We鈥檝e all felt tired at times. But if you鈥檙e over 50 and waking up just as tired as when you went to bed, or if you find yourself needing more and more coffee just to get through the day, it may be time to ask: what鈥檚 really going on?
Fatigue is one of the most common reasons people visit their doctor鈥攜et it鈥檚 often brushed off as a natural part of aging. While energy levels do shift over time, persistent fatigue is not something you have to accept. It鈥檚 often a sign that something deeper needs attention.
As a naturopathic physician, my first step when a patient comes in with fatigue is a thorough assessment. That includes listening to their story, performing a detailed physical examination, and ordering targeted lab tests to uncover the root cause.
Iron and B12 are classic culprits鈥攅specially in women who鈥檝e had years of heavy periods, or in anyone with digestive issues that impact absorption. Low iron can make you feel foggy, weak, or short of breath. B12 deficiency, more common with age, can sneak up with symptoms like numbness, low mood, and deep fatigue.
Thyroid function is another key area to check. The thyroid acts like your internal thermostat鈥攚hen it鈥檚 underactive, everything slows down. You might feel cold,sluggish, constipated, or gain weight without trying. A proper thyroid assessment includes not only TSH, but often free T4, free T3, and thyroid antibodies for a complete picture.
Sleep apnea, surprisingly underdiagnosed, is a major cause of fatigue. Even people who think they sleep fine may not be getting deep, restorative sleep if their breathing is interrupted throughout the night. If a partner notices snoring or pauses in breathing, or if you wake up groggy or with headaches, it鈥檚 worth investigating.
Chronic stress over decades can tax the body. HPA axis dysfunction refers to a disruption in the normal functioning of the hypothalamic-pituitary-adrenal axis, a key system regulating the body's stress response. When imbalanced, people may experience poor stress resilience, low morning energy, and that 'wired but tired' feeling.
In addition, persistent fatigue can be an early sign of more serious conditions like cardiovascular disease, cancer, digestive disorders, autoimmune disease, MS, andmore. I believe in being very thorough with my fatigue patients to look for clues of deeper pathology. Once we鈥檝e ruled out or addressed medical causes, it鈥檚 time to look at restoration. This is where naturopathic medicine shines.
Restoration means nourishing your body with quality sleep, balanced meals, and rhythm in your day. It may involve replenishing nutrients like iron or B12, supporting thyroid or adrenal function with herbs, or improving sleep hygiene and stress management.
Sometimes, we use natural supports like ashwagandha, rhodiola, or magnesium鈥攁nd can prescribe pharmaceutical treatments when appropriate.
The goal isn鈥檛 just to mask the fatigue, but to help your body function optimally again.Because yes, energy changes with age鈥攂ut you should still feel vital, sharp, and engaged with life. Fatigue is a signal. The question is: are we listening?
Dr. Deidre Macdonald is a naturopathic physician who has practiced in downtown Courtenay since 1997. Visit or call 250 897-0235.
