Fatigue | Exhaustion

The Many Causes of Fatigue


Fatigue can have many causes. Overcoming fatigue, on a consistent basis requires that the underlying causes be understood and addressed. Below you will find the most common causes of fatigue. Generally when these areas are addressed energy levels come up and the feelings of vitality and well being increase.

In our clinic we ask a number of questions on every visit to asses the overall subjective experience of health and well being. These questions are on a scale of 1-10 with 7 being what we consider good health. Many of our patients come to us because their subjective experience of energy and vitality is below 7, often below 4.

If your energy levels are below 7/10 or if you want to raise your energy levels even higher then you may want to consider the following areas. The list is not exhaustive but does cover the vast majority of cases.

Adrenal Fatigue and Exhaustion
When you think about the adrenal glands, you should think about stress. Stress can take many forms: taking an examination, recovering from a broken bone, running away from an invading army, or maintaining proper levels of energy substrates in the face of even mild starvation. For human males, there is even considerable stress associated with shopping.

The adrenal produces three major classes of hormones, each of which aid in dealing with the multitude of small and large stresses faced by animals and people almost daily. There is no doubt that at least two of these groups - glucocorticoids and mineralocorticoids - are necessary for life.

Stress takes its tole on the adrenals leading to Stage I to Stage IV adrenal exhaustion. The following products and programs have proven successful in rebuilding the adrenal glands and restoring energy levels.

We strongly recommend the Adrenal Stress Index Test to see the current state of your adrenal glands. A second option is to combine Adrenal testing with Neurotransmitter testing. We find re-balancing and restoring the neuro-endocrine system and dramatically improve quality of life. Really.

If you have adrenal fatigue then we recommend a comprehensive program of adrenal support to rebuild adrenal function. Done properly this can make a tremendous difference in how you feel. 


Thyroid Function and Hypothyroid
Your thyroid gland tells every cell in your body the rate at which it should function. Having too little hormone, called hypothyroidism, can lead to fatigue, hair loss, depression and much more.

This is a problem for more than 10 million Americans-of whom 8 million don't know it. Having too much hormone, called hyperthyroidism, races your engine, so you feel all revved up-as if you were burning out. This problem affects some 4.5 million Americans, but at least 600,000 of them have yet to be diagnosed.

Feeling tired and chilly, having constipation or losing your hair, can mean your thyroid is underactive-but these could also come from overwork, or aging, or a dozen other causes. Feeling totally tense and overworked could mean an overactive thyroid-or just plain stress.

Hypothyroidism is an often missing diagnosis and is often worth checking into. Although typically diagnosed through blood tests, we like to also underarm basal body temperature over 97.8 and an Iodine Loading Test.

If you suspect hypothyroid you can try one of the thyroid support formulas. You can monitor the effectiveness by logging the basal temperature or by rechecking thyroid function through blood or saliva. The blood test is considered the most accurate When checking blood hormone levels we feel it is important to check TSH, T3 and T4.



Neurotransmitter Exhaustion
Of all the conditions afflicting us these days perhaps the most common and most insidious is those that affect our brain and our mind. The brain is the most important organ in the body. It plays a primary role in controlling all other body functions. Loss of brain function can dramatically effect the quality of our lives.

The most common disorders of the brain are Attention Defect Disorder, Attention Defect Hyperactivity Disorder, Autism, Alzheimer's and Parkinson's. In addition to these is the gradual loss of memory that many experience as they age. Add to this the chronic fatigue, moodiness, and depression that are so common and you can see how pervasive disorders of brain chemistry are. The GOOD NEWS is that many of these conditions are caused by imbalances in brain chemistry. Brain chemistry can be tested and in many cases treated successfully and without resorting to drugs!

In our clinic we routinely run Neurotransmitter Tests. These test look at the major neurotransmitter, such as epinephrine, norepinephrine and dopamine for the energy pathways and serotonin and GABA for the inhibitory pathways, like the breaks on a car. Over and over again we find significant deficiencies and imbalances in brain chemistry.

When imbalances and deficiencies in brain chemistry exist we use Targeted Amino Acid Therapy to address these imbalances. By tailoring our programs to the individual we increase our likelihood of success.

Hormone Depletion
Hormone depletion is common in men and women as we age. Although this could be considered natural it is not necessary to live with the effects of low hormone levels.

Hormones fall into two general categories for our purposes. There are the female hormones of estrogen and progesterone and then there are the male hormones, primarily testosterone. The third category of hormones that we look at is growth hormone.

