Why am I so tired all the time?

Why am I so tired all the time?

Jul 01, 2020

“Why am I so tired all the time?” I hear this question from patients nearly every day. And no wonder — it’s estimated that up to 2.5 million Americans are dealing with chronic fatigue. But many have not been diagnosed, or can’t find a provider who will take their symptoms seriously. And chronic fatigue syndrome (CFS) can be hard to treat, especially because it’s not always easy to tell what’s causing it.

At My Pure MD, I’ve spent countless hours working with patients to uncover the hidden causes of their chronic fatigue. I’d like to shine a spotlight on this common condition, and highlight some of the things that can trigger it.

What is Chronic Fatigue Syndrome?

Sometimes referred to as myalgic encephalomyelitis, chronic fatigue syndrome is a serious illness that can make living a normal, active life extremely difficult. In addition to a feeling of exhaustion that no amount of sleep can cure, symptoms of chronic fatigue include:

  • Decreased ability to do things that weren’t difficult before illness
  • A feeling of “crashing” after engaging in normal physical or mental activity
  • Sleep problems such as falling or staying asleep
  • Impaired cognition, including memory problems, trouble concentrating, and “brain fog”
  • Dizziness
  • Headaches
  • Muscle and joint pain
  • Frequent sore throats

Whether you have to drag yourself out of bed every morning or simply struggle to check items off your to-do list, you may be experiencing chronic fatigue.

What’s Causing My Chronic Fatigue?

One of the reasons people sometimes have a hard time finding a practitioner who will take their chronic fatigue seriously? We’re not exactly sure what causes it. But functional medicine specialists like myself can identify certain triggers that are often overlooked. Here are some of them.

Gut Imbalance

Your gut is home to a community of bacteria, both good and bad. An imbalance of these bacteria can lead to many health problems, including chronic fatigue. Scientists have identified abnormal levels of certain gut bacteria in patients with chronic fatigue syndrome. The more of these specific strains of bacteria in the gut, the more severe the symptoms of chronic fatigue.1 Leaky gut, a condition where undigested food and harmful microbes can pass through the intestinal walls and into the bloodstream, has also been associated with chronic fatigue.

Exposure to toxins

Exposure to mold and other environmental toxins has been linked to chronic fatigue syndrome.2 This is why many people who have been diagnosed with “sick building syndrome” after living or working in a mold-infested space often show symptoms of CFS. I explore the connection between mold exposure and chronic fatigue syndrome here.

Thyroid or Adrenal Issues

Problems with the thyroid and adrenal glands can cause chronic fatigue. Many of my patients with autoimmune thyroid conditions like Hashimoto’s list tiredness as a primary symptom. And adrenal fatigue, a condition that develops when the adrenal glands are taxed with producing too much of the stress hormone cortisol, is also associated with chronic fatigue.

Mitochondrial Malfunction

Mitochondria are like tiny energy factories inside your cells. When they’re not working as well as they should, you may experience chronic fatigue. Poor mitochondrial function has also been linked to sluggish metabolism and weight gain, as I explain here [INSERT LINK].


People with chronic viral infections like Lyme disease and Epstein-Barr often struggle with CFS. Chronic fatigue is also associated with some fungal and bacterial infections. This includes small intestinal bacterial overgrowth (SIBO). I see a lot of patients with SIBO who don’t even know they have it.

Nutritional Deficiencies

Even if you eat a healthy diet, you may not be getting enough of certain nutrients your body relies on for fuel. Low levels of iron, vitamin D, magnesium, and vitamin B12 have all been linked to chronic fatigue. I work with my patients to identify nutritional gaps that may be contributing to chronic fatigue.

Chronic Fatigue is Treatable!

If you haven’t been able to find a practitioner who understands chronic fatigue, you may feel like you have no choice but to live with your condition. Don’t give up hope! At My Pure MD, our functional approach allows us not only to diagnose your chronic fatigue, but to pinpoint hidden causes. Once you know why you’re so tired, you can address these causes under our expert care. Together we’ll formulate a personalized treatment plan so that you can finally feel like yourself again.


1. Dorottya Nagy-Szakal, et al. Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome, 2017; 5 (1)

2. Racciatti D, et al. Chronic fatigue syndrome following a toxic exposure. Sci Total Environ. 2001;270(1-3):27-31.

July 1, 2020

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