Unclear causes. Diffuse symptoms. What now?
Sometimes the cause of the exhaustion is an infection, often a longer, more serious illness or a traumatic experience such as an accident or a stroke of fate. For most patients, however, the actual starting point can no longer be traced. The symptoms have crept in over too long a period of time and the strength has diminished. Until suddenly the level of suffering is so high that it can no longer be ignored. This is where it becomes clear how complex individual medicine is, because the numerous possible causes make diagnosis challenging. Viral diseases such as Borellia or Epstein-Barr virus infections play a role, as do various other factors.
The following causes are often found for exhaustion and tiredness:
- Iron deficiency or ferritin deficiency, which is the storage iron:
In women, this is often caused by constant blood loss due to menstruation. Nevertheless, other sources of bleeding should also be excluded. These include, for example, bleeding in the gastrointestinal tract due to ulcers or polyps. If you fill up a storage iron deficiency and the ferritin level still only remains within the normal range for a short time, further diagnostics may be required here, possibly including a gastrointestinal endoscopy.
- Thyroid disorders:
It should be clarified whether there is a functional disorder of the thyroid gland, usually hypothyroidism. This initially requires simple laboratory diagnostics based on a blood sample, but all the essential thyroid values should be examined. In addition to the TSH, this means above all the free hormone values ft3 and ft4, and possibly also the thyroid antibodies for the diagnosis of autoimmune thyroid diseases such as Hashimoto’s and Graves’ disease, as well as reverse T3 in order to be able to differentiate more precisely. If thyroid disease is present, adequate hormone replacement must be carried out first. It only makes sense to reassess the symptoms of fatigue once there has been a significant improvement in the patient’s condition, as it is often difficult to separate the two. Ultimately, well-being is decisive for treatment, even before the hormone values are considered in isolation.
- Food intolerances:
If there are unrecognized intolerances to certain foods for months or even years, our immune system is permanently stressed and, to a certain extent, constantly under attack. This can lead to various symptoms, especially as classic intolerances – in contrast to typical allergies with immediate reactions – often only lead to symptoms after a delay of up to 48 hours or more. The diagnosis is still controversial in conventional medicine and many correlations have still not been proven. I am of the opinion that clear tendencies can be recognized on the basis of the available laboratory tests and that these should also be taken into account. many patients benefit from this approach with a significant improvement in their condition. The most common intolerances are to wheat, gluten and dairy products, but other reactions are of course also possible.
- Leaky gut – impaired intestinal barrier:
A disturbed intestinal barrier means that the intestinal mucosa is more permeable to certain food components than it should be. This can be caused by stress, an unhealthy diet or certain medications. Here too, our immune system in the intestine is constantly overwhelmed with a flood of antigens – and at some point can no longer keep up with the defense reactions. Gradually, many patients develop clinical symptoms, which can be very individual. Many react primarily with abdominal discomfort or diarrhea, others often with chronic fatigue or joint pain. Detailed stool diagnostics with analysis of the bacterial flora in the intestine are then required. Based on this, intestinal therapy can then be started with the aim of balancing the flora and gradually restoring the intestinal barrier.
- Nutrient deficiency:
A lack of various nutrients can also manifest itself in symptoms of exhaustion. People with chronic illnesses in particular, but also those with high workloads at work or at home, have a significantly increased need for nutrients. In contrast to the past, when agriculture was different and less industrially oriented, today our soils are increasingly depleted, insecticides are used extensively, many types of fruit and vegetables are no longer produced regionally and are not very rich in nutrients due to long storage periods. It may therefore be necessary to consider dietary supplements in addition to a balanced diet rich in vegetables, and it is important not to take just any supplements. Even if food supplements are often available over the counter, too much can clearly be harmful. Therefore, a blood analysis should always be carried out beforehand to determine the current situation of the essential nutrients. Of course, individual factors such as known illnesses etc. must be taken into account. Only then does nutritional supplementation really make sense! Supplements should be selected by a doctor – it is often the exact composition and dosage that brings success – or can impair tolerance if the wrong supplement is chosen.
- Hormone disorders:
A deficiency of certain hormones can quickly become noticeable – typically in women during the menopause – but often long before this and not infrequently in men too. It is therefore worth taking a careful medical history and taking a blood sample for a precise diagnosis. With a few exceptions, I myself only work with blood values because I consider these to be the most reliable. Cortisone samples can be taken from saliva, for example, if a day or night profile is useful for diagnosing adrenal function. All sex hormones are analyzed using a blood sample. Therapy may then consist of treatment with bioidentical hormones, depending on the deficiencies present. In the case of adrenal dysfunction, more comprehensive and longer therapeutic support is advisable, as individual lifestyle changes as well as the compensation of various nutrient deficiencies are usually required, depending on the extent of the functional impairment.
- Unfavorable fat distribution, especially abdominal fat:
The fat in the abdominal area has the unfortunate characteristic of being hormone-active. This means that it produces hormones and various other substances that make us more susceptible to various serious illnesses. A hidden inflammation develops and affects our entire organism. Very often, general performance also suffers significantly. In many patients, we gradually work together on all the “construction sites” mentioned here and often achieve pleasing improvements. Patients with the unfavorable fat distribution described here usually benefit greatly from losing weight, especially in the abdominal area, if all other measures have already been taken into account. This often improves performance quite a bit – so a change in diet and appropriate training measures are doubly worthwhile.
Once the causes of permanent exhaustion and fatigue have been identified, individual therapy concepts can be developed which usually have a very rapid positive effect.
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