Both men and women have all the hormones and proper levels and ratios are key to good health. For years western medicine has been addressing this area with HRT, Hormone Replacement Therapy. But like with many areas of western medicine, they got it wrong. Thinking that replacing the hormones was a good idea they discovered the horse urine had hormones in it. They then decided to extract this horse hormone and give it to women. Anybody who has been paying attention to medical news knows that this approach to hormone replacement has produced some undesirable effects, like increased incidence of disease and death.

So what to do.

Natural medicine has an answer, it is called bio-identical hormone replacement. We replace the hormones with hormones that are biologically identical to human hormones. Or we supply the precursors to that the body can make its own supply.

In the case of the female hormones we use bio-identical replacements. as sublingual tablets, creams or as sublingual progesterone drops.

For male androgens we offer DHEA and Pregnenolone Drops from BioMatrix, as well as Red Rooster by BioRay, a Chinese herbal tonic with libido enhancing effects. Clinically shown effective and our favorite libido enhancer..

The master gland, the pituitary, produces growth hormone. This is an area of much interest in the anti-aging world. Our own clinical studies have shown that our growth hormone secretagogues can raise growth hormone levels up to 40% in three months. To read more about the anti aging effects of growth hormone, HGH see our Anti Aging Home.

We offer marny forms of HGH releasers,

Mitochondrial Dysregulation
Mitochondria are sometimes described as "cellular power plants," because they convert food molecules into energy cells. They produce the energy inside the cells of you body. Due to genetics, toxemia and poor nutrition these processes can break down and when they do they produce less energy

When assessing low energy conditions it is sometimes necessary to check the mitochondrial function by doing an Organix Test. This is a comprehensive test of metabolic processes in the body and we consider it one of our base lines tests.

The mitochondria require:

  • B-vitamins, particularly vitamins B1, B2, and B3, play central roles in driving the Krebs cycle and energy (ATP) production.
  • Alpha lipoic acid, a powerful antioxidant, helps cells efficiently burn glucose and increases energy production.
  • Carnitine, a component of protein, helps transport fats into cells where they are burned for energy.
  • Coenzyme Q10 plays key roles shuttling around energy-carrying electrons and protons in OXPHOS, leading to higher ATP.
  • Ribose - plays a role in energy metabolism
  • Resveratrol - helps increase the number of energy producing mitochondria

The Aging Metabolism pdf - click to open

Blood Sugar Imbalances, Hypoglycemia and Diabetes.
Blood sugar imbalance are now reaching epidemic proportions in this country. As hard as it may be to hear this, blood sugar problems, hypoglycemia and diabetes, are primarily self caused. These conditions are primarily caused by what you eat. You do this to yourself. Of course this is good news and bad new. The bad news first. Your eating habits create the major cause of all blood sugar irregularities. The good news, since you are in charge of what you eat, you can have a major influence on your blood sugar by what you eat.

Americans, by their poor diets, are self inducing hypoglycemia and diabetes. Both conditions are on the rise and promise to become much worse in the coming decades. The primary cause of these health disasters is the overconsumption of high glycemic carbohydrates. Too much sugar! And to be clear you must realize that breakfast cereal, oatmeal, pasta, breads, cakes , cookies, crackers, chips and other such products are sugar. That is the body breaks each of these foods down into sugar. Not only does it break down into sugar, it does it much more rapidly then the body is properly equipped to handle.

Rapid breakdown of high glycemic carbohydrates (sugar) leads to a rapid rise in blood sugar and then, once the body's resources have been depleted, to a rapid decline. This process of the rise and fall of blood sugar happening on a daily basis for years leads to the deterioration and exhaustion of the pancreas, the liver and the adrenal glands. Left unchecked this process leads to hypoglycemia, diabetes and adrenal exhaustion. A very sad state of affairs. All preventable by eating a proper diet.

This raises two questions. One, what is a proper diet. Two, if you already have one of these conditions what do you do to recover.

First, what is a proper diet. For this I refer you to my colleagues, Dr's. Rain and Gary Klepper. They wrote a very useful article on the Paleo Diet. Although we will never have everybody agree on what a proper diet is for humans, we have found clinically that the Paleo Diet forms the basis of a healthy way to eat for most of us. Please click on the link above to read this article.

Secondly, what do you do if you are already experiencing hypoglycemia or diabetes. Well, the first thing is to look at your diet and stop adding fuel to the fire. Second is to begin to replenish and restore organ reserve so as to heal the body. Although many organs can be involved in this, the primary areas to look at are adrenal function and adrenal support nutrients; liver detox and strengthening; and finally pancreatic detox and support.

Healing from hypoglycemia is usually very doable. Healing from diabetes (Type II) is more difficult. In either case if you need assistance, Ask Dr. Steve.

