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​When Fatigue Is More Than “Just Tired”

Experiencing extreme fatigue for 6 months of more may indicate Adrenal Fatigue and can accompany thyroid, immune, and sleep disorders.


Dr. Andrew Neville


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Of Course, Some Fatigue Is Normal

We have all experienced fatigue during our lives for various reasons. Sometimes it’s in short spurts, and we’re able to get some rest and recover. Sometimes it’s due to crying babies in the middle of the night or the sleepless nights with sick toddlers. There are times when work or family require more waking hours than might be strictly “healthy.”

Being exhausted isn’t serious if it is occasional. But if we’re not careful, constant fatigue can sneak up on us and be a sign of more concerning health issues, anywhere from Fibromyalgia to Adrenal Fatigue to Chronic Fatigue Syndrome.

How Does Chronic Debilitating Fatigue Feel? 

Since this is a highly subjective, multidimensional experience, “it’s “fatigue” is not the same for everyone. In general, it’s perceived as:

  • Physical tiredness or exhaustion
  • A need for reduced activity
  • Reduced motivation
  • Mental “burnout” or mental fatigue

Sounds like some fairly common symptoms, don’t they?

But it’s not simply a matter of needing to sleep. When longterm chronic fatigue negatively affects every system in the body, that is Adrenal Fatigue, which is a stress response system dysfunction.

Prolonged Fatigue Is the Number One Reason for Doctors’ Visits

With our stressful and busy society, it’s not at all surprising to me that extreme fatigue is the number one reason for doctor’s visits. What is surprising is how lackadaisical medical treatments have become for addressing a patient’s concerns about living with fatigue.

If left unaddressed, the physiological factors leading to fatigue can carve a path to more serious health issues over time, including insomnia, chronic pain, autoimmune disorders, hormonal imbalances, brain fog, and digestive disorders.

Why Is This Condition So Easily Dismissed and Overlooked?

By the time patients address fatigue concerns with their doctor, their motivation is longterm suffering. They are exhausted, and it is affecting all areas of their life. During a brief office visit, however, fatigue can often be attributed to depression. Just in case, the doctor orders labs. When those come back “normal,” the doctor can find no reason for the exhaustion the patient describes.

It is then that so many patients, especially women, are given a prescription for an anti-depressant and sent home believing they found a solution. Meanwhile, their condition slowly continues to worsen. Fatigue and depression not only have the same symptom crossover; they are both initial symptoms of Adrenal Fatigue and need to be addressed at the deepest level.

I am convinced that Stress Response System Dysfunction (Adrenal Fatigue) is the number one cause of fatigue in this country. I have dug my heels into researching every aspect of the adrenals and fatigue. It is real, and it’s affecting nearly every system in our bodies.

Mainstream GPs Never Offer a Full Health Assessment

Short doctor’s appointments don’t leave much time for assessing lifestyle, diet, and other factors that lead to steady health decline. The lack of an in-depth health assessment can lead to chasing after symptoms and a lot of unnecessary testing.

Unfortunately, insurance will happily cover endless tests and prescription medications, but doctors are permitted to spend only 10-15 minutes per patient appointment.

Ten minutes is not enough time to get to know the patient, their current symptoms and concerns, to discuss nutrition, sleep, exercise, etc. They are checking off boxes…and quickly.

Unnecessary Testing Prolongs Healing Disease at Its Root

While standard blood tests are helpful to rule out vitamin and mineral deficiencies, patients are often told that nothing is wrong if their test results come back in “normal ranges.”

Testing for Epstein Barr Virus and sleep apnea are other common recommended tests, but still don’t always lead patients to the best treatment or any treatment at all if they also come back as “normal.”

These “normal” test results can lead to a lot more unnecessary testing or leave patients with feedback that their symptoms are “all in their head.”

If insomnia is part of the equation, patients are given sleep medication. Sleep medications may be a temporary solution for relief. And while a seemingly obvious solution for fatigue, those meds do not correct the underlying issue.

Erratic stress hormones need to be addressed to prevent any further long term wear and tear on the body. There is one simple test that helps me interpret someone’s stage of Adrenal Fatigue. It’s noninvasive and done at home.

Exhaustion Is One of the First Warning Signs of Adrenal Fatigue

  • We no longer function as well at work and people start to notice.
  • We become more irritable and our relationships start to suffer.
  • We lose motivation and simple tasks start feeling overwhelming.
  • Brain fog can start to affect our memory and decision-making abilities.
  • Making plans starts to feel like a chore and we become more isolated.
  • Depression sets in and we lose enjoyment in life.

Symptoms are the signals our bodies give off to say something needs our attention. When we ignore these symptoms, they will continue to get louder until we take the steps to correct whatever is causing them in the first place. If not caught early, fatigue can start to affect every aspect of our life, signaling to us that we have a stress response dysfunction, otherwise known as Adrenal Fatigue.

If you have been experiencing extreme fatigue for 6 months of more, I implore you to listen to your body and heed its warning signs. 

The Importance of Advocating for Your Health

It has been disheartening to hear how difficult getting the right medical care has been for many of my Adrenal Fatigue patients. Most of my patients have not received adequate care, and it’s no fault of their own. 

As a Naturopathic Doctor, my initial appointment with new patients is 75 minutes. An in-depth Health assessment is an essential part of my All Access program. It is what I attribute to my patients’ successful outcomes. 

Here are some measures I recommend to get the best possible health outcomes.

  1. Find a doctor that listens to you. If your doctor dismisses your health concerns as “all in your head,” find another doctor that will listen to you.
  2. Take your symptoms seriously. Many of us ignore our symptoms until they start affecting our quality of life. Some of us are embarrassed to see a doctor for something that seems “mild.” Make your health a priority and don’t wait to address symptoms until they are heavily affecting your life. 
  3. Do your own health assessment. Assess where you could make improvements in your diet, lifestyle, and habits to support your health.
  4. Get curious. I’m always telling my patients to play detective and ask “why?” Our bodies are always giving us feedback. If you have a new symptom, explore what has currently changed in your life. 
  5. Don’t fall for fads and “quick fixes.” If you’ve been suffering from chronic health issues, the body needs to be treated as a whole. Be leary of anyone selling a one-supplement cure-all. Healing takes time and a multi-faceted approach. 
  6. Don’t give up! Just because you haven’t found answers yet, doesn’t mean they aren’t out there. 

One Last (Very Important) Note: Sleep Is When Our Body Heals and Repairs

Even if it seems cliche, I want to express the importance of getting good quality sleep. It’s during quality sleep that our body is healing and repairing. When we’re experiencing fatigue for prolonged periods of time, we run the risk of getting stuck in stress physiology leading to more serious health issues. Listen to your body and let it guide you back to health. 



Dr. Andrew Neville


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the severity of your symptoms and how to treat them.

Dr. Neville’s assessment tool will provide you with clarity on the severity of your symptoms and how to treat them.

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