EP139 The One About The Three Big Causes Of Fatigue


The number one complaint of women who visit my clinic is low energy. They’re exhausted.

They’re also frustrated because their blood tests are mostly normal. How can blood tests be normal even though they definitely don’t feel normal?

In this episode we talk about the three main causes of fatigue.

We discuss which hormones are to blame, deficiencies, and food.

We also talk about what you can do right now to get your energy back.

TRANSCRIPT OF TODAY'S EPISODE

Dr. Martin, Jr.: Hey, I’m Dr. Martin, Jr.

Dr. Martin, Sr.: And I’m Dr. Martin, Sr.

Dr. Martin, Jr.: And this is The Doctor Is In Podcast and this is episode 139. And today, we want to talk about something that’s probably [00:00:30] the number one reason – or I shouldn’t say reason, necessarily – but the number one complaint that people have that visit your clinic, and that’s low energy or fatigue. No question. Am I right by saying that?

Dr. Martin, Sr.: Oh, absolutely. The first, first question that I ask every patient that’s in my office is, “I’m ten out of ten,” and I usually am and I mean that, thankfully. I thank the Lord for that. That I’m generally always feeling pretty good, I’m a big baby when [crosstalk 00:01:00]

Dr. Martin, Jr.: Well, you [00:01:00] played softball last night. How were you at the plate yesterday?

Dr. Martin, Sr.: Good.

Dr. Martin, Jr.: You had a good night at the plate?

Dr. Martin, Sr.: I surprise everybody, you know? They all played the shift on me because they know which way I hit and then I flew them. The old guy puts it the other way, right?

Dr. Martin, Jr.: But Martin clinic lost last year in the A division finals by one run.

Dr. Martin, Sr.: By one run. A walk-off. Thought about that all winter.

Dr. Martin, Jr.: All winter. You’re highly energetic.

Dr. Martin, Sr.: Right? I’m very thankful for that. I don’t want to take [00:01:30] that for granted, but I’m also very sympathetic, because when people come into the office and they tell me, I always tell them, “What’s your end-” You know, here’s the complaint. “I’m so tired, Doc, of being tired. I’m tired of being tired,” because once I get the number out of them, it’s usually, well, not always and it’s women. I say, “Okay, what the big thing?” “I’m exhausted. I’m tired.” They give me a one out of ten, zero out of ten, [00:02:00] two out of ten.

You know what? They’re not good because having low energy all the time, look. You had a long weekend and you’re tired on Monday morning, that’s sort of normal, but it’s never, never, never normal not to have high energy any given day.

Dr. Martin, Jr.: And a lot of them are frustrated because the problem with low energy is that it’s not a disease and what we mean by that, on routine blood testing, generally, nothing show up, right? If they’re not anemic, then- And [00:02:30] the standard blood testing that’s ordered, usually this is kind of the scenario that we hear a lot of times. Somebody’s not feeling well, they’re tired all the time. Like you said, they’re tired of being tired. They wake up tired. They go to their doctor, they share that with them, they get a bunch of blood tests, and the blood tests come back normal and we always ask the question, “Well, how can things be normal when the person’s exhausted?” But that’s generally what happens, so they’re frustrated.

The doctor generally or their primary care physician generally [00:03:00] kind of dismisses it after, right? “Well, everything’s good. You’re good.” And we like to tell people that energy is not something that should be ignored and the example that we use all the time is that – we like to use it a lot – is the check engine light in the car, right? I get my long line of no skill whatsoever with automobiles or construction from you, who got it from your dad, who got it from their dad.

Dr. Martin, Sr.: Martin and son, we never made a living fixing cars or having to build [00:03:30] anything.

Dr. Martin, Jr.: No, I just-

Dr. Martin, Sr.: Or fix anything.

Dr. Martin, Jr.: A friend of mine who fixes my cars – he’s a car guy, obviously – and he always asked me and I always tell him, when he goes it explain it to me, “Assume that I know nothing about cares.” If I push a button and it doesn’t start, that’s the extent. So if I call in and I said to him, “Hey, there’s something wrong with my car.” He’d say, “Well, what’s going on?” I’d say, “It doesn’t start.” That’s it. Nothing else, right? So I get that-

Dr. Martin, Sr.: And there’s gas in right, so it can’t be that.

Dr. Martin, Jr.: Yeah, it can’t be the [00:04:00] gas and, you know, I know I just got my oil changed, so it can’t be that, but here’s the thing. Those check engine lights in your car- Cars are basically computers nowadays and those check engine lights could be quite frustrating, right? A lot of people, they ignore it. I’ve even seen people put tape over it because it just drives them crazy.

