Chronic fatigue is common, but it’s certainly not normal. It’s common, in that many people experience it on occasion. But a healthy body doesn’t naturally feel worn out — even when dealing with a fairly hectic lifestyle.

In fact, if you’re unsure about the underlying cause of your brain fog or fatigue, you shouldn’t be feeling that way. For example, if you’re working 12 hours a day and your baby or your neighbor’s dog is keeping you up all night, you have a clear reason to be fatigued.

However, if you’re eating healthy foods, remain physically active, get six to eight hours of sleep each night, and you still feel tired or unfocused during the day, something’s wrong. And you most likely have a medical condition that requires evaluation and treatment.

In this blog post, I discuss how to move away from brain fog and fatigue and toward increasing focus, energy, and vitality. You and your doctor need to take it seriously, acknowledge the problem, and work together to identify the root cause(s), with the end result being solutions intended to restore your energy and mental sharpness.

The take-home message here is this: Solutions exist. Stay focused and be persistent until you receive treatment that makes you feel your best.

Where Conventional Medicine Falls Short

If you have read any of my other blog posts, you already know what I think about the conventional medical approach to treating chronic health conditions, including thyroid disease, chronic fatigue, depression, menopause, high blood pressure, and diabetes. Conventional medicine focuses on diagnosing illness and treating its symptoms —typically with medication. It rarely identifies or addresses the root causes of these illnesses. These often include:

  • Poor nutrition
  • Too much, too little, or the wrong types of exercise
  • Exposure to environmental toxins
  • Poor sleep
  • Leaky gut
  • Other lifestyle and treatment options we have influence over

Imagine entering your doctor’s office and complaining of fatigue or brain fog. Your doctor orders some blood tests and tells you the results show no cause for concern. According to your doctor, you’re perfectly healthy.

Or, you go to see your doctor complaining of fatigue and brain fog, and you’re treated for high blood pressure or high cholesterol, neither resulting in a resolution to your fatigue issues. You have digestive issues, so you’re referred to a gastroenterologist who treats you for acid reflux or irritable bowel disease, but again your fatigue remains untreated. Why is this? Because none of the “solutions” were the main reason you went to the doctor, and the doctor only has a limited amount of time to meet with you and is obligated to provide what they have been led to believe is the standard medical care — “treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals.”

Since cholesterol medication is widely accepted and used, even though you are tired, you received the right care based on your lab results. Everyone except you is satisfied.

Experiences like these can be both frustrating and demeaning — frustrating, because you continue to feel fatigued even after seeking and perhaps receiving treatment, and demeaning because your doctors seem to be ignoring what you’re telling them.

Exploring Root Causes of Fatigue and Brain Fog

Fatigue and brain fog are vague symptoms that practitioners of conventional medicine have difficulty attributing to any of the illnesses they commonly treat. As a result, they often pin down these symptoms to depression, anxiety, chronic fatigue syndrome, fibromyalgia, or other vague diagnoses.

Fatigue and brain fog are actually early warning signs of inflammation, which can occur anywhere in the body, including the brain. Here’s a short list of conditions associated with fatigue:

  • Anemia
  • Cancer
  • Chronic infection — COVID, Epstein Barr virus (EBV), Lyme disease
  • Chronic stress
  • Diabetes
  • Hashimoto’s (autoimmune hypothyroid disease)
  • Heart disease
  • Hypothyroid or hyperthyroid (underactive or overactive thyroid)
  • Irritable bowel disease
  • Liver disease
  • Lupus and other autoimmune conditions
  • Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS)
  • Traumatic brain injury/concussion

Clearly, fatigue can be associated with almost any health condition, which is not surprising. When the body is stressed, fatigue is one way of indicating that it needs rest to recuperate.

Why is it that some people are able to avoid fatigue even though they work hard, have families, and deal with stressful events in life? This is what happens when all systems in the body are in balance. The scientific term for balance is homeostasis.

