Fatigue is more than simply feeling tired after a long day. For some patients, low energy can become persistent and begin to affect concentration, motivation, exercise tolerance, sleep, mood, and overall quality of life.

At Needles, Herbs & Labs, Dr. Naylous takes a Functional Medicine approach to fatigue by looking beyond the symptom itself and considering the broader factors that may be influencing energy production, recovery, and overall health.
 

Fatigue Can Have Many Possible Contributors
 

Low energy can be associated with many different areas of health, which is why there is rarely one universal explanation.

Depending on the patient, Dr. Naylous may consider factors such as:

• Iron deficiency or anemia

• Vitamin B12 or folate status

• Vitamin D

• Thyroid function

• Blood sugar and insulin regulation

• Hormonal health

• Sleep quality

• Stress and nervous system health

• Digestive and absorption concerns

• Inflammation

• Nutrient deficiencies

• Medications and supplements

• Diet and hydration

• Environmental exposures

• Other underlying health conditions

The goal is to determine which factors may be most relevant to the individual patient rather than assuming that all fatigue has the same cause.
 

Common Symptoms That May Occur With Fatigue
 

Patients may experience:

• Persistent low energy

• Feeling tired despite adequate sleep

• Difficulty getting out of bed

• Daytime sleepiness

• Brain fog

• Difficulty concentrating

• Weakness

• Poor stamina

• Reduced exercise tolerance

• Feeling exhausted after physical activity

• Energy crashes during the day

• Fatigue after meals

• Headaches or lightheadedness

• Feeling cold frequently

• Poor motivation

• Difficulty recovering from stress or illness

These symptoms can have many possible causes and should not automatically be attributed to a nutrient deficiency, hormone imbalance, or one specific condition.
 

Looking Beyond a Basic Blood Count
 

When someone complains of fatigue, a basic laboratory evaluation may not always provide enough information to explain why they feel poorly.

Depending on the clinical picture, Dr. Naylous may evaluate areas such as:

• Complete blood count

• Ferritin and iron studies

• Vitamin B12

• Folate

• Vitamin D

• Thyroid markers

• Blood glucose

• Hemoglobin A1c

• Fasting insulin

• Inflammatory markers

• Liver and kidney function

• Electrolytes and minerals

• Hormonal markers

• Other nutrient or metabolic markers when appropriate

Rather than focusing on whether one result is simply marked “normal” or “abnormal,” Dr. Naylous looks at patterns between relevant markers and considers how they fit with the patient’s symptoms and health history.
 

Iron, B12 & Nutrient Status
 

Nutrient deficiencies are one possible contributor to low energy and poor stamina.

For example, a patient may have declining iron stores before obvious anemia develops, or they may have concerns related to B12, folate, vitamin D, or other nutrients that influence normal energy metabolism and blood formation.

When appropriate, Dr. Naylous evaluates these markers together rather than relying on a single value.
 

Blood Sugar & Energy Crashes
 

Some patients notice that their fatigue changes throughout the day or becomes worse after eating.

Blood sugar and insulin regulation may be one area worth evaluating in these situations. Dr. Naylous may consider fasting glucose, hemoglobin A1c, insulin, diet, meal patterns, and other metabolic markers to determine whether blood sugar regulation may be contributing to changes in energy.
 

Sleep, Stress & the Nervous System
 

Poor-quality sleep can contribute significantly to daytime fatigue, even when a patient believes they are getting enough hours of sleep.

Stress may also affect sleep quality, muscle tension, digestion, and the body’s ability to recover. Dr. Naylous considers sleep habits, stress patterns, caffeine use, lifestyle, and other factors that may influence restorative sleep and daytime energy.
 

Digestive Health & Absorption
 

The digestive system can also be relevant when evaluating persistent fatigue.

Patients with chronic digestive symptoms, restrictive diets, or absorption concerns may be at greater risk for certain nutrient deficiencies. Depending on the patient, Dr. Naylous may consider whether stool testing, SIBO testing, nutrient evaluation, or other digestive testing may provide useful information.
 

Environmental & Other Health Factors
 

For some patients, environmental exposures, chronic inflammation, or other health concerns may also be relevant to the broader fatigue picture.

When appropriate, Dr. Naylous may review exposure history and consider additional testing based on the individual patient’s symptoms and clinical needs.
 

Who May Benefit From a More Detailed Fatigue Evaluation?
 

A more comprehensive evaluation may be considered for patients who:

• Experience persistent or unexplained fatigue

• Feel tired despite adequate sleep

• Have poor exercise tolerance

• Experience frequent energy crashes

• Have previously been diagnosed with anemia or nutrient deficiencies

• Have thyroid or hormonal concerns

• Experience chronic digestive symptoms

• Have difficulty concentrating or frequent brain fog

• Feel that their symptoms have not been explained by previous testing

• Have complex symptoms involving multiple body systems
   

A More Individualized Approach to Energy
 

The goal is not simply to find one supplement that “boosts energy.” Persistent fatigue may reflect several contributing factors occurring at the same time.

At Needles, Herbs & Labs, Dr. Naylous looks at nutrition, iron status, thyroid function, hormones, metabolism, sleep, stress, digestive health, inflammation, environmental factors, and other relevant laboratory findings to better understand the patient’s overall health picture.

Depending on the findings, care may include nutrition, targeted supplementation, lifestyle and sleep strategies, acupuncture, Chinese herbal medicine, or referral for additional medical evaluation when appropriate.