By Dr. Carla Cashin, ND

Fatigue is one of the most common reasons that people reach out to me for naturopathic care

Many don’t feel like their old selves; they have a hard time getting out of bed in the morning and feel sluggish throughout the day. They often push themselves to get through daily activities, whether it’s work, household errands, or taking care of their children. After becoming reliant on coffee or sugary treats to provide a bit of a boost to tackle the day’s tasks, many long for the vital energy they once had.

As a naturopathic doctor, my job is to assess why someone may be experiencing such fatigue, for which there are many different causes. In this article, I review the three most common causes of fatigue that I see in my practice. Once we identify the factors contributing to your fatigue, you can take back your health.

Anemia or low iron levels:

Low iron levels are particularly common in women and those following a vegetarian or vegan diet. This is best identified through blood work: a complete blood cell count (CBC) and ferritin, which can be ordered by either your medical or naturopathic doctor. In naturopathic medicine, we are looking for both overt iron deficiency anemia and suboptimal iron levels. I find most women feel their best when ferritin levels are 50 and above. In addition to supplementation of iron in these cases, it is also important to identify why an individual may have low iron levels. Are levels low because of heavy or prolonged menses, inadequate dietary intake, or poor absorption of nutrients? The naturopathic approach seeks to address the root causes of low iron levels as well as raise levels with supplementation.

Hypothyroidism:

The thyroid gland is a key part of our hormonal system and is responsible for setting our metabolic rate and maintaining energy levels. Hypothyroidism or an underactive thyroid gland is very common in North America, and is estimated to affect 4.6 percent of the population. Aside from fatigue, symptoms associated with hypothyroidism include difficulty losing weight, constipation, dry hair and skin, discomfort in cold temperatures and more. The recommended screening blood work for hypothyroidism is called Thyroid Stimulating Hormone (TSH), and can be ordered by your medical or naturopathic doctor. As a naturopathic doctor, I’m looking for both overt hypothyroidism as well as subtle thyroid imbalances. This means that if TSH is not within an optimal range, I will generally order a broader thyroid panel including T4, T3 and thyroid peroxidase (TPO) antibodies for a more comprehensive assessment. Subtle thyroid imbalances can be addressed with naturopathic therapeutics including diet and lifestyle recommendations, herbal medicines, and vitamin and mineral supplements. In more overt cases of hypothyroidism, thyroid medication is used.

Adrenal Fatigue (Stress Related Fatigue):

The adrenal glands are an important, but often overlooked organ. Intimately involved in the stress response, the adrenals produce the hormones cortisol and adrenaline. When cortisol output is affected, you can feel both tired and wired, or just flat-out exhausted. The normal circadian rhythm of cortisol output involves a release of high cortisol levels in the morning, moderate levels midday, and low levels at night. This normal rhythm can be altered under stress. For example, cortisol levels can be low in the morning leading to morning fatigue, or high at nighttime contributing to poor sleep and associated fatigue. In my practice, we look at your history of stress and symptoms in detail to determine whether stress related fatigue may be an issue for you. Also available are salivary and urinary metabolite cortisol lab tests, which can help fine tune treatment. With effective stress management techniques, good nutrition, herbal medicine and vitamin and mineral supplementation, stress hormone balance and restoration of your adrenal health can be achieved.  

In good health,

Dr. Carla Cashin, ND
Naturopath Victoria