Top 5 reasons for feeling tired all the time – Part 1: physiology

Do you ever feel like you’re having to force yourself to get out of the bed in the morning?
Do you struggle to maintain energy levels throughout the day and find it hard to get the work done in the afternoon?
Do you feel so tired when getting to the bed that you can’t actually fall asleep?
You’re not the only one. “Chronic fatigue” is a very common problem affecting millions of people, and especially those seeking to achieve a lot in life.
Entrepreneurs, artists, corporate high-achievers, doctors, nurses, etc.: no one is immune to this problem.
I personally struggled with “chronic fatigue” for a long time, eventually accepting it as a price to pay for my success.
Ultimately, I started asking myself whether it’s possible to work hard, achieve a lot, but still feel fresh and energized throughout the day.
After extensive research and self-experimentation (and using others as guinea pigs!), I realized that YES, it IS possible, and here’s how:
Reasons for “chronic fatigue” can be classified as physiological (physical) and psychological (mental).
In this post (Part 1) I’ll address the Physiological (physical) aspects. In Part 2, I’ll discuss Psychological aspects.
Here we go:

Top 5 physiological reasons for fatigue:

1.       Nutritional deficiencies
2.       Adrenal fatigue/stress
3.       Sleep quality
4.       Blood sugar fluctuation
5.       Hydration

1. Nutritional Deficiencies 

This is probably the most common reason and the one overlooked most often.

Most common nutritional deficiencies associated with fatigue:

  • Vitamin B12
  • Iron
  • Magnesium
  • Vitamin D
  • Selenium
  • Heavy metals toxicity

Nutritional deficiencies can be due to:

  • Inadequate diet
  • Inflammation in the digestive system

Dietary sources for key nutrients: (focus on high quality, organic free-range only)

  • Vitamin B12: meat, fish, dairy, eggs.
  • Iron: liver, some seeds, some nuts, meat, dark leafy greens.
  • Magnesium: dark leafy greens, nuts, seeds, fish, avocados, yogurt.
  • Vitamin D: sufficient sunlight exposure and sufficiently high levels of fat intake (raw material needed to produce Vitamin D from the sun).
  • Selenium: Brazil nuts, some fish.

 Heavy Metals Toxicity:

  • Excessive mercury (from certain fish or cosmetic products) combined with inadequate intake of selenium will impair your ability to convert T4 to T3 (active form of thyroid hormones), leading to a feeling of fatigue.
  • Reduce your intake of high mercury fish (e.g. Tuna) and use of high mercury cosmetic products (e.g. bleaching creams) and increase your intake of selenium (Brazil nuts, 2-3 per day only).

Should you supplement?

  • You should be able to obtain most nutrients from foods (as listed above).
  • You most likely will need to supplement with Magnesium and Vitamin D (most people deficient in both). Aim for 2x500mg of Mg/day and 2000 IU of Vitamin D/day. 

Inflammation in the digestive system
An inflamed digestive system lining will impair your ability to absorb key nutrients.
Most common causes for digestive system inflammation: antibiotics, small intestinal bacterial overgrowth (SIBO), gluten (in some), dairy (in some), soy, artificial sweeteners, grains (in some), eggs (in some). Avoiding these inflammatory foods is the first step.
Aiding in digestive system recovery: bone broth (organic), collagen (in supplement form), glutamine (in supplement form), digestive enzymes with heavy meals.

Adrenal Fatigue / Stress

High levels of Cortisol (stress hormone) produced during excessive mental stress (emotional) and physical stress (heavy training, lack of sleep) will impair the ability of your digestive system to absorb the nutrients. 
Furthermore, Cortisol uses the same raw materials as Vitamin D (and sex hormones). High levels of Cortisol means less raw material is available for Vitamin D (and stress hormones), leading to deficiencies
Lifestyle changes combined with stress management tools (e.g. diaphragmatic breathing, meditation, yoga) and nutritional changes (less caffeine, sugar, soft drinks) will help in lowering Cortisol. 
If leading a very active lifestyle (e.g. triathletes, marathoners, Crossfit athletes): it’s worth investing in heart rate variability testing to manage your training load and ensure that you’re not pushing yourself into adrenal fatigue (or worse: exhaustion).

Sleep Quality

Some people argue that they can operate on 6 hours of sleep and others need 8. What you need to be aware of is the following: it’s the QUALITY of sleep that matters more than the number of hours.
Your body needs to be able to cycle in and out of different phases of sleep (including deep sleep) to engage recovery protocols and prepare you for the next day.
Tips to improve sleep quality:

  • Avoid blue light (tablets, smartphones) in the last 90min before bed (blue light tricks your body into thinking that it’s morning and it’s time to get up).
  • Reduce stress levels before bed (avoid watching the news, arguments).
  • Engage in an evening routine (empty your mind into a journal, meditate, read from real paper).
  • Drink herbal relaxing teas (chamomile) and avoid caffeine in the 6 hours before bed.
  • Take magnesium and taurine before bed.
  • Keep room temp comfortably on the cooler side.

 To monitor sleep quality:

  • Use devices (e.g. Fitbit) or sleep monitoring apps (e.g. Sleep Cycle) to monitor the quality of your sleep and track what’s affecting your sleep the most. Remember to put your phone in airplane mode if using any such app.

Blood Sugar Fluctuation

A drop in blood sugar will cause your adrenal glands to produce Cortisol (stress hormone). This is a normal defensive response built into your DNA as a protective measure: if blood sugar is too low, it’s time to get up and go and hunt / forage for food, hence the need for such a system.
In order for you to avoid a blood sugar crash (and Cortisol spike) in the middle of the night:

  • Completely avoid sugary foods to keep blood sugar stable throughout the day.
  • Ensure that you get some good quality (low glycemic load) carbs in the evening.
  • Avoid high intensity exercise within 3 hours of bed-time.


Almost 70% of your body consists of water. Even mild dehydration can throw off all of your systems, leading to imbalances in electrolytes and hormones. In addition, loss of water means your blood becomes thicker, making your heart work harder and delivering less nutrients to your body.
A body under stress is a body which feels threatened, which in turn means production of stress hormones (Cortisol). Re-read the above to learn about the negative impact of excessive Cortisol.
Climate controlled environments (like your office or bedroom) can be excessively dry because of the air being pumped in through the vents. This causes you to lose a lot of water through your breathing and skin, leading you to get severely dehydrated. 
Remain adequately hydrated:

  • Drink 1L of water within 60min of waking up.
  • Remain hydrated during exercise.
  • Drink at least 3L of water during the day (in addition to hydration during exercise).
  • Get enough minerals from your diet to maintain electrolyte balance (e.g. use real sea-salt with full mineral profile).

Of course, there could be many other physiological reasons for fatigue (e.g. thyroid problems, sensitivity to mold exposure, insulin resistance / pre-diabetes, cardiovascular problems, etc.), but the 5 reasons list above tend to be by far the most common ones and addressing them is relatively easy (given enough commitment and intention).
As usual, any questions / comments: feel free to email/reply/comment.