I’ll never forget the day that I couldn’t make it down one flight of stairs. I was living in a second floor walk up in Brooklyn at the time and I needed to leave the apartment to teach a class. Should have been simple, right? I remember having to sit down at the top of the staircase and physically push myself down, one at a time, just to get down the stairs. I had been feeling unwell for quite some time at that point but that was the turning point at which I knew something was very, very wrong.

In 2016, I was diagnosed with Hashimoto’s Thyroiditis, an autoimmune thyroid condition. One of the major things that let me know something was wrong was incredible fatigue. Unfortunately, many doctors are frankly quite terrible at diagnosing this condition until it is very advanced. Your fatigue might not be as dramatic – maybe it’s just a general feeling of tiredness that coffee just doesn’t seem to help anymore.

Not only should you not have to feel this way – you do NOT have to! As fatigue has been one of my number one health challenges to overcome, I have done quite a bit of research on it. If you are feeling tired, sluggish or fatigued, check out these possible reasons why and get back to feeling vibrant!

1) Check your Vitamin D Levels

42% of Americans are deficient in Vitamin D. Yes, 42%. This is huge number and quite alarming. I cannot stress enough the importance of Vitamin D. It is called a vitamin, however it is actually a critical hormone. It is a crucial element of your energy levels, not to mention metabolism immune system and fertility (for both men and women!) and even mood as well. There is a direct link between Vitamin D deficiency and disease and research is now showing that an estimated 75% of cancers could be prevented by adequate Vitamin D levels. Many women (including me!) have had trouble becoming pregnant until raising their Vitamin D levels. It is also important to note that many of the lab result measurements for adequate levels are out of date and that the ideal number to reach is actually around 60-70. A level of 25 may show as “adequate” by some test measurements but it is quite far from optimal! I personally feel best when my levels are at least at 50 and I am constantly striving to get that number higher.

Often referred to as “the sunshine vitamin”, Vitamin D can be obtained naturally from sunlight. However, as many people work from 9-5 each day in an office or live in cold climates where there is very little sun for several months of the year, obtaining Vitamin D naturally can be challenging. Even more challenging – due to the risk of skin cancer from the thinning of the ozone layer, many of us wear sunscreen when we do go outdoors. However, sunscreen actually can cut the skin’s Vitamin D production by 99 percent! While I would never advise anyone to spend hours in the sun without sunscreen, there is a definite benefit to spending just 15 minutes in the midday sun without sunblock. 15 minutes is the recommend amount of time to absorb Vitamin D through natural sunlight and it is a short enough period that it does not expose you to sun damage. There are a few food sources of Vitamin D as well, such as salmon (wild if possible), tuna and mackerel.

I do however, absolutely recommend supplementation as well, as it is increasingly difficult to reach optimal Vitamin D levels naturally. I personally take this Omega-3 supplement with D3 by Nordic Naturals, with great effect. I like that I am able to take my Omega-3s (also very important for immune health!) and my Vitamin D in one supplement.

2) Iron Levels ok? Check your Ferritin Levels!

When I first started on thyroid medication, I felt an immediate improvement. However, fatigue continued to be an issue for me on and off and I knew that something still wasn’t quite right. I asked my endocrinologist to do more bloodwork. My iron levels were fine but my Ferritin was very low. Ferritin is the iron reserve protein in your body. While you should definitely check to make sure your iron levels are ok (Anemia can definitely cause serious fatigue!), Ferritin levels are often overlooked by the average doctor and can be a major cause of fatigue. Even if your Ferritin levels show up as “normal”, optimal levels are between 90-110 ng/mL. If you are experiencing fatigue, you want optimal levels! I take Pure Encapsulations OptiFerin C to keep my Ferritin levels optimal and it works brilliantly. Once I started taking this, my energy levels improved almost overnight! Another bonus – my hair stopped falling out, another issue that I had been having along with the fatigue. Please note – Ferritin levels do steadily build up in your body and it is important not to have too much Ferritin either. If you are supplementing, please regularly have your levels checked so that you don’t raise your levels too much!

3) Check for Hashimoto’s or Thyroid Issues

Ask – no insist actually – that your doctor do a test to measure if you have thyroid antibodies – even if your TSH or thyroid panel is “fine”. This is how they finally found my issue and I now take Armour Thyroid; a natural thyroid medication that is prescription only. Helps so much! After giving birth, women are particularly susceptible to developing Hashimoto’s (although mine showed up pre-baby), so it’s especially important to check for this if you’ve had a child in the past few years.

I do have a pretty good endocrinologist but he is not the one who originally diagnosed my Hashimoto’s. I knew that there was something off with me several years ago and I refused to accept my doctor saying that I was “fine”.

I went to see a Naturopathic physician and told him how badly I had been feeling. Right away, he had a hunch that it was Hashimoto’s. He told me to go back to my doctor and insist that she run the specific tests – most specifically checking for the presence of thyroid antibodies, the marker of Hashimoto’s. He was right – they came out positive. The next step was to hunt for a good endocrinologist, which can be very difficult to find. I had done a lot of research and I knew that I wanted to take Armour thyroid (a natural, prescription thyroid medication) rather than the synthetic Synthroid. I searched until I found an endocrinologist who prescribed it. Many endos don’t want to prescribe Armour because it is more difficult to dose. My current endocrinologist is very good. He has quite a long waiting list! But I am passionate about being your own medical detective.

If you know something is wrong with you physically, you are probably right! Unfortunately, the average medical care has become in many ways like fast food – get patients in and out as quickly as possible and bill them. Even on medication, I am always checking my bloodwork to make sure my levels of everything is at an optimal level. That is how I feel best. Treatment of Hashimoto’s requires a commitment to healthy living if you want to feel your best 😊

If you do find that you have Hashimoto’s or if you are already struggling with it, I can’t recommend enough reading Izabella Wentz’ excellent book, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause . This book is brilliant and was unbelievably helpful to me in finding ways to manage my Hashimoto’s beyond just medication. Her blog is also excellent and an amazing resource for Hashimoto’s and autoimmune disease!

That was Part 1 of my two part series on fatigue! Are you struggling with less dramatic fatigue but still need some pick me up tips for general sluggishness? Stay tuned for Part 2 of this topic coming next week!

Know someone else who is struggling with fatigue? Tap the share button and spread the love! :)

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Want to do yoga with me? If you live in Miami or NYC, please feel free to get in touch for private yoga sessions. Live elsewhere? I also offer sessions on Skype :)