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FATIGUE: Let's talk about it

Updated: Apr 19, 2023


Chronic fatigue can be caused by lack of sleep, poor sleep, chronic stress, nutritional deficiences and hormone imbalance.

Fatigue is a feeling of physical or mental tiredness or weakness and is best described as having a lack of energy. Fatigue can have a negative impact on a person's ability to perform daily activities and can also be a symptom of an underlying medical condition.

It is estimated that up to 33% of women report difficulties with fatigue. Women are more likely than men to report having issues with fatigue, and it is identified as one of the top 5 medical concerns women report every year.



Fatigue can be caused by a variety of factors, including:

  • lack of sleep

  • poor quality sleep

  • physical exertion

  • illnesses

  • chronic stressors (psychological, emotional and physical)

  • nutritional deficiencies

  • auto-immune disorders

  • hormonal imbalances

  • medications

  • work

  • hormone imbalance- particularly thyroid issues

  • abuse of drugs and alcohol

While fatigue can be short-lived and at times quickly and easily reversible, it can also present in a variety of conditions, including:

  • Adrenal fatigue

  • Adrenal insufficiency

  • Chronic fatigue syndrome

What is cortisol and how is it linked to adrenal fatigue?


The adrenal glands which are found on top of our kidneys produce our cortisol hormone. Cortisol is a steroid hormone that is sometimes referred to as the "stress hormone" because it is released in larger amounts when the body responds to stress with what we call a fight-or-flight response. Cortisol plays a key role in the body's stress response by increasing blood sugar levels, suppressing the immune system, and affecting the metabolism of proteins, carbohydrates, and fats.

Cortisol also plays a role in regulating blood pressure, heart function, and the sleep-wake cycle. In appropriate amounts, cortisol is essential for normal bodily function, but chronic stress and elevated cortisol levels over a prolonged period can have negative effects on our health which contribute to fatigue syndromes.


Low levels of cortisol can be caused by a variety of factors, including:

  • autoimmune disorders

  • infections

  • genetic conditions

  • hormone imbalance

  • chronic stress

  • nutritional deficiencies

Adrenal fatigue:


This is a term used to describe a non-specific group of symptoms, including:

  • fatigue

  • body aches

  • nervousness

  • feeling "tired but wired"

  • difficulty falling asleep

  • inability to awaken feeling refreshed after a full night of sleep

As the symptoms attributed to adrenal fatigue are non-specific and sometimes vague, mainstream medicine has yet to embrace the idea of adrenal fatigue. Some experts believe these symptoms are caused by chronic stress and dysfunction of the adrenal glands. Other causes could include predisposing conditions, such as sleep disorders, depression, and chronic illnesses.


Adrenal insufficiency:


Low cortisol levels, also known as hypocortisolism or adrenal insufficiency, can lead to a range of symptoms and health problems. Some of the common symptoms of low cortisol levels include:

  • Fatigue

  • Weakness

  • Dizziness or lightheadedness

  • Nausea

  • Abdominal pain

  • Weight loss

  • Salt cravings

  • Low blood pressure

  • Skin darkening (in some cases)

Chronic fatigue syndrome:


Also known as myalgic encephalomyelitis (ME), is a complex and poorly understood medical condition that the Institute of Medicine estimates affects 836,000-2,5million Americans/year. It is characterized by persistent and disabling fatigue that is not relieved by rest and is often accompanied by other symptoms such as pain, cognitive difficulties, and sleep disturbances. The cause of CFS is not known, and there is no definitive diagnostic test or cure for the condition. It is estimated that up to 90% of people with CFS are not diagnosed or treated for this condition.


How can adrenal insufficiency be treated?


The integrative medicine approach to treating adrenal insufficiency or low cortisol levels involves combining conventional medical treatments with evidence-based complementary and alternative therapies to find and address the root cause of adrenal insufficiency.


The goal of integrative medicine is to provide individualized care that addresses the whole person, rather than just the symptoms of the condition. The integrative medicine approach to treating adrenal insufficiency may include a combination of conventional treatments, such as

  • hormone replacement therapy

  • medications

  • complementary and alternative therapies, such as acupuncture, massage therapy

  • dietary and lifestyle modifications.

  • use of supplements, such as adaptogenic herbs to support adrenal health

The Bottom Line:


Don't let debilitating symptoms of hormonal imbalance and fatigue control your life. If you're experiencing any of these symptoms, it's important to seek the help of a healthcare provider trained in identifying and treating hormonal imbalances. By doing so, you can restore your sense of balance and improve your overall quality of life.


Carol Rademeyer is a highly regarded Advanced Practice Registered Nurse with a wealth of experience in women's health. With over 25 years of professional practice and a Master of Science Degree in Midwifery from the Midwifery Institute at Philadelphia University, she is a respected expert in her field. Her rigorous academic and professional background has earned her board certification in her specialty, and she has fulfilled the requirements in Florida for Autonomous Practice as an Advanced Practice Registered Nurse.


In addition to her clinical practice, Carol has also made significant contributions to the broader medical community. She has been published in several prestigious medical journals and has been a speaker at the national conference for the American College of Nurse Midwives, where she has shared her expertise and insights with her peers.


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