Why Am I So Damn Tired?
Are you tired of feeling tired? It seems like so many women in middle age have this complaint. We have families to raise, career ladders to climb, houses to care for, aging parents to look after as well. All of these responsibilities can be exhausting, but do you ever feel as if there is something else causing your fatigue? Is it out of proportion to what you are doing all day long? Do you ever feel as if you will never get through the day?
I am a physician, originally educated in traditional medicine, and then I transitioned to integrative medicine. I also suffered from chronic fatigue. I tried to blame it on my kid, my occasional night shifts, my lack of sleep, and my hormones, but none of it explained why I felt SO tired that some days I thought I was dying of some undiagnosed illness. I was concerned by the fact that I may have multiple sclerosis, or cancer, or chronic fatigue syndrome, or many other diagnoses that would end in my demise. I couldn’t be there for my child or myself. I was no fun. I even had blood work done several times and no one could find anything wrong with me. I knew that something was wrong, and I knew that traditional medicine was not going to help me.
Have you seen your physician, had lab work, and still cannot find an answer? You do not have to battle it alone. Many hidden causes for chronic fatigue can be treated, and you can feel your best again. Here are my top 10 causes of fatigue in middle age and what you can do about them:
Sleep: This may seem obvious. However, many people do not the right KIND of sleep. It doesn’t seem to matter how many hours you spend in bed, or even if you thought you were knocked out all night. What really matters is something called sleep architecture. You have to progress through all of the stages of sleep, at a certain time during the night and stay in them for a certain period of time. Many substances can interfere with the stages of sleep without you knowing it. Basically, ANY prescription sleeping pill or over-the-counter sleep medication can interfere with your sleep architecture, making you feel groggy the next day and exhausted. It’s a cruel trick because many of these medications say that they are helping you sleep when in fact they are robbing you of the most important parts of sleep. Even melatonin, when taken at high dosages, can push you into dream sleep too quickly, resulting in less than ideal dream states. It is important to know the right dosage of this important supplement. If you suffer from wicked insomnia, do not despair! Several herbs can cause relaxation without interfering with the stages of sleep. Some of the best herbal mixtures can include Passionflower, Kava kava, and Valerian. If you are taking any substances for sleep, switch them out for these relaxing herbs instead.
Alcohol: Have you ever had that happy hour drink and then felt worthless for the rest of the day? Alcohol can rob you of your energy, not only the same day but it can alter you sleep architecture as well. This results in poor sleep later. Alcohol robs you of the following day as well because it can make you more anxious when it wears off. Have you ever gone out for a night of drinking, collapsed into your bed super-relaxed only to awaken at 3 AM packing over something random? When the alcohol wears off it causes your nervous system to rebound with all kinds of anxiety-provoking substances. Anxiety is exhausting in and of itself. If you are having trouble with fatigue, definitely switch out your alcoholic beverage for something more hydrating (as dehydration can also worsen fatigue).
Chronic infections: In case you needed another reason to get your vaccine, new research shows that COVID is one of the viruses that can contribute to a post-COVID syndrome. This means that it can be one of the causes of severe fatigue that can last for months if not years. To me, this seems worse than a couple of days of side effects from the vaccine, and it scares me to have to suffer through something like this and wonder if it will ever go away. Other infections can cause chronic fatigue, such as the Epstein Barr Virus as well as certain agents. Chronic Lyme disease is the most well-known culprit. Up until recently, many have relied upon lab tests to diagnose this condition. Many patients have been absolutely CONVINCED that they had all of the symptoms, only to be told that they didn’t by their physician. This leads to the creation of many online support groups and counter-medical culture movements to convince ourselves the opposite is true. Recently, many in the medical world have come to understand that these tests are imperfect at best. Now a questionnaire has been validated as a way to diagnose the condition. Apparently we really do know our bodies, and these lab tests can go in the trash. If you think you have it, you may be right. Seek out a practitioner who is experienced in treating the condition and won’t treat you as if you are a lunatic.
Depression: This is the most insidious condition to cause fatigue. In many people it is the only symptom. You don’t feel sad, or want to drive off of the overpass, but you are just so damn TIRED all the time. This can be one of the warning signs that something isn’t right, and that resting more simply isn’t going to fix it. I myself had this flavor of depression, and I didn’t recognize it for years. I blamed night shifts. I blamed having a baby. I blamed stress. I blamed my ex, and I tried to sleep more. Nothing seemed to make it better, until my brain was better. I worked on my diet, took herbs for depression, and I threw all of the toxic people and jobs out of my life. I refused to take anti-depressants, because I wanted more than anything to NOT have a serotonin imbalance in my brain. I cannot drink the Big Pharma Koolaid commercials that tell us we are all walking around with some kind of chemical imbalance. How does that even make evolutionary sense? My efforts eventually paid off, and the fatigue went away. Rather than focusing on the fatigue and its causes, focus on what needs to be different in your life for you to feel better. Treating depression, whether with western medicine or other modalities, can often provide you with instant relief.
Vitamin Deficiencies: In a country where we are mostly obese, or even super-obese, its hard to imagine that anyone could be deficient in anything. However, the Standard American Diet leaves us deficient in many of the nutrients that our nervous system needs to function correctly. B vitamins are especially important for brain function, and our food system does not have enough of them. Omega 3 is a very important supplement for those suffering from fatigue, and mental health conditions, but our diet is full of the grouchy Omega 6 which can oppose its happier cousin. Many scientists also believe that our soil is actually different than it was when we evolved due to over-farming and farming techniques, leaving our fruits and vegetables deficient in many minerals that we NEED in small amounts. The number of nutrients needed to optimize brain and nervous system function is too large to list here, but many vitamin manufacturers target their formulas for this reason. Contact me for help with picking a supplement that would be right for you.