Vitamin/Mineral/Fatty Acid/Amino Acid Deficiencies
Deficiencies of vitamins, minerals, amino acids and fatty acids is relatively common is our society. The combination of poor diets, deficient soils, high stress and lunatic weight loss schemes can often lead to deficiencies in one or more of these basic nutrients. You can address these areas by taking a high quality, broad spectrum multiple vitamin, mineral and fish oil or you can test each of these areas to find out whether you are deficient in any of these nutrients. With testing you can target your individual needs.

You can run individual tests or, to save money, we recommend The  ION Test. It contains:


Heavy Metals
Toxic metals are all too present in our environment, including our food, air and water. For sensitive individuals, even mercury amalgams may cause serious problems. These heavy metals can cause a severe drain on the body's ability to function, including creating damage to the immune system and the nervous system.

Some of the worst problems we see are lead and mercury toxicity. Much the mercury can come from dental amalgams especially when improperly removed. Another major area of mercury toxicity comes from the mercury that is in vaccinations. Evidence is pointing to the too early, too rapid vaccination of our children as a causative agent in ADD, ADHD and Autism. Many times this mercury is stored in the body for many years after the initial vaccination and special programs must be used to eliminate heavy metal toxicity.

We offer Heavy Toxic Metal Testing and well designed comprehensive treatment programs for this condition. 


Testing at Genova Diagnostic Labs as well as other labs indicate that many of us have intestinal parasites. These can vary from microscopic, so that we cannot see them, to large worms. In addition is the intestinal dysbiosis caused by use of antibiotics, poor diets and exposure. This may be a far more common problem that was suspected. If you suspect parasites we recommend the Comprehensive Parasitology test by Genova Diagnostic Labs as one of the foremost testing labs.

Parasites can be difficult to find and just as difficult to eradicate. Often times it is best to test first to find out what you have and then to pick a specific remedy that works for that parasite. Alternatively you can use one of the general parasite cleanses. The difficulty here is that you are not sure it will work and if you did not test you are not sure you got rid of it.

Another problem with cleaning of parasites is that the can be burrowed into the linings of the large or small intestines and they can be in layers. This can make it hard to detect them. In addition it may mean that you have to do several rounds of cleanses as each round may only kill the topmost level. As the gut heals from the inflammation the underlying parasites are now accessible and can be killer. Unlike many of the popular parasite programs out there that promise quick results, the facts are that killing all the parasites and infections can take some time and requires persistence.

Parasite Eggs
Parasites are living breeding organisms and as such lay eggs. These eggs can lay dormant for some time. You may do a very good parasite cleanse but stop too soon. You killed all the active parasites but left the eggs. The eggs then hatch and you are now in the same place as before except you are probably frustrated. So any good program has to be long enough to get the eggs as well. Sometimes the addition of a castor oil pack will get the eggs to hatch thus speeding their eradication.

Fungus and Candida Yeast Infections
Fungus and yeast infections are very prevalent in our society. They seem to come about from a breakdown of the immune system often due to unhealthy alterations in the body terrain. By the time the fungus or yeast has taken root there has probably been an ongoing problem for some time. This is part of the reason why it can be so difficult to kill them and get rid of them permanently.

An addition consideration when trying to kill yeast is that they appear to metabolize heavy metals in the gut. Heavy metal toxicity is very common in our culture due to the mercury in our mouths (whose idea was that), the mercury used as a preservative in our childhood vaccinations (another crazy idea) and the mercury and other toxic metals in the environment.

Some practitioners feel that trying to kill the yeast with a candida program before removing the metals is inappropriate. So before deciding on killing yeast in your body you may want to do a heavy metal program or test to find out if you have this common problem.

Gluten, Wheat Sensitivity, Food Allergies and Celiac Disease
Another problem when dealing with parasites are sensitivities that affect the lining of the gut. This includes gluten, gliadin, food allergies and celiac disease. These conditions can cause inflammation of the gut lining. When the gut lining is inflamed parasites can burrow deep inside making it very difficult to find and kill them.

When there are sensitivities involved it may be necessary to first resolve the inflammatory process before killing the parasites. Alternatively working on both at once is also a useful approach, that is removing the irritants such as allergens or wheat and also killing the parasites. The trick here is that there may once again be layers of parasites due to the inflammation and so repeated parasite cleanse will be often be necessary. Some clinicians have found an average of three layers of parasites.

To detect food allergies we recommend one of the our multi-panel food allergy tests. For gluten sensitivity and celiac disease we recommend one of the gluten sensitivity tests.

Not Certain What To Do Next?
If you are uncertain as to which products or programs to use or which tests to take; or, if you would like additional help:

  • Contact us with a brief question.
  • Arrange a phone consultation with Dr. Forrest.
    Call ( 408) 354-4262