I know so many people who are exhausted.  Completely and utterly exhausted.  My friends, my patients, my work colleagues, often myself.  Fatigue, exhaustion, burnout – it seems to be the chronic disease of our time and I find it quite depressing thinking about it and its impact on our ability to not only work, produce and succeed in life but also to enjoy life, enjoy our families and enjoy ourselves.  So my next few blogs are going to be written especially for those of you who are struggling with fatigue.  I’m hoping to give you some tools you can use to explore what is going on with your health and what you can do about it. 

The first step in ‘fighting fatigue’ begins with finding the underlying cause of the fatigue, finding out why you are so tired. Unfortunately, this is a lot easier said than done.

Is your lifestyle making you tired?

Start by looking at your daily habits. Are you a parent who works a full day in the office, comes home to cook and clean, put your kids to bed and then…sit down at your computer to do a few more hours work…often until after midnight? If yes, then there is your reason for being so tired.

To be honest, how on earth can anyone live like this and not be tired? If you think you can survive on 3-4 hours sleep then read my blog, One Good Reason to Sleep, and hopefully you will start making sleep a priority.

Similarly, do you have a coffee for breakfast, skip lunch, have a chocolate or some chips late afternoon and then usually pasta for dinner? If yes, then of course you will be tired!

Is an underlying health condition causing your fatigue?

If you can’t find the cause of your fatigue in your lifestyle, then you need to start looking at common health conditions that cause fatigue. Visit your doctor for a full check-up and also ask him/her to run a few tests to investigate the following common conditions that are all associated with fatigue:

  • Anaemia – low iron levels are common in growing children, menstruating or pregnant women and vegetarians and they cause fatigue, decreased immunity, headaches and dizziness. 
  • Hypothyroidism – this is a major cause of fatigue, especially if that fatigue is accompanied by weight gain, dry skin and hair, constipation and depression.
  • Infection – I feel I am opening a can of worms when I mention this topic. There are so many pathogens that can cause chronic fatigue as a consequence but the most common are Borrelia burgdorferi and Borrelia mayonii (Lyme Disease), Epstein Barr Virus, Cytomegalovirus and chronic lung or gut infections.  Your doctor will be able to help you investigate these.
  • Low vitamin B levels – the B-vitamins are responsible for maintaining your nervous system, mental health and energy metabolism.  I like to call them the ‘stress vitamins’ because they are quickly used up by your body in times of stress.  If you are going through a stressful time or have experienced a great deal of stress in your life, then ask your doctor to check your vitamin-B levels.
  • Low vitamin D levels – although not really an ‘energy’ related nutrient, low levels of vitamin D negatively affect the absorption of many minerals and result in muscular weakness and bone pain as well as depression.  If you are struggling with ongoing fatigue accompanied by a lot of aches and pains or muscular weakness, then have your vitamin D levels tested.  This is especially important if you do not get enough sunshine. For example, if you work night shifts, live in a highly polluted city or spend far too many hours in the office.

What else can be making you so tired?

If your doctor has ruled out any health conditions that may be making you tired, yet you are still struggling with chronic fatigue, then you need to ‘throw the net wider’ and start looking at other causes of fatigue.  These include:

  • Medications – unfortunately lethargy and fatigue are a common side effect of many medications.    Medications for high blood pressure, high cholesterol, reflux/heartburn, antibiotics, antihistamines, antidepressants and those used to treat anxiety and insomnia are all known to have fatigue as a side effect (Neel, 2012).  Never take yourself off a prescribed medication as this can be dangerous, but instead talk to your doctor who may be able to adjust your dosage or prescribe an alternative to what you are taking.
  • Chronic inflammation, dysbiosis or an unhealthy microbiome, leaky gut and food intolerances are all associated with chronic fatigue and I will discuss these more in detail in later blogs.
  • Menstrual problems – many women struggle with painful, heavy or too frequent periods and long term these problems can be utterly exhausting and even debilitating.  Unfortunately, the more exhausted you become, the more irregular and difficult your cycle will be so it is very important that you focus on good nutrition and a healthy routine in order to keep your menstrual cycle as balanced as possible.
  • Menopause – chronic fatigue is also common in menopausal women whose sleep often becomes disrupted by hot flushes or night sweats. For hints and tips on how to survive menopause, read my blog, Managing Menopause Naturally.

If you eliminate all of the above as possible causes and are still exhausted, then you need to start exploring the deeper reasons for your fatigue – often these are more than simply pathophysiological. If you need some help and guidance then please book a consultation with me.

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Author: Dr Ruth Hull. Ruth is a homoeopathic doctor and integrative health consultant with a special interest in working with people struggling with chronic fatigue, burnout or insomnia. She is author of Anatomy, Physiology & Pathology for Therapists and Healthcare Professionals as well as three other health-related textbooks. She is based in Perth, Australia, runs the online educational organisation, The Health Lounge, and also consults online: http://www.ruthhull.com/


Hull, R. Anatomy, Physiology and Pathology for Therapists and Healthcare Professionals. Lotus Publishing: Chichester

Mortimore, D. The Complete Illustrated Guide to Vitamins and Minerals. Harper Collins Publishers Ltd: London

Neel, A. (2012). 9 Types of Medications That Can Lead to Chronic Fatigue, AARP. Online. Accessed 17 November 2020. Available: https://www.aarp.org/health/drugs-supplements/info-06-2012/medications-that-cause-chronic-fatigue.html

DISCLAIMER: You should not rely on this information as a substitute or replacement for professional medical advice, diagnosis or treatment. If you have any concerns regarding your health and before making any changes to your lifestyle or diet you should always consult your general medical practitioner or other health professional. The use of any information provided by Ruth Hull and/or The Health Lounge is at your sole risk and no assurance can be given that the information provided will always include the most recent findings or developments. All events and information are provided according to the laws of Western Australia.

