These complaints are so common today, that to not hear them now seems odd. There are many, many reasons for fatigue, and therefore, a good comprehensive evaluation is necessary if the underlying reason for the fatigue is to be illuminated and resolved. Unfortunately, the common treatment is to just call it depression or anxiety and administer psychotropic drugs.

Finding the underlying culprit can be easy or complex. Let's review some of the causes. Starting from the top, down, we'll begin with the head. The most obvious is sleep. Too much, not enough or poor quality of sleep can contribute to tiredness/fatigue. Inability to fall asleep, stay asleep, sleep apnea or sleeping odd hours due to work schedule all contribute as well. These are all conditions that can be alleviated or managed.

Certain neurological disorders such as MS, Lou Gehrig's, and any disturbance in normal output of the brain hormones such as serotonin, dopamine, and endorphins can affect energy levels. Also, psychological states such as depression, anxiety, grief, stress, loneliness, overwhelm, lowered ambition, can all have an impact on energy levels. These too can be helped to varying degrees to offset tiredness.

Heart and lung diseases such as congestive heart failure (in any of its varying stages), dysfunctional heart muscles or valves, asthma, emphysema, COPD or pneumonia can have significant impact on your energy levels. If you feel these conditions are beyond help, be comforted in knowing there are still things we can do to help with energy.

Of course, nutrition will certainly impact energy levels. Whether we're talking about excesses (food quantity or quality), stimulants which later cause you to crash (such as coffee, energy drinks, soda pop and other sugars), or even electrolyte imbalances, nutrition plays a vital role. Along with that, we have to look at the level of digestive capacity. Gastrointestinal disorders such as reflux (GERD), heartburn, inflammatory bowel disorders and enzyme deficiencies will alter how much nutrition can be digested and absorbed. These will impact energy.

Endocrine disorders such as low thyroid functioning, cortisol imbalances due to stress, sugar consumption or altered adrenal function, diabetes, low blood sugar or sex hormone imbalances can cause fatigue. This includes pregnancy, menopause, andropause (male menopause), menstrual disorders, estrogen or progesterone deficiencies, etc.

Chronic infections, connective tissue disorders (arthritis, lupus, fibromyalgia, etc.), anemia, cancer and autoimmune disorders need to be considered. Certain medications, such as blood pressure and heart meds, opiate-derived pain meds, muscle relaxants and even the medications given for depression and anxiety can cause fatigue. Lack of exercise, or even too much exercise can also contribute.

Generally more than one thing is involved. It is rarely simply one reason. That's why it's important to have a complete, comprehensive evaluation from a practitioner who looks deeper than just their specialty.

In Part II of "I'm Exhausted, Wiped Out, and So Tired!" we will discuss options to help remedy many of these reasons for fatigue.

Meanwhile, sign up for my upcoming health class, Natural Solutions to Fatigue & Lack of Energy, Wednesday, April 8th 7 p.m. at Vital Health in Coeur d'Alene. Fee: $10. RSVP: (208) 765-1994.

Holly Carling is a Doctor of Oriental Medicine, Licensed Acupuncturist, Doctor of Naturopathy, Clinical Nutritionist and Master Herbologist with more than 36 years of experience. Carling is currently accepting new patients and offers natural health care services and whole food nutritional supplements in her Coeur d'Alene clinic. Visit Carling's website at www.vitalhealthcda.com to learn more about her, view a list of upcoming health classes and read other informative articles. Holly Carling can be reached at (208) 765-1994 and would be happy to answer any questions regarding this topic.