4 things you need to look out for if you are dealing with chronic fatigue

I'm Anindita!

I am a Functional Medicine certified Health Coach and AFMC Practitioner. I help women with autoimmune conditions I help women with autoimmune conditions reverse their symptoms with their body as their guide

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You don’t have to put up with chronic fatigue for the rest of your life. Fatigue and chronic pain are the two main symptoms most people with autoimmune diseases struggle with.

The good news is that once you understand what is at play you can make changes that will support energy production and hormonal balance.

“Focus on health, energy and vitality- not weight”

Karen Salmansohn

sleep, fatigue

Addressing underlying imbalances

Conditions associated with chronic fatigue like fibromyalgia and chronic fatigue syndrome were not that common even ten years ago. They were not considered as real diagnoses and usually dismissed as not being “real”. Also, more women struggle with these conditions than men.

Fatigue is also very common for those dealing with hormonal imbalances like insulin resistance, suboptimal thyroid function and adrenal imbalances. In order to reduce fatigue, you need to address the underlying imbalances and deficiencies. Unfortunately, it is very common in a conventional medicine setting to get a diagnosis of anxiety and depression and put on anti depressants.

This is really unfortunate because this does nothing to address the underlying imbalances and rarely works to improve health outcomes. However, becoming aware of the underlying reasons is the first step to addressing them.

4 common causes behind chronic fatigue

Some common underlying reasons for fatigue are lack of proper sleep, low iron levels and poor nutrition. However, chronic fatigue may not go away by addressing getting more sleep or simply focusing on our diet. In order to reduce our fatigue, we need to address other factors as well.

The good news is that you can reduce your fatigue by making changes in your lifestyle and diet. These will help you to manage these or even reverse these symptoms in some cases.

#1 Gut Dysfunction

Gut dysfunction can show up in various ways. This includes small intestinal bacterial overgrowth (SIBO), chronic viral or bacterial infection, fungal overgrowth. Food sensitivities to dairy, gluten, soy, eggs and other foods also play an important role in poor gut health.

Research shows that poor gut health (gut dysbiosis) can lead to impaired energy production and fatigue. Also, imbalances between beneficial and pathogenic microbes contribute to enhanced intestinal permeability (leaky gut) and chronic inflammation.

Another thing that arises out of gut dysbiosis is poor digestion and malabsorption. Bacteria in your gut are responsible for making enzymes that improve digestion. You need to have optimal levels of digestive enzymes and stomach acid to absorb key nutrients like vitamin B12, zinc, iron and magnesium.

Any deficiencies in these nutrients contribute to weak or imbalanced immune function and energy production. As you can see now, poor gut health leads to many downstream effects including (but not limited to)

decreased digestion and absorption

-immune dysregulation

chronic inflammation

impaired detoxification

#2 Mitochondrial dysfunction

Mitochondria is the battery or the powerhouse of each and every cell in your body where energy is produced. That energy is called adenosine triphosphate, or ATP, and it is used to support every function in our bodies. We have more than 100,000 trillion mitochondria in our bodies and this is where metabolism takes place. However, this ATP is not to be stored but to be used rapidly.

Mitochondria is important not only because of energy production but also because they are key regulators of cellular vitality and longevity. They determine the health of each and every cell in your body. Optimal energy production is important for vitality and survival.

Cellular energy production provides us with vitality and vibrant health, but it also produces a lot of oxidative stress. This needs to be handled by our body with the help of antioxidants. As we grow older, our ability to digest worn out or damaged cell parts (autophagy) decreases. So does our ability to repair, recycle and reuse them for regeneration. Mitochondrial dysfunction increases naturally as we grow older simply because of this wear and tear of the mitochondria. This is the main cause of low energy levels as we grow older.

However, poorly functioning mitochondria are very common in autoimmune diseases. This is due to reasons like poor nutrient absorption, high levels of oxidative stress, and low anti oxidant protection.

