I am tired all the time. I am tired of being tired.

I hear that all the time: from friends, family and patients. There are many reasons for fatigue. For most people, the first step in addressing it involves a trip to the primary care and getting blood work done. To most people’s surprise, their blood work comes back normal and they are left with unexplained debilitating fatigue. This often leads to feelings of depression and lower self-confidence.

Men and women experience fatigue. People of all ages experience fatigue. There are some common causes that transcends gender and age. Unfortunately, the truth of the matter is that, the test they got done at the doctor’s office often doesn’t cover all the bases. A comprehensive, holistic approach is necessary to approach fatigue. These are some of the reasons for fatigue and the appropriate ways to test them.

Thyroid: It is important to check for hypothyroidism and Hashimoto’s. This involves a more extensive thyroid panel that involves TSH, free T4, free T3, AntiTPO, and Anti-thyroglobulin. In some cases, Total and Reverse T3 is needed to better assess the T4 to T3 conversion.

Hormones: Hormones not not only important for fertility and libido but they are important for energy, endurance, mood and confidence. For women, Estrogen, progesterone and DHEA is a good start. For men, Total and free testosterone and DHEA.

Blood sugar: A comprehensive look at blood sugar levels and body’s capacity to handle high blood sugar level is important for addressing fatigue.

Adrenals: Early morning cortisol blood test is often used to check for adrenal health. Unfortunately, it gives a limited view of adrenal functioning. A complete picture will involve assessing saliva samples collected at different times of the day to map out the pattern of the level.

Vitamins: Unfortunately, an average American diet and lifestyle falls short of many of the necessary daily vitamins. Supplementation maybe needed in some cases to optimize energy. Immune health may also be affected because of deficiencies. Vitamin D3 level and Vitamin B12 levels are important for energy.

Micronutrients: They are essential for optimal body functioning. Unfortunately, there are often many deficiencies in this area but it is never identified. Some people continue taking supplements for many years without checking the status of absorption only to find out that they have bad absorption and that they need to address that first. Toxin build up is another reason for fatigue that is not often addressed. Tests that check for micronutrient and toxin levels are important aspects of the comprehensive health view.

If there is a family history of autoimmune issues or cancer, more tests maybe ordered for further evaluation. If you or someone you know is struggling with unexplained fatigue, it is a good idea to use a holistic approach to check for the causes. Finding answers can be first step to happiness, freedom, and healing.

Brandon Tarpon Springs