Fatigue is one of the most common concerns patients bring to doctors, yet it can be one of the most complex to evaluate. Rather than viewing fatigue as a diagnosis in itself, naturopathic care seeks to uncover the underlying causes that drain the body’s energy reserves.
“Often there are multiple factors, across multiple body systems, causing chronic fatigue. The longer visit length in naturopathic appointments allow us more time to thoroughly assess these systems for our patients,” says Dr. Kristaps Paddock, who has been working up chronic fatigue regularly since he started practice in 2010.
Stress and Hormonal Imbalances
Chronic emotional stress and the subsequent changes in circadian stress hormones (sometimes called “adrenal fatigue”) are frequent contributors. Prolonged stress impacts the body’s natural cortisol rhythm, leading to:
- Energy crashes
- Brain fog
- Poor stress resilience
Assessing and improving stress management, sleep hygiene, and lifestyle factors is often an essential first step. A naturopathic doctor will ask about sleep, daytime and nighttime routines, diet, exercise, and current and past stressors.
The Role of Sleep
Poor sleep can both worsen and contribute to chronic fatigue. Many patients experience difficulty falling or staying asleep due to stress or anxiety, perpetuating a cycle of exhaustion.
Optimizing sleep quality, not just quantity, is central to recovery. Drs. Runde and Paddock often assess for:
- Sleep apnea
- Blood sugar dysregulation at night
- Circadian cortisol secretion
Nutrition and Micronutrients
A balanced diet with adequate protein and micronutrients plays a key role in energy production.
- Vitamin B12 and iron deficiencies are particularly common and can significantly impact energy levels.
- Naturopathic doctors check these nutrients through basic blood work to ensure they’re at optimal levels.
- Correcting imbalances through testing and targeted supplementation can make a measurable difference.
Hormonal Testing
Many patients ask about hormone testing. Naturopathic doctors discuss:
- Which hormones make sense to test (blood, urine, or saliva)
- The appropriate timing for testing
The goal is to ensure no hormonal imbalances are impacting energy levels.
Post-Viral Fatigue
In recent years, post-viral fatigue syndromes, including long COVID, have become increasingly recognized. Integrative medicine doctors have long considered the impact of past viral illnesses on chronic fatigue and pain syndromes.
Post-viral conditions can disrupt:
- Immune function
- Mitochondrial function
- Nervous system function
A Comprehensive Approach
Ultimately, many diverse conditions, from thyroid dysfunction to autoimmune disease, can present with fatigue. A naturopathic doctor’s comprehensive approach combines detailed testing (usually done through your basic, in-network lab), individualized treatment, and lifestyle guidance to restore balance and help patients regain sustainable, lasting energy.