I think almost every single one of us has at some stage of our lives experienced that awful feeling of simply lying awake all night, waiting for the sun to rise so that we can finally get up and have a cup of coffee.  After it has happened for a few nights then that sense of dread sets in – when you spend half your day dreading the coming night because you know you just aren’t going to sleep.  Or you might be lucky enough to fall asleep and then the dog, or cat, or neighbour….or something…will wake you up around 3am and you will spend the rest of your night lying there staring at the ceiling.

When these sleepless nights turn into sleepless weeks a chronic cycle of insomnia develops – a cycle that is very difficult to break and can often need professional help.  Homoeopathy can work wonders with insomnia and does not interact with any daily medication you may be on. Yet in addition to this, there are 3 simple steps you need to take to get a good night’s sleep.  Put these 3 steps into action TONIGHT and after a week you should hopefully have reset your body clock and broken that awful cycle of sleeplessness.

    • Get into bed at the same time every night.
    • Set your alarm for the same time every morning.
    • As soon as your alarm rings EXPOSE YOUR EYES TO BRIGHT LIGHT for a few minutes (preferably natural) – it is very important that you do this at the same time every day.
    • Do not eat a heavy meal for 3 hours before you go to bed.
    • Have a warm milky drink (see recipe below).
    • Warm up your body – have a warm bath/shower or do some gentle stretching.
    • Get into bed and relax – read, chat to a partner or simply daydream!
    • Your bedroom is for sleep, relaxation and sex only! There must be no TV, cellphones, ipads, flashing digital clocks etc in your room.  It needs to be a quiet, peaceful place that you can retreat to and switch off in.
    • Your room should be clutter free – don’t have piles of unpaid bills or work on your bedside table. Clear out your room so that you only have things that you love and that relax you.
    • Your room should be as dark as possible so that you sleep well.

This lovely ayurvedic drink contains cardamon and nutmeg which are well-known for their sedative properties.  It is relaxing, nourishing and full of goodness.

  • Boil a mug of milk on the stove with a pinch of cardamon powder (or a few pods), a pinch of nutmeg and a pinch of saffron (ONLY a pinch of each of these)
  • The milk must boil for a few minutes
  • Remove from the heat and add a teaspoon of ghee (also called clarified butter….buy in an indian shop or health shop)
  • When it is at a cool enough temperature to drink add some honey to make it taste sweet
  • Optional: add two tablespoons ground almonds or almond powder (brain food).

good night and sweet dreams

Author: Dr Ruth Hull (Homoeopathic Doctor)

Ruth is an integrative health consultant, four-times published author and homoeopath.


IMAGE SOURCE: https://innerbattle.me/blog/tag/insomnia/

Your internal environment is regulated by hormones and even the slightest change to hormone levels can have a large and lasting impact on your body.

Cortisol, The Hormone of Stress

One hormone, in particular, has a significant effect on your day-to-day life, affecting your ability to cope with stress, your energy levels, your weight, and even your reproductive and sexual health.

This hormone is cortisol and it is primarily released in times of stress via the activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis.

Circadian Rhythms

Cortisol has many functions in the body and is the hormone that helps you wake up in the morning, gives you energy to exercise and helps you cope with stress.

It is released in a cyclical (circadian) rhythm, peaking in the mornings at approximately 8am and then waning in the afternoons, between 3-4pm. 

This rhythm enables you to get up and function in the mornings and then relax and ‘switch off’ at the end of the day.

Interrupted Sleep, Insomnia, Fatigue

If, however, cortisol is constantly being released into your bloodstream due to ongoing stress, then this natural rhythm and hence your sleeping rhythms become displaced. 

High levels of cortisol circulating in your blood stream in the middle of the night means you will be wide awake in the middle of the night.  When these levels crash early in the morning you will too.

Blood Glucose Levels, Insulin Resistance, Inability to Lose Weight, Exhaustion

Another of cortisol’s functions is to increase the level of glucose in your blood stream.

However, constantly high levels of glucose in your blood stream lead to insulin resistance and the effects of insulin resistance include fatigue, increased appetite, abdominal weight gain, and eventually Type II Diabetes Mellitus.

Poor Immunity, Frequent Infections & Poor Healing

High levels of cortisol also suppress your immune system resulting in frequent infections and poor healing.

Gut Health, Woman’s Health and Pregnancy

In addition, excess cortisol has a negative effect on both your digestive and reproductive systems leading to digestive disorders, PMT and difficulties in conceiving or maintaining a pregnancy.

What is Stress Doing to You?

So if you find you can’t sleep at night, can’t lose weight, are constantly sick or struggle with digestive or menstrual/reproductive problems then perhaps it is time to stop for a minute and take a closer look at your stress levels and how you are coping with them.

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Author: Dr Ruth Hull (Homoeopathic Doctor)

Ruth is an integrative health consultant, four-times published author and homoeopath.


Jain, J.  2005.  Chapter 31, Animal Hormones, Fundamentals of Biochemistry (online). Available at: http://www.cuchd.in/e-library/resource_library/University%20Institutes%20of%20Sciences/Fundamentals%20of%20Biochemistry/Chap-31.pdf (Accessed 26 May 2016).