One of the top health problems I talk to people about is chronic fatigue or extremely low energy levels. From generalized fatigue to the more serious chronic fatigue syndrome (CFS), this epidemic of extreme tiredness is hitting a record amount of people.

Chronic fatigue syndrome by itself affects more than 1 million Americans, more people in the United States than multiple sclerosis, lupus, and many forms of cancer.

These statistics don’t even take into account all the people struggling with daily low-grade fatigue. Fatigue also can be very dangerous, with around 20% of fatal car accidents involving driver fatigue. Many people will brush off their low energy levels as just part of getting older, which makes it difficult to distinguish between what is common and what is “normal.

While fatigue is common, it’s certainly not biologically normal. This false assumption makes many people settle for feeling lousy and tired of most of their lives. Fatigue can affect every aspect of your life: your family, friends, job, and activities will suffer.

In this article I want to share with you the eight main culprits of chronic fatigue that I see in my practice and tips on how to overcome it:

1. Macronutrient Imbalances

Macronutrients are fats, proteins, and carbohydrates. Your body runs on these three macronutrients, and we need proper ratios of each one to suit your diet and lifestyle. One of the most common micronutrient deficiencies in the West is low-fat consumption.

Since the latter part of the 20th century, fat has been cut out of the standard American diet and that caloric deficit has been replaced with refined carbohydrates, specifically grains. When you’re in the sugar-burning mode, you get the inevitable sugar crash, leaving you with mood swings, irritability, weight loss resistance, and fatigue.

When I refer to fat, I’m not talking about margarine or some other kind of bad fat. Coconut oil, avocados, eggs, and, if you eat meat, grass-fed beef, and wild-caught salmon, are all great forms of whole food fat for your energy! From a biochemical standpoint, your body’s best and slowest-burning form of energy is fat.

Furthermore, your brain is made of 60% fat and 25% cholesterol, so nourishing that precious organ is the cornerstone to overcoming fatigue. Although rarer, inadequate amounts of protein and carbohydrates will also contribute to low energy levels.

2. Micronutrient Deficiencies

Our bodies are alive and functioning because of biochemistry. When we don’t nourish them with the specific nutritional requirements that make health possible, it can start with you feeling tired and lethargic.

Some nutrient deficiencies that I see on a regular basis in patients that are fatigued are iron, vitamin D, and vitamin B deficiencies. Each one of these nutrients can be checked by a simple blood lab and should be considered when you are struggling with low energy.

3. Poor Gut Health

Known as the “second brain,” your gastrointestinal system is an essential and often overlooked factor in your energy levels. You don’t necessarily have to have noticeable gut symptoms to have an underlying chronic gut issue. Your gut-brain axis is a complex web of communication between these two vitally important systems when it comes to your energy levels.

If your body is bogged down with conditions like permeability of the gut lining (leaky gut syndrome), small intestinal bacterial overgrowth (SIBO) or just generalized imbalances in your gut bacteria (dysbiosis), it can drain your energy significantly.

When these conditions are resolved, energy levels and vitality are restored back to normal. Interestingly enough, chronic gut dysfunctions are also linked to fatigue’s stubborn partner, weight loss resistance.

4. Inflammatory Foods

The foods we eat are dynamically instructing our biochemistry and our energy levels. Our meals are either helping or hurting your energy levels; there’s no neutral food when it comes to your body’s function.

It’s no secret that refined foods, excess carbohydrates and empty calories will negatively affect your health, and that will typically begin by zapping your energy levels. The infamous “sugar coma” can only be stopped if you stop eating what is fueling your low energy!

Underlying intolerance to foods like gluten, gluten-free grains, and dairy can also cause fatigue. If you’re suffering from fatigue, start by eliminating the inflammatory foods in your diet and try kick-starting it off with my real food challenge here.

5. Toxins

The word “toxin” has become so cliched and ubiquitous in the health community that the common person reading this article will probably roll their eyes right about now. The reality, though, is that our world today IS a lot more inundated with substances that are toxic to our health.

We are not genetically adapted to this onslaught of toxicity, and our energy levels are typically the first “check engine light” that something is not right. With a comprehensive health history and the use of proper diagnostic testing we can rule out common toxicities like heavy metals or plastics; if you don’t want to wait for tests, there are ways to reduce toxins in your life now.

6. Hormonal Dysfunctions

Our body’s different systems communicate through an intelligent web of hormonal pathways. A properly functioning endocrine (hormonal) system is essential for your energy levels.

Two relatively common hormonal pathway dysfunctions that I find in people who are struggling with low energy levels are hypothalamic-pituitary-adrenal dysfunction (adrenal fatigue) and low thyroid function. There are many different reasons for low thyroid function.

7. Medications

Every pharmaceutical drug has side effects and one of the most common side effects that I see is fatigue. Common medications are given for blood pressure, cholesterol, pain, diabetes, acid reflux and depression can all cause chronic fatigue.

It amazes me how little people know about the side effects of the drugs they take every day. If you’re on any medications, I would recommend finding out if fatigue is one of the side effects.

If your medication is causing or adding to your fatigue, discuss with your doctor about what other options you have. My main goal as a functional medicine practitioner is to get people healthy so they don’t have to be on the common medications that cause fatigue and other side effects.

8. Poor Sleep

Sure, this sounds like an obvious one! Yes, it’s true, if you’re just staying up too late at night because you’re watching your favorite reality show and drinking tons of caffeinated beverages, stop it. Go to bed earlier. But many people don’t know they aren’t sleeping well, and even if they do, they can’t fall asleep or stay asleep even if they tried.

Sleep disorders like insomnia and sleep apnea affects millions of people around the world with very little options in the mainstream model of care. Dealing with the underlying issues that are causing the sleep disorder is essential to restore your energy levels.

For mild insomnia, herbs like valerian and chamomile can be effective. For sleep apnea, CPAP machines work for some people and allow them to get the rest they need to regain their energy.

While breathing machines and herbal medicines may be effective in the short term, ultimately the question should be asked, “Why do I have this problem in the first place?” For my patients, when we deal with the individual root mechanisms of their poor sleep and low energy, they’re able to reverse sleep disorders and sleep apnea sustainably.

Customized Health Solutions

Obviously, this isn’t a complete list of everything that could be causing low energy. In functional medicine, it’s my goal to investigate the multifaceted nature of conditions like chronic fatigue. If you notice, the eight causes of low energy are connected, just like your body.

For example, toxins can cause hormonal imbalances, which can cause poor sleep. Eating inflammatory foods can damage your gut health which will cause a micronutrient deficiency.

There are many different pathways and possibilities for fatigue, or any chronic health concern, for that matter. These different dysfunctions need to clinically “untangled” and dealt with on an individual basis. Taking into account the individual instead of a generalized “one-size-fits-all” approach is the only way I have seen the consistent, reliable, and sustainable resolution of health problems like fatigue.


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