To understand homeostasis, imagine your body being equipped with a complex thermostat that’s sensitive to infection. When infectious bacteria enter your body, its internal thermostat cranks up the heat, raising your body temperature to a point at which the bacteria die. As the bacteria succumb, the thermostat lowers your body temperature back to normal. Your body contains numerous homeostatic mechanisms that maintain balance and health. When these mechanisms malfunction, your body struggles to restore balance, which causes you to lose energy and focus.

The key to correcting chronic fatigue is to identify and address what’s preventing your body from returning to homeostasis.

Causes and Solutions for Chronic Fatigue

Here are some of the more common causes and solutions for chronic fatigue:

  1. Low ferritin (iron storage) levels in the blood. Low ferritin is associated with a variety of anemias (hemoglobin deficiencies). We need iron for the hemoglobin that carries oxygen in our cells. Many doctors check iron, red blood cells, and hematocrit, all of which can appear normal even when ferritin is low. It pains me when I see patients who have not had their ferritin levels checked, because it is a simple test that can reveal a deficiency or elevation — either of which can negatively impact a patient’s health. Low ferritin is common in women who are menstruating, and while the solution for fatigue isn’t necessarily found in supplementing with iron, it certainly can be. Elevated ferritin is a sign of a genetic disorder or chronic inflammation. Either way it needs to be addressed.
  2. B vitamin deficiency. A variety of B vitamin deficiencies can cause anemia. The most common being B12, B9, and B6. Checking blood levels of B vitamins can sometimes reveal the problem, but most healthcare providers are not routinely checking for deficiencies. Additionally, patients need to be checked for their ability to convert these vitamins into a usable form. Checking B12 and folate in the blood is not a reliable way of knowing for sure whether these vitamins are working optimally in your body. About 20 percent of the population has a problem with methylation of B vitamins.
  3. Thyroid dysfunction. Your doctor should order comprehensive thyroid tests — not only traditional tests that check thyroid function but also tests to check for thyroid antibodies. Many patients I see have been chronically tired and did not know they had an autoimmune condition affecting the thyroid (Hashimoto’s). Antibodies can be present years before the traditional thyroid labs show disease.
  4. Exposure to toxic mold. Have your home and workplace (or the school you attend) tested professionally for mold. Mold exposure is more common than you think and can cause multiple health problems, with fatigue and brain fog leading the pack.
  5. Hormone imbalance. Hormone levels decline as we age. You may be struggling with fatigue as a result of hormone decline in combination with one or more of the problems listed above. Hormone replacement can be helpful after any anemia, B-vitamin deficiency, thyroid dysfunction, and environmental concerns are addressed.
  6. Cellular damage and dysfunction. As I’ve already covered, there are many chronic conditions associated with fatigue, and we know that chronic conditions weaken cellular health and signaling. A variety of peptides, which are small signaling proteins derived in a lab, can be targeted to various systems in your body. These can reduce brain inflammation, support tissue repair and healing, modulate immunity, improve circadian rhythm, and energize mitochondria (the energy production facilities inside cells). Peptides can help boost energy while slowing the aging process at the cellular level. Peptides include KPV, BPC, Ipamorelin CJC, Thymulin, Epitalon, and others.
  7. Lifestyle issues. Lifestyle solutions includes changes to diet, exercise habits, stress levels, relationship building, counseling, and so on. We have more influence on our health than we are led to believe. Your healthcare practitioner should be understanding and supportive of your health, suggesting improvements to your lifestyle that positively impact your fatigue.

If you are experiencing chronic fatigue or brain fog, depression, low energy, or other vague symptoms, it’s not “just in your head.” These are early symptoms of an imbalance in your body. Your body is telling you that something is out of whack. Don’t let anyone — including a doctor — lead you to believe otherwise. Solutions are available. You just need to find a healthcare provider who knows how to uncover and treat the underlying causes. I recommend seeing a doctor who has had extensive training and experience in functional and integrative medicine.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.