low energy tired all the time fatigue Fatigue

Fatigue: Lose the Snooze Button

An overwhelming majority of my patients report NOT feeling refreshed in the morning when they wake up. I’m always a little pleasantly surprised when I ask and a patient says yes, they feel refreshed.  Fatigue or feeling tired all the time is not normal.  These may be a sign that there’s something wrong, so it should never be ignored.

If you are not waking up feeling refreshed, there are a number of possible explanations.  Here are some common reasons for chronic fatigue:

  • Not enough sleep
  • Low iron or anemia
  • Low thyroid or hypothyroid
  • Underactive adrenal glands, adrenal fatigue or HPA axis dysfunction
  • Allergies or food sensitivities
  • Depression
  • Pregnancy
  • Chronic pain

Not enough sleep

Studies show that the optimal amount of sleep is 7-7.5 hours of restful sleep.  If you wake frequently in the night or get up to go to the washroom, try having a bite or two of protein-rich food before you go to sleep.  This stabilizes your blood sugar overnight. While you may be getting enough hours of sleep,  if it is not deep, restful sleep, then it may not be of sufficient quality to prevent fatigue throughout the next day.  There are herbs, vitamins and minerals that I can recommend to help you get into a deeper sleep.

Low iron

Ferritin is a blood test that we do to check your stored iron.  Iron deficiencies can lead to fatigue, weakness and exhaustion.  An optimal ferritin level is above 60 mcg/L.  Some labs consider anything above 5 mcg/L to be normal.  So, your doctor may have told you your iron (ferritin) was normal when it was a fair bit below ideal. Ferritin below 40 mcg/L can definitely lead to problems with low energy (and hair loss).  If you struggle with maintaining your iron level, you may have difficulty absorbing iron.  I only recommend the best-absorbed iron and I will correct what may be preventing you from absorbing iron.

Low thyroid

Your thyroid regulates your energy, body temperature, and metabolism.  Sluggish thyroid function has a huge impact on energy. Blood work for thyroid is usually limited to testing TSH.  This is a hormone that should stimulate your thyroid to work harder if it is underactive.  So, a lower TSH means that your thyroid is working well.  The normal range for TSH is 0.35-5.00 mU/L.  This is a wide range, it’s like saying that 35 to 500 is normal.  Once your TSH gets above 3.00 your thyroid is underactive.  Some endocrinologists and fertility specialists medicate your thyroid if the level is above 2.50.  As with ferritin, you may be told that your thyroid is “normal”.  As a naturopath, I treat a patient’s thyroid if the TSH exceeds 3.00. We restore normal thyroid function before it becomes any worse.

Hashimoto’s disease is a common cause of low thyroid function. Hashimoto’s is an autoimmune thyroid problem. Most doctors don’t test for it.  Blood tests for Hashimoto’s can be abnormal even when your TSH is “normal”.

Adrenal Fatigue or HPA Axis dysfunction

If all else above has been ruled out, the chronic snooze button use is likely due to underactive adrenal glands.  These are your stress glands. They sit on top of your kidneys and regulate a wide range of bodily functions.  These include regulating blood pressure, blood sugar, your nervous system, libido, energy, drive, motivation, stress response, inflammation, hormone balance etc.

Signs of low adrenal function include:

  • NOT feeling refreshed after at least 7 hours of sleep
  • hypoglycemia
  • PMS
  • anxiety
  • fatigue
  • depression
  • feeling dizzy or light-headed on standing up quickly
  • low libido
  • inflammatory conditions like allergies, asthma, eczema, arthritis, and inflammatory bowel disease etc.

Your HPA axis needs certain vitamins and minerals to work well.  Chronic work or personal stress, poor diet, and modern agriculture mean that you aren’t able to take in enough of these vitamins and minerals, leading to adrenal fatigue.  As a naturopath, I would target the specific vitamins and minerals your adrenals need to work at their best.


Allergies can often leave people feeling exhausted a good deal of the time.  Because their immune system is working double time, all the time.  Environmental allergies, food allergies or food sensitivities all overwork your immune system leaving you feeling tired.  As a naturopath, I help people calm down their allergies to improve their energy.


Excessive stress, under-functioning thyroid or adrenals, vitamin or mineral deficiencies, and hormone imbalance all lead to signs of depression.  Symptoms of depression include difficulty getting out of bed or feeling motivated to do anything and a lack of joie de vivre.  Depression isn’t just a psychological problem.  Sometimes it is a physiological one, meaning that there are metabolic imbalances at the core of the issue.  These can be corrected through appropriate diet, lifestyle, herbal medicine and other supplementation.


The first trimester of pregnancy is a common time for women to feel fatigued, all the time.  The shift in hormones that accompanies pregnancy is usually the cause.  However, sometimes there is a shift in thyroid function or problems with low iron in pregnancy.  I can help optimize both.

Chronic Pain

Chronic low back pain, body aches, muscle pain, fibromyalgia, arthritis or any other type of ongoing pain, often leaves people feeling tired.  Coping with chronic pain is tiring.  Chronic pain also often leads to poor sleep or insomnia and therefore fatigue.   I help with chronic pain through anti-inflammatory diet, reducing stress, supporting the HPA axis, improving sleep quality and quantity and acupuncture.  My colleagues at Forces of Nature have multiple tools for helping with pain: chiropractic, massage therapy, osteopathy, acupuncture, craniosacral therapy and trigger point therapy to name a few.

As a naturopathic doctor, I have abundant safe, natural treatment options for all of the above conditions.

For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.

Authored by Dr. Pamela Frank, BSc(Hons), ND

DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this website.

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