Dr. Martin, Sr.: They don’t want to see it.

Dr. Martin, Jr.: They don’t want to see it. So the check engine light goes on and the funny thing is with the check engine light- And this has happened to me before because Rob, who’s my car guy, I call him up and I said, ” [00:04:30] Hey, my check engine light’s on,” and because he knows my car, he says, “Well, when was the last time you put gas in it?” I said, “Like three days ago.” “Did you tighten the gas cap properly?” So then I’m like, “Oh, for sure I did.” And then I said, “Wait one second, let me go check.” And I go and sure enough, it clicks and so it could be nothing. It could be your gas cap is not tight enough, or it could be something a little bit more like the thermometer’s off, or it could be something very serious, but it’s just a check engine [00:05:00] light. It could mean nothing. I mean, listen, if there’s air getting in the gas- I mean it could be a problem if you let it go for a while. That’s why the check engine light goes on, or it could be very serious.

The body kind of behaves the exact same way.

Dr. Martin, Sr.: Exactly, yeah.

Dr. Martin, Jr.: Right? The body behaves the exact same way. We get check engine lights that go on all the time and energy is a check engine light. So when your energy, like if all of a sudden, you’re like, “You know, I just don’t have the same kind of energy I used to have,” or the women that come in or the men that come in and they’re exhausted. [00:05:30] That’s a check engine light. Their body is telling them that something is definitely going on and it may not be a big deal now, but left untreated or left without figuring out what’s causing that could lead to some serious issues down the road, right?

So what we want to do on today’s episode is we want to kind of talk about the top three reasons, so the big three reasons why people are fatigued and this would cover probably 80, 90% of the people that have [00:06:00] low energy and, well for the most part, their blood tests would be normal. So let’s kind of go through the list.

The first, the most common cause, especially in women, of fatigue by far is hormones.

Dr. Martin, Sr.: Yup. Absolutely.

Dr. Martin, Jr.: And if you were to narrow it down, because I mean there are so many hormones in the body. The big three hormones that we always talk about because it always kind of comes down to this, the big three hormones that cause fatigue [00:06:30] are cortisol, estrogen-

Dr. Martin, Sr.: And your thyroid.

Dr. Martin, Jr.: And your thyroid. Now, if you were to prioritize those three hormones, out of those three hormones, which one is the most guilty party?

Dr. Martin, Sr.: Very close, one and two, and they affect number three. And the reason I’m putting-

Dr. Martin, Jr.: Oh, that’ not an answer.

Dr. Martin, Sr.: I know it’s not a good answer because you wanted one answer, but I got to tell you-

Dr. Martin, Jr.: No, they’re all tightly connected, which is why-

Dr. Martin, Sr.: They’re so connected because probably a week ago, I would’ve said estrogen [00:07:00] until I had a week- Jeanette said it the other day, one of our nutritionists said to me the other day, “We always seem to run on themes in here. Today the theme is stress, or cortisol, right?” So coming back to your question, what are the three- Or, we said it. It’s cortisol, estrogen – which is ovarian, comes from the ovaries – and thirdly, the thyroid. But all of them are connected to each other.

I’d probably say that [00:07:30] number one is cortisol, closely followed by estrogen and number three is thyroid, but the reason that you’re low energy is the thyroid’s always affected by high levels of cortisol and high levels of estrogen.

Dr. Martin, Jr.: Yeah, if you have high levels of estrogen and high levels of cortisol, you have a thyroid issue.

Dr. Martin, Sr.: It’s slowing down.

Dr. Martin, Jr.: It may not show up on a blood test. We call that functional thyroid, right? Functional hypothyroid, meaning that [00:08:00] your thyroid may be normal, but functionally, when it needs it to do its job, it’s sluggish, so it’s a sluggish issue. So, the interesting thing about cortisol is that there’s a lot of different ways that cortisol can really kill your energy. High cortisol can kill your energy in a whole bunch of different ways, but there’s kind of three ways, in a sense, three big reasons why cortisol kills your energy.

Of course, the first one is that cortisol kills your sleep. High cortisol – we’ve done this, if you go back and listen to our last episode, episode [00:08:30] 138, we talk about cortisol and how it kills your sleep – so if you’re not sleeping well and getting into that deep R.E.M. sleep and you’re not releasing the human growth hormone and all those kind of things, you’re not resetting, your circadian rhythm’s off, you’re tired. You’re tired. There’s no question. That’s the one way.

