When it comes to fatigue, women have it rough. There are many issues that cause fatigue that are overlooked in women’s health. I am going to discuss all of them here.


We can look at fatigue and exhaustion from 3 major angles, nutritional status, stress response, and environmental toxin exposure. Let’s narrow it down and examine each of these so you can see which might be the issue for you. Keep in mind, it could be all three areas!

Nutritional status 

There are several factors that contribute to poor nutritional status; genetics (things like the MTHFR gene defect), whether you take a high quality absorbable multivitamin and other necessary nutritional supplements, gut health, and lifestyle factors. All of these contribute to a unique, individual nutritional requirement. The U.S. healthcare system does not place value on nutrition as a primary factor in chronic disease and instead focuses on prescription drugs. This has led to many people not making lifestyle changes to improve their situation since they can just take a pill and the symptoms go away.


Nutrition is the foundation of all naturopathic physicians’ approach since it addresses almost all chronic disease and has the power to prevent and reverse chronic disease. However, what about those who live a healthy lifestyle (eat a plant-based diet, are physically active, don’t smoke, etc.)? Yes, even healthy people can have nutritional deficiencies! Here are just a few important examples:


  • Vitamin D: Most Americans are deficient in vitamin D because we are told to avoid the sun or live in a place where the sun’s rays are blocked by the weather and or northern latitudes. This means that we all need to supplement vitamin D! Check your vitamin D status to know how much you need to take. A good primary care doctor will be willing to check this for you, but be aware your insurance might not cover it. Optimal vitamin D levels are between 60-80 ng/mL. Symptoms of vitamin D deficiency are fatigue, getting sick a lot, bone, back, or muscle pain, depression, impaired wound healing, and hair loss.
  • Iron: this is specific to women and is often missed by doctors because we only screen for it using a blood count. If you are extremely deficient, your blood count may be affected, however, many women have a normal blood count but poor iron storage (ferritin). I always test iron storage to uncover a hidden iron deficiency (anemia) or what is never addressed in conventional medicine, iron-poor blood. This means you might not have a frank anemia but your fatigue could be coming from a functional problem of having iron-poor blood. This would show up as a normal blood count but low-normal ferritin. I consider a healthy ferritin in someone with fatigue 70 µg/L or above. In the case of low iron, one must assess whether you are losing it with blood loss, not consuming enough in the diet, or not absorbing it well in the gut. The main symptoms of poor iron status, or iron deficiency anemia, are fatigue, depression, easy bruising, pale skin, shortness of breath, restless leg syndrome, heart palpitations, and dizziness.
  • Activated B vitamins: Genetics determine whether we can activate and recycle our B vitamins, particularly B12, folic acid, and B6. In addition, stress and physical activity deplete these at a faster rate. It is important to therefore ensure you are taking a high quality and high potency product. Most doctor’s grade multivitamins will meet these standards so my recommendation is if you are taking a multivitamin already, don’t waste your money on something that is poor quality such as Centrum. The B vitamins should be in the absorbable and usable form by everyone, even if you have genetic factors that prohibit absorption of the cheaper forms. Vitamin B12 in particular can easily go low because it depends on healthy digestion which decreases with stress and age. Deficiency of B vitamin symptoms are similar to iron deficiency with fatigue being one of the most common but also can include nervous system changes such as pins and needles, vision disturbances, changes in cognition or mood.



We are inundated with stress in today’s world and in fact, women who are caregivers/parents and work full-time carry the burden of the emotionally exhausting tasks. This places the weight of the world on our shoulders, it is my area of specialty in helping busy-burned out women get their health and energy back so we can make a bigger impact in the world without running ourselves into the ground! 


Women have a unique biological stress response that causes a hormone imbalance and most women don’t know about it! Women struggle with daily health issues such as fatigue, anxiety, insomnia and even go as far as asking their doctors if it could be their hormones. But when the tests come back they are told everything’s normal. Well, everything is not normal! I’m writing a book about this right now called, Everything’s Not Normal, The Empowered Woman’s Guide to Getting the Healthcare You Deserve. 


I’m going to cover the high level concept of how stress causes a hormone imbalance briefly here with this simple breakdown:


Stress —> cortisol production —> progesterone deficiency 


Cortisol, the main fight or flight hormone is part of the sleep-wake cycle and determines what hormones are produced. Low cortisol causes fatigue whereas high cortisol causes insomnia, weight gain, and thyroid issues. Cortisol and progesterone are on the same production pathway so if you are making a lot of cortisol, the production of progesterone stops. Low progesterone (or a low progesterone to estrogen ratio) causes anxiety, insomnia, weight gain, PMS, etc. Later on down the road, chronic stress will also cause other hormones to be low such as DHEA, testosterone, and estrogen.


This is called adrenal fatigue syndrome. Anyone can suffer from adrenal fatigue, but working for over a decade in this field and seeing thousands of salivary adrenal and hormone tests, I have never seen a perfect test come back unless they had completed a 6-month process called the Crawford Hormone Revitalization Method. What this means is that almost every woman is in some stage of adrenal fatigue (whether she knows it or not)! 


Since this stress response is the root cause of hormone imbalances in women, it is my belief that all women should take actions to protect themselves from stress (since we can’t necessarily get rid of stress). This includes adequate, high quality protein, vitamin C, vitamins B5 and 6 and adrenal adaptogenic herbs. I also think all women deserve access to having appropriate testing and care for adrenal and hormone imbalances. I have several different ways that I have made available for women to work with me. You can get more information here or book a Complimentary Metabolic and Hormone Assessment with us.


Environmental Toxins

This is also a burgeoning field that is not addressed at all in conventional medicine. There are many environmental toxins that are now directly linked with every chronic disease. Toxic minerals such as lead and mercury affect important enzymes that produce blood for example. Blood carries oxygen throughout the body and if it is reduced, will result in fatigue among other things. In fact, things like Sick Building Syndrome or organochlorine pesticides have been linked to Chronic Fatigue Syndrome.


Toxins have two major ways of harming our health according to Dr. Joseph Pizzorno, author of The Toxin Solution and co-author of Clinical Environmental Medicine:


  1. Oxidative stress —> inflammation
  2. Direct damage —> neurons, enzymes, mitochondria of cells, etc.


First steps to decreasing toxic burden is to stop letting the toxins in!

  1. Eat organic (or at least avoid the “Dirty Dozen” from The Environmental Working Group)
  2. Change cleaning and beauty products to healthy, chemical-free versions
  3. Water and air filters (drinking water, shower water, HEPA air filter in the home)


For more guidance to become toxin free in 30 days, check out our 30-Day Hormone Detox online plan! This independent plan takes you through an elimination of household, beauty, and dietary toxins as well as inflammatory foods so you can feel vibrantly healthy and energetic again! 


But don’t forget, your hormones are also out of balance and you may have specific nutritional issues that need to be addressed! We are here to help! Book a complimentary assessment to find out where to start based on your specific situation.