Why You’re Still Tired: The Hidden Causes of Fatigue

You’re getting “enough” sleep. You try to eat healthy. You even take supplements. So why are you still exhausted every day? If this sounds familiar, you’re not alone. Chronic fatigue—defined here as the inability to generate or sustain sufficient energy to meet the day’s demands or one’s personal goals—is one of the most prevalent health concerns in the modern world. Yet, most conventional evaluations either overlook fatigue and burnout entirely or fail to explore the deeper imbalances that silently drain energy over time.

Fatigue isn’t simply about sleep deprivation or being overworked. It’s often a symptom of deeper systemic dysfunction involving hormonal regulation, digestion, neurological health, mitochondrial health and stress resilience. It can stem from poor sleep architecture, hormone dysregulation, improper exercise timing, or dietary mismatches, amongst many others. It’s also a hallmark of depressive or anxious states, and frequently the fallout of prolonged, unresolved stress. People can often pinpoint a high stress period marked by a rapid and steady decline in health. Conversely, ample and balanced energy levels are one of the top hallmarks of good health, mood, and a variety of related metrics such as quality of sleep and the like.

Restoring energy isn't just about being a productive member of society. Foundationally, it's about regaining the ability to take care of yourself—cooking, exercising, meditating, being present—all of which become manageable again once energy returns. When we’re depleted, even basic self-care feels out of reach. That’s why building vitality is so essential: it sets the stage for a virtuous cycle where health-building behaviors become not only feasible, but deeply fulfilling.

Almost everyone has experienced a bout of fatigue. But when it becomes chronic, the weight of unfinished tasks, strained relationships, and a diminished quality of life can add layers of emotional and psychological stress. Before diving into statistics or lifestyle changes that can help reverse this pattern, it’s worth considering a more nuanced view: even fatigue, and suffering more broadly, can carry hidden benefits.

Illness has a way of clarifying what matters. In the depths of depression or exhaustion, our priorities shift. The people who truly care become evident. Old habits and unhelpful patterns reveal themselves. In those low moments, our desire for health sharpens and we begin imagining the things we’ll do once we feel like ourselves again. In the process of falling apart and rebuilding, we often uncover something more valuable than wellness alone—humility, compassion, and a deeper sense of purpose. Suffering becomes a bridge to service. We not only understand others better, we gain tools, empathy, and awareness that support healing on a broader level.

Restoring energy becomes more than a personal goal; it’s a way to honor this rare, fragile, and miraculous life. Human life, with its unique balance of joy and difficulty, offers the opportunity to grow in insight, kindness, and wisdom. When we’re low, we develop compassion and purify obstacles to growth. When we’re thriving, we gain perspective. And when we’re balanced, we can cultivate lasting happiness and equanimity. Every state holds something valuable and can be transformed from an obstacle into an opportunity for growth.

Let’s Look at the Numbers

Chronic Fatigue (General Population)

● According to the CDC, chronic fatigue syndrome (CFS) affects approximately 836,000 to 2.5 million Americans, though most remain undiagnosed (CDC, 2021).

● A U.S.-based population study estimated that 10–15% of adults experience persistent fatigue lasting six months or more, even without meeting full CFS criteria (Jason et al., 2015). Interestingly, these numbers correlate very closely with rates of depression and anxiety as well.

Burnout (Workforce)

● The World Health Organization (2019) recognizes occupational burnout as a syndrome caused by chronic workplace stress.

● A 2021 Indeed survey found that over 52% of workers reported feeling burned out, with millennials and Gen Z showing even higher rates (Indeed, 2021).

● Among healthcare professionals, particularly post-COVID, burnout rates have exceeded 60% in some specialties such as healthcare workers (Dzau et al., 2020; Shanafelt et al., 2022).

Chronic Fatigue

● Chronic Fatigue Syndrome (ME/CFS), is acknowledged by the CDC, NIH, and Institute of Medicine.

● Symptom Hallmarks:

○ Fatigue lasting 6+ months

○ Not relieved by rest

○ Post-exertional malaise (PEM) i.e. really tired after effort

○ Unrefreshing sleep

○ Cognitive impairment

○ Orthostatic intolerance - dizzy or lightheaded upon standing

● In everyday terms: you have low energy and don’t feel so great most of the time.

Burnout

● Burnout’s not considered a medical diagnosis, but it’s a well recognized occupational syndrome (WHO, 2019).

● Defined by:

○ Energy depletion or exhaustion

○ Mental distance from one’s job

○ Reduced professional efficacy

● Chronic fatigue we could say is more generalized whereas burnout is perhaps more occupationally specific. You will commonly hear people report being burnt out for a variety of reasons though.

