The treatment of non-specific fatigue is one of the most common complaints that presents to naturopathic physicians.  The successful treatment follows a correct diagnosis either through a thorough history and exam or with the help of additional laboratory studies.


One particular patient, a middle-aged female whose presenting complaint was severe fatigue, complained that she didn't have the energy she needed to keep up with her life. Her doctor had told her to get more rest. After history and exam, conventional labs were run to rule out serious diseases such as cancer, diabetes, and classical hypothyroidism. Further testing confirmed that the adrenal glands were unable to secrete enough anti-stress hormones  the end result was fatigue on waking and yet an inability to sleep at night. 


After 2 weeks of intravenous nutritional treatments with a modified Myer's cocktail (see website), dietary changes to stabilize blood sugar (to rest the adrenal glands), and B12 injections (to restore the normal diurnal rhythm of cortisol secretion), the patient was feeling significantly better. Her sleep had improved, she had energy through-out the day, lost weight,  and had taken on a new level of work vitality and efficiency.


The above is a simple example of how a functional assessment can treat and restore health those who can't find a conventional cause for their symptoms. In terms of fatigue, a comprehensive medical work-up is usually done to rule out diseases such as cancer, diabetes, anemias, heart disease, and classical hypothyroidism.  



What needs to be kept in mind is that conventional diagnoses and the search for such diagnoses is based upon pathological-medicine.  The study of pathology is based by definition on disease visible under the microscope.  For example, if classical liver disease was suspected, blood work would be done to test for elevated levels of AST and ALT. These two enzymes leak into the blood once the liver cell breaks open (it's already dead).  A functional assessment would look at the role the liver cells play in life  that of detoxification.  Thus, a functional assessment would look at how well the liver is detoxifying; this can be measured by the clearance rates of aspirin, caffeine, and acetaminophen.  Impairment in clearance is a clear indicator of decreased liver cell detoxification  an indication of ill health before cell death has occurred. 


The same must be done for other body systems to uncover the true causes of fatigue.  For one particular patient, this may mean an assessment of the thyroid function; for another, it may be an assessment of adrenal function.  Many times, the history and physical exam alone give a clear indication of the treatment.  


Fatigue is not normal; feeling unwell is not normal  it is the start to ill health!


Fatigue, sugar cravings, and poor sleep are all signs of a slip down the road to poor health! The time to take action and prevent more serious diseases is now. It's not worthwhile to wait until conventional tests pick up heart disease, diabetes, or cancer.


Optimal health is defined as a state in which you can achieve your daily goals without decreased efficiency due to your body feeling sick.  Optimal health is therefore not simply the absence of disease: it is a state of maximal, correct, and balanced function of the body's systems.


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 the total daily amount that is important for these two hormones, 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, you should feel refreshed on waking!  It then declines steadily before another rise (only about 50% of the first peak) in the mid-afternoon  this prevents the mid-afternoon slump in energy that many people experience.


In response to chronic stress, the rhythm of cortisol secretion is 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 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.  These are signs of your adrenal glands being too stressed and unable to keep you feeling good, energetic, and healthy.


Melatonin is another hormone that has a strong daily rhythm.  Melatonin is produced only in the dark.  Production of this hormone tends to peak in the early hours of 2-3 am.  This hormone is known to be a potent antioxidant and protectant against cancer.  Low levels (and abnormal secretion times) are associated with various types of insomnia, and high levels are associated with some types of SAD (seasonal affective disorder). Identifying the secretion patterns can give you indications of underlying causes to feeling run-down, tired, and exhausted.


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 can revert to normal

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

-sleep becomes easy to achieve and restful

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


These are the keys to health; it's really quite simple.  Maximize your body's ability to function at an optimal capacity to maximize what you get out of life!  It's more than eating healthy and exercising, especially if you are already feeling tired and headachy. 

Conventional Medical Causes of Fatigue:


- anemia

- hypothyroidism

- diabetes

- infectious mono

- hepatitis

- other major diseases


When to seek help:


- No amount of fatigue is normal, and thus a thorough evaluation should be done if you feel you are performing sub-optimally


- 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, functional assessments should then be done to diagnose the cause of fatigue




Treatments used depend on the cause that is diagnosed. Many do benefit from either:


- IV Myer's cocktail

- oxidative medicine

- hormonal treatments