Getting to the Bottom of Constant Fatigue

Constant fatigue affects a large part of the population.  It’s normal to get tired from time to time, but when it becomes the norm, you may begin to suspect something is not right and start to look for answers.

There are various reasons why a person may be feeling tired all the time. Unfortunately, the real reason may take some time to discover and how to deal with it is not always well understood.

Usually, your doctor will start by ordering some blood tests. Perhaps your iron or B12 is low? More often than not everything looks fine and further investigation is needed.

It often takes some time to get a proper diagnosis and during that time the patient may be left to take care of themselves.

With billions of years of evolution crafting the human form, we should be well geared to make it through the day.

As the descendants of hunter-gatherers, who were always on the move, it’s our evolutionary advantage to have abundant energy. It’s our birthright, so to speak.

Every ancestor you have had has survived famine, injury and disease at least long enough to produce another generation. Our genes have evolved to adapt to and overcome many types of stresses.

The problem is that our world is changing very rapidly. The types of stressors we have to deal with today are quite different from the ones our ancestors had to face.  Processed diets, chemical and toxic metal exposure, constant work stress, a lack of sunlight, poor sleep quality, the list goes on.

It can be difficult for our bodies to adapt to the ongoing and novel stressors that we face in today’s modern world.

When a person becomes severely fatigued on consistent bases, it’s the result of their body’s failure to adapt to ongoing stress from their environment.

For some people, it’s years of physical, emotional and chemical stress that add up to ongoing malaise.

For others, it can be quite acute. Fatigue can come on quite sudden following an infection such as Lyme disease or from the shock of a motor accident.

For some people, it means dragging their heels through work and collapsing when they get home. For others, it means only being able to work part-time or not being able to work at all.

Knowing why you are tired all the time is half the battle. A diagnosis really isn’t enough. You have to understand what the root cause of the diagnosis is. This can be different for each individual.

Let’s explore the main fatigue diagnoses and take a look at the factors which lead to these conditions. This will help you to pinpoint the root cause of your condition or at least give you avenues to explore.

Understanding the root cause will allow you to tailor therapeutic action that will help you to recover your energy levels.

HPA-Axis Dysregulation

Chronic Fatigue Syndrome/ Myalgic Encephalitis



Hypothalamic Pituitary Adrenal Axis Dysregulation (AKA Burnout).

This state of malaise is characterised by chronically low levels of cortisol. Cortisol is the body’s anti-stress hormone. It reduces pain and inflammation while raising blood sugar, all important factors for being active during the day.

In a healthy person, cortisol should be highest in the morning and lowest at night.  We need cortisol to wake up and get going at the start of the day and we need to lower it as the day goes on so we can wind down and rest in the evening time.

Cortisol also spikes in times of stress. When the body is under pressure it revs up levels of cortisol to temporarily increase energy and reduce pain so that the issue can be dealt with.  High cortisol feeds back to the hypothalamus in the brain, damping the signal to release more.

This feedback loop is known as the Hypothalamic Pituitary Adrenal Axis (HPA Axis).  When the body needs cortisol, a signal is sent to the hypothalamus which signals to the pituitary gland to release a hormone called Adrenocorticotropic hormone (ACTH) which in turn signals the adrenal glands to raise cortisol levels.

Stress comes in many forms. It could come as an immediate threat (real or imagined), a high workload, an infection, ongoing inflammation, toxic substances, poor nutritional choices, over-exercise, a lack of sleep or an emotional reaction.

You can also add toxic emotional baggage to the list. Resentments, anxieties and depression all create inflammation and stress in the body which require increased cortisol levels to manage.

Trauma and childhood wounds can cause a person to go into a state of stress.  Some situations trigger stress as a coping mechanism to deal with perceived dangers, even though these may be psychological and not always appropriate.

Trauma can also make a person hyper-vigilant. Their nervous system is permanently on high guard, as it has leant that danger is everywhere.

Stress, It’s More Than You Think!