Recently, I was asked to look at the labs of a woman in her late forties complaining of fatigue and malaise, despite eating healthfully and exercising regularly.
Basically, her physician looked for anemia and low thyroid—both are possible causes of fatigue—and finding that all were within normal limits said, “You’re healthy!” and sent her on her way.
There are a myriad of conditions that can cause fatigue and malaise; unfortunately, she was only tested for two of them. But even these two possible causes are too often not critically assessed. For example, most doctors look at hemoglobin and hematocrit contained in a CBC, but they don’t check ferritin levels. With regard to thyroid function, rarely is a full thyroid panel ordered. Typically, mainstream doctors look at TSH and maybe T4. However, if this patient’s T3 was low, it would never be discovered.
Moreover, if ferritin is low, the thyroid is not being optimally supported. All of this would go unnoticed. Worse, the patient was dismissed by her doctor because the lab workup didn’t support her complaints. Such as it is in mainstream medicine.
But let’s say for the sake of this example that all of these lab values, had they been conducted, were truly in the normal range. This then merits a deeper dive into what may be causing fatigue and malaise. From an Integrative and Functional Medicine standpoint, a more comprehensive investigation would have been undertaken including (but not limited to) the following:
- Epstein-Barr Virus (among other viruses)
- Adrenal function/Cortisol levels
- Micronutrient deficiencies
- Blood sugar disturbances
- Candida
- Leaky gut
- Gut toxicity
- Heavy metal toxicity
- Environmental toxicity
- Hormones
- DHEA sulfate
- Food allergy or intolerance
- Gluten sensitivity
- Celiac disease
- Lyme disease
- Sleep assessment
In my experience, I will tell you that 99 percent of the time the cause of fatigue is revealed in one or more of these tests.
The objective is to treat the cause of fatigue, not just the symptom.
To your health!
Leyla Muedin, MS, RD, CDN
