Are you constantly tired, even waking up feeling sluggish? Does the slightest exertion leave you exhausted, perhaps for days? Maybe your GP’s test results have come back normal, while fatigue is preventing you from doing the things you want to do.
Feeling tired and fatigued can have an array of underlying reasons. The goal of a Functional Medicine consultation is to discover the underlying causes of health issues, and tiredness is no exception. This article will delve into some of the real reasons you might not be feeling full of beans.
The thyroid gland is probably many people’s first port of call when thinking about persistent fatigue. And for good reason, because the thyroid acts like your body’s accelerator pedal. If it’s not working well, metabolism will slow, and one of the first symptoms you’ll experience is tiredness.
However, many people have been told that their thyroid hormone levels are fine, when behind the scenes the gland is not working as it should. Traditional tests use a broad reference range, with people on the edges of the range considered normal. However, these ‘normal’ levels may be sufficiently low to produce symptoms because optimal ranges naturally vary from individual to individual.
Furthermore, standard NHS tests only look at certain thyroid hormones, namely thyroid-stimulating hormone (TSH), and thyroxine in the form of T4. A slightly different thyroid hormone containing fewer iodine molecules is called T3, made by your body from T4 when needed, and it’s this hormone that’ affects cell metabolism. So, your T4 levels could look fine, when all the while there’s not enough of the active hormone, T3.
A simple finger-prick of blood can reveal your levels of TSH, free T3 and free T4, the forms of thyroxine not bound to a carrier protein in the blood. The test also measures total T4, useful to assess overall thyroid gland function and how it’s affected by your liver health. Finally, it will reveal whether your thyroid is being attacked by antibodies. This is a type of auto-immune reaction.
Your adrenal glands are responsible for your body’s response to stress. With ongoing stress being a major contributor to low energy, it’s important to assess how your adrenals are functioning.
The primary stress hormone, cortisol, helps mobilise energy stores, as well as regulating metabolism, blood sugar levels and the immune system. Therefore, if cortisol is unbalanced, this can have a significant adverse effect on energy levels.
Cortisol can be measured in saliva. However, because its levels naturally fluctuate over a 24-hour period, several samples are needed to obtain an accurate result. Cortisol should be highest upon waking, rapidly declining over the next couple of hours, then gradually tapering off for the rest of the day. If cortisol is lower than expected in the morning, or drops very rapidly, this is an indication your adrenals aren’t coping well. It could be they have been adversely affected by a prolonged period of stress, for example. This decline in function is associated with persistent fatigue, and it means the adrenals need additional nutritional, herbal or lifestyle support.
The adrenals also produce the hormone DHEA, which influences cellular energy production. Although DHEA naturally declines with age, lower levels than expected are connected with fatigue. Equally important is the DHEA:cortisol ratio. Low levels of DHEA relative to cortisol can indicate dysfunction in the HPA axis, the connection between your adrenals and your brain. This communication channel regulates your body’s stress response and energy production.
Deficiencies in many nutrients, particularly iron, B vitamins, co-enzyme Q10, magnesium and vitamin D can lead to tiredness. Therefore, knowing your levels can be incredibly useful. Although some nutrients, like vitamin D, can be accurately measured in the blood, for many others, blood levels don’t reflect the amounts of these nutrients in the tissues. This is because the levels of many nutrients need to be tightly controlled in the blood, so may appear to be adequate, but they’re lacking in tissues.
A more accurate way of assessing nutrient status is to look at substances known as organic acids, byproducts of cellular processes. These fluctuate depending on the availability of certain vitamins and minerals. Organic acids can easily be measured in a urine sample.
As well as any need for additional nutrients, results will highlight the health of your mitochondria, the energy-producing powerhouses of your body’s cells. They additionally give insights into key aspects of your digestive health, as well as how efficiently your body is methylating, a process closely linked to energy production.
Because there are so many possible reasons that might lie behind your tiredness, we’ve created a convenient testing package to assess a broad range of factors. The four-pronged assessment examines hormones and nutrients to provide answers as to why you’re so tired. Once you receive your results, they’re designed to be user-friendly, however, you may book an interpretation with one of our expert practitioners if you wish.
Start your journey now. To see if we’re a good fit for you, why not book a free 15-minute Discovery Call?
If you want support for tiredness and fatigue and you are not sure why. You feel you get enough sleep, but still wake up feeling tired, then why not book a FREE Discovery Call to see how Functional Medicine can be of help.
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