Article by Eleni N. Gage for Eating Well Magazine, March 2022


If you’re having trouble renewing your energy even after a full seven hours of sleep, one of the common causes of fatigue might be to blame.
Exhaustion is normal now and then (sick kid, late nights at the office). And in those cases, the solution is as simple as hitting the sack an hour or two early to recover. But if you’re chronically tired, something more serious could be to blame. “Fatigue is a common symptom of many health conditions,” says Grace Keenan, M.D., an internist in Ashburn, Virginia. Fortunately, most of these ailments are easy to remedy. Here, experts arm you with solutions so you can get back your get-up-and-go.

A Vitamin or Mineral Deficiency
Having low levels of iron or vitamin D or B12 can make you feel tired, anxious and weak, says Irene Park, a nurse practitioner in New York City. Many experts believe that a significant percentage of the U.S. population is deficient in vitamin D. “And lower levels of vitamin D can cause muscle weakness and pain,” says Keenan. Also, if you’re a woman of reproductive age, you’re statistically at greater risk for iron-deficiency anemia.

The only way to tell if you’re low in any vitamin or mineral is to see your doctor for a blood test. Meanwhile, to bolster your body’s stores, consider taking a multivitamin with at least 100 percent of your daily requirement of vitamins and minerals. (Experts generally advise that healthy adults also supplement with 1,000 to 2,000 international units of vitamin D daily.)

The Blues
Research has indicated that people with depression may be four times as likely as the nondepressed to experience unexplained fatigue. Aerobic exercise—specifically, 30 minutes or more three to five days a week—is effective at treating mild to moderate depression and may minimize the sleepiness associated with it.

If that doesn’t help, however, speak to your doctor, who may recommend talk therapy or a mood-boosting medication, like a selective serotonin reuptake inhibitor (SSRI). If your depression and related fatigue seem to strike more frequently in winter, you could have seasonal affective disorder (SAD).

Treatment for SAD may include using a special light box, says Marla Wald, M.D., a psychiatrist at Duke University Medical Center in Durham, North Carolina. But venturing outside for about 20 minutes a day can provide similar benefits, she says.

Your Adrenal Glands
They’re responsible for secreting the fight-or-flight hormones adrenaline and cortisol, which surge as a response to stress—whether the prehistoric-days type, like being chased by a tiger, or the modern-day version, like financial worries or your mother-in-law. But when you’re feeling stressed all the time, those glands may become overworked and can tire out—a condition commonly called adrenal fatigue, says Keenan. The inability to secrete enough cortisol during the day can cause energy dips, then spikes at night that can interfere with restful sleep.

To give your adrenal glands a chance to recharge, Keenan recommends meditation, which she thinks of as parking the body in neutral. “Meditation has the effect of slowing down the production of cortisol for a while,” she says. Try sitting quietly and clearing your mind for at least five minutes a day.

Vitamins B5 and C have also been shown to support adrenal function, says Jacob Teitelbaum, M.D., the Kona, Hawaii, medical director of the Fibromyalgia & Fatigue Centers and the author of From Fatigued to Fantastic! He recommends getting at least 50 mg of B5 and 500 mg of C daily. Other stress-reduction techniques work well too. “Exercise is particularly effective,” says Park.

What You Drink and Eat
Caffeine can be a lifesaver on sleepy mornings, but too much may be problematic, since it can act as a diuretic. “And dehydration can cause fatigue,” says Bonnie Taub-Dix, a registered dietitian in New York City. Aim for at least eight cups of fluids a day, more if you eat a lot of high-fiber foods, which absorb water.

Food sensitivities and their side effects can also bring on fatigue. “Lactose intolerance, for example, can cause diarrhea, which can result in dehydration,” says Taub-Dix. Teitelbaum notes that a diet high in processed foods can aggravate food sensitivities and lead to fatigue (one such sensitivity is the inability to metabolize gluten, which is found in many processed foods). An internist or a registered dietitian can determine if you have a food intolerance. When you’re suffering from GI-related complaints, a dietitian might recommend an elimination diet, in which you eliminate specific foods for a period of time and then slowly reintroduce them and monitor your symptoms for possible reactions.

A Stealth Sickness
When nothing else seems to be at the root of your fatigue, consider seeing a doctor. Fibromyalgia and chronic fatigue syndrome commonly cause intense tiredness, in addition to poor sleep quality, brain fog and muscle pain. (Hypothyroidism, an underactive thyroid, often occurs with the disorders.) Much is not understood about fibromyalgia and chronic fatigue syndrome, but doctors estimate that up to 14 million Americans suffer from one or the other.

And women are more likely than men to experience them. “There’s usually a genetic predisposition,” says Kent Holtorf, M.D., a Los Angeles thyroidologist and the founder of the National Academy of Hypothyroidism. Some doctors surmise that fibromyalgia is a result of abnormalities in the central nervous system and that chronic fatigue syndrome is linked to infection.

Other experts think both conditions are a result of a dysfunction of the hypothalamus and the pituitary and adrenal glands. Most standard blood tests fail to identify the disorders, so the conditions are typically diagnosed through a physical exam and a detailed medical history. Standard treatment may include an SSRI or a muscle relaxant.

Another disorder that may be to blame: obstructive sleep apnea. A person who suffers from it experiences repeated pauses in her breathing while sleeping, often because she has narrow airways in her nose, mouth or throat (some telltale clues: loud snoring or gasping for breath while sleeping).
If your doctor considers your sleep history and suspects sleep apnea, he or she will send you to a specialist for treatment or to a sleep clinic for an overnight evaluation. Treatment may be as simple as changing your sleeping position or wearing an oral appliance, or as complex as sleeping in a mask attached to a C-PAP (continuous positive airway pressure) machine. In extreme cases, surgery may be necessary.