How to Combat Fatigue and Regain Energy

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

If you’re feeling exhausted, you’re definitely not alone – especially now! Most everyone will have bouts of tiredness from things like lack of sleep, late or hard work hours, caring for children in any capacity, or fighting the occasional cold.

However, for some people, fatigue can be more extreme, and not just the side effect of a long night, tough day or rough week. In fact, millions of people suffer from some sort of ongoing general fatigue, and some even suffer from chronic fatigue syndrome. And while it’s common, it’s definitely not “normal” or a “just a part of the aging process.” Feeling worn down every day can take a toll on your body and mind. You lose quality of life and you’re too tired to do anything about it, a frustrating experience.

Unfortunately, this is becoming “the new normal” for many people during these challenging covid-19 times.

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What is fatigue?

You know when you’re tired. That’s a given. But that’s just one symptom of fatigue. Getting yourself back on track and making sure you take care of yourself requires recognizing the more profound fatigue symptoms in yourself, which can include:

  • Extreme exhaustion after physical or mental exertion
  • Sleep problems
  • Forgetfulness or difficulty concentrating
  • Muscle and joint pains
  • Headache

These aren’t the only physically uncomfortable and inconvenient symptoms, but they do tend to be the main ones. In the short-term, many can cope with these. However, when they last for several months, they can leave you feeling downright terrible.

Causes of Fatigue

Fatigue can be due to anything from simple side effects of medication to disease-related problems, such as multiple sclerosis, thyroid issues, heart disease, diabetes, depression or cancer. One biggie I saw a lot in patients during my years of practice was chronic stress and anxiety, which take a huge toll on the mind and body. And finally, vitamin deficiencies, poor diet or not getting enough exercise can also be part of the problem.

I want to stress, first and foremost, that if you are experiencing unrelenting fatigue that is more severe than your usual feeling of being worn out, you need to talk to your doctor. S/he can check to make sure you don’t have underlying health problems that are contributing to your fatigue. Once more serious causes have been ruled out, you can get right into making some changes to help you feel and live better.

Causes of Fatigue

How to Gain More Energy, Change Your Lifestyle and Battle Fatigue

If you’re sick and tired of being sick and tired, here are some natural remedies for fatigue that can help you start combating fatigue and regaining your energy:

1. Get moving.

The most important advice I can give you about exercise is that the best exercise is exercise you will actually do. For one person, it may be circuit training or weight lifting in your home gym, and for another, it may be walking or doing yoga at home. Whatever you’re capable of doing, just get moving. It may be hard at first since your tiredness is already overwhelming, but it’s okay to start small. After all, you don’t have to run a marathon. You just have to start; you just have to put one foot in front of the other and get your heart rate up (in a positive way) once a day for at least 30 minutes. Even a little exercise will up your energy and reduce your stress.

2. Vitamins and nutrients: find out what you’re missing.

While you may try your best to get the vitamins you need through a diet of whole foods and complex carbs, you might still be low on a few of them. This can be caused by a variety of normal circumstances, ranging from quantities of the nutrient you’re providing your body, as well as your body’s ability to absorb it when it is provided with it.

The most common nutrient deficiencies that tend to cause fatigue or low energy are that of iron, coenzyme Q10, and vitamins B12 and D. If you suspect a deficiency, ask your doctor to test your levels of these nutrients to see whether or not they are low. If they are, this is an easier fix than most; simply ask your doctor for dosage suggestions on whatever you’re low on, and begin taking a daily supplement. You should notice your energy levels rise as you get more of the missing nutrient(s) in your system, if a nutrient deficiency is the underlying cause of your fatigue.

3. Fuel your body properly.

Your body requires the right fuel, just like your car does. If it’s not getting what it needs, it’s going to slow down. Too many carbs and sweets spikes and then plunges your energy, so limit your intake. Try to eat a variety of low-glycemic fiber-rich foods like fresh fruits and vegetables, and healthy proteins like free-range poultry, meats and fish with extra virgin olive oil, avocado, coconut oil and raw nuts. Eating the right types of fat not only boosts brain function, but it also provides more consistent energy.

4. Check out your medications’ side-effects.

You may not have known this, but in the midst of a few others, one of the most common side-effects of medication is fatigue. Often, medication for blood pressure, cholesterol, diabetes and depression make you more tired than usual. So if you’re feeling extremely low on energy, ask your doctor about whether or not your medications could be the culprit, and discuss potential other options or replacements.

5. Nurture your body, belly to brain.

Surprisingly, your belly and its inner workings have a lot to do with your brain and your energy levels. For example, having a healthy amount of the right kinds of gut bacteria is crucial to energy levels. This balance can be thrown off by antibiotics and other factors, but a daily probiotic should help alleviate this situation. In addition, consume fermented foods or beverages like plain yogurt, kefir, sauerkraut, kim chi and kombucha to help keep everything balanced.

