If you feel tired all the time, you have lots of company. Each year, Americans make almost 900 million visits to the doctor seeking treatment for fatigue.

Many people who frequently feel tired fear they have the debilitating condition of chronic fatigue and immune dysfunction syndrome. (CFIDS)

If your fatigue has persisted for more than six months or is accompanied by sleep disturbances, joint pain, headache, inability to concentrate, or short-term memory loss, you may indeed have CFIDS.

In sad cases, it is best to seek treatment from a CFIDS specialist. For a list of specialists in your area, google “CFIDS Specialist Doctor Near Me” to find the correct information for your site. 

Good news: About 10% of my patients with fatigue have CFIDS; most of the rest suffer from garden-variety fatigue caused by too little sleep or exercise, poor dietary habits, or other easily correctable problems.


One of the major causes of chronic fatigue is the over or underproduction of tyrosine. That’s the thyroid hormone regulating how the body’s cells consume energy.

Overactive thyroid: symptoms of hyperthyroidism include fatigue, anxiety, insomnia, heart palpitation, and verging ice. This condition is treated with thyroxine-blocking drugs, surgery, or radioactive iodine to destroy the thyroid gland.

Underactive thyroid: If you feel depressed or lethargic, chill quickly, gain weight, or suffer from premenstrual syndrome PMS, muscle aches, dry skin, eczema, hair loss, low libido, a hoarse throat, frequent colds, or flu.

Checking your basal body temperature is a good idea if you face any of these symptoms. Insert a thermometer under your armpit as soon as you awaken before getting out of bed—record the result for three consecutive mornings.

A basal temperature of 97.4 degrees or lower suggests hypothyroidism. To confirm your suspicions ask your doctor to order a blood test.

Most doctors treat hypothyroidism with synthetic levothyroxine (Synthroid). However, some patients show more improvement when they take a natural thyroid hormone (Armour Thyroid). If Synthroid doesn’t relieve your symptoms, ask your doctor to consider that alternative or you can try this excellent supplement to restore thyroid function.


Anyone with fatigue, malaise, frequent illnesses, allergy, low blood pressure, or sugar may be making too little of the adrenal hormone dehydroepiandrosterone(DHEA).

Adrenal insufficiency is usually an autoimmune disease or adrenal gland damage stemming from long-term use of cortisone.

If a blood test reveals a low level of DHEA, you might need to take a supplement that comes in a different presentation, and my favorite is an oral spray.

DHEA has been used to boost immunity and combat fatigue, but you need to find a doctor with expertise in Integrative Medicine. Most traditional doctors are unfamiliar with supplements and are more inclined to prescribe synthetic drugs. 


Adult-onset diabetes is an often overlooked source of persistent fatigue. Ask your doctor for a fasting blood glucose test to rule out this condition.

  The normal sugar range is 80 to 100 milligrams per deciliter of blood. If you fall above that range, eating a special diet and regular exercise can help lower blood sugar levels. That should boost your energy. I usually recommend this advanced nutritional support for healthy insulin & glucose metabolism.


In men, a low level of testosterone can cause chronic fatigue. Men suffering from this problem (which we can spot with a simple blood test) can boost their energy level by taking testosterone supplements.

Hormone problems can cause fatigue in women too. But tests for hormone imbalances in women are often inaccurate.

Instead of relying on a blood test, women should suspect hormone problems if they experience the following.

  • Their fatigue is cyclical, getting worse before menstruation and improving afterward.
  • Weight gain of more than five pounds before each period.
  • They perpetually crave sugar, spicy food, or chocolate
  • Migraines or breast tenderness when taking birth control pill

To treat hormone-related fatigue, women should reduce their intake of alcoholic beverages, meat, and dairy products, eat more dietary fiber and less sugar and refined foods, and take gamma-linolenic acid or GLA supplements. Primrose, borage, and black currant seed oil, available at a health food store, are all rich in gamma-linolenic acid.

Women with extreme PMS-related fatigue should ask their doctor about having Meyer’s cocktail once a month; that’s an intravenous drip of calcium, magnesium, and vitamin B and C.


Chronic, mild food allergies can cause fatigue. Suspect allergy if you have dark circles under your eyes, are frequently irritable, feel foggy or depressed, or have frequent infections or dry skin.

Cravings for particular food or cycles of energy and fatigue suggest food allergies, especially wheat and dairy products. These foods can cause the body to produce an energy-sapping morphine-like substance.

Consider a medically supervised fast of one to four days to see if your energy increases. Add foods back to your diet only with the doctor’s permission.


If you can’t find another source of fatigue, you may suffer from indoor pollution exposure. Usual culprits are:

  • Benzene. in linoleum and degreasers.
  • Formaldehyde. In new carpets and new drapes.
  • Lead. In top water and house paint.
  • Mercury. in dental fillings and some house paint.
  • Nitrogen dioxide. Released by kerosene heaters, gas stoves, and furnaces.
  • Trichloroethylene. Used in dry cleaning.

Have your home tested for environmental toxins. For companies that test air and water, look under laboratory testing in the Yellow Pages.

If toxins are the problem, install carbon-based water and air filters. Ensure your home has good ventilation so that fumes can escape.

Another option is to fill your home with house plants to help filter the air. 

Your doctor should test your blood for chemical markers of contaminants and your hair for lead, mercury, and other toxic metals. If testing reveals traces of toxins, ask your doctor about adding selenium, vitamin E, beta-carotene, garlic, and sodium alginate to your diet. They help rid the body of toxic metals. Here is a heavy metal test I recommend to my patients.


In many cases, overeating sugar triggers fatigue. Sweet and refined carbohydrates make your blood sugar rise. It signals the pancreas to produce insulin. Too much insulin leads to hyperglycemia and low blood sugar, which causes extreme fatigue.

If you suspect hypoglycemia (low blood sugar) episodes, ask your doctor for an oral glucose tolerance test. If you experience heart palpitations, mental confusion, extreme fatigue, or feel dizzy or shaky during the trial, suspect a sugar problem even if your doctors say your blood sugar level is average.

Treatment is simple – stop eating sugar. Also helpful: Eating six small meals instead of three big meals. Small, frequent meals help stabilize life’s blood sugar level.

Finally, ask your doctor about taking ergogenic (energy-generating) dietary supplements, including vitamin B15, L-carnitine, octacosanol (a wheat extract), and ginseng.

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