Many of us have met or heard of those who have quit their job, or even quit their marriage or relationships due to ‘burnout’. Burnout is that state of mental, emotional and physical exhaustion that is both overwhelming and crippling. Many doctors now use the term ‘Chronic Fatigue Syndrome’ after excluding things such as heart disease, lung disease,  liver disease,  diabetes and poor sleep patterns. Let’s discuss a number of common categories of fatigue problems.

This is a diagnosis given to people who have no other causes of fatigue, and which has persisted or recurred over six months and is interfering with normal everyday activities. Symptoms may include; impaired concentration or short-term memory, sore throat and glands, muscle pain, joint pain, headaches, unrefreshing sleep, irritable bowel, alcohol intolerance, and fatigue following exertion (for example sport) lasting more than 24 hours. As there are many causes of fatigue it is well worth getting some expert advice for peace of mind. You may be surprised at how good you can feel after getting energy back again.


Fatigue can often last weeks following even a simple viral respiratory infection. The immune system may also become activated causing continuing problems even after the initial infection has been resolved. Antibiotics do not help the immune system and do not treat viral infections, only certain bacterial infections.


Many people are chronically sleep deprived, falling far short of the required seven to nine hours of sleep per night. Caffeine may provide an initial energy pickup but may also rob you of a restful nights sleep. It can also be quite addictive as those withdrawal headaches will show you. Poor fitness levels combined with long work hours set the stage for fatigue. Exercise does not have to be time consuming but ideally should be regular and strenuous enough to cause a sweat.


Iron is important because when it is too high or too low fatigue may be the result. A low iron level means that the red cells are unable to carry the necessary oxygen for the brain and body organs to function at an optimum level. This is known as iron deficiency anemia and a simple blood test can rule this one out.  Don’t simply take iron tablets as they may cover up an underlying problem or even lead to iron overload. Other mineral deficiencies worth checking for (but often missed) include magnesium and zinc.


Many women have taken hormone replacement for those troublesome hot flushes and insomnia only to find that the treatment causes worse side effects then when they started. This is because ‘menopause’ is not the same as ‘estrogen deficiency’, but more a result of hormone imbalance involving a central control via the pituitary and hypothalamus in the brain. Other important areas to check are thyroid and adrenal glands. For example fatigue with cold intolerance, dry skin, constipation and hair falling out may be caused by an underactive thyroid gland, whereas fatigue and lightheadedness may be an adrenal gland problem.



Also known as ‘snoring sickness’, this is due to the upper airway collapsing during sleep, shutting off breathing and causing a person to wake up dozens of times a night. Sleep apnoea can result in heart failure if left untreated due to repeated pressure created on the pulmonary circulation.



Grieving following the death of a loved one can take months or even years to get over. Even the loss of a job or loss of independence in older age can cause fatigue.



This is a common and treatable cause of fatigue associated with neurotransmitter chemical imbalance (such as seratonin) in the brain. At the Medical Sanctuary we sometimes use a multichoice questionairre to graph which neurotransmitters are deficient and the severity of that deficiency. There are a number of supplements available to then balance these neurotransmitters. Severe depression may require medication.



If you have been tired and thirsty and needing to empty your bladder often you may have diabetes. Simple blood tests such as a fasting glucose can rule this out. There are many people with undiagnosed diabetes which can lead to nasty consequences if ignored.


Dr Paul Payton, Nutritionally Trained GP, The Medical Sanctuary


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