If there’s one single symptom that brings patients most frequently into the offices of WholeHealth Chicago, it’s this: “I’m tired all the time and doctors can’t find anything wrong.”
The “can’t find” you all are experiencing is the real problem of today’s health care system. It’s that notorious fifteen minute medical encounter of primary care medicine: vital signs by the nurse, eyeball physical exam, and over to the lab to check your blood count, metabolic profile, cholesterol, TSH (thyroid), sed rate (inflammation), and perhaps levels of vitamin B 12 and D. Overly suspicious doctors will check you for pregnancy, HIV and even syphilis. (Maybe AI orders these tests, I don’t know).
Then, if you have one or more specific symptoms, like something in your belly, a pain in your elbow, you’re lateraled like a football from one specialist to another. Maybe a gastroenterologist for some scopings or a rheumatologist for more blood tests. They find nothing, tell you, “Good news everything’s normal!” But you’re still tired and now you’re depressed. (“Psych referral, anyone?”). You’ve travelled from specialty “silo” to “silo” finally exiting the last silo in an empty field with PTSD from the healthcare system.
To me, “we can’t find” really means “we didn’t bother to look.”
Each of these listed causes of chronic fatigue has a link to a longer article on our website:
Long COVID: if you were a reasonably well person until 2021 and developed fatigue after one or more episodes of COVID or COVID immunizations, then join the 14% of Americans suffering from any of the 100 (!!) long COVID symptoms of which fatigue is right at the top. Because there is no specific test and no specific FDA approved treatment, patients don’t get much help from conventional medicine. By the way, researchers now think this fatigue is similar to that caused by chronic mono (Epstein-Barr).
Chronic Lyme Disease: finally an accepted diagnosis but both tests and treatment are still inadequate. Always suspect Lyme when family vacationed in WI or MI. It’s usual for the tick bite to occur around age 10 and then resurface in adulthood.
Mold Biotoxin Illness (Chronic Inflammatory Response Syndrome-CIRS): a genetic susceptibility to the off gassing of certain mold species triggering systemic inflammation. Victims are made ill in water damaged buildings, get well in dry areas and when the biotoxins are cleared from their bodies using binders like cholestyramine (and the dwellings are mold remediated).
Subclinical hypothyroidism: all the symptoms and signs of underactive thyroid but with normal thyroid tests. Often responds to (T3) liothyronine (Wilson’s Syndrome) or Armour thyroid
Adrenal fatigue: the two walnut size glands sitting atop your kidneys give you energy enough for one day and then are restored at night. Adrenal fatigue presents as a mid-afternoon “crash” between 2 PM and 4PM.
Intestinal parasites/dysbiosis/candida: during the past two years an increasing number of research papers discussed links between parasites and chronic illnesses especially the once derided term ‘leaky gut’ finally got some respect.
Vitamin and mineral deficiencies: the three most associated with ‘fatigue’ are magnesium, B-12 and D. Daily supplementation of each is encouraged.
Sleep disorders: if you wake up exhausted in the morning or fall asleep easily during the day or your bedmate says you snore loudly or even stop breathing, get a sleep study.
Side effects of prescription drugs: virtually no one reads the package insert on new prescriptions but a vast number of them can make you tired and when you combine two or three together can make you non-functional. You’ll also discover how doctors are VERY reluctant to discontinue another doctor’s prescription even if he/she knows this is the problem.
Multiple chemical sensitivities (MCS): although MCS was first met with skepticism if not downright hostility when first described in 1950 by allergist Theron Randolph, M.D. to this day neither the mechanism nor the treatment is understood but unexplained fatigue is often the first manifestation followed by the slow realization on the part of the patient that once harmless products (carpeting, furniture, clothing) are causing a variety of seemingly unrelated symptoms.
So, it’s the New Year. If you or a friend or loved one is struggling with chronic fatigue, forward this checklist and suggest an appointment at any of the WholeHealth Chicago offices.
Be well,
David Edelberg, MD