Fatigue that won't go away? Here’s what to do about it

Fatigue is one of those symptoms that’s hard to explain in specific terms---you’re tired, your body feels blah, you’re not yourself---and yet, it’s with you through every step of your day, making it tough to function anywhere near your best.

And because it’s considered one of those “nonspecific symptoms,” meaning it can be present in a large variety of health conditions, it can also be tough for doctors to help you figure out.

Fatigue can come in the form of physical fatigue, where you lack energy to participate in the activities you love or where getting through every day can feel like a slog. Fatigue can also be mental fatigue, where you just can’t seem to focus or are dealing with serious brain fog.

Sleep, exercise, and supplements are usually the first changes we turn to when we notice fatigue creeping up. But they are often ineffective when you don’t actually know the root cause of your fatigue.

Whatever the manifestation of your fatigue, testing a few key biomarkers is a smart way to start to figure out what’s at the root cause of your symptoms.

So what should you test to figure out your fatigue?

Vitamin D has been shown to play a role in muscles’ mitochondrial function, also known as the energy powerhouse of the cell. In addition, D also helps regulate sleep, has a hand in melatonin production, and may also be involved in conditions that impact your ability to get a good night’s rest, such as restless legs syndrome, according to a study in 2020 by Italian researchers.

High blood sugar levels can lead to fatigue, and HbA1c is a good indicator of whether you’re in the high range. Higher levels can be indicative of type 2 diabetes, a metabolic disease linked to cognitive problems, such as brain fog and issues with memory and attention. In addition, 85% of people who have prediabetes (when blood sugar is elevated but not yet to diabetic levels) are unaware their blood sugar is teetering at a dangerous point.

Getting your TSH levels checked shows how well your thyroid gland is working. An underactive thyroid, called hypothyroidism, causes your whole body to slow down, triggering symptoms like fatigue, a low mood, and muscle weakness.

Vitamin B12 is involved in red blood cell formation, while iron is a component of hemoglobin, a protein in red blood cells that carries oxygen from lungs around your body. Running low on either of these causes anemia and can bring on fatigue.

One symptom of low testosterone? Fatigue. (Oh, and by the way, don’t forget that both men and women have testosterone.)

Cortisol is the body’s stress hormone. And though it ticks up in times of stress, it’s also necessary for the healthy function of your body. Problems arise when stress becomes chronic and levels remain elevated when they shouldn’t be.

If you’re looking for a more convenient, cost-effective way to do these tests, or you feel as if you’re not being adequately heard by your healthcare provider, you can try at-home testing.

One option is through Base. For fatigue, you’ll want to focus on their Energy Testing Plan, which can test for thyroid dysfunction, nutritional deficiencies, or adrenal fatigue.  Or you can try Base Complete, Base’s most comprehensive testing bundle.

After identifying the Base kit that best suits your needs, you’ll get a finger prick or saliva test sent to your door. When it’s convenient for you, you can collect your sample in the comfort of your own home. (If taking your own blood sample isn’t something you’re comfortable with, no problem. You’ll just find a Quest Diagnostics lab near you and zip over to have it done.)

Soon after sending in your sample, you’ll receive your data via Base’s app. Based on the results, you’ll also receive personalized recommendations on how you can improve your diet or lifestyle habits, as well as what supplements you can take, in order to improve your nutritional or hormonal levels.

For example, if testing reveals that you’re running low on vitamin D, iron, or B12, you’ll be encouraged to change your diet to pack more of these nutrients in. For instance, trout, salmon, UV-exposed mushrooms, and fortified cow and plant-based milks are all good sources of D. For iron, eating fortified breakfast cereal or dark chocolate, or B12, eating nutritional yeast or yogurt, can help plug the gaps in your diet. If you can’t get enough from diet alone, supplements will ensure you meet your body’s needs.

When it comes to HbA1c, make sure you’re adding exercise to improve your body’s blood sugar control, research in Medicine & Science in Sports & Exercise finds. Any physical activity you can get is a win, but the study specifically found that doing aerobic or a combination of aerobic and resistance training was best to control glucose.

For thyroid disease, the best treatment is via medication management through your doctor. Of course, a healthy lifestyle will support your energy and mood, too.

Cortisol levels can be tough to manage, especially if you’re used to a go-go-go lifestyle. Often, stress management requires slowing down via techniques like deep breathing, meditation, resting, and getting adequate sleep. 

Exercise is also known as a stress-buster and mood-booster, and can help you deal with whatever your day throws at you or aid in stress recovery. Whether that’s a walk around the block, 10 minutes of HIIT, or a run to clear your head, movement counters cortisol.

Finally, there may also be a role for supplementing with magnesium, a mineral that helps regulate your stress response to keep you chill, shows research. Eating magnesium-rich foods like pumpkin and chia seeds, almonds, and cashews will also up your levels.

After working on those changes for a month, you’ll then take another test to track your progress so that you know what habits are working for you (and what might not be). It’s all about personalizing the treatment for you, rather than relying on a one-size-fits-all set of recommendations. Because that’s where the real difference in how you feel will come from.