Fatigue: Our Daily Struggle

I see so many adults in clinic that struggle with chronic fatigue. I hear it often, in our day to day grind, more and more individuals complain of fatigue. They come into the clinic hoping for a quick answer and sometimes, those lab results come back normal and to their dismay, they are left without an answer.

There can be a multitude of causes for your fatigue, ranging from your diet, dehydration, quality and quantity of sleep, to your stress levels and other underlying diseases causing side effects of fatigue.

I will discuss a few here, but this is just the tip of the iceberg. It is imperative that you find a medical provider that you trust and can confide in so that you can do a proper and thorough workup in order to find and treat the underlying cause of your fatigue.

Underlying Disease

Our primary concern when patients present with fatigue is to rule out underlying medical etiology of symptoms. Fatigue is obviously a medical complaint, therefore all of the workup we perform is medically rooted, but one of the first steps I recommend is to do a thorough lab panel to rule out underlying causes such as anemia, hypothyroidism and inflammatory disease.

Another important discussion is to have a candid conversation about any anxiety and depression you may be experiencing. Sometimes individuals can present with symptoms of fatigue, but when we dive deeper we find that patients can be struggling with feels of feeling sad, loss of interest in activities they enjoyed, decreased libido and even frequent crying.

Similarly, anxiety can leave you feeling worn out. As you navigate your emotions of anxiety and worry, you can struggle with quality and quantity of sleep, causing you to feel run down and tired. Furthermore, with all that energy and anxiety coursing through you, you end up using more of your energy to manage your anxiety and that can cause fatigue too.


Whether the labs and workup come back normal or not, lifestyle changes are imperative in order to bring about change.

Sleep: It might seem obvious but the amount and quality of sleep you get can contribute to your fatigue. Most adults require 6-8 hours of sleep a night. Some techniques to help with sleep are maintaining a sleep wake schedule, limiting light in the room, limiting activities in bed that are not related to sleep, and limiting television and phone time before bed. Sometimes, in spite of getting 8 hours of sleep, you can wake up feeling tired. This can be an indication that you might be snoring or not getting good quality sleep. A sleep study and proper workup with your medical provider can help determine the reason you are still waking up tired.

Diet: Our diet plays a critical role in our health. A critical change in thought process is to start to realize that food is nourishment and helps fuel our body. When we start to treat food as a healing power that helps our body thrive, we use the nutrition to heal and empower our body.

Meet with your medical provider to determine what foods are and are not ok for you. Maintain a food diary, if certain foods are causing you bloating, nausea and flare ups, you can get an allergy test to determine if you have an allergy or sensitivity to these foods and considering omitting them from your diet. Learn about blood dyscrasia and know what you can do to avoid such conditions as well.

Exercise: Exercise enables the body to heal and thrive. It helps improve cardiovascular health, boost your immune system and even help heal your wounds. “There is no medication or nutritional supplement that even comes close to having all of the effects exercise does,” says David C. Nieman, PhD, author of The Exercise-Health Connection: How to Reduce Your Risk of Disease and Other Illnesses by Making Exercise Your Medicine (Human Kinetics, 1998). “It’s truly the best medicine we know of.”

It’s important to also find an exercise you enjoy. After having a stressful day, a good workout that you enjoy can help you unwind and reduce stress. However, if you do exercise that you do not enjoy and it increases your stress, it can actually increase your stress levels and cause more inflammation.

Fatigue is a complex, multi-fold symptom that can be due to a multitude of underlying causes. Also, remember, that of the possible causes of fatigue, you do not necessarily have to have one or the other. Sometimes, one of the underlying causes can actually cause the other issues. So, its important that you work with your medical provider to identify the etiology of your symptoms and work on resolving your underlying cause and truly start to regain your quality of life. Again, these are just a few basic concepts to start the conversation with your medical provider. Your healthcare provider is your partner in helping you understand how to help your body function at it’s best, so find one that you trust and who listens to you!

Asma Bhaidani