The second way is, I mean, think of the effect that cortisol has on blood sugar levels, so it’s like this yo-yo effect all day. The primary purpose of cortisol is to raise blood sugar, so your blood sugar levels are elevated because you have [00:09:00] high cortisol and, of course, and you’ve said so many times, blood sugar is toxic. You can’t just have high blood sugar levels, so your body secretes insulin, insulin lowers your blood sugar, and then cortisol brings it back up and insulin brings it back down, and you get this yo-yo effect all day.

Dr. Martin, Sr.: Big time.

Dr. Martin, Jr.: And that kills your energy. Cortisol’s one of the more inflammatory hormones. It creates inflammation, it irritates the gut lining, it increases inflammation throughout the body. Somebody who’s high levels of cortisol has [00:09:30] high levels of inflammation and, as we talked about on our age proofing webinar that we did a while ago, nothing drives aging faster than inflammation. Inflammation is the primary driver of aging, as well as a few other things-

Dr. Martin, Sr.: Free radicals.

Dr. Martin, Jr.: Free radicals and high insulin-

Dr. Martin, Sr.: But they’re connected.

Dr. Martin, Jr.: But they’re connected. Absolutely.

Dr. Martin, Sr.: It’s a double-edged sword, yeah.

Dr. Martin, Jr.: So if you have high levels of inflammation, you’re tired. I mean, there’s a lot of other ways that cortisol kills your energy, but at the end of the day, especially for a woman, if you’re fatigued, [00:10:00] there’s a good chance that your hormones are off. They’re unbalanced and, specifically, you’ve got an issue with cortisol, you have an issue with estrogen, and then you have an issue as well with thyroid. Your thyroid’s sluggish, it’s slowing down.

Dr. Martin, Sr.: And I’m always emphasizing: never accept being tired as normal. It’s normal. So a lot of people think, “Well, that’s my new normal. Yeah, I’ve been tired, doc, for a lot of years and I get all my blood work done and my thyroid’s come back within normal limits,” [00:10:30] and all that. But never accept that because it’s never, never benign in the sense that if you have low levels of energy, it is never normal. It’s often subclinical, meaning they can’t pick it up, but this is why we do biomarkers. This is why we look outside that box.

We look at the things, we look at things in combination. We don’t look at estrogen without knowing its effect on thyroid. We don’t look at [00:11:00] cortisol, the adrenal, and you can literally get adrenal gland exhaustion. Some people come in with that. They’ve actually got to the point that the cortisol was high for such a long period of time, it exhausted the adrenals and that causes a whole syndrome, in a sense. Chronic fatigue syndromes which, I believe, is an adrenal exhaustion. It’s when the cortisol, for such a long period of time, just gets drained. Now you’re messed [00:11:30] up and we call that our metabolic storm. We have a whole course on it, that you’re in a category five and everything is going down.

A lot of people would identify just listening to this today. They know exactly, exactly what we’re talking about and they’re all messed up.

Dr. Martin, Jr.: The interesting thing is that – as you were mentioning just off-air before we came on – that another complaint that kind of goes along with fatigue is [waking 00:11:58] and you can see it’s the same [00:12:00] hormones, the very same hormones that kill your energy also kill your metabolism. And that’s why, as you mentioned, that program we have, the Fix Your Metabolic Storm program, deals with the underlying issue that makes you tired, it causes you to gain weight, and when you fix that, it’s really exciting to see the results that these women have had. And these women have had long-standing hormonal problems and couldn’t lose weight for the life of them, but when they fix a few things, it’s just amazing [00:12:30] how fast the body wants to heal itself.

So the number one cause really is hormones. That’s probably the most common reason why women and men are tired, but women especially, so that’s the first one. Let’s talk about the second cause of fatigue – and this is a big, as well – which is deficiencies and, really, specifically, if you were to list probably the number one deficiency that leads to poor energy, that would be what?

Dr. Martin, Sr.: B-12. Vitamin B-12. [00:13:00] Again, we talk about it a lot. It’s such a key, key, key vitamin. You know that your body does not operate properly without B-12 and the vast majority – and I mean this sincerely – the vast majority of people are deficient in B-12 and B-12 from hormones to your metabolism to your brain to your skeletal system, your muscle system, B-12 is an essential vitamin. It’s often overlooked. The [00:13:30] blood work for B-12, it’s a hundred years old. Give it a birthday party and send it to bed.

