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13 Root Causes of Fatigue - It's Not All In Your Head

a tired woman sits on the floor near a window

Experiencing fatigue and been brushed off or told it’s all in your head?

Fatigue is a really common symptom and can be a hard one to describe because people experience it differently. It might feel like full body tiredness, feeling out of breath, feeling uninterested in doing anything or like you just want “to spend all day on the couch.” There may be good and bad days and no obvious pattern to how you feel.

Adding to this confusion is the fact that there are so many possible underlying causes. Sometimes health practitioners don’t want to look deeper and dismiss it as stress or imply that it’s just a “normal” part of getting older. I don’t think that’s fair for anyone, especially women, to be brushed off like that.

Possible causes of fatigue:

  1. Insomnia

  2. Medications

  3. Depression

  4. Heart issues

  5. Liver issues

  6. Digestive issues

  7. Anemia

  8. Diabetes

  9. Hypothyroidism

  10. Chronic infections

  11. Environmental toxicity

  12. Nutrient deficiencies

  13. Chronic stress and adrenal fatigue


If you’re having trouble falling asleep or staying asleep you’re not going to get into deep, restful sleep. Hormonal changes during PMS or menopause, spikes in cortisol or issues like gut infections might be interfering with your sleep, too.


Antidepressants, antihistamines, and blood pressure meds are just a few that can have side effects of fatigue. If you think your medication may be making you tired, look it up. Epocrates is where I go to look this information up. Medications can have a long list of possible side effects and I like that Epocrates lists the more common ones.


Antidepressants may cause fatigue but it can also be a symptom of depression. You may feel uninterested in doing things you once enjoyed, feel unmotivated, sad, and feel less hungry. Depression can also interfere with sleep and perpetuate the fatigue cycle.

Heart/Liver/Gut Issues

Issues in other body systems like these may cause fatigue including arrhythmias, heart murmurs, liver disease, hepatitis, digestive infections, and food sensitivities.


Not having enough iron to carry oxygen around to all your cells can definitely leave you feeling tired. Iron deficiency may be caused by heavy periods, dietary deficiency, blood loss or poor digestion.


When your cells aren’t responsive to insulin signals and aren’t able to bring in glucose, they have no fuel for metabolism and you can end up with low energy.


Our thyroid is very important for metabolism and energy production so if it’s functioning at a low level, you may feel tired, among other symptoms like brain fog, constipation, coldness, dry skin or hair, depression and weight gain.

Chronic infections

This can include EBV, CMV, Lyme and many others. If your body is fighting these infections, it doesn’t have much energy left over for anything else.

Environmental toxicity

This can include mold or heavy metal exposures that put stress on your immune and detox pathways.

Nutrient deficiencies

Our cells need a number of vitamins and minerals to keep metabolism going. You may not be getting these if you’re not eating enough, aren’t eating nutrient dense foods, or aren’t able to absorb them.

Chronic stress/adrenal fatigue

Stress can wreak havoc on your body in a number of ways including interfering with sleep; lowering thyroid and adrenal function; altering digestion; suppressing your immunity and affecting your mood. Your adrenals keep you going for a little while, but eventually you may feel burnt out and exhausted.


Fatigue is a really common symptom and can be a hard one to describe because people experience it differently. Fatigue can be caused by insomnia, medications, depression, heart/liver/gut issues, anemia, diabetes, hypothyroidism, chronic infections, environmental toxicity, nutrient deficiencies, chronic stress/adrenal fatigue. It's important that you discuss how you feel with your doctor to see if any of these underlying causes are contributing to your fatigue.

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In health,

Dr. Jamie

13 root causes of fatigue that you should get checked out

This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.


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