Dr. Alison shares her top testing tools for chronic fatigue based on how your body is feeling. We cover hormones, gut health, yeast, nutrition, and more!
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Top testing options for Fatigue
You are listening to Functional wellness with Dr. Alison and I am so glad you are here! Today we are talking about testing options for fatigue. If you are struggling with feeling tired all of the time, totally drained with no energy, and no matter how much sleep you get, you still need more: this is the place for you. And at the end of this podcast, I will share how you can get discounts on your testing.
I want to address these tests by topic or health issue so you know where to start. In my practice, I don’t always require testing because I know it is very expensive. I do require everyone to have basic blood work to rule out anything obvious or major. So we will cover how to manage and test for fatigue if you are also having hormone issues, gut issues, autoimmune concerns, and what to do if you have everything or nothing and how to know where to start.
Basics
The easiest and best place to start with everyone is blood work because the most common culprits are here and can be easily addressed. We want to run a full iron panel and CBC because anemia is so common and easily treated. We want to look at the thyroid and inflammation levels like CRP, ferritin, histamine, and homocysteine.
Let’s assume all of those look good, we have all heard “your blood work looks great! There is nothing I can do for you.”
Hormones
When I say hormones I am typically talking about estrogen, progesterone, testosterone, DHEA, and cortisol. We already covered the thyroid through blood.
Imbalances in sex hormones almost always lead to fatigue. Low progesterone, low testosterone, high or low estrogen are common culprits. Especially if you are super fatigued around your period. I would also suggest getting your basic blood work done during your period to check for acute anemia and around ovulation to see how your body rebounds.
For sex hormones I recommend either saliva or Dutch urine testing because that tests available hormones where blood testing only tests bound and inactive hormones. These tests can be done at home and mailed directly to the lab and you want to do them on day 21 or day 3 of your cycle. If you aren’t cycling from either hormone complications, menopause, or other reasons, we have options for you too.
And you need to start with testing here because you don’t want to guess and then start taking medications that will drastically change your hormones in the wrong direction.
Adrenal Fatigue
If you are thinking you have adrenal fatigue then a saliva or urine test will be best for you to track your cortisol over the day and night.
Cortisol is not your enemy! I always hear people saying they need to lower their cortisol, but that will make them sick too. All of my patients are different because there are many stages of adrenal fatigue. If you are in the early stages you will probably have a normal chart that has cortisol high but within normal ranges in the morning and then it slowly comes down during the day and is low at night so you can go to sleep. Early stages also will have hyper or increased function and there will be more cortisol throughout the day. Mid stages of adrenal fatigue can look normal, if we are catching you on the downward trend where you were high, but as your function lowers you look normal. And then at later stages you will have cortisol low throughout the day. Another common trend is to have a cortisol spike after lunch in the afternoon, either from sugar, stress, or habits.
Using adaptogens will be extremely important for your adrenals so you do not push them one way or another. This is also why I like the Dutch test because you can see different forms of cortisol and cortisone, see how they work together, and then testing the DHEA will also tell you what stage of fatigue you are in.
Metabolism
Have you ever said your metabolism is slow? Or maybe doing a long term restrictive diet ‘ruined your metabolism’? You might find you can’t lose weight no matter what or how you eat. You are constantly tired, hair falling out, but your thyroid and adrenals are normal! Now what?
If all these tests come back normal I would check your nutritional panels and organic acids through Genova. They offer blood and urine so you can decide what test you want based on if you can get a blood draw in your area. This will tell us if there are nutritional deficiencies and what needs to be addressed instead of just taking random supplements and hoping they work.
Don’t worry: you didn’t ruin your metabolism. It will just take some time and training to get back to a fuel and fat burning stage based on what is going on with your body.
Gut Health
Do you have IBS, constipation, bloating, diarrhea or reflux? And you are super tired? This is where the GI Map can be helpful.
Research shows that gut issues like IBS and fatigue are closely related. Feeling chronically tired as well as abdominal pain, bloating, diarrhea, constipation and reflux are related to a leaky gut, lowered immune function, lowered mitochondrial function, and lower levels of antioxidants.
Much of this is related to yeast, opportunistic bacteria build up, and chronic viral load. Also, these bugs create biofilm which produces toxins which further destruction of the gut and bacteria.
So finding out what types of bacteria are underdeveloped and overdeveloped and supporting those will increase the healthy and good bacteria, reduce biofilm, support the wall of the gut to reduce and leakage and passing through of bacteria and yeast, calm the immune system, and reduce toxins. And this test covers all of this.
Infections
The most common culprit of fatigue and infections is Epstein Barr, most commonly known as mono. I run a full immunoglobulin test and PCR test on many patients and almost always find that they are reactivated when they have severe fatigue. And if there is another issue going on, Epstein barr will almost always reactivate under high stress.
After I went through my colitis scare in 2020 and was released from the hospital, I was so slow to recover. I asked my doctor to run the panel, and he said no and I didn’t need it. I told him to run it anyways and he did. What do you know… fresh viral infection! So we treat this with homeopathic programs and it works wonderfully.
Other tests include Lyme, mold, yeast (but yeast is in the organic acids test and GI map), and metals. We didn’t even talk about autoimmune panels, food sensitivities, and cross reaction panels. There are lots of test that you can do, but start with what seems most obvious to you.
Thank you so much for tuning in today. As always, please reach out and schedule an initial consultation so we can create your wellness plan together and you don’t have to guess on supplements or testing any more. Make sure to like and subscribe to stay up to date on all my weekly podcasts and we will see you next time!