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Which Type of Fatigue Are Your Patients Experiencing?

Posted Aug 07, 2019

About one-third of healthy teens and adults report feeling exhausted or fatigued. (1) Chances are, many of your patients are complaining of fatigue. So, what kind of tired are they? In order to better put together a treatment plan, you’ll need to know. In this blog we’ve outlined the 3 types of fatigue, as well as what causes each.

1. Physiological Fatigue

If your patients find themselves feeling sapped of energy after a hard day’s work, they may be feeling the effects of physiological fatigue. This general sense of exhaustion is also experienced by individuals that play a lot of sports or work out often.

Muscles need certain levels of glycogen, glucose and oxygen to thrive. These fuels give power to the body, allowing it to fulfill the functions it needs to perform. (2) However, there are necessary by-products of energy productions that result in waste materials, such as lactic acid, carbon dioxide and sarcolactic acid.

These by-products gradually build up in the bloodstream and can result in an imbalance of metabolic homeostasis, thus leading to fatigue. (3) While your patients  may feel they’re living an active, bustling life, it’s possible that it’s to the detriment of their health.

Another driver of physiological fatigue is lack of proper rest. A study performed at the University of Chicago found that 9 hours was the standard amount of sleep at the beginning of the 20th century. That number has plummeted to an average of 7 hours in recent years (2), and your patients may be paying the price. If they’re getting less than 8 hours of sleep each night and are feeling exhausted or fatigued, you may want to look into methods to assist them in getting a healthy amount of rest each night.

2. Pathological Fatigue

Pathological fatigue is a form of exhaustion brought on by a physical illness. This could include elevated blood pressure, inflammation issues, immune problems, thyroid complications, or even adrenal fatigue. (2)

Feeling chronically fatigued is not unusual for individuals with adrenal or thyroid issues. If your patients feel constant tiredness, irritability, hypoglycemia, drowsiness, poor memory, or lack of sleep, this may be a result of depleted adrenal glands. However, even overactive adrenals can lead to insomnia. (2) These patients could benefit from a salivary cortisol test to measure adrenal hormone production to see if adrenal fatigue could be a contributing factor to their fatigue.

The thyroid is another endocrine gland sensitive to the effects of stress. Unlike the adrenal glands that have many functions, the thyroid has one major function: to control the rate at which energy is produced in the individual cells of the body. Low thyroid function can be the cause of many symptoms such as constipation, dry skin and brittle nails, aches and pains, depression, and, of course, fatigue.

Supporting the adrenal glands can go a long way in supporting the thyroid gland. Underperforming adrenals can tax the thyroid, and vice versa. In addition to diet and lifestyle changes, there are herbs, vitamins and glandular extracts available that can help with adrenal support.

3. Psychological Fatigue

Psychological fatigue is most often connected with conditions such as stress, anxiety, and depression. (5) In the 1930’s, pioneering endocrinologist Dr. Hans Selye studied the body’s response to stress. He was able to demonstrate a stress-induced breakdown of the hormonal system that could lead to ailments such as high blood pressure and heart disease. (2)

Modern doctors often cite stress as the source of headaches, heartburn, insomnia, and various heart conditions. Chronic stress has even been linked to deadly diseases such as cancer. (5)

Emerging evidence is tracing the pathways of the mind-body interaction. For example, in a study done on college students, it was concluded that chronic feelings of loneliness can help to predict health status. This is perhaps due to lonely people having more psychological stress or experiencing it more intensely. Moreover, stress can hamper immunity. (6)

Chronic stress can affect both physical and psychological well-being by causing a variety of problems including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system.


  1. Spritzler, F. 10 Reasons Why You’re Always Tired (And What You Can Do About It). Healthline. https://www.healthline.com/nutrition/10-reasons-you-are-tired
  2. Bakker, E. Are You Always Feeling Tired? Ericbakker.com. http://ericbakker.com/always-feeling-tired/
  3. Wan, J et al. Muscle fatigue: General understanding and treatment. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668469/
  4. Murrell, D. Tiredness and fatigue: Why it happens and how to beat it. Medical News Today. https://www.medicalnewstoday.com/articles/8877.php
  5. Heid, M. How stress affects cancer risk. MD Anderson Cancer Center. https://www.mdanderson.org/publications/focused-on-health/how-stress-affects-cancer-risk.h21-1589046.html
  6. Hawkley L and Cacioppo J. Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874845/