Three Surprising Fixes for Fatigue

By David Blyweiss, M.D., Advanced Natural Wellness

September 20, 2013

  • Aging doesn’t mean feeling old, weak and tired
  • Simple and easy tests your doctor may have missed
  • Two vitamin deficiencies that lead to fatigue

The minute people realize I’m a doctor, they all seem to want to talk to me. This happened to me just the other day at a social event. I met a gentleman who appeared to be around 60 years of age.

He was really quiet, but once he found out I was a physician, he had plenty to talk about!

Seems he went to his doctor about a year ago complaining of general fatigue. So he thought a good physical exam was in order. The next thing he knew he was getting an EKG, a stress test, MRI, CT scan, colonoscopy, endoscopy… and more!

That’s a lot of tests for someone who’s feeling tired. And after going to all of that unnecessary trouble, the results indicated he was in pretty good health. He just had a little acid reflux. And his cholesterol was slightly high.

Now he wonders if the doctor missed something. Or worse, if his low energy levels are a permanent symptom of old age.

Well I’ll be the first to tell anyone who asks that aging doesn’t have to come with weakness or lethargy. However, in today’s world it’s not uncommon to feel more tired than you should.

You see, there are many environmental and lifestyle factors that can contribute to poor energy levels that leave you feeling pooped out. But feeling tired is such a “general” symptom that many physicians find it hard to diagnose.

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But with the right tests, it’s easy enough to discover – and correct – the underlying cause.

Here are a few of the tests I run…

There are certain tests most physicians will run automatically. They’ll do a CBC to measure things like your red and white blood cell count.

They also test for lipid counts (cholesterol, triglycerides) and blood sugar. These days a lot of docs are even testing for homocysteine and C-reactive protein. These are both inflammatory markers for heart disease and other degenerative diseases.

I test for all of these things. But I also run several other tests that can really fill in the blanks when it comes to your overall health. Let’s take a look at a few of them…

Thyroid. The thyroid – a butterfly-shaped gland located in the neck – is the master gland of metabolism. If your thyroid is underactive or overactive, it could lead to fatigue.

If it’s not working up to par, it can’t produce the hormones needed to keep your energy levels up. On the other side of the coin, if the thyroid is working overtime you start to burn out.

Unfortunately, getting your thyroid activity accurately measured can be a medical minefield. Your doctor may order the wrong tests. Sometimes the results get misinterpreted. And the prescribed treatment could be ineffective.

Here are the tests I run to check thyroid function:

  • Full thyroid panel: Make sure any thyroid testing includes T3 and T4 and a TPO (not just a TSH) – also known as a full thyroid panel. Many doctors are calling for thyroid screens starting at age 35. It’s a great idea, but until it becomes the norm, you might have to ask.
  • Reverse T3 (rT3): This test is most-often used for the person who is on thyroid medication and isn’t feeling better. It tests a thyroid hormone that isn’t included in a full thyroid panel – and solves an important mystery for many people with thyroid conditions, whether known or unknown.

It’s an inactive metabolite of the main T4 hormone and reflects the level of thyroid receptors which may have this hormone attached, blocking the active T3 from doing its job regulating metabolism.

I have specific recommendations for patients with thyroid problems. My typical suggestion is 500 mg of L-tyrosine, 5-10mg of iodine and no more than 200 mcg of selenium daily. But these levels need to be monitored regularly. So it’s important to work with a qualified healthcare specialist.

In the meantime, there are certain foods that may interfere with thyroid activity if eaten frequently and in quantity. These include cruciferous vegetables, soy, turnips, spinach and mustard greens. Radishes, rutabaga, pine nuts, peanuts and millet can also cause problems.

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Other foods support normal thyroid activity. This is especially true of seafood and seaweed, which are loaded with iodine. Other foods are Brazil nuts, which are a rich source of selenium; and whole proteins such as fish, chicken, turkey, and eggs, which contain L-tyrosine.

