If you have been experiencing that drained, worn out, exhausted, depleted feeling that you just can’t shift, you are not alone….. in fact fatigue is incredibly common in New Zealand, with 1 in 5 people reporting feeling tired most of the time and 1 in 10 people experiencing ongoing tiredness, with women particularly more susceptible to fatigue than men. However, tiredness or exhaustion that continues on for longer than a month or two is a signal that something isn’t quite right and it may start to impact on your ability to enjoy everyday life.
In this article we discuss
- Lack of Sleep – Do you get enough, or is your circadian rhythm disturbed?
- Thyroid Dysregulation – Do YOU know what to fully check for optimal thyroid function?
- Stress – What are some of the physiological symptoms?
- Peri-Menopause / Menopause – What hormone imbalances can occur as triggers to fatigue?
- Chronic Fatigue Syndrome – Do you have unexplained long-standing fatigue that could be related to other underlying conditions?
- Post-Viral Fatigue Syndrome – What kind of viruses exist and what are the related symptoms?
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AUTHOR: Tonia Willson (Naturopath & Medical Herbalist)
Contributing Factors of Fatigue
There can be many contributing factors that result in fatigue, including poor sleep, thyroid dysregulation, stress, nutrient depletion, peri-menopause / menopause, chronic fatigue and post viral fatigue to name just a few. Looking at and evaluating when and how this fatigue commenced gives naturopaths insight into the root cause of a person’s concerns and allows them to take a holistic approach into allowing the person to heal. Using knowledge acquired through a thorough consult, alongside information gleaned through functional tests and serum markers we are better able to build you a road map back to optimal health.
If you have been feeling fatigued, the following may resonate with you and help you to learn what to do about it.
1. Lack of Sleep
Research suggests that we should get at least 7-9 hours of sleep per night for the body to adequately function, yet many of us are leading incredibly busy lives, with work-life balance often difficult to realise. If you are having trouble sleeping, a naturopath can assist to work out the reasons why you may be having difficulty, in both getting to sleep or staying asleep.
Investigative tools such as the DUTCH Test can assist natural health practitioners to explore whether there may be insufficient melatonin production, or an increase in cortisol that may be contributing to poor sleep. It may simply be, that your sleep wake cycle has been disturbed and you need to reset your circadian rhythm with sleep hygiene practices, along with some herbs and or supplements to support you to get a great night’s sleep.
2. Thyroid Dysregulation
Thyroid disorders can often go misdiagnosed and are a very common cause of fatigue. The common marker to assess thyroid function is TSH, yet this is a poor indicator for picking up thyroid dysregulation and will only typically show as being out of range when overt thyroid disease has already been diagnosed.
Often many people may suffer with fatigue for years before realising that their thyroid is in fact underperforming. As preventative health practitioners, we will investigate further, looking at total thyroid hormone function – this includes additional thyroid hormone tests to rule out any possibility of autoimmune disease being the driver of the dysfunction.
Assessment of stress levels and nutrient deficiencies will also be considered as these can have a significant impact on thyroid health.
It is no surprise, that one of the major causes of sleep disturbances and fatigue is stress, with stress and fatigue often presenting together in unison.
Stress results in inducing the Hypothalamic- pituitary- adrenal axis (HPA axis) to upregulate the Sympathetic Nervous System (SNS) with its typical flight or fight response, increasing adrenaline and cortisol. The result being:
- Increased heart rate
- Increased blood glucose
- Decreased digestion
- Increased inflammation
- Decrease in thyroid hormones production
Long term stress leads to a blunted response, with a decline in cortisol levels, blood sugar dysregulation and ‘adrenal burnout’. This often leads to carb cravings to increase tryptophan levels in the brain, which are associated with mood elevating results.
Being told to reduce stress is simply not enough, you must be given some tools to assist you in doing so, and a naturopath has a variety of options in their kit to assist the individual, in helping to calm down the stress response and to build on their resilience to stress.
4. Peri-menopause / Menopause
This can be a very difficult time for many women with fluctuations in hormones often resulting in fatigue. There are multiple mechanisms involved in this, including:
- Increased inflammation due to the decrease in protective progesterone which acts as an anti-inflammatory.
- HPA axis fatigue, due to a problem with your stress response system because of the reduction in progesterone prior to menstruation or a drop or total reduction of progesterone in peri-menopause / menopausal women.
