Fatigue: Functional Medicine Solutions

By Susan Blum, MD, MPH Board Certified in Preventive Medicine and a Chronic Disease Specialist Founder and Director of Blum Center for Health

Fatigue: Functional Medicine Solutions

Functional medicine looks at fatigue differently than traditional medicine does. How? Functional medicine focuses on the prevention and treatment of chronic disease by finding the cause of the imbalance or symptom the person is experiencing. Ever since I completed the training in functional medicine 10 years ago, this has been the sole focus of my medical practice.

It is holistic medicine, with a whole-person view, and yet also molecular medicine, with tools and testing to evaluate the biochemistry of cells, tissues and organs – and how they are all interconnected. Is there something in your body that isn’t functioning right to explain it? What else is going on in your life? 

Because everything is interconnected, there is usually more than one thing out of balance to cause fatigue and any other symptoms. On the show, I focused on thyroid hormones, and will focus on the thyroid here as well. Below is the checklist I use when trying to figure out why your energy is low.

1. Is your diet making you tired?

2. Is your body low in key vitamins, minerals or amino acids?

3. Do you have low hormones (looking at thyroid, adrenal and sex hormones)?

4. Are you filled with toxins?

5. Do you have chronic infections?

Findng Balance: Hormones and Fatigue


Hormones together create an orchestra, with each hormone necessary for the harmony that is the human body. If one is out of balance, it throws everything else off. Therefore, I do a thorough evaluation that includes the whole orchestra of hormones. These include the thyroid, adrenal and sex hormones.  

The thyroid gland is the organ most often blamed for weight gain and low energy. My expanded testing includes TSH, Free T4, Free T3, Total T3, Reverse T3, and anti-thyroid antibodies. With these additional tests done through a standard lab, I can diagnose forms of a low functioning thyroid that are often missed and not evaluated by your endocrinologist or internist. One example is low T3, something often overlooked because they aren’t testing for it.

If I find a low functioning thyroid gland, I will also do further detective work to figure out what is causing the problem. I want to know if you are low in the vitamins and minerals the thyroid needs. This can cause the thyroid gland to be stressed and not work properly. The most important minerals are zinc, selenium and iodine, and the best thing for a sluggish thyroid gland is to take a multi-mineral and to start eating foods rich in these nutrients. Iodine is found in sea vegetables like kelp, kombu and iodized salt. Brazil nuts are a rich source of selenium, and I recommend sesame tahini as a potent source of zinc.

Sometimes, there are other reasons why the thyroid gland is sluggish. Heavy metals, especially mercury, can damage the thyroid tissue, causing low thyroid hormones. There is also an autoimmune disease, called Hashimoto’s thyroiditis, where the body’s immune cells attack the thyroid gland, causing inflammation and damage. This is a common cause of hypothyroidism. 

The good news? Functional Medicine offers tools to treat both these conditions. I regularly work with my patients to remove mercury and to cure the autoimmune disease. Using this approach, the thyroid can recover and begin to function normally again, reinstating the hormone harmony that is so important. 

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