personalized path to feeling like yourself again.
