More people worldwide are experiencing fatigue than ever before. The impacts on our personal, family and work life is making us all more aware of work-life balance and how to stay healthy given the daily stresses we are undergoing.  A 2023 study from the National Institutes of Health revealed over 42% of people experience significant fatigue on a daily basis. (1)

What are the key symptoms of fatigue? 

-Physical symptoms include a feeling of tiredness during the day, waking up not feeling refreshed, blurry vision, a sense of listlessness, headaches, muscle weakness and dizziness. 

-Mental symptoms include a lack of executive function, lack of clarity of thought, brain fog, memory issues, difficulty in making decisions and a lack of overall well being. 

-Emotional symptoms include a sense of overwhelm, irritability, frustration with the inability to accomplish the same amount of work or tasks, lack of ability to engage in life, a feeling of needing time out. 


In order to alleviate fatigue, one needs to figure out the cause or causes. 

The most common cause comes from having long term stress without the needed rest to balance it.  Being in a stressed state for too long causes something called adrenal fatigue.  This often comes with suboptimal thyroid function because these glands, the adrenal and thyroid, function along the same axis, the hypothalamic pituitary axis. 

Adrenal Gland Insufficiency

The adrenal gland produces cortisol, the stress hormone but after some time, it stops producing as much and this causes a level of fatigue.  The body is literally asking you to rest and recover.  But in this day and age, that does not seem possible.  It is best to do a saliva test for your cortisol levels if you can in which your levels are tested morning, noon, evening and bedtime.  If you are low in cortisol all day, you may need medication.  If you are just low in the morning and normal the rest of the day, then adrenal glandular products, herbs and vitamins can help the adrenals recover.  You need to modulate your stress to fully recover but these supplements will help.  

Things that help are adrenal glandular products and herbs such as Ashwagandha, Ginseng, and Rhodiola. The vitamins for the adrenal glands are B5 or pantothenic acid, vitamin C and also trace minerals.  You will need a minimum of 6 months taking these support nutrients to be able to stop and have your energy back again. 

Suboptimal Thyroid Function

The second most common cause is suboptimal thyroid function. The thyroid gland when it is not producing optimally will let you know by making you tired.  This gland also works closely with the adrenal gland and so both deficiencies may be happening.  The testing for this is via blood test but the tests are more than the ‘normal’ testing standards.  The tests are TSH, free T3, free T4 and reverse T3.  If your free T3 is < 3.5, then you have suboptimal thyroid function and you have difficulty converting your T4 to T3.  In this case, you need the medication L-liothyronine (T3) to be prescribed.  

Natural support for the thyroid include herbs such as Ashwagandha, Kelp, Brown Seaweed, and Schisandra.  The thyroid also needs selenium and zinc.  Thyroid glandular products are available but can be too much for some people.  They also vary from bottle to bottle so I do not use these in my office unless they are standardized by a lab. (2)

Other Possible Causes

There are many other causes of fatigue such as poor sleep, diet, lack of exercise, and lack of nutrients especially the B vitamins, iron, zinc, magnesium and selenium. Other causes are an accumulation of heavy metals and or environmental toxins such as mercury, lead, plastics, herbicides, and pesticides,  Chronic infections such as Epstein Barr Mono, Lyme disease and COVID-19 can also contribute. The other thing I see way too commonly is dehydration.  Every human needs to drink half their body weight in ounces of pure filtered water every day to keep up their energy, brain function, and emotional health optimized. 


  1. Yoon JH, Park NH, Kang YE, Ahn YC, Lee EJ, Son CG. The demographic features of fatigue in the general population worldwide: a systematic review and meta-analysis. Front Public Health. 2023 Jul 28;11:1192121. doi: 10.3389/fpubh.2023.1192121. PMID: 37575103; PMCID: PMC10416797.
  2. Wellwood C, Rardin S. Adrenal and Thyroid Supplementation Outperforms Nutritional Supplementation and Medications for Autoimmune Thyroiditis. Integr Med (Encinitas). 2014 Jun;13(3):41-7. PMID: 26770099; PMCID: PMC4684134.

Hi I’m Dr. Wendy Wells, a licensed Naturopathic Physician in Arizona in the United States.  I was awarded a Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine, now called Sonoran University. I’m a member of the American Association of Naturopathic Physicians and the Arizona Board of Naturopathic Medical Association.  I enjoy helping patients with a variety of acute and chronic issues such as thyroid issues, hormone balancing, chronic fatigue, food sensitivities, gut health, mental health, autoimmune and skin issues. My passion is finding the source beneath any health concerns, getting the body back in balance, educating patients and their communities about how the body heals itself, and setting a course for continued wellness going forward.

Reclaim Your Energy with Dr. Wells

Feeling constantly tired or low on energy? Discover the root causes of your fatigue and unlock your path to renewed vitality with a personalized consultation. Dr. Wendy Wells, a licensed naturopathic physician, will provide expert insights and tailored solutions to help you feel your best. Don’t wait—schedule your free consultation today and take the first step towards a healthier, more energetic life!

Learn More Health Tips and Tricks