The treatment of non-specific fatigue is one of the most common complaints that presents to naturopathic physicians.  The successful treatment, in my experience, follows a correct diagnosis by means of a thorough history, physical exam and with the help of additional laboratory studies as indicated.

The functional assessment of the fatigued patient may mean testing thyroid function, adrenal function, iron stores, red blood cells, baseline blood chemistry, and other lab tests, depending on history, physical examination findings and previous labs.  Many times, the history and physical exam alone give a clear indication of the treatment.  

Fatigue is not normal; feeling unwell is not normal.  In my opinion, it is the start to ill health.

To take an example, cortisol and melatonin are two hormones in the body which have a daily rhythm to their secretion.  In other words, it isn't always the total daily amount that is most important for these two hormones (although this may be a factor), it is when they peak and decline during the day.

Cortisol is the body's anti-stress hormone, and it is produced by the adrenal glands.  It rises in the morning to help the body adapt to the stress of waking up.  With healthy adrenal glands, in my opinion, you should feel refreshed on waking.  Cortisol then declines steadily before another rise (only about 50% of the first peak) in the mid-afternoon.  This may prevent the mid-afternoon slump in energy that many people experience.

In response to chronic stress, in my experience, the rhythm of cortisol secretion may be thrown off. The net effect may lead to a reversal in secretion patterns, with low levels in the morning and high levels in the night. With this pattern, you may feel tired on waking, somewhat better throughout the day (but not nearly 100%) and then you have difficulty sleeping or wake a few hours after falling asleep.  In my opinion, these may be signs that your adrenal glands being too stressed and unable to keep you feeling good, energetic, and healthy.

In my opinion, the proper way to deal with symptoms of fatigue, insomnia, sugar cravings are not the one minute solutions such as a cup of coffee, a sleeping pill, or a piece of bread.  It is necessary to identify underlying functional causes so that:

-hormonal biochemistry may revert toward normal

-important organs such as the liver, adrenal glands, and the gastrointestinal system can rest and then function at optimal capacity

-sleep becomes more easy to achieve and more restful

-energy through-out the day increases so that you become more productive,  effective, and confident

 exercising, especially if you are already feeling tired and headachy.

Conventional Medical Causes of Fatigue:

- anemia

- hypothyroidism

- diabetes

- infectious mono

- hepatitis

- other major diseases

Functional Assessment of Fatigue

- Comprehensive blood work should be done to assess the organ systems, blood counts, large deficiencies in hormones

- Toxic burden analyses allergies to food or environment, hormonal rhythm disturbances