Low Energy States Are Commonly Overlooked

Many people report feeling low on energy, yet this often goes unrecognized or brushed aside. If you’re persistently tired and the usual fixes aren’t working, your experience is valid. Before turning to medications like amphetamines to manage fatigue or brain fog, it’s worth considering the deeper imbalances that may be contributing to the problem. Conventional medicine may rule out obvious culprits like sleep apnea, thyroid dysfunction, anemia, infections such as Epstein-Barr virus, or autoimmune conditions, which is great. But even then, treatment often stops short of addressing the full picture.

Mental and emotional stressors, along with everyday lifestyle patterns, play a major role. Chronic fatigue is often rooted in lifestyle habits: poor sleep hygiene, overstimulation, excess alcohol or drug use, processed foods, or a lack of restorative downtime. A comprehensive evaluation can bring these patterns into focus, and with the right support, meaningful and sustainable changes become possible.

For those already deep in the experience of fatigue—when exhaustion seems to have taken on a life of its own—a functional and integrative approach can be truly restorative. We’ve touched on psychological and emotional contributors like chronic stress, workplace dissatisfaction, and unresolved worries. But the list doesn’t stop there. Financial pressure, geopolitical instability, existential uncertainty, self-judgment, and emotional states like envy or hopelessness all affect our inner world and physiology. These influences can be the cause, the result, or a complex mix of both. That’s why it’s essential to address both body and mind.

So what do you do when fatigue feels all-encompassing? When it becomes deep-seated in your body, intensifies mental suffering, and begins to unravel your sense of stability? In these moments, a deeper approach is required. In the next section, we’ll explore key physical signs to pay attention to, the hidden factors that are commonly overlooked and contribute to fatigue, along with foundational strategies that help regulate stress and support the return to lasting well-being.

HPA Axis Dysfunction and Cortisol Imbalance

The hypothalamic-pituitary-adrenal (HPA) axis controls the body’s response to stress and regulates cortisol—a key hormone for energy and circadian rhythm. Chronic emotional stress, sleep disruption, inflammation, and overtraining can lead to cortisol dysfunction, often mischaracterized as "adrenal fatigue" (Mariotti, 2015; Zänkert et al., 2019).

Symptoms may include morning grogginess, evening alertness, sugar or salt cravings, and dizziness upon standing. These often reflect a flattened cortisol curve, which conventional lab work may miss.

Sleep Architecture and Circadian Rhythm Disruption

Sleep quality, not just quantity, is vital. Nighttime cortisol spikes, late-night screen use, and irregular sleep-wake cycles interfere with melatonin and reduce time in deep and REM sleep (Kräuchi & Cajochen, 2021).

Even minor circadian misalignments can reduce cognition and increase inflammation (Wright et al., 2013). Clients often report waking around 2–4 a.m., typically linked with liver detox cycles and cortisol surges. Sleep disturbances can be due to any of the factors mentioned as well as blood sugar dysregulation, infection, and toxin overload which can all uniquely contribute to fatigue.

Exercise Mismatch

Exercise can either drain or replenish energy, depending on timing, intensity, and one’s state of stress. Those with mitochondrial dysfunction or cortisol dysregulation may not tolerate high-intensity workouts well. However, many people aren’t overtraining—they’re under-training.

If you're tired all the time, skipping movement may worsen your condition. Experiment with moving workouts earlier in the day and increasing intensity incrementally. The body evolved to move. If gentle yoga isn’t helping, try brisk walks, cycling, or strength training tailored to your capacity. Don’t compare your needs to others—determine what's best for you by sampling different types of exercises and intensities. Again, unless you’re training for an Iron Man or triathlon, think undertraining, not overtraining.

Dietary Stress and Blood Sugar Instability

Poor blood sugar regulation is a common but overlooked cause of fatigue. Skipping meals, low protein intake, or relying on caffeine instead of regular meals can create reactive hypoglycemia and afternoon crashes. Generally speaking, the wrong diet for you.

Micronutrient deficiencies—especially in iron, B12, magnesium, CoQ10, and carnitine—impair mitochondrial energy production (Giustarini et al., 2019).Oxidative stress from poor diet and environmental toxins further compounds the issue and damages mitochondria. Food sensitivities and gut permeability can further impair nutrient absorption and tax the immune system (de Punder & Pruimboom, 2015).