I had a doctor the other day just call me on B-12 and because, “Ahh, your patient and my patient,” she said to me, “are high in B-12.” I said, “Good.” That was my aim, I was trying to get them to. “Well, it’s way above normal.” I said, “Okay, so what does that mean? How are they feeling now? Yeah, they’re feeling better with it, right?” “Yeah, but that’s high.” I said, “So what? What does it mean?” Then [00:14:00] you wait for the answer. Of course the answer doesn’t come because there’s no answer to it. I want them to be high in B-12!

Dr. Martin, Jr.: And it goes back again to why that range that they test for has been determined to be the range of optimal. There’s a difference between deficiency and optimal and you see that with vitamin D, you see that with a lot of the other vitamins as well, so B-12. And what interesting about B-12 is you don’t have to get a B-12 shot in order to get your B-12 levels [00:14:30] back up again.

Dr. Martin, Sr.: No.

Dr. Martin, Jr.: In fact, you prefer the sublingual B-12 that we have.

Dr. Martin, Sr.: Yeah, because if you’re deficient in it – think about it – then you’re better off to take it everyday. You can go get a shot once a month and doctors are reticent to it. They don’t like to give it because they got away from it. Doctors of the past were … You know, B-12 shots. What, you’re tired? Here’s a B-12 shot. They knew the remedy for fatigue, but they got away from it just because, “Ah, your B-12’s normal.”

[00:15:00] We’ve said this before and we just emphasize again – it’s not to be negative, it’s just the reality of medicine today – he lab tells the doctor what’s wrong. It controls their behaviour in a way. What happened to instincts? You see patients, I’ve seen patients, thousands and thousands of patients over the years. I can just look at people and go, “You know what? You’re not looking good.” Like, I don’t have to see their blood work to say … I look at a lady, [00:15:30] I can think of her yesterday, I looked at her and said, “You’re anemic.” She looks at me. “What?” I said, “You’re anemic. I can tell just by looking at your colour. You’ve got no colour.” And, of course, she’s exhausted, whatever, then I look at it, then I said, “Yeah, I told you. You’re anemic.” What happened to those instincts?

I get a little frustrated because people come to me and, you know, “Everything’s good.” According to the lab, everything’s good.

Dr. Martin, Jr.: Yeah, they’re so over reliant on … And that’s the thing, we see [00:16:00] this a lot with thyroid. You can have every symptom in the book that practically scream thyroid, and yet the blood test comes back and then the doctor’s like, “Well, looks like your thyroid’s good.”

Dr. Martin, Sr.: “Can’t be your thyroid. It’s impossible.”

Dr. Martin, Jr.: No.

Dr. Martin, Sr.: Well, sure, it’s possible. Maybe you didn’t do all the tests, maybe you’re looking at [crosstalk 00:16:19]

Dr. Martin, Jr.: Yeah, it is frustrating.

Dr. Martin, Sr.: You’re gaining weight, you’re fatigued-

Dr. Martin, Jr.: Your hair’s falling off, your eyebrows are thinning-

Dr. Martin, Sr.: Your hair’s falling off.

Dr. Martin, Jr.: I mean, it’s crazy.

Dr. Martin, Sr.: Remember the eyebrow test, you know? I love that because you look at the eyebrows and go, “Oh wow. You got a thyroid issue, right?”

Dr. Martin, Jr.: [00:16:30] So B-12 is another big cause and it’s an easy fix as well, right? And then the third major cause would be insulin, which is-

Dr. Martin, Sr.: Ta-da!

Dr. Martin, Jr.: Yeah. And it’s interesting, right, it’s kind of the opposite. You and I have talked about this before, but you have three hormones that raise blood sugar and then one that brings it down, so it’s no surprise, then, that if they got an issue with cortisol, which brings it up, they’re going to have an insulin issue [00:17:00] as well. And the fact of the matter is people eat foods that make them tired, no question, and it’s generally high-processed-

Dr. Martin, Sr.: Crappy.

Dr. Martin, Jr.: Crappy carbs are generally the issue and the funny thing about insulin is- Think about it this way: because, as I mentioned, glucose is toxic, so basically everything you eat is broken down into glucose. Your blood sugar levels go up. High blood sugar’s danger, so you put some insulin in there and insulin gets rid of it.

