The most important tests to run if you have fatigue

• ​Fatigue is more than feeling groggy because you stayed up too late watching Netflix and missed your morning coffee.

 
It is a persistent ache-in-your-bones feeling, like walking through mud every day and struggling to do the little things. It is the disorientation of not feeling like yourself for the past few weeks, months or years. It clouds your brain, steals your sense of humour and weighs heavily on your relationships. And then there’s the guilt and self-judgement about why you just can’t seem to get it together.
 
One of the biggest struggles that people with persistent fatigue face is that outwardly they look normal. Coworkers, friends and families may offer “helpful” suggestions about being more organized or going to bed earlier (a great point, but not THE point) or completely fail to understand. Even physicians may struggle to help once the basic blood work comes back “normal”.
 
Lifestyle factors can and do play a massive role, so it is critical to ensure that you are getting enough good quality sleep, eating well, exercising, managing stress and taking good care of yourself. Working with a therapist, registered massage therapist, personal trainer and your health team can be helpful to make sure you’re covering your bases.
 
If you are already addressing these areas and still feel like something is missing, Naturopathic Medicine can be a great solution. The next step is digging deeper and doing a thorough investigation to determine the cause of the fatigue and how these factors might be affecting your overall health.
 
Here are some of the most important lab tests that we run to assess the fatigue you’re experiencing.

Ferritin and iron panel – ferritin, % saturation, serum iron and total iron binding

• Iron is essential as it is required to help our body transport oxygen. Adequate levels are critical for optimal thyroid function. Ferritin is a measurement of stored iron and so can be very useful in seeing what’s in the bank. If you are also dealing with inflammation ferritin becomes less reliable as it will artificially inflate. Running a full iron panel can be helpful to discern whether the issue is actually low iron or inflammation.

Vitamin B12

• Low vitamin B12 levels are associated with fatigue, anxiety, depression and other mood disorders as well as neurological sensations like pins and needles. B12 deficiency can be caused by acid blocking medications like proton-pump inhibitors and antacids.

Thyroid Panel – a full panel includes TSH, free T4, free T3, reverse T3 and anti-TPO

• The thyroid sets the pace for every cell in your body aka your metabolism. If this rate is slowed down, everything is going to feel harder and you will most likely feel fatigued, have brain fog, weight issues as well as many other issues. This is one of the most under-diagnosed and poorly managed areas I see in practice. Getting the FULL panel is critical and the only way to give us the full picture.

DUTCH Hormone Test

• This is the most comprehensive hormonal evaluation available and gives a big picture view of how your hormones are working. One of the more common imbalances we see is either very high or low cortisol. This can greatly contribute to fatigue, as well as anxiety, insomnia and is a harbinger for other chronic health conditions. Your sex hormones progesterone, estrogen, testosterone and DHEA also play an important role in keeping you going and even small imbalances here can wreak havoc on your energy and mood.

Autoimmune and Inflammatory Markers – hs-CRP, ESR, ANA, rheumatoid factor, tissue transglutaminase IgG and/or IgA

• Low grade inflammation and undiagnosed autoimmunity as in Celiac disease, Hashimoto’s thyroiditis, lupus, psoriasis, rheumatoid arthritis as well as chronic pain take a lot of your body’s energy to keep under control. Sometimes fatigue is main presenting sign of autoimmune disease. These markers can also serve as a useful baseline to track your treatment progress.

Organic Acids Test

• The Organic Acids test gives us an intricate overview of how your body is physically making energy, if there are any bacterial and/yeast overgrowth concerns, and if you are deficient in some of the major nutrients required to keep your body functioning properly. I highly recommend this test for anyone that has been experiencing chronic fatigue, mood disorders, autism, ADHD and chronic pain.

 
Other factors to consider:
 
You know yourself best. If you feel that something is off, you are probably right. It is better to know where you stand and choose to work with a health care provider that can offer you the evaluations you need to get to the bottom of things.
 
A thorough investigation is important, but it is even more important to have a plan in place to address what you find.
 
Diet and lifestyle factors like how you eat, how you move, how you sleep and managing your stress will ALWAYS need to be a part of any treatment plan you undertake. It can be easy to get caught up in a complicated regimine of supplements and medications, but focusing on a strong foundation is what really determines your outcome.
 
If you have “tried everything”, have you been consistent enough? Being fatigued IS exhausting and it is only natural to get excited about the next newest thing… but nothing will work if you don’t give it a fair shot.
 
You need a team. The support of a partner or friend or online community can make a world of difference when you are suffering from an invisible illness. Work together with your health care providers to get the right assessments and guidance to help you recover. If you feel unsupported, unheard or like you are bothering your provider, find another professional to work with that will take your concerns seriously.
 
Working with a Naturopathic Doctor to address the causes of chronic fatigue can be invaluable to your recovery by helping you systematically address each of the areas above and make a concrete plan based on YOU.

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If this sounds like you, I invite you to schedule a complimentary Health Discovery session with me to talk more about your specific concerns. ​ Please share this article with someone you know that is suffering.

In health,

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References:

1. Valuck RJ, MJ Ruscin. A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B12 deficiency in older adults. Journal of Clinical Epidemiology. Volume 57, Issue 4, April 2004, Pages 422-428 http://www.sciencedirect.com/science/article/pii/S0895435603003834
2. https://dutchtest.com/
3. https://www.greatplainslaboratory.com/organic-acids-test/