Why am I always tired?

‘Why am I always tired? No matter what I do, I just don’t feel energized, I don’t have that ‘get-up-and-go’ feeling I used to have.’ These are things way too many people are feeling way too often, especially women Feeling less than optimal all the time means that we dragging ourselves through our days rather than enjoying life’s precious moments.

Having hypothyroidism, a tendency to low iron, becoming a mom while going through naturopathic med school and being a recovering perfectionist means that I’m way too familiar with fatigue, and it means that it creeps up easily if I don’t keep everything in check.

Fatigue is one of the most common health concerns brought to doctor’s offices, but the tricky thing with fatigue is that is has many causes. If you search your symptoms on Google (which I highly recommend avoiding), you’ll find lots of causes, many of them being the scary ones too. Although these shouldn’t be overlooked, here are some of the most common causes of fatigue and what you can do about them. (Please note that many conditions that cause fatigue, including fibromyalgia, cancer, chronic fatigue, Lyme disease, etc. will not be discussed here).

Nutrient deficiency: Many nutrients play a role in energy. In my experience, the most common nutrient deficiencies include:

  • Iron (deficiency can cause fatigue, hair loss, shortness of breath, heavier periods, can contribute to hypothyroidism).

  • Vitamin B12 (deficiency can cause fatigue, depression, anxiety, numbness in fingers and/or toes, hair loss, insomnia).

  • Vitamin D (deficiency can cause fatigue, low immune system, low done density, depression, low hormone production).

  • Magnesium (deficiency can cause fatigue, anxiety, depression, muscle tension or spasms, more frequent headaches, insomnia).

These vitamins and minerals, with the exception of magnesium, can be measured through a simple blood test. Having them within range is important, but having them in an optimal range is even more important. For example, if your ferritin (iron stores) is barely within range, you will feel all the symptoms of an iron deficiency. For women, ferritin should be around 50 ug/L, but if it’s at 10 ug/L, it’s still within the normal range and may not be identified as low.

If these are low, it is important to take a supplement in order to bring them back into a normal range. It is important to support these through diet as well, but diet alone is usually not enough. It is also important to identify why these are low in the first place.

Hormone imbalance: Hormones play a significant role in energy production and feeling well. Although all hormones are important here, the most significant hormones affecting energy are the hormones produced by the thyroid gland, adrenal glands, ovaries (in women) and pancreas (insulin). These must all be in optimal range in order to feel good, and they must all be in harmony as they are all related. For instance, an excess in estrogen will slow down the thyroid gland, or excess stress leading to excess cortisol production will affect progesterone and the thyroid gland.

It is impossible to guess if hormones are out of balance. Testing will give more accurate indication of what is going on and will allow for adequate treatment to be provided.

Within hormone balance however, the first hormone to balance is insulin, which is mainly done through diet. This is actually the exception to testing. Although it is possible to test fasting insulin and then calculate insulin resistance with something called the HOMA Index, it isn’t always done. In most cases though, following a diet that helps keep blood sugar balanced is important regardless of the HOMA Index result and will offer benefit as well.

Stress: High stress and/or chronic stress wreck havoc on the body. When we’re looking at feeling tired, this is a major contributor. If you’re feeling exhausted at fall asleep as soon as your head hits the pillow, you are most likely depleted from long term stress, and if you’re tired but feeling wired at the same time, you are also most likely to be experiencing the impact of long term stress.

Stress leads to hypothalamus-pituitary-adrenal axis dysregulation, which is commonly referred to as adrenal fatigue. The body’s normal response to stress is to release adrenaline and then make cortisol for any stressor that lasts more than 5 or 10 minutes. When this is ongoing, the body’s ability to cope declines and we start to feel it.

If these is the case, stress reduction techniques need to be explored. This can include taking a hard look at lifestyle choices and making changes where they are needed, trying meditation, breathing exercises, yin yoga, etc.

Adaptogenic herbs such as withania (ashwaganda) rhodioal, ginseng (eleutherococcus), licrorice root are some example of herbs that are used to restore the body and balance the stress response. Other important things to consider are magnesium, B vitamins, and diet.

Neurotransmitter imbalance: If you’re feeling a lack of motivation and a lack of get-up and go, your neurotransmitters may be out of balance, especially endorphins or dopamine. This is the neurotransmitter that makes us feel motivated and energetic and it’s also the one responsible for making you feel great after exercising or achieving a goal. It is mainly depleted by chronic stress, inflammation and unbalanced diet.

These are some common causes of fatigue and feeling tired. If any of these resonate with you, it’s time to explore some of these causes to see if they are affecting you. It’s incredible what addressing these imbalances can do to how you feel.

No matter what the cause of your fatigue, here are a few important things that you should keep in mind and see if you have any room for improvement.

Adequate hydration: Are you getting enough water? Even slight dehydration can cause sore muscles, improper elimination and lower energy. You may even want to add a pinch of salt to your water, especially if you know you have low blood pressure or feel light headed easily.

Nutrition: Are you eating enough, getting enough good foods, enough of the building blocks for your health? This means starting the day with a good dose of protein and healthy fats, and avoiding sugar all together for your first meal of the day, and then getting enough protein, a variety of vegetables and fruit, enough carbohydrates and enough fat during the rest of the day?

Quick note on carbohydrates: Keeping a low carb diet is a popular trend, but not the solution for everyone. For many people, it is beneficial to have complex carbs such as a whole grain (quinoa, brown and wild rice, sweet potatoes, squash) with the evening meal as this can help keep blood sugar balanced for a deeper sleep.

In all of the causes of fatigue listed above, diet plays a crucial role and it part of any strategy in healing and reaching optimal health.

It’s also important to consider food intolerances, especially dairy, gluten and sugar as these can be major contributors to fatigue and lethargy. If you know these affect you, stay away from them as much as possible. If you don’t know if they affect you or not, you may want to give avoiding them a try for at least a few weeks and see if you feel better. This could be a game changer.

Following an anti-inflammatory and blood sugar balancing diet is a good place to start as it can kickstart healing. You can check out my Health Reset 1 week anti-inflammatory meal plan as a starting point. This type of diet is something I recommend to most of my patients, and with great results.

Exercise: Exercise is important, but the type of exercise you do is even more important. If you’re feeling exhausted, intense exercise several times per week will most likely set you back rather than help you feel better. Opt for light forms of exercise that don’t leave you feeling exhausted and slowly build up as your endurance builds.

Sleep: This may seem like a no-brainer, but it’s surprising how many of us get inadequate sleep even if we are exhausted. It’s important to stay on routine - going to bed at a regular hour, before midnight, and getting up at a regular hour. Most people need 7 to 8 hours of sleep per night, some needing a little more and some needing a little less. Listen to your body and get what you need. If you have a hard time sleeping, make sure your room is dark enough. If you can see you hand when it’s stretched out in front of you, your room isn’t dark enough.

Doing things you love: Although this may seem like it has nothing to do with what we’re talking about, it actually has everything to do with what you’re talking about. Taking time to do the things we love impacts every single aspect of our health. For example, if your iron is low and you are constantly overwhelmed and never have any time to do things you love, you will feel the symptoms of iron deficiency much more significantly than if you do take the time to do things you love.

In order to be happy, we must do the things that make us happy. This actually helps bring down our stress hormones production and increase our neurotransmitter (serotonin and dopamine) production which we need to feel energized and motivated.

In the end, everything is connected and nothing is black and white when it comes to health and wellness. It’s important to look at things from all angles in order to really get to the bottom of what’s going on.