Chronic Fatigue — Get Your Energy Back!
At my practice, I run the following tests on my patients with stubborn symptoms of fatigue:
- A conventional CBC (complete blood count), testing for anemia and evidence of infection;
- A CMP (comprehensive metabolic profile) to test electrolytes, blood sugar, blood protein, pH (acid/base) balance, and liver and kidney function
A mono spot, testing for mononucleosis- A Lyme titer, and if positive, a Western blot and/or PCR
- An Epstein–Barr titer
- Allergy, food sensitivity, and parasite testing
- Adrenal stress index
- Blood thyroid panel
- Blood hormone panel
- Heavy metals panel
- Sleep apnea test/REM monitoring (especially important for any woman with a BMI over 28)
- A stress test for any post menopausal woman with extended fatigue, to check for occult heart disease
Thyroid function and fatigue
Most women who come in with debilitating fatigue unrelated to an infection think it is somehow related to their thyroid. While it’s true that an underactive thyroid (hypothyroidism) can contribute to weight gain and fatigue, more often than not I find that my patients are usually struggling with one or two core issues, the most common being inflammation, undiagnosed digestive issues, food sensitivities, and burnt-out adrenals.
Infection and fatigue
An immune response of any kind is physically taxing on the body — that’s why you feel so worn out when you’re coming down with a cold or the flu. Chronic inflammation will always cause a corresponding degree of fatigue, and though chronic inflammation has numerous causes, there are various symptom complexes where infectious agents may be at play. 
Prolonged and unremitting fatigue can sometimes be the primary symptom of these mysterious and as-yet ill-defined conditions — which include Lyme disease, Epstein–Barr virus, and chronic fatigue syndrome (CFS), among others. Because the underlying pathways in these conditions remain poorly understood, infection is sometimes overlooked as a possible cause for a patient’s chronic low energy. A simple blood test may reveal that you are fighting a bacterial or viral infection, but it cannot always pinpoint the culprit.
Of course, fatigue heralds many very serious conditions like leukemia and other cancers, and for this reason alone it is always wise to take fatigue seriously.
Keep in mind that your immune system needs extra support not only during but after treatment for an infection. This is especially true after a course of antibiotics, which can exacerbate GI inflammation by upsetting the balance between good and bad bacteria in your digestive system.
Food and chemical sensitivities, dysbiosis and fatigue
Digestion is the process that renders food into fuel for your cells. It is a complicated, elegant mechanism that can break down at many points along the way. And when it does, guess what happens? You feel tired.
Chronic, undiagnosed food allergies and sensitivities will cause an immune reaction and imbalance in the colonies of flora that line your intestines. Called dysbiosis, this condition indicates a digestive imbalance, either enzymatic or between the friendly and unfriendly bacteria in your GI system. In both cases, your body must work overtime to handle it.