How to Combat Fatigue

Nearly everyone feels tired sometimes, and experiences lethargy and sleepiness after working too hard, not getting enough sleep, partying, parenting, grandparenting or some mixed bag of these circumstances.

But feeling extreme exhaustion or fatigue is a more complicated story, one that doesn’t end happily after one good night of sleep. Millions of people suffer from general fatigue or the more serious chronic fatigue syndrome. So it’s certainly common—but definitely not “normal” or “just part of growing older.” No one should have to put up with feeling physically and mentally lousy every single day!

Of course, tiredness is a top symptom of fatigue. Other profound fatigue symptoms include extreme exhaustion following physical or mental exertion, sleep problems, difficulty with memory or concentration, and even muscle/joint pain, headache, and other physical discomfort. These symptoms can last for several months, leaving you down and out.

Causes of Fatigue

There are many potential causes of fatigue. They can range from medication side effects to a huge range of conditions like multiple sclerosis, thyroid problems, heart disease, diabetes, depression, and cancer. Other common causes that I’ve personally witnessed while treating patients have included chronic stress and anxiety, vitamin deficiencies, poor diet, and sedentary lifestyle.

How to Combat Fatigue with Lifestyle Changes

If you are experiencing unrelenting fatigue that extends beyond the occasional bout of sleepiness and lethargy, see your doctor, who can check for any underlying health problems. Once those are ruled out, making some changes to your lifestyle and everyday habits can help you fight fatigue. Here are some important things you can do:

Start exercising

I know it may seem counterintuitive to tell someone who is flat-out exhausted to start working out. But honestly, part of the reason so many people are fatigued is because they are out of shape! You don’t have to start training for a marathon or become the next Arnold. (I get exhausted just thinking about that!) All you need to do is go out for a walk every day, start swimming at your local Y, or maybe even take up dance lessons. You’d be surprised how little exercise it takes to really boost your energy level. An added benefit: exercise reduces stress and anxiety, both of which contribute to fatigue.

Address nutritional deficiencies

The most common nutrient deficiencies associated with fatigue and low energy are iron, coenzyme Q10, and vitamins B12 and D. Your doctor can test your levels of these nutrients to determine if they are low. Fortunately, they are easy to raise by taking supplements.

Improve your diet

Eating too many carbs and sweets leads to energy spikes then plunges, much like an erratic roller coaster ride. To steady out your energy levels and combat fatigue, minimize your intake of refined carbs and sweets. Favor low glycemic, fiber-rich foods like fresh fruits and vegetables, and healthy proteins from sardines and other fatty fish, free-range poultry and meats, and raw nuts. Also, remember that your brain is made up of mainly fat, and dietary fat also happens to be your body’s slowest-burning form of fuel. Consuming the right types of fat not only can improve brain function but also provides a steady source of energy. The healthiest fats (in addition to fatty fish) are olive oil, avocado, and coconut oil.

Check your medications

You’d be hard-pressed to find a pharmaceutical that doesn’t have side effects. And one of the most common side effects? You guessed it—fatigue. Common medications used for blood pressure, cholesterol, diabetes, and depression can all lead to symptoms of fatigue. Talk to your doctor about whether your meds could be a cause of fatigue. If so, discuss what other options you have.

Improve gut health

You may be surprised to learn that your gut can play a big role in your energy levels. Maintaining optimal levels of beneficial, health-promoting bacteria in your gut is crucial in this regard. Even the simple act of taking antibiotics—even if they’re necessary to fight a bacterial infection—can lead to symptoms of fatigue because the medication kills both harmful and beneficial bacteria. The solution is to take a probiotic supplement that replenishes the good bacteria. Take them for a month or so after an antibiotic course, or better yet, make it a daily habit. Routinely eating fermented foods like plain yogurt, kefir, or sauerkraut is also good.

Balance hormones

A properly functioning endocrine (hormone) system is essential for combatting fatigue. Symptoms of fatigue are often seen in people who have low levels of thyroid and adrenal hormones. You may also want to consider taking melatonin, the hormone that regulates your sleep cycle. Many factors can affect our natural production of melatonin, including electropollution and age. Low levels of melatonin can lead to disrupted sleep and fatigue.

Take my “awesome foursome.”

Over the past several decades, I’ve been recommending a combination of four nutritional supplements to not only boost lagging energy levels but also improve heart health. I call them my “awesome foursome” because, well, they really are awesome. Together, these nutrients support mitochondria, the “power plants” in cells where energy is produced. They work to increase energy in tired cells, much like wood gives new life to fire as it’s dying out. My awesome foursome is:

  • CoQ10–100 mg in the soft gel form (not capsule) with breakfast.
  • Magnesium–200 mg once or twice a day, also with food.
  • Carnitine–1 g on an empty stomach.
  • D-ribose–5,000 mg either in the powder form with water or juice, or as capsules.

Obviously there are other causes of fatigue, as well as solutions to combat it. But in the absence of other major underlying health conditions, I do believe that in a vast majority of cases, these lifestyle changes can provide great relief from debilitating fatigue. Give them a try and see how you feel!

Additional Reference:

© 2016 HeartMD Institute. 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.

    1. 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

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