Hidden Causes of Chronic Fatigue

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If you feel tired all the time, you have lots of company. Each year, Americans make 500 million visits to the doctor seeking treatment for fatigue.

Many people who frequently feel tired fear they have the debilitating condition chronic fatigue and immune dysfunction syndrome (CFIDS).

If your fatigue has persisted for more than six months or is accompanied by sleep disturbances, joint pain, headaches, inability to concentrate or short-term memory loss, you may indeed have CFIDS.

Good news: Only about 10% of my patients with fatigue actually have CFIDS. Most of the rest are suffering from “garden variety” fatigue, caused by too little sleep or exercise, poor dietary habits or other easily correctable problems.

Thyroid problems

Many cases of chronic fatigue are caused by over- or underproduction of thyroxin. That’s the thyroid hormone responsible for regulating how energy is consumed by the body’s cells.

Overactive thyroid

Indications of hyperthyroidism include anxiety, fatigue, heart palpitations, insomnia and also bulging eyes. This condition is treated with thyroxin-blocking drugs or with surgery or radioactive iodine to destroy the thyroid gland.

Underactive thyroid

Suspect hypothyroidism if you feel lethargic or depressed, chill easily, are gaining weight or suffer from muscle aches, eczema, dry skin, low libido, premenstrual syndrome (PMS),  hair loss, a hoarse throat or frequent colds or flu.

If you’re experiencing any of these symptoms, it’s a good idea to check your basal body temperature. Insert a thermometer under your armpit as soon as you awaken, before getting out of bed. Record results for three consecutive mornings.

Basal temperature of 97.4 degrees or lower means hypothyroidism. Doctor can give you a blood test to verify your doubts.

Most of the doctors deal with hypothyroidism with synthetic levothyroxine (Synthroid). Though, some patients show progress when they take natural thyroid hormone (derived from beef or pork).

If Synthroid doesn’t relieve your symptoms, ask your doctor to consider that alternative.

Adrenal inadequacy

Anyone whose fatigue is accompanied by malaise, frequent illness, allergies or low blood pressure or sugar may be making too little of the adrenal hormone dehydroepiandrosterone (DHEA).

Adrenal insufficiency is caused by autoimmune disease or by adrenal gland damage stopping from long-term use of cortisone.

If a blood test reveals low levels of DHEA, you might need to take it in pill form.

In Europe, DHEA has long been used to boost immune function and combat fatigue though few American doctors have much experience with the drug.


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Adult-onset diabetes is an usually-overlooked cause of tenacious fatigue. To rule out this condition, ask doctor for a fasting blood glucose test.

The normal range of insulin is 80 to 100 mg per deciliter of blood. If you fall above that range, eating a special diet and getting regular exercise can help lower blood sugar levels. That should boost your energy.

Hormonal problems

In men, chronic fatigue may be caused by abnormally low levels of testosterone. Men suffering from this problem (which can be spotted with a simple blood test) can boost their energy levels by taking testosterone supplements.

Hormone problems can cause fatigue in women, too. But tests for hormone imbalances in women are often inaccurate.

Instead of relying on a blood test, women must suspect hormone problems if

  • Their fatigue is recurring, becoming worse before menstruation and improving later.
  • They experience more weight gain prior to each period.
  • They perpetually crave sugar, spicy foods or chocolate.
  • They experience migraines or breast tenderness when taking birth-control pills

To deal with hormone-related fatigue, ladies mush decrease their consumption of meat and dairy products and alcohol, consume more dietary fiber and less sugar and refined foods take supplements of gamma linolenic acid (GLA).

GLA is found in primrose oil, borage oil and black currant seed oil, available at health-food stores.

Women with PMS-related fatigue must ask their doctor about having a Meyer’s cocktail once per  month. That’s a venous drop of magnesium, calcium and vitamins B and C

Food allergies

Chronic, mild food allergies can cause fatigue. Suspect allergies if you have dark circles under your eyes are frequently irritable feel foggy or unhappy or have recurrent infections or dry skin.

Cravings for particular foods or cycles of energy and fatigue also suggest food allergies especially to wheat and dairy products. These foods can cause the body to produce an energy-sapping morphine-like substance.

Consider a medically supervised fast of one to four days, to see if your energy increases.

Add foods back to your diet only with the doctor’s permission.

Environmental toxins

If you can’t find another source of fatigue, you may be suffering from exposure to indoor pollutants. Usual culprits

  • Benzene. In linoleum and degreasers.
  • Formaldehyde. In new carpets and new drapes.
  • Lead. In tap water and house paint.
  • Mercury. In dental fillings and in some house paints.
  • Nitrogen dioxide. Released by gas stoves, furnaces and kerosene heaters.
  • Trichloroethylene. Used in dry cleaning.

If toxins are a problem, install carbon based water and air filters. Make sure your home is well-ventilated so that fumes can escape

Another option is to fill your home with house plants to help filter the air.

Your doctor should test your blood for chemical markers of contaminants and your hair for lead, mercury and other toxic metals. If traces of toxins are found, ask him/her about adding vitamin E, selenium, garlic, beta-carotene and sodium alginate to your diet. They help rid the body of toxic metals.

The role of sugar

In many cases, fatigue is the result of eating too much sugar. Sugar and refined carbohydrates make your blood sugar rise. This signals the pancreas to produce insulin. Too much insulin results in hypoglycemia (low blood sugar), which causes extreme tiredness.

If you suspect hypoglycemia, ask your doctor for an oral glucose-tolerance test. If, during the test, you experience  mental confusion, heart palpitations or extreme fatigue,  feel shaky or dizzy, suspect a sugar problem even if your doctor says your blood sugar levels are normal.

Treatment is simple stop eating sugar. Also helpful: Eating six small meals rather than the usual three huge meals. Small, frequent meals help alleviate blood sugar levels.

Lastly, ask your physician about taking ergogenic (energy-generating) dietary supplements, including vitamin B-15 L-carnitine octacosanol, a wheat germ extract ginseng.

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