Processed food and food allergies: It may be that your unrelenting feelings of fatigue are actually a reaction to your food. These days, our food is full of chemicals and ingredients that we don’t understand. Our immune systems do not understand them either. Do you know the feeling you get when you are coming down with a cold or the flu and you just feel tired? That is due to chemicals that your immune system manufactures that cause fatigue such as interferon and interleukin-6. They ensure that you feel crappy enough to lie down and rest so that your body can fight off the foreign invaders. However, if you are sensitive to something in your food, your body is going to release the same chemicals, every time you eat it. How about a food allergy test to figure it out? These tests are not always accurate, and can miss many common triggers. Just because your friend does not eat gluten and feels better, doesn’t mean that is the culprit in your diet. We are all bio-individual. It is important to work through your own sensitivities to find what is bothering you. An elimination diet can be especially helpful, but it should be done under the care of an experienced practitioner.
Chronic stress: While this may seem obvious, it is hard to notice what kind of havoc your body is going through when stress creeps up slowly on you year by year. This is the chronic day to day stress of dealing with ailing parents, or several children, or stressful in-laws, or nasty bosses, a prolonged divorce, job losses, or any number of stressful events. The constant stain on your nervous system leads to exhaustion. The stress hormones all interact in something called the Hypothalamic-Pituatary Axis. This is a feedback system of hormones that control everything in your body from your immune system to your mood to the type of bacteria that you have in your gut. It can wear out similarly to the way your tires can wear out when you don’t replace them and….you have a blowout. Have you ever heard of adrenal fatigue? This is not as accepted in traditional medical circles but is a well-known phenomenon in herbal and Chinese Medicine. Perhaps this is because Big Pharma has not figured out a drug that would help with chronic fatigue so why bother talking about it? Thankfully, herbs have something to offer. We often use plants called adaptogens to regulate the stress response and bring the system back into balance. This can result in dramatic improvements in energy and stamina. I don’t know of any drug that can do that! I have used several of these plants to assist my recovery, and I can attest to the dramatic nature or their effects.
Strained relationships: Much like the stress response, hostile relationships can wreak havoc on our immune and nervous systems. Animals that are ostracized from the herd or group for some reason release stress hormones that make them more suspect able to infection. The stress hormones keep them alert, because most likely that are on the periphery of their group where predators are lurking. This makes them much more reactive and difficult for predators to catch. However, prolonged exposure to this type of situation causes the body to break down. Being marginalized from your group is incredibly stressful biologically, and leads to autoimmune conditions, allergies, more frequent infections, and inflammation of all sorts. Although you may think that your annoying mother-in-law or your toxic ex are not correlated with your health, your biology is telling you something entirely different. Your survival instinct is telling you that rejection from your social group could mean your immediate death. The stress hormones rise in order to keep you alert as you are in danger of being eaten by a predator while you are at the fringes of your group. After years of this kind of stress, your body will start to break down just as the animals do. You might have a heart attack, or a stroke, or develop depression or even obesity. Most likely you will just feel the effects of chronic inflammation as fatigue. The easiest way to relieve yourself of fatigue caused by this kind of social dysfunction is to rid yourself of toxic people. I do not really care if they are related to you or not. Fill your life with people who lift you up, even if you have to incorporate them into your life one at a time. You really cannot afford to put up degrading people or careers any longer.
Hormones: If you are a woman, which many with chronic fatigue are, you may notice a relationship between your cycle, your mood, and your energy. As we age, these hormonal fluctuations can become much greater and cause greater swings in energy levels. This is why you just can’t accomplish in your 40s what you could in your 20s without difficulty around your period. Some women are completely incapacitated around the times of their periods. Does this mean that you are doomed to feel awful without hormone replacement therapy? Not necessarily. Several diet interventions as well as herbs can mitigate the effects. Increasing the amount of soy in the diet as well as herbs such a chaste berry can greatly relieve the suffering of those low on female hormones.
Sugar: Much of our food has hidden sources of sugar .High fructose corn syrup can cause an extreme rise in insulin which stresses the pancreas and the rest of the body. After insulin has been churning out for quite awhile, the sugar wears off but the insulin does not. This results in a decrease in blood sugar that can feel exhausting to your body. These constant swings day after day can cause the body to feel worn out. You may be busy with your day, but your body is constantly fighting swings in your blood sugar and cranking out hormones to put them into a normal range. Try eliminating sugar for a few weeks and see how you feel. Make sure to look up alternate words for sugar because food manufacturers will try to trick you on the label. The simple dietary intervention can have dramatic results.
I hope you now have some insight into what may be causing your fatigue and what you can do about it. Several other causes exist and are not as readily apparent. Chronic fatigue is a condition that the traditional healthcare system can do very little about. However, many times simple changes in diet and lifestyle, or adding herbal supplements can do wonders for energy levels. If you are fighting fatigue, I would be happy to help you as I have been there myself! I love to help people through Integrative Nutrition as well as health-coaching. I have a virtual practice so I can see you in your pajamas if you prefer from anywhere in the world. I offer free initial health-coaching consultations at http://www.calendly.com/gingerdoc. If you would rather chat about it, send me an email at firstname.lastname@example.org.