Sleep can also be interrupted at this time, particularly if night sweats and insomnia are troubling you. As progesterone enhances sleep, disrupted hormones can influence your ability to get a good night sleep. Iron deficiency due to heavy bleeding can also be a consideration as to why you may be experiencing more fatigue than usual.
A naturopath is well placed to investigate all these hormone markers, ensuring that they are well balanced and that nutrient levels and all forms of iron are in the optimal range. We also use the international D.U.T.C.H. tests (read more here) to give us a complete picture of hormones, stress, mood, sleep, methylation processes, and some key neurotransmitter markers. We highly recommend this test and it can be paid through LAYBUY.
5. Chronic Fatigue Syndrome (CFS)
Also known by SEID, CFE or ME is a condition characterised by persistent medically unexplained fatigue, lasting for at least 6 months, and accompanied by other symptoms such as:
- Impaired concentration
- Attention and memory difficulties
- Flu-like symptoms
- Sore throats
- Muscle pain
- Post-exertional fatigue
These symptoms can often co-occur with other illnesses such as fibromyalgia, chemical sensitivities, and irritable bowel syndrome. When treating CFS we will take into consideration all the risk factors involved with the onset of the disorder, as often there is an illness or trigger that initiated the condition.
6. Post Viral Fatigue Syndrome
Similar to CFS, post viral fatigue syndrome, or long-haul COVID, long-haul syndrome, post-viral or post-acute viral syndrome related to SARS-CoV-2, is initiated by the onset of a viral illness.
The predominant persistent symptoms are fatigue which has been shown to be the most prevalent symptom, followed by:
- Muscle and body aches
- Shortness of breath and difficulty breathing or air hunger
- Brain fog and difficulty concentrating
- Exertional intolerance
- An inability to exercise or to be active
- Difficulty sleeping
- Memory and other cognitive issues
- Tachycardia (fast heart rate)
- Joint pain
- Gastrointestinal disturbances, diarrhoea
- Sore throats
- Night sweats, and many more.
It is not known yet why the onset of Post viral fatigue occurs, however there are several hypothesis relating to how it is initiated including:
Viral persistence – Persistence of the virus which could be anywhere within the body
Inactive virus – The virus is still there but inactive causing the immune system to react against genetic material
A hyperactive immune system – Where the virus is gone but leaving the immune system stuck in a highly active state. There may also be food and or environmental sensitivities or intolerances that the body is also having to deal with that is putting the immune system into overdrive and increasing inflammatory responses within the body.
Opportunistic Stealth infections – stealth, persistent infections that were lying dormant but have had an opportunity to replicate as the immune system has become weakened and is no longer able to suppress them
Metabolic energy deficiency and difficulty in producing ATP – A difficulty in the bodies energy exchange system at the cellular level.
In a Nutshell
Unexplained tiredness is very common, and as naturopaths our holistic approach to exploring the underlying issues in their entirety, and reviewing all areas (as noted above) is our goal, as it is most certainly to be yours.
While it can be incredibly tempting to keep reaching for the coffee or an energy drink or head back to bed for a nice nap, there are more effective alternatives and sustainable ways to fight fatigue that can be resolved through getting to the root cause of the issue with your naturopathic practitioner.
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Health Navigator, (2022). Tiredness and Fatigue. Retrieved from https://www.healthnavigator.org.New Zealand/health-a-z/t/tiredness-fatigue/
Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., Hazen, N., Herman, J., Katz, E. S., Kheirandish-Gozal, L., Neubauer, D. N., O'Donnell, A. E., Ohayon, M., Peever, J., Rawding, R., Sachdeva, R. C., Setters, B., Vitiello, M. V., Ware, J. C., and Adams Hillard, P. J. (2015). National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep health, 1(1), 40–43. https://doi.org/10.1016/j.sleh.2014.12.010
Sarris, J., and Wardle, J. (2019). Clinical Naturopathy: An evidence-based guide (3rd ed.). Elsevier.
Hechtman, L. (2019). Clinical Naturopathic Medicine (2nd ed.). Elsevier.
Christensen, L., Brooks, A. (2006). Changing food preference as a function of mood. Journal of Psychology. 140 (4):293-306.
Briden, L. (2021). Hormone repair manual: Every woman’s guide to healthy hormones after 40. Pan MacMillan Australia.
A growing number of ‘long haul’ COVID-19 patients: mydr.com.au. 2021 Oct 01. (Accessed July 27, 2021): https://www.mydr.com.au/practice-connect/growing-number-of-long-haul-covid-19-patients/