Always Tired but Labs Are Normal?

If you feel tired all the time, even though your labs say everything’s normal, you’re not alone.

Let’s talk about it.

If you have lingering fatigue, waking up tired, even though you might have gotten a great night’s sleep, exhausted in the afternoon, or perhaps you can keep your energy up, but only if you keep moving and as soon as you sit down, you feel like you’re going to fall asleep.

Fatigue is often dismissed by doctors.

That’s because fatigue doesn’t always show in your labs. Fatigue is very likely to be hormonal, and it often begins in the hypothalamus.

Here are the THREE Most Overlooked Hormonal Imbalances That Can Cause Fatigue:

#1: Thyroid Imbalance

Just because your labs look great doesn’t mean you’re not suffering from low thyroid function.

Hypothyroidism is often missed because only looking at thyroid-stimulating hormone, TSH, you can’t see if there’s an imbalance in the hypothalamic pituitary thyroid axis. You need to compare TSH with free T4 and free T3 levels, and you can have hypothyroid symptoms and normal levels of thyroid hormone, but they’re too low for you.

If you have hypothyroidism, you’re going to feel tired generally, but if you keep moving, you feel a little bit better and as soon as you sit down, you’re drained and might even fall asleep. You may also be cold, especially your extremities, with a lower than normal base of body temperature. If T3 is inadequate or can’t get into your cells, you have a slower metabolism.

That’s thyroid hormone, particularly T3, stimulates mitochondrial production of ATP energy. So when your thyroid is not functioning optimally, you have a low cellular metabolism, and you can start gaining weight. You can also feel like your brain is foggy and have symptoms of depression.

#2: Adrenal Dysfunction, Also Known As Adrenal Fatigue

Your adrenal glands produce stress hormones, particularly cortisol. When you’ve been under stress for a long period of time, your adrenals do not function optimally. It doesn’t have to be classic stress, like a death, a divorce, a job loss, or a financial crisis. It can be long-term chronic stress like a physical illness, lack of sleep, poor nutrition, any kind of long-term stressor that wears out your HPA axis, your hypothalamic pituitary adrenal axis.

Without proper orchestration from the hypothalamus, your adrenal glands do not produce adequate amounts of cortisol during the day. Typically, the fatigue is in the afternoon. Now you can be fatigued all the time, but you definitely get an afternoon crash from about 3:00 to 5:00 PM all of our adrenal glands slump, but people with adrenal fatigue crash.

Late afternoon is not a good time to be taking a test, and it’s the worst time for my patients to come in for their initial consult because they cannot remember anything that I tell them when they’re in this kind of adrenal fog. Typical symptoms are exhaustion and not being able to deal with normal life stressors. If you get stressed out easily, becoming overwhelmed and exhausted, and if you crave sugar after meals, then you’re not producing enough cortisol.

Cortisol releases stored sugar, so you’re supposed to have a post-meal cortisol surge to fuel your body until you digest your meal. If you’re dependent on any sugar for energy, you’re going to wear out that natural mechanism that allows cortisol to release your stored sugar. Cortisol levels are very hard to measure and whether by blood or saliva, there only a snapshot of the moment.

Patient Story

Once, I had a patient that I suspected had adrenal fatigue. So I ordered an adrenal salivary cortisol test, in which she had to provide saliva samples four times during the day. When we get the results back, her saliva samples show low normal levels, yet all of a sudden, she peaks in the middle of the day and then kind of stays peaked through the evening. Which was not what I was expecting with her symptoms.

So I asked her: What happened right before you took that saliva sample?

Well, she was hiking and broke her ankle. That is not a good time to be sampled. At least she did have a good adrenal reserve, and she was able to make enough cortisol. But for days after that, the major stress of breaking her ankle put her in bed. She crashed.

#3: Hypothalamic Dysfunction

Remember, your hypothalamus is the maestro of all of your symphony of hormones. It’s the root control of your adrenal glands. And your thyroid gland, your gonads, everything. It controls your metabolism, particularly your cellular metabolism. Your hypothalamus is highly sensitive to stressors, physical or emotional injuries, illness, toxicity, and malnutrition.

If the hypothalamus does not get the nutrients it needs, it will develop a miscommunication with the rest of the body and not function normally. Like it can’t hear that the thyroid needs stimulus. It can’t hear the adrenals need for more or less stimulus according to your stressors.

Your hypothalamus gets out of balance.