Well, if you have high insulin [00:17:30] all the time and you’re constantly fighting your blood sugar, insulin takes glucose out of your blood and stores it, and glucose in your blood is there for energy purposes, so you’re not burning off energy. Also, when you have insulin in your blood, you’re also not burning fat for energy. Your furnace is not working properly. You’re removing the glucose from the blood and you’re also not putting fatty acids out there so that you can burn them as ketones and burn them off so it creates a problem [00:18:00] in so many different ways. Plus, high insulin makes you inflamed, kills your energy that way. High insulin is stressful, brings up cortisol. I mean, on and on and on, which-

Dr. Martin, Sr.: Diet’s important, isn’t it?

Dr. Martin, Jr.: Which is why it’s amazing when people control their insulin or they eat in a way that stabilizes their blood sugars and they make sure that their B-12 levels are optimized and they fix their hormones, their energy energy always comes back.

Now, our most popular supplement by far – [00:18:30] we got a couple of them that are pretty neck and neck now – has always been, and we’ve had it for such a long time, is our Navitol because it’s a pine bark extract and, of course, pine bark extract holds a special place in our family, obviously, because of the effect it had on mom. It really fixed her energy, right?

So there are a lot of good things out there that you could take to improve energy. There’s no question and what’s interesting about- You know, we just look at a study off-air. We have a [00:19:00] private Facebook group called the Martin Clinic Club. If you want to join it, go to our website and just look for the Martin Clinic Club. Join it. It’s a private Facebook group. We were just doing a Facebook Live in there just before coming on and doing this podcast and we talked about that new study that came out that said one in three adults are taking a medication that’s exposing them to depression, right?

Dr. Martin, Sr.: It increases their depression by one-third, right? The risk of depression by one-third.

Dr. Martin, Jr.: Why, it’s insane.

Dr. Martin, Sr.: Isn’t it?

Dr. Martin, Jr.: No, [00:19:30] it’s one in three medications.

Dr. Martin, Sr.: Oh, one in three medications increases the risk of depression.

Dr. Martin, Jr.: It’s sad, so a lot of these patients, they come in, they’re on medications. They’re depressed, they’re exhausted, and this is the thing. It’s kind of a pet peeve of ours. A lot of the times, these women go to their doctor and they’re not feeling well and the doctor says, “Well, it’s depression.” It’s kind of like the chicken and the egg. I mean, they’re depressed because they’re not feeling well. I mean, if you’re exhausted all the time, it’s [00:20:00] pretty hard not to feel depressed or anxious, right?

So they enter into this kind of real, we use the term “metabolic storm”, but it’s this real storm that goes around them where they’ve got low energy, they’re gaining weight, they’re not sleeping well, they’re feeling depressed, they’re feeling anxious, and it’s amazing. But the nice thing is we’re here to tell you it’s very fixable and the nice thing is it’s fixable by just changing some of the things you’re eating and then adding some nutrients, some key nutrients, that make a big, big difference.

Dr. Martin, Sr.: Yup.

Dr. Martin, Jr.: [00:20:30] So we want to thank you for listening to this episode. If you have any questions, you can go to our website at martinclinic.com. There, we have live chat that goes on. You can email us at info@martinclinic.com. You can join you, every Thursday morning. You do a Facebook Live where you answer questions. You’re answering a ton of questions, a ton of people on there, and you just … Again, you had a technical difficulty this past week. It was funny, we were laughing, you went live, so here we are. You go live, you went live-

Dr. Martin, Sr.: You hired a dinosaur. You’re going to have [00:21:00] some issues.

Dr. Martin, Jr.: You went live on your personal page, which you have so many privacy settings in there that nobody was able to watch it and people were messaging us and, “Hey, where’s the Facebook Live?” And our staff’s like, “No, he’s on Live. I can see him.” It’s because they’re all your friends on Facebook, so they could see you. And then when I looked at it, as soon as I saw it, I saw you were going live through your page, so I messaged you. Of course, you got all your notifications off so, man, you did a 40 minute Facebook Live to all your-

Dr. Martin, Sr.: It was so good, though.

Dr. Martin, Jr.: To all your nephews and cousins and family, so it was awesome. Well, even [00:21:30] you were commenting on there for a while, it’s like, “Oh, I got a lot of grandkids on there.” Anyway, so aside from the technical difficulties, you do a Facebook Live every Thursday. We also jump into our new group that we have as well where we answer some questions and talk about a few different things, so there’s a lot of ways that you can get in touch with us, a lot of ways that you can get information as well about your health.

So, again, we want to thank you for listening. Have a great day.