Part 5: Unexpected Reasons You Might Have Fatigue

by Gavin Guard, PA-C, MPAS, CISSN, Pn1

Medical Director, Roots Integrated Care

If you’ve missed it, be sure to check out parts 1 through 4 of this series. Let’s finish with reason #5: anemia.

Reason #5: Anemia

Addressing anemia can be an absolute game changer to improving fatigue! Why? Because it’s common and usually easy to fix.

Anemia encompassess impaired oxygen carrying capacity. It usually is due to iron deficiency but can also be due to other micronutrient deficiencies such as folate (B9), B12, and copper. Often, these deficiencies are attributed to poor gut health and poor absorption of these nutrients.

Here are some signs that you might be affected by anemia:

Inadequate intake: especially for those who are vegan or vegetarian.

Poor absorption: due to digestive issues. One common condition is called gastritis which leads to impaired absorption of B12 that can lead to anemia. Signs and symptoms include burning stomach, you get full easily, older age, or you have an autoimmune disease (e.g. Hashimoto’s thyroiditis).

Excessive elimination of iron: commonly seen in those with heavy or long periods.

Getting a comprehensive lab assessment can be particularly helpful. The labs that I look at for my patients include:

Hemoglobin and CBC: to assess for presence and type of anemia

Ferritin: to assess iron levels

B12 and folate: important B vitamins

Parietal cell and intrinsic factor antibodies: to assess for autoimmune gastritis

Gastrin: to look for low stomach acid that may lead to poor absorption of B12 and iron

Celiac disease panel: a cause of poor absorption of nutrients need by red blood cells

If you have anemia, be sure to work with a provider that can help you with the following:

Ensure adequate intake: supplement if necessary with iron, B12 lozenges.

Ensure good gut health: screen for underlying issues that could reduce absorption and work through improving your gut health in a stepwise fashion.

Fix sources of blood loss if necessary: Manage periods and excessive bleeding. A colonoscopy may be necessary (especially if over 45 years old or family history of colon cancer).

The Bottom Line

That’s it for this series. Don’t let these issues go unaddressed and unsolved. Work with a knowledgeable provider to help you address your health concerns.

I hope you found this information useful and helpful in your journey back to a healthier and happier life.