Common Causes of Fatigue

Think about it. When was the last time you woke up feeling refreshed and ready to take on the day with no need for that morning coffee? When was the last time you felt recharged after lunch and not in need of a nap? When was the last time you came home at the end of the day feeling strong and energetic enough to tackle cooking dinner and the laundry? Maybe a better question is have you ever felt like that? 

Our energy and our vitality are the first things to go when our health declines. But for most of us, declining health is a slow process. It happens over years and years. So we often chalk up our lack of energy, our poor digestion, our aches and pains to age. But how we see the people around us aging is not healthy aging. Common, yes. Healthy, no.

Yes, your body will change as you age, but getting old is not a good reason for not having enough energy to do all the things you want to do. Here are some real causes of not having enough energy:

Common Causes of Low Energy

  • Low free cortisol (aka "adrenal fatigue" aka HPA axis dysfunction)
  • Anemia
  • Chronic insufficient sleep
  • Chronic stress
  • Hormone imbalances
  • Hypothyroidism
  • Inflammation
  • Lack of exercise
  • Nutrient deficiency
  • Poor detoxification
  • Poor digestion
  • Poor nutrition
  • Stagnant lymphatics

At the heart of most fatigue lies chronic stress and adrenal dysfunction. This is how it works. For most of us, our lives are filled with things that stress us out. When we perceive something to be stressful, our brain sends a signal to our adrenal glands to dump cortisol into the blood. Cortisol is our stress hormone and its job is to prepare our body to run away. Because once upon a time, lions, tigers, and bears stressed us out. And we could run away from them.

So cortisol tells our liver to make glucose so our muscles will have fuel, redirects our blood flow to our muscles, increases our heart rate, and speeds up our breathing. But if we can't run away from our stress, this isn't actually helpful. And when we are constantly stressed and our adrenals are constantly pumping out cortisol, it can be very damaging to our body.

High levels of cortisol will imbalance our blood sugar creating inflammation and excess fat, will inhibit our immune system leaving us susceptible to colds and the flu, will interfere with our digestion making it hard to absorb nutrients, and will disrupt our sleep leaving us more tired than ever.

While our adrenal glands are pressed to make cortisol, they are not able to make all their other hormones. The adrenal gland is responsible for making hormones regulating electrolytes, blood pressure, and reproductive hormones, as well as cortisol. So chronic stress indirectly causes further hormone imbalances. Great, right?

After a while, though, our body shuts down the adrenal glands so they don't release anymore cortisol. While this is in theory, a protective mechanism against the damages of high cortisol, often times, it results in very low amounts of cortisol in the blood, which leads to fatigue. To learn more about this, check out this article.

For most people, it is not just one thing causing their lack of energy. It is a combination of factors. Only a thorough medical and lifestyle history and appropriate diagnostics can determine the cause of your fatigue. And a holistic approach involving nutrition, targeted nutrient therapy, lifestyle modifications, stress management, and botanical medicine can vastly improve your energy levels. So stop settling for health that is less than optimal. You can feel so much better than you do right now. 

On this journey to recovery, it is important to work with the right doctor. Unfortunately, many doctors out there do not have the holistic training to appropriately diagnose causes of fatigue. I have often heard from my patients that other doctors just told them that their fatigue is normal aging or that there is nothing wrong with them because their basic blood work was normal. If you're doctor has told you some version of that, then it is time for a new doctor. Fatigue, while common, is not normal or healthy. So find a doctor who will listen to you and actually do the work to figure out your physiology.


I'm Dr. Carly and my mission is to create a health revolution. I believe that another prescription is not the answer. I believe in using natural therapies that go beyond the symptoms. And I believe that doctors should spend way more than 7 minutes with a patient.