What You Can Do at Home Today

● Wake with the sun or at least get sun in the am if naturally a night owl

● Reduce screen and overhead light exposure after dark

● Eat protein and fat with every meal, reduce all refined carbs and added sugars.

● Set a caffeine window - i.e. cutoff 8 or more hours before bed

● Move daily—walking and stretching -> cardio and resistance training

● Establish a nighttime routine: magnesium, warm shower, dim lights, meditate

● Fill basic nutrient deficiencies with a methylated multivitamin

How We Can Help

If fatigue is affecting your work, relationships, mood, or wellbeing—and you’re not getting relief from basic self-care—it’s time to dig deeper.

At Seed to Fruit, we address the root causes of fatigue. Our functional assessments, weekly coaching, and personalized protocols can help restore health from the ground up.

Functional Testing to Uncover Hidden Imbalances

We go deeper with testing beyond standard labs:

● Salivary or dried urine cortisol testing: Reveals daily rhythm and stress adaptation.

● Comprehensive GI panels: Detects leaky gut, dysbiosis, or infections.

● Micronutrient/mitochondrial markers: Identify nutrient depletion, oxidative stress.

● Neurotransmitter assessments: Reveal dopamine, serotonin, or GABA imbalances.

● Lifestyle analysis: Reveals diet, sleep, or stress imbalances.

This data allows us to personalize evidence-based protocols and reduce the guesswork. When the underlying contributing factors have been identified, unnecessary stressors have been removed, and the right nutrients, supplements, and behavioral modifications have been included, fatigue can be reversed relatively quickly and energy can continue to increase incrementally.

Energy is foundational to life. Without it, pre-existing conditions worsen or new ones can develop. Rebuilding energy levels means supporting your body’s natural rhythm, restoring the vital reserve, resuming a life that’s meaningful to you, and ultimately–honoring this precious human life.

�� Visit seedtofruit.health to schedule a discovery call or explore our functional testing panels.

References

Centers for Disease Control and Prevention. (2021). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). https://www.cdc.gov/me-cfs/

Jason, L. A., Sunnquist, M., Brown, A., Newton, J. L., Strand, E. B., & Vernon, S. D. (2015). Chronic fatigue and post-exertional malaise in people with and without ME/CFS. Fatigue: Biomedicine, Health & Behavior, 3(2), 92–107. https://doi.org/10.1080/21641846.2015.1023767

World Health Organization. (2019). Burn-out an "occupational phenomenon": International Classification of Diseases. https://www.who.int/mental_health/evidence/burn-out/en/

Indeed. (2021). Employee Burnout Report: 2021. https://www.indeed.com/lead/preventing-employee-burnout-report

Dzau, V. J., Kirch, D., & Nasca, T. (2020). Preventing a parallel pandemic — a national strategy to protect clinicians' well-being. New England Journal of Medicine, 383(6), 513–515. https://doi.org/10.1056/NEJMp2011027

Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Satele, D. V., & Dyrbye, L. N. (2022). Changes in burnout and satisfaction with work-life integration in physicians during the first two years of the COVID-19 pandemic. Mayo Clinic Proceedings, 97(12), 2248–2258. https://doi.org/10.1016/j.mayocp.2022.09.002

Mariotti, A. (2015). The effects of chronic stress on health: New insights into the molecular mechanisms of brain–body communication. Future Science OA, 1(3), FSO23. https://doi.org/10.4155/fso.15.21

Zänkert, S., Bellingrath, S., Wüst, S., & Kudielka, B. M. (2019). HPA axis responses to psychological challenge linking stress and disease: What do we really know? Frontiers in Human Neuroscience, 13, 517. https://doi.org/10.3389/fnhum.2019.00517

Kräuchi, K., & Cajochen, C. (2021). The role of melatonin and the circadian system in regulating sleep and mood. Current Psychiatry Reports, 23, 7. https://doi.org/10.1007/s11920-020-01225-4

Wright, K. P., Jr., Lowry, C. A., & LeBourgeois, M. K. (2013). Circadian and wakefulness-sleep modulation of cognition in humans. Frontiers in Molecular Neuroscience, 6, 1–13. https://doi.org/10.3389/fnmol.2013.00007

Giustarini, D., Dalle-Donne, I., Tsikas, D., & Rossi, R. (2019). Oxidative stress and human diseases: Origin, link, measurement, mechanisms, and biomarkers. Critical Reviews in Clinical Laboratory Sciences, 56(4), 1–54. https://doi.org/10.1080/10408363.2018.1539557

de Punder, K., & Pruimboom, L. (2015). The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients, 7(9), 7714–7731. https://doi.org/10.3390/nu7095351