Laurie Menk Otto, ND, MPH

Naturopathic Medicine | Portland, Oregon

Why am I tired?

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Do you have difficulty getting out of bed in the morning, or making it through the late afternoon hours? Do you find yourself reaching for that second, or third, cup of coffee mid-day just to get through? Fatigue can become such a usual feeling that it’s easy to assume that it is an expected part of a fast paced, demanding lifestyle. Fatigue is not normal, and I discuss with my patients why it’s important to discover underlying causes of fatigue. Here are some things to consider having evaluated if you feel frequently tired:

  • Sleep – not enough sleep, interrupted sleep, or sleep disorders such as sleep apnea are frequent causes of fatigue. For more information on sleep disorders see this article by the National Institutes of Health.

  • Stress – causes multiple chain reactions that contribute to fatigue. There is no avoiding stress in life. The work comes in with developing stress management strategies and continually adapting to change, because life will never be stress-free. This article by Success Magazine outlines several stress management strategies.

  • Nutrient deficiencies – Anemia is a common cause of fatigue in women, and low level of D or B vitamin may cause minor fatigue in anyone. Routine blood tests show whether you are deficient in any of these.

  • Blood sugar imbalance – Mid-day fatigue is a key indicator of blood sugar imbalance that can lead to afternoon energy crashes. Mental fog and fatigue after lunch or any meal can point to blood sugar issues as a potential cause. You don’t have to be overtly diabetic to have an issue here. Naturopathic physicians, excel at addressing dietary causes of fatigue, so you are best starting evaluation by consulting a licensed ND.

  • Health conditions – Low thyroid function can cause fatigue, so it’s good to have this checked out annually and especially if you have thinning hair, feel cold, and have dry skin.

  • Chronic health conditions and some medications can also cause fatigue. Your doctor can help you pinpoint potential causes.

The bottom line is that you should work closely with your doctor to investigate any unexplained fatigue. NDs are licensed as primary care physicians in Oregon.



Author: Laurie Menk Otto ND, MPH

Dr. Laurie Menk Otto is a naturopathic physician at Reconstructed Wellness, adjunct faculty for Helfgott Research Institute, and holds a master's in public health from the University of Arizona. Contact: 503.323-3215 or

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