6. Keep your hormones in check.

Controlled by your endocrine system, your hormones are essential for combating fatigue. Melatonin, the hormone that regulates your sleep cycle, is one way to help balance that end of the spectrum, since (otherwise) low levels of melatonin can lead to disrupted sleep and fatigue.

7. Supplement with these top four nutrients:

For decades, I’ve been recommending a combination of four key nutritional supplements that, together, boost energy and heart health. I call them my “awesome foursome” because, they really are that awesome. Together, they increase energy in tired cells. The foursome consists of:

  • CoQ10–100 mg in the softgel form (with breakfast)
  • Magnesium–200 mg one to two times daily (with food)
  • Carnitine–1 g on an empty stomach (it is more easily absorbed this way)
  • D-ribose–5 g dissolved in water or juice

There is obviously more to fatigue outside of what I’ve discussed here – with regard to both causes and ways of combating fatigue. Talk to your doctor and find the options that work best for you, and see how these suggestions can make a difference in your day-to-day.

© Stephen Sinatra, MD. All rights reserved.

Leave a Reply


  1. Angelyn Akins

    on September 21, 2016 at 1:12 pm

    Why do you recommend Carnitine on an empty stomach? Do all types of carnitine need to be taken this way? I like to take a variety of kinds, especially Acetyl-L-Carnitine to cross into the brain. I have an easily irritated stomach and wonder if I assimilate less when I take them after a meal. I have learned not to take Ribose or Carnitine too close to bedtime. Please comment, Dr. Sinatra. Thank you.

  2. Cheryl

    on September 21, 2016 at 1:20 pm

    I’m surprised that you don’t mention earthing. I wish I could find a moccasin that wasn’t lined. I would like to see more products designed to connect people with the earth’s energy.

  3. HeartMD Editor

    on September 22, 2016 at 10:39 am

    Hi Cheryl,

    Yes, reconnecting to the Earth’s energy via Earthing may help with fatigue. If you are looking for Earthing shoes check out Pluggz shoes here!

    HMDI Editor

  4. Bobbie B.

    on June 15, 2017 at 12:45 pm

    Dr. Sinatra, I have been taking your Fish Oil for several years, I take coconut oil, vita E , C. and B-comples, B-12. I at times have atrial Fib, I saw my doctor yesterday and he wants me to take Eliquis, blood thinner. My blood i so thin already, I can hardly stop it from bleeding. I don’t want to be on a blood thinner, I was on Cumadin for 5 years and I was such, my blood was too thin.
    Because I lhaave had 3 T.I . A. one was 2003 and last one was 2010. I took myself off Cumiidun because of its bad side effect. I Started taking garlic, ginger and supplement that keep the blood thin. My blood is still thin , every morning I get up with new blood spots on my arms, then turn to dark
    brown spots, Doctor say its just my age. I am 84 year old and in good health. I have a big problem with over ac give bladder at nights. could you help me there to?. what do yourecomend for my problems without drugs. I do take 50 mg morning, and night.Nifedipine for blood pressure Bobbie

  5. Gene

    on June 15, 2017 at 8:33 pm

    Hello Friend, as far as finding shoes without pads underneath…….perhaps you can try simply removing the ones that are in there already. It worked for me. Plus, I use a grounding sheet, under my lower bed sheet. Which grounds me all night long. I also vortex my water, which I get the most viable results from. Hope this helps you too. Thank you kindly.

  6. HeartMD Editor

    on June 22, 2017 at 2:43 pm

    Hi Bobbie,

    A-fib and TIA are serious conditions which certainly do require careful attention to blood viscosity and often times treatment with conventional blood thinners – they can be lifesavers. However, I understand your concerns about side effects. It might be helpful for you to consult with one of the cardiologists on Dr. Sinatra’s Top Docs List to get another opinion on what the best options are for your specific condition. As for overactive bladder here is an article that discussed the condition and some possible causes.

  7. Denise

    on April 4, 2019 at 10:47 am

    I am looking for information concerning statins causing peripheral neuropathy. My husband who has CAD, had a stent in the LAD back in 2007 and more recently had a 3 vessel CABG surgery in October 2018. He has been on atorvastatin for years and the dose was quadrupled with the recent heart surgery. He has been having pain in his feet for a number of yrs now which was attributed to his back. The past year he had an EMG study done which revealed that he has polyneuropathy in both lower extremeties with the sural nerve being affected with muscle wasting. None of the doctors involved in his care can tell us why he has this neuropathy. He is not diabetic and has always be physically active. The pain has increased since the increase in the dose of his atorvastatin. We started doing some searching and inadvertently found some information concerning statins and peripheral neuropathy. Do you know of any studies or published articles that I can present to his cardiologist?

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