The good news is that there are certain things that you can do to increase energy production, starting with your diet. You can read more about how you can take care of your mitochondria here.

fatigue, chronic stress

#3 Chronic stress

Stress is a HUGE driver in the case of most chronic illnesses. This can be in the form of mental/emotional stress and even physiological stress. A few common causes behind physiological stress are microbial imbalances, toxin exposure, medications and food sensitivities to gluten and dairy. Stress has become an ingrained part of our day and messes up with our gut microbes in a substantial manner.

Most of us are under a tremendous amount of stress and operate almost constantly in a fight or flight (sympathetic) state forcing our bodies to be in constant survival mode. All of this gets compounded if we are dealing with any chronic illness. As a result, our body implements a purposeful hormonal response in order to survive. This can lead to sub optimal thyroid function and cortisol imbalances and impaired metabolism and energy production.

Stress hormones weaken and damage the gut lining leading to a leaky gut (enhanced intestinal permeability). This, in turn, creates more stress for the body, activates the immune system and produces further inflammation.

Living in a perpetual fight or flight state means that we are no longer able to produce adequate amounts of key hormones. When the levels of the hormones like cortisol and DHEA hit rock bottom, severe exhaustion sets in. This is very common for those with chronic conditions like autoimmune diseases.

When we remove and calm what the body perceives as threatening, our body finds a way to bring back our hormones into balance. You can find out more about this topic here.

#4 Anemia and iron absorption

Anemia and low iron levels are other very common reasons for fatigue for women. Low iron levels can be due to different reasons. Low iron intake, poor absorption and storing the iron to protect the body from supporting an ongoing infection are quite common.

Optimal levels of hemoglobin and red blood cells are necessary to transport oxygen to each and every cell in our body. Anything that interferes with having sufficient levels of iron affects other functions in our body and contributes to immense fatigue.

This is because iron is a major component of hemoglobin. Hemoglobin is the “delivery service” that takes oxygen to all parts of our body. Low iron levels mean too few blood cells, insufficient hemoglobin or red blood cells that are too small to carry adequate oxygen. Since oxygen is critical for energy production, anything that leads to insufficient oxygen levels will contribute to fatigue.

Sufficient levels of iron are also required for thyroid hormone creation. Since thyroid hormones control metabolism, losing weight becomes an issue for many women who also deal with iron deficiency anemia. Those who experience heavy blood loss can also have temporary episodes of anemia. This is due to the blood loss and the body’s ability to replace the red blood cells.

It is important to note that iron is often the first nutrient to suffer due to poor gut health, food sensitivities or medications like painkillers, birth control pills and SSRI antidepressants. We need strong stomach acid production to absorb iron from our food.


Uncovering the underlying causes behind chronic fatigue and then addressing them will help you start improving energy production. A root cause, Functional Medicine approach is key to feeling more energetic and getting your life back. If you are interested in learning more about how I can help you with this, click here.


A carefully curated and comprehensive collection of carefully selected books, podcasts, websites, blogs, and other resources from the field of Functional Medicine with a focus on autoimmune diseases

If have been looking to get ANSWERS to questions like

-Why do I have this disease?
-Will I get any better?
-Can anyone help me? Nothing is working
-Is there any hope for me to get my life back?
-I am still waiting for a diagnosis, which direction do I need to move towards?

 then this GUIDE would a game changer for you!

“Autoimmune Disease 101” is a carefully curated and comprehensive collection of carefully selected books, podcasts, websites, blogs, and other resources from the field of Functional Medicine with a focus on autoimmune diseases.

The Functional Medicine model of care for chronic diseases seeks to answer the question “Why do you have this disease” so that you can get personalised and effective care for your unique condition.

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Health Coach, author, blogger, podcaster, mom of two and avid reader

Before you get any further....
Hi, I'm Anindita!

I am a Functional Medicine certified Health Coach and AFMC practitioner. I help women with autoimmune conditions reverse their symptoms with their body as their guide

I work with women who want to go beyond symptom management, reconnect with their bodies and learn how to get well and stay well by tuning into their body's wisdom 

Learn more


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