The Symptoms of Hypothalamic Dysfunction Are:

• Fatigue
• Insomnia
• Temperature dysregulation
• Sluggish metabolism
• Insulin resistance
• Depression
• Anxiety
• Gut issues
• Autoimmunity
• Frequent infections
• Imbalanced thyroid, adrenal, and sex steroids

It will look like adrenals, but that’s not the root. It’ll look like hypothyroidism, but that’s not the root.

Your periods become irregular, and your libido suffers. You have issues with infertility, both men and women. You may feel incredibly overwhelmed, and you’re basically burned out from the system-wide hormonal dysregulation.

Why Can’t We See This In Traditional Testing?

Most of the time, when you go to a conventional provider, you’ll get basic blood work that may check a TSH for your thyroid, yet you also need free T4 and free T3 and look at whether or not the TSH could correspond to the T4 and T3 levels appropriately.

Remember, it’s like a negative feedback system, a seesaw. So if the T4 and T3 levels are low, the TSH is going to be higher. And if your T4 and T3 levels are too high, TSH should be lower. When I see low normal T4 and T3 and low normal TSH, that’s a poorly responsive hypothalamic pituitary thyroid axis, which means that the problem is not the thyroid producing enough hormones.

The problem is the hypothalamus becoming dysregulated and not being sensitive to the low levels of thyroid hormone, and thus not stimulating the pituitary gland to produce enough TSH to tell the thyroid to produce more thyroid hormone.

It Starts in the Hypothalamus. The Same with the Adrenal Glands

When you’re trying to check cortisol levels, typically in blood work, we look at 8:00 AM and 4:00 PM levels. The 4:00 PM is the crash time, and the 8:00 AM is what you should be waking up with, but it’s not necessarily that accurate. You have to have adrenal insufficiency for those cortisol levels to be bottomed out. While saliva testing may be a little more sensitive, again, like I explained before, it really matters what happens during that day.

I prefer to look at DHEA Sulfated to determine adrenal reserve, since DHEA follows cortisol production. I find doing a full blood work panel looking at not just adrenals and thyroid, but also the rest of the endocrine system.

What is the body doing in terms of glucose metabolism?

I look at the Hemoglobin A1C.

How high is the prolactin level in the morning?

If it’s elevated, prolactin is going to block your hormonal receptors, especially steroids. So cortisol levels may be normal, but it can’t get into your receptor sites, so you’re not going to get proper cortisol functioning.

I also look at cholesterol.

If your cholesterol levels are too low, you don’t make enough low-density, large particle, LDL to produce enough steroid hormones like cortisol, DHA, estradiol, progesterone. That’s a problem. Looking at a full blood panel and always rolling out classic fatigue, instigators like anemia with a CBC can really make a difference in assessing the patient.

Plus, most providers aren’t looking at your blood work from a hypothalamic perspective. With long-standing fatigue, I like to assess gut function. If you’re not absorbing nutrients properly, you’re fighting off chronic infections, you have toxicity, you’re going to have your energy affected.

What Do You Do to Feel Better?

1. Support Optimal Hypothalamus Function with Genesis Gold®

Genesis Gold® helps to balance out your adrenals, your thyroid, and the rest of your hormones naturally. It improves receptor site activity. Genesis Gold® improves the hypothalamic pituitary axis, so it’s more responsive to the adrenal and thyroid feedback.

The nutraceuticals in Genesis Gold®, including the Sacred Seven® amino acids, sea vegetation, sprouted ancient gluten-free grains, phytonutrients from the herbs, digestive supports—all help to enhance energy production and balance out your natural cycles, so your thyroid and your adrenals function normally.

Lifestyle Is Important

Focus on getting enough sleep in the dark, turning off screens after dusk, and getting up with the sun to reset your circadian rhythm. Make sure that you’re eating a plant-based diet. The Mediterranean diet is an anti-inflammatory diet, so you’re not burning energy on reducing inflammation. But for your day-to-day activities, you definitely want to avoid dependence on sugar and caffeine, particularly sugar.

Managing Your Stress is Key

My calm meditation can really help you learn to turn on GABA, which is a parasympathetic nervous system neuropeptide that calms down your nervous system. Now, you would think that if you’re fatigued, you don’t want to calm down your nervous system, but actually it’s adrenaline that wears your nervous system down.

You’re not lazy. You’re not making it up. Your body is talking to you when you’re tired. When your brain is tired, when you can’t function because of the fatigue, you really need to think about what is out of balance hormonally.

If you nourish the root, which is usually hypothalamic, with Genesis Gold®, you can restore your energy naturally.

Join our free Hormone Reboot Training to really understand how to heal your hypothalamus. And please subscribe to my YouTube Channel and share this video with a friend.