What to do if you’re tired all the time

By Dr Sandra Cabot

To be tired all the time is not normal and yet many people come to accept it as they are too tired to fight it, or even to get help. They continue in life just by putting one step in front of another.

Fatigue is insidious and can be a killer, as it increases the risk of accidents.

Chronic Fatigue Syndrome (CFS) is a diagnosis but it does not provide the cause of the fatigue and for this reason there are literally thousands of treatments that are promoted. There is no one magic bullet which can help someone with CFS and a holistic program is required to overcome it so one can enjoy a normal life.

What are the most common causes of fatigue?

  • Hidden and chronic infections in the body – these can be bacterial such as Lyme Disease from tick bites, streptococcus, staphylococcus, or viruses such as herpes, glandular fever, hepatitis viruses and many others.
  • Autoimmune diseases where your immune system attacks your cells in different parts of your body causing inflammation. For more information see our book titled Healing Autoimmune Disease: A plan to help your immune system and reduce inflammation.
  • Leaky gut is often associated with dysbiosis (excess unhealthy bacteria in the gut) and/or food allergies and intolerances. My 15 Day Cleanse can improve this condition. After the cleanse, take a good probiotic for 6 weeks. Fermented foods such as Kombucha, sauerkraut, kim chi, miso, can improve gut flora.
  • Adrenal exhaustion with inadequate amounts of adrenal hormones (cortisol, adrenalin, DHEA etc) being produced.
  • Low levels of neurotransmitters in the brain (especially dopamine, adrenalin and serotonin) resulting in mental fatigue and mood disorders. Tyrosine Mood Food supports neurotransmitter production.
  • Fatty liver can cause unstable blood sugar levels, poor detoxification capability and sluggish metabolism. As a result, the breakdown of toxic chemicals from the environment, food and water is compromised and general body toxin load increases. See the book Fatty Liver: You Can Reverse It.
  • Inactivity and sedentary lifestyle results in poor circulation of blood.
  • Insomnia and/or stress. This can be helped by taking a strong magnesium supplement and the sleep hormone melatonin can help sleep initiation – you need a doctor’s script for melatonin.
  • Thyroid problems which often remain undetected – these can be due to deficiencies of iodine and selenium.
  • Testosterone deficiency in men and women.

Nutritional deficiencies

Iron deficiency in menstruating women is the most common – this is easily found by doing a blood test for iron studies. If your iron levels are very low, have an intravenous infusion of iron (ferinject) and if they are moderately low, take a well-absorbed iron supplement every day.

Other common nutritional deficiencies in Australia, and indeed worldwide, include vitamin C, vitamin B 12, vitamin D, magnesium, iodine, zinc and selenium. Even in countries where there is plenty of food, these deficiencies are common because our soils are depleted, and food is mass produced and processed. Deficiencies can be easily tested for in a blood or urine test.

Protein deficient diet which does not supply the body with enough amino acids.


There are many other causes of CFS some of which are obvious, but some are hard to detect and that is why it is vital to see a medical doctor who is thorough and does not give up. Regular doctor visits with follow up are required. So, you can see that blood tests are required to check the immune system, nutritional status and the hormone levels.

I have not mentioned the more esoteric and rarer causes of CFS such as mitochondrial disorders and genetic polymorphisms, but they need to be considered by the treating doctor if more common causes are not found.

Treatment of CFS

Once we find the cause, or often multiple causes, we can start to treat the CFS with specific and accurate therapies. It takes time to overcome these causes and patience is required.

We may need to administer different types of thyroid hormones such as Porcine Thyroid Extract or triiodothyronine which is known as T 3 and is 10 times more active than regular synthetic thyroid hormone known as Thyroxine (T4).

We may need to administer adrenal hormones such as adrenal glandular extract, hydrocortisone and DHEA to treat adrenal exhaustion.

We may need to administer natural testosterone in the form of a cream or pump. If we can replenish very low testosterone levels, the energy of the body can rise dramatically. All of these hormones require a doctor’s prescription.

It is always important to assess liver and gut function in someone who is excessively tired. The liver is the major producer of energy and proteins in the body, and if your liver is fatty or inflamed, you will have less energy produced in the liver. I have also found that people who are overweight and tired, and cannot seem to lose weight no matter what they try, need to focus on improving their liver and gut function. This is the starting point and the key to a successful and sustained journey to increased energy and healthy weight loss.

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