A salivary adrenal profile is the best test of your adrenal glands functioning. If I find a positive Arroyo sign on physical examination (your pupils pulse larger/smaller… open/close and cannot hold their miosis (shrinkage) to bright light, a salivary adrenal test is appropriate. If your adrenals are dysfunctioning they will not do one of their jobs expected by the body; to help convert inactive T4 to active T3 thyroid hormone.

Heavy metals in the body are linked to numerous health problems – and are often overlooked. These metals include lead, mercury and arsenic.

They’ll not only leave you feeling weak and tired but heavy-metal exposure can lead to depression, irritability and mood swings. Even worse, they can cause tremors, autoimmune diseases, chronic infections and cancer.

Unfortunately, these poisons are something you are exposed to every day.

The environment is laden with heavy metals, mostly as a result of industrial waste. Anyone who eats a fish sandwich, inhales secondhand smoke, drinks a glass of water or simply breathes the air can be exposed.

This is why I normally run tests for serum heavy metals and organic pollutants. Now these tests don’t show the body’s complete burden of stored toxins. But they do reveal enough to know what you might need to remove and detox from your body. This can help reduce fatigue and other health problems.

If you have an unhealthy level of these pollutants, it may call for chelation therapy. Chelating agents, like EDTA, are compounds that bind with heavy metals and carry them out of the body.

Intravenous EDTA chelation has a direct and powerful effect on the body. But it can be expensive and time consuming. Fortunately, oral chelation may be an option.

I recommend a high potency oral chelation supplement that contains EDTA, as well as high levels of aspartic acid (which plays a vital role in generating cellular energy), vitamin C, magnesium, manganese, selenium and zinc.

There is one more thing you should be aware of, and you might find it quite surprising.

Vitamin deficiency is more commonplace here in the U.S. than you would think.

And this is especially true of vitamins B12 and D. According to a major study, almost two out of five Americans don’t get enough B12. Now as crazy as it might sound, almost three quarters of U.S. adults are vitamin D deficient.

Vitamin B12 deficiency has long been tied with low energy levels, poor metabolism and moodiness. And low levels of vitamin D create problems of its own. While you might associate vitamin D with bone health, a deficiency can also lead to weakness and fatigue.

In an interesting study, researchers discovered many patients who report muscle and bone pain, headache and fatigue are vitamin D deficient. As such, the study recommends anyone with any of these have their vitamin D levels checked.

Because these deficiencies are running rampant here in the U.S., I consider testing both vitamin D and B12 levels to be two of the most important tests I can run.

A 25-hydroxy vitamin D test is the most accurate way to measure how much vitamin D is in your body.

If you are found to be deficient in vitamin D I suggest supplement with up to 5,000 IU of vitamin D3. This is also known as cholecalciferol. It also won’t hurt to get out in the sunshine for a little while each day without sunscreen. Just a half hour in the sun will give you 10,000 to 15,000 IU of vitamin D.

I test serum or urine methlymalonic acid to reveal B12 deficiency. If you are deficient, your best bet is investing in a sublingual spray containing at least 2,500 mcg. of vitamin B12 and use three times a week.

Oregon Public Health Division, Office of Environmental Public Health.

Tucker KL, Rich S, Rosenberg I, Jacques P, Dallal G, Wilson PW, Selhub J. Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. Am J Clin Nutr. 2000 Feb;71(2):514-22.

Knutsen KV, Brekke M, Gjelstad S, Lagerløv P. Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scand J Prim Health Care. 2010 Sep;28(3):166-71

2 thoughts on “Three Surprising Fixes for Fatigue

  1. Shar

    Dr. Blyweiss, Thank you for your informative, easy-to-understand articles that help your readers better understand their bodies and how to take care of them!
    Which specific test(s) do you prefer to measure heavy metals? If you like the urine 6 hr collection, do you think they debate about the reference ranges really matter OR is it just helpful to know what kinds of metals are being excreted from your body? Thanks.


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