“Hi this is Dr. Ruscio and let’s talk about fatigue.
Fatigue is something that pretty much everyone is going to be affected with at some point in their life and some people will struggle with fatigue. Now what options are there besides reaching for coffee, tea, red bull, and 5 hour energy, what have you? Well there are quite a few things we can do to help the fatigue process and different people will have fatigue for different reasons so what I’m going to do is run through the causes of fatigue and the symptoms that correlate with each cause to help you figure out what might be causing your fatigue.
Fatigue can first be caused by hormones. Now sex hormones can cause fatigue. Imbalances of testosterone and estrogen can cause fatigue. So what will this look like? Someone with fatigue who also is having problems with erection or drive or sexual function as a man or as a woman who’s having problems with sexual function also but is experiencing vaginal dryness, dry hair, dry skin, dry nails, that may be an estrogen mediated form of fatigue. It’s important to keep that in mind because fatigue for these people may be as simple as rectifying imbalance in testosterone or estrogen.
Now thyroid hormone imbalances can also cause fatigue. Someone with a thyroid hormone imbalance induced by fatigue or inducing fatigue may also experience that they have colder hands or feet or they have intolerance to the cold. They may also notice that they’re constipated. They may notice that their cholesterol is going high. They may notice that there is a thinning in the lateral third of the eyebrow or puffiness in the face, just to name a few.
Stress hormone imbalances can also cause fatigue. Cortisol or epinephrine, or adrenaline, both these hormones while they are stress hormones and we don’t want to have very high levels, but we want to make sure we don’t have very low levels either because the right amount of stress hormones will help give you energy. If people are low on stress hormones, which is actually more common than you might think, I see it all the time in clinical practice; this is certainly something that can be contributing to fatigue.
Insulin resistance also and the way that insulin resistance works is you need to get sugar into your cells so you cells can burn it as fuel. If your insulin resistant that means you cells are resistant to letting fuel enter into them so they can use that fuel as energy. One of the keynote characteristics of insulin resistance is people who are tired but also tend to crave sweets or crave starch. Blood sugar regulation ducktails into the insulin resistance piece. Blood sugar regulation can be thrown off into a condition called adrenal fatigue or when people have low levels of stress hormones and how this all ties in is stress hormones in addition to giving you energy help your body keep blood sugar in the appropriate ranges.
People who have low levels of cortisol stress hormone are also at risk for what’s called hypoglycemia where they have low blood sugar and that can certainly have fatigue. Like we just mentioned a little while ago insulin resistance can also throw off blood sugar because insulin helps get blood sugar from your blood stream into your cells to be used as fuel. If your cells are resistant to insulin signaling then your cells are essentially starving for fuel, and if your cells are tired you’re going to be tired.
Now anemia can also play a role and we have our iron anemia or our b-vitamin anemia and the most common cause of anemia is usually a dietary deficiency oftentimes found in vegetarian dieting or people who have gastrointestinal problems. People who have celiac disease or subclinical gluten intolerance will have damage to their intestinal lining and that will impede their ability to absorb iron specifically and some of these people may also have something known as pernicious anemia which is an autoimmune condition which part of your stomach is being damaged that is needed to absorb be-12 via a factor known as intrinsic factor.
Chronic infections can also cause fatigue. Chronic infections can cause fatigue through two different routes. Now chronic infections, what they’ll look like is in some cases people who have energy for a few days and for a few days they’re tired. This is cyclical fatigue and what this has to do with is a life cycle of certain infections: as the infections goes into a more proliferative phase where it is causing more damage people get more fatigue because they’re immune system tries to rise up, beat down the infection. Once the infection is beaten down their energy gets better until the infection tries to rise up again… Then the immune system has to come back up and when the immune system has to up ramp itself that causes a lot of fatigue in the body because it requires a lot of energy. Infections if they’re in the digestive tract certain worms for example can interfere with the absorption of things like some of your b-vitamins and iron also so infections can cause that anemia factor we talked about a little while ago.
Certain toxins can also be an issue. Mercury toxicity can interfere with hemoglobin production in the body and the ability or the viability of your red blood cells to essentially do their function, carry oxygen. Also toxins can cause problems with your brain chemistry and can cause problems with your hormones. Toxins cause problems with fatigue in a multitude of areas. People who have been exposed to toxins maybe people who work as hairdressers in salons, people who work in an industry where they’re exposed to a lot of chemicals may be at risk for toxin induced fatigue.
Food allergies, someone who has food allergies is someone who is going to eat and then notice they get fatigue shortly thereafter. They may or may not also have digestive symptoms like gas, bloating, loose stools, intermittent diarrhea and things like that. Certainly food allergies will cause an inflammatory response in the intestines and an inflammatory response in the intestines can cause a whole myriad of problems but it certainly will cause fatigue. So if you eat and you notice your fatigue shortly thereafter that’s a tell-tale sign that you have a food allergy inducing fatigue.
Also, problems with brain hormones like serotonin and dopamine. This is someone who is fatigued but they also feel like they’re sad or they also feel like they’re overwhelmed or they also may even feel a little bit of anxiety because the brain hormones are imbalanced causing these neuropsychiatric symptoms that accompany fatigue.
Also, finally, sleep and exercise: Sleep and exercise have a multitude of effects in the body but maybe the strongest one is that sleep and exercise will both help keep your hormones in good levels and help keep your hormones balanced.
So, this is a list of the different things that can cause fatigue and I outlined some of the symptoms that are associated with them so hopefully that gives you a little bit of information that can help you navigate this topic of trying to figure out what’s your causing fatigue.
This is Dr. Ruscio, I hope you found this helpful.”
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