A Functional Medicine View of Fatigue

Fatigue. It’s become all too common. From debilitating fatigue (chronic fatigue syndrome) to waking tiredness, fatigue is contributing to significant inefficiencies at work, problems with concentration, personal performance, and relationships.

Fatigue can touch almost all of life and can be caused by many varied circumstances.

The Functional Medicine approach to fatigue looks at the whole person and sees the complex interrelationships among many diverse variables:

Step 1: Understand the problem through a complete history and targeted benchmark laboratory data.

Step 2: Replenish the identified nutritional deficiencies using food wherever possible and supplements as necessary. While few of us have a deficit of calories in our diet, many of us have significant micronutrient deficiencies. Some potential nutritional deficiencies that can cause fatigue are folate, B12, B3, B6, magnesium, zinc, and iron.

Step 3: Understand and optimize how the gastrointestinal tract functions. If nutrition can’t be properly ingested and assimilated, or if molecules that are not supposed to be able to enter actually do (food sensitivities), fatigue can occur.

Step 4: Understand inflammation and reduce it. Whether by foreign food-based molecules, infectious disease (Lyme, hepatitis, Epstein Barr for example), sugar dysregulation, smoking or other causes, uncontrolled inflammation, mediated through numerous different molecules, can trigger fatigue.

Step 5: Understand and optimize hormone function. Whether through imbalanced thyroid hormone, low adrenal function (low cortisol), low estrogen or testosterone, or by high insulin (causing first high blood sugar levels then low blood sugar levels), imbalanced hormones can lead to fatigue directly or through their combined effects on the body (obesity contributing to sleep apnea).

Step 6: Understand and balance mood. Depression can cause fatigue. In turn, depression can be caused by imbalances in a number of neurotransmitters. Optimizing neurotransmitter balance through food and supplements can alleviate fatigue. Stress contributes to fatigue through this mechanism.

Step 7: Remove toxic exposures and toxic burden. Heavy metals such as mercury and lead can directly create fatigue by poisoning our energy-generating mechanisms, or mitochondria.

Step 8: Understand a person’s genetic makeup. Genetic inefficiencies can cause fatigue even if all other findings appear normal.

In short, everything that has ever happened to you collectively brings you to the place of feeling fatigued. Usually, fatigue results from a complex set of interacting factors rather than a single cause. For each of us, the source of fatigue may be different because our specific genetics are different and our specific exposures are different.

The GOOD NEWS: by looking at the whole person over the course of his or her lifetime, it is possible to not only alleviate fatigue, but to reverse it.