7 Factors of Chronic Fatigue and How to Combat Them

According to a 2015 report published by the Institute of Medicine (IOM), an estimated 836,000 to 2.5 million Americans suffer from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME-CFS).  Unfortunately, many doctors are unsure of how to diagnose or treat chronic fatigue since many of the symptoms are broad in scope. For example, people who suffer from chronic fatigue may have trouble concentrating, poor stamina, non-restorative sleep patterns, tender lymph nodes or even flu-like symptoms. In 2011, the Sleep Research Society published a study outlining the Sleep-Wake Behavior in Chronic Fatigue Syndrome which measured sleep patterns over a 5 day period for patients with Chronic Fatigue Syndrome (CFS) and without. The results showed higher ratings of pain sensitivity and sleep disturbances in those with CFS.

While symptoms can be quite general, below I’ve outlined seven factors that can contribute to CFS, and some steps you can take to help address your symptoms.

Poor Sleep Quality

Poor sleep quality can be contributed to many things including, difficulty falling asleep, difficulty staying asleep, disruption in the brain's biological “clock” (see excerpt from study below), and some syndromes such as restless leg syndrome.

“Human sleep is part of an oscillating sleep-wake pattern following a circadian rhythm. These cyclical rhythms are directed by the brain's biological “clock” located in the suprachiasmatic nucleus and cause fluctuation of body temperature, hormone levels, and sleep over a 24-h period. These behavioral and physiological rhythms are synchronized to external physical environmental and social/work schedules. The strongest synchronizing agent in humans is changes in light and darkness which “set” the biological clock and help determine the need to wake up or go to sleep. The circadian clock not only provides temporal synchronization between these various rhythms, but it also promotes wakefulness, and coordinates the timing of sleep-wake behavior, which are involved in aspects of physiological and neurocognitive functioning.” For better sleep quality, stop using electronics one hour before bed.

Reactivated Virus

A common virus that becomes latent (inactive) in the body and can reactivate is the Epstein-Barr Virus (EBV), a common virus that is typically encountered during adolescence. Once the symptoms go away, the virus sits dormant in the body. EBV tends to reactive with high amounts of stress, and once reactivated it can cause severe fatigue. To decrease effects of EBV, try meditation. It can be as simple as 5 minutes of deep breathing first thing in the morning.  Inhale through your nose breathing deep into the belly and allowing your stomach to expand. Fully exhale. Pause and repeat.

Endocrine Disorders

Uncontrolled blood sugar (insulin resistance) and thyroid dysregulation issues are two common endocrine disorders attributed to CFS.

Uncontrolled blood glucose levels: Most people have heard of insulin resistance being associated with diabetes but insulin resistance can also happen with pre-diabetics or with sub-clinical blood sugar imbalance. When you have insulin resistance, the insulin in the body doesn’t work as it should - typically causing excess weight gain and difficulty with energy after meals. Exercise helps to naturally regulate blood sugar levels, even just a 10 minute walk after dinner will be beneficial.

Thyroid: Did you know that there are thyroid receptors on every cell of our body? Every cell needs thyroid hormones to function optimally. There are lots of thyroid issues that conventional medicine does not pick up such as thyroid conversion issues, thyroid resistance, and antibodies to the actual thyroid gland (where your own body begins attacking itself). Eating brazil nuts contain Selenium, a mineral that has been proven to support a healthy thyroid.

Stress-Response System Issue

When we are stressed, our brain sends signals to our body to release hormones such as cortisol, epinephrine, and norepinephrine. Over time, the chronic activation of our stress-response system leads to dysfunction within the system. This dysfunction causes changes in cortisol output, disruption in cortisol rhythm (high when its supposed to be low and low when it is supposed to be high, always high or always low), and changes in production of other hormones such as epinephrine and norepinephrine. Cortisol is our primary stress hormone that is secreted from our adrenal glands. If you have heard of the phrase “adrenal fatigue”, it is due to cortisol dysregulation caused by dysfunction in our stress-response system, not the adrenal glands themselves. You may find that it is difficult to rise and get going in the morning if this is your situation. Learn to slow down. It’s okay to say no every once in a while. Your friends will understand.

Poor Overall Diet

The new trend in the world of health is the idea of the gut being your body’s second “brain”. And while there is still much research to be done, one thing that has been clear for decades is what lives in your gut directly affects the functioning of the body.  Constantly eating junk and missing out on key vitamins can drastically affect how you feel on a day-to-day basis. The B Vitamins, which contribute to energy levels, are a great starting point when evaluating CFS.

Sex Hormonal Issues

Estrogen and Progesterone are known as the sex steroid hormones. While most people understand they fluctuate over the course of your life and are vital components to a woman’s monthly cycle, there are many other functions they provide. These hormones are made up of cholesterol, and travel through the bloodstream passing easily through cell membranes. This allows estrogen and progesterone to get into the central nervous system, which in turn affects the brain. Both men and women need balance of these sex hormones. Changes in the sex hormone levels can affect anxiety, depression, memory, and activity levels. To support healthy hormone levels, include healthy dietary fats such as avocado, wild-caught salmon, ghee, walnuts, chia seeds, flax seeds and olive oil.


Ever wonder why you have to drink lots of water before and after you donate blood? Well, dehydration causes a loss of blood volume known as hypovolemia. The same thing goes for when you lose blood volume, you become dehydrated. When there is a dip in blood volume it causes the blood vessels to narrow and the heart has to work harder to get oxygen and nutrients to all of your organs, tissues, and cells. As a result, we feel fatigued. Drinking enough water will keep the body functioning optimally. Aim for half your weight, in ounces, of water daily.

Please share this post with others that may find it beneficial. If you'd like to work with me directly, email hello@carolinaholistichealth.com to setup a free 15-minute consultation.

In health & happiness,

Dr. Erin Stefanacci, DC

#functionalmedicine #fatigue #holistichealth


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