How Irritable Bowel Syndrome Could Be Causing Your Fatigue

In the clinic I often see problems in the gut as the true underlying cause of fatigue and/or adrenal fatigue.  Let’s review a recent study that found IBS was associated with fatigue, depression and brain fog. The good news here is if you can improve your gut health you can overcome many cases of fatigue, brain fog and/or depression.

Dr. R’s Fast Facts

Fatigue: a distressing symptom for patients with irritable bowel syndrome

  • A total of 160 patients with IBS completed self-reported questionnaires assessing fatigue, gastrointestinal symptoms, psychological distress, and sense of coherence.


  • Fatigue is a distressing symptom which occurs in a sizeable proportion of patients with IBS. It affects life in a multidimensional way, with poor bodily stamina being the most prominent feature.
  • Fatigue, along with sense of coherence, depression and anxiety, needs to be assessed, confirmed and targeted for interventions.
  • In Dr. Ruscio’s observation – the most commonly overlooked causes of fatigue are problems in the gut.
    • If you can take the time to improve your gut, you will see fatigue, brain fog, and mood improve.

In my new book Healthy Gut Healthy You there is a whole section that explains the connection between the adrenal and the gut as well as how to heal your gut.

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Dr. Michael Ruscio: Hi, this is Dr. Ruscio. And let’s discuss one, if not the most commonly overlooked, cause of fatigue, your gut. I’ve been saying this for a while. And I think this is a concept that’s finally really starting to get the appreciation that it deserves.

But if you’re fatigued, one of the most common causes of fatigue or adrenal fatigue, or however you want to term it, may be your gut. And we see a recent study published that supports this. So I’ll put the abstract up here on the screen and read you a few quotes from the study. The study was titled “Fatigue: a distressing symptom for patients with irritable bowel syndrome. And in the study Trusted SourcePubMedGo to source, what they did was they took a total of 160 patients with IBS. And they completed a questionnaire assessing fatigue and digestive distress, psychological distress, and sense of coherence or mental acuity; sometimes a lack of this is known as brain fog.

And their conclusion, and I’ll quote here: “Fatigue is a distressing symptom which occurs in a sizable portion of patients with IBS. It affects life in multi-dimensional ways, with poor bodily stamina being the most prominent feature of fatigue. Fatigue, along with a sense of coherence, brain fog, inability to think, depression, and anxiety need to be assessed confirmed and targeted for interventions.”

So like I said a moment ago, in my observation, one of the most common causes of fatigue or adrenal fatigue, however you want to term it, is or are problems in the gut. And I can’t tell you the number of patients that I’ve seen who have spent a decent amount of time and money on adrenal testing and trying to quantify what they thought was the cause of their fatigue. Looking at cortisol levels, with the four-point saliva cortisol test as an example, spun their wheels there. And only when they improved the health of their gut did they see their fatigue and their brain fog, as this study is suggesting, improve.

Now, in my book Healthy Gut, Healthy You, there is a whole section dedicated to the adrenal-gut connection and the gut-adrenal connection. And we talk about how there is this bidirectional relationship. So, if you have fatigue that can be driven from your gut. But also, you can have stress and lifestyle factors that can cause problems with fatigue; or termed another way, adrenal fatigue.

So we want to look at this from both ends: Lifestyle, exercise, sleep, nutrition, diet. But also from the other end: gut health. And again, in my observation, just making this practical in terms of what I see in my interaction with patients here in the clinic, is the most commonly overlooked cause of fatigue or adrenal fatigue are problems in the gut. And if you can take some time to optimize your gut health, then you have the chance to see fatigue improve, brain fog improve, and your mood. And we’re seeing some literature published to support this connection. And I’ve certainly seen a number of these cases in the clinic. I talk about it in the book. I share a case study about that in the book.

And so if you’re struggling with fatigue, instead of chasing down testing to quantify that from a hormonal perspective like adrenal testing, I would recommend you invest some time and money to optimizing your gut health. And I think you would be very happy with the results that that produces.

Okay. This is Dr. Ruscio. And hopefully this helps you get healthy and get back to your life. Thanks.

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