Undiagnosed Fatigue Treatment at COEM in Charleston, South Carolina

Appropriate diagnostic testing can save untold time trying to guess what might be the problem.

“I am so exhausted!” These may be the words that you find yourself saying day after day. Perhaps you just don’t enjoy activities or you’re unable to fulfill your work obligations as you once did. What are some of the causes? There are literally dozens of reasons for fatigue, and an office visit with a holistic physician is the best place to begin.

Unfortunately in today’s medical world, most routine office visits are so brief that the well-meaning doctor has to listen to your complaints, make a decision, order some tests, write prescriptions, and generate a well-documented note—all in ten minutes! Holistic physicians take a different approach and carefully look for hidden factors that can be uncovered by taking an in-depth, two-hour medical history.

At The Center for Occupational and Environmental Medicine (COEM), we consider the following areas for clues about undiagnosed fatigue, depending upon a patient’s history:

1- Hidden inhalant and food allergy—Food to which you’re allergic can be a cause of fatigue, and specialized skin testing or ELISA blood tests are performed to detect these. Foods can cause fatigue up to 48 or 72 hours after eating, but many patients will notice tiredness 30-60 minutes after eating an allergenic food.

2- Hidden low thyroid—Many people with “normal” thyroid test results can still suffer from low thyroid function. Special tests like Free T-3, Free T-4, and Autoimmune Antibodies are useful. Having several hypothyroid symptoms may help confirm the diagnosis even if “the numbers” indicate otherwise. Doctors need to use the lab results, but they must also listen to what the patient is saying.

 3- Hypoglycemia—Over 30 percent of Americans have metabolic syndrome and many suffer from fatigue from glucose (sugar)/insulin dysfunction. It often takes a 5-hour glucose tolerance test with insulin levels simultaneously, or an after-meal insulin test, to detect this cause. Special low glucose/insulin diet challenges are good tools. People with this problem may routinely get tired 1and ½ to 2 hours after eating, especially after lunch. These laboratory tests are performed at The Center, if needed.

4- Hypoadrenalism—Stress and poor diets damage our adrenal glands. These glands sit on top of our kidneys and play a key role in energy. Classic symptoms will include sleep that is non-refreshing, often causing a person to struggle through the day fatigued and needing coffee or sugar just to stimulate him/herself to keep going. Salt and sugar craving are keys. Dizziness when getting out of bed or a chair is common. A mild depression often accompanies adrenal gland fatigue, and an energy crash between 2 to 3 pm also frequently occurs. A saliva hormone test is a great diagnostic aid for this problem.

5- Low Vitamin B12—Most people would never think of this deficiency being a cause of fatigue, since they assume their multivitamin would be sufficient. Some studies show that digestive tracts damaged by Candida yeast, food allergies, and toxicity are only capable of limited absorption of B12. One study showed that B12 absorption over age 50 could be less than 10 percent. Blood testing for B12 or methylmalonic acid are good indicator. Sometimes a therapeutic trial with a few B12 shots is diagnostic.

6- Amino acid deficiency—It may seem hard to believe with all the food people eat that such a deficiency could be an issue, but malabsorption syndrome (documented by hair analysis or red blood cell mineral analysis) could result in low amino acid levels. L-Taurine is one amino acid that is commonly low in fatigued patients.

7- Sleep apnea—Millions of Americans think they sleep well throughout the night but never realize that their daytime exhaustion originates from multiple episodes of sleep apnea (breathing stoppages). Clues may be snoring and non-refreshing sleep. Being overweight or having a large tongue may be clues that point us to look deeper into this issue.

8- Mitochondria dysfunction—Each cell has a powerhouse, the mitochondria, inside of it to produce energy. Scientists tell us that mitochondria can weaken from toxicity and insufficient nutrient absorption. Testing for L-carnitine and B vitamins can reveal this deficiency. An organic acid or ion panel test can be useful.

9- Testosterone deficiency—this hormone is required in minimal amounts to help with muscular strength and endurance, but many men and some women experience low levels as they approach their late 40’s. Signs that accompany this deficiency may include depression and decreased sex drive. Free testosterone and total testosterone blood tests or saliva tests are useful.

10- Candida yeast—This yeast is normally found as part of the bowel flora but can increase dramatically with sugar-rich diets, steroid use, or with antibiotic use. People with yeast overload often feel that their brain is tired but their body is fine. Related symptoms could be brain fog, stomach bloating, and itch. An organic acid urine analysis can detect this problem.

11- Deconditioning—When we fail to exercise, our muscle functions weaken, our circulatory systems become sluggish, and we don’t oxygenate our tissues effectively.

12- Medication side effects—this can be a common cause of fatigue especially when a person is taking multiple medications, which increases the risk of drug interactions.

13- Acupuncture/Meridian imbalance—The Chinese have taught us that the meridian systems of the body should be balanced in order to have energy. Testing of these systems can be done by pulse or by a recent technological development called the Accugraph. Using a noninvasive measuring electrode and a sophisticated computer program, a doctor can record all 24 primary meridians and evaluate for imbalances that could be the underlying reasons for fatigue.

When there are so many possible reasons for fatigue, you can see why we say a comprehensive evaluation is the best place to begin! Appropriate diagnostic testing can save untold time trying to guess what might be the problem while experimenting with trial-and-error recovery programs. At The Center for Occupational and Environmental Medicine (COEM), we work closely with each patient to uncover hidden imbalances causing fatigue and provide appropriate treatments to resolve them.

If you would like us to help you overcome fatigue, please contact The Center for Occupational and Environmental Medicine (COEM). We serve patients from Charleston, Mt. Pleasant, Summerville, North Charleston SC, Ladson SC, Hanahan SC, James Island SC, John’s Island SC, Daniel Island SC, all of South Carolina, Nationally, and Internationally. Patients routinely fly into Charleston to be evaluated by COEM and to enjoy this beautiful city which is a Condé Nast and Travel and Leisure Top Domestic and International Tourist Destination. For more information, you may also wish to browse through other related topics on this Website describing our treatment approaches to:

• Allergy
• Natural Hormone Balancing For Men and Women
• Yeast Eradication