Fatigue: Thyroid vs. Adrenal

Your tired. And it’s more than something a good night’s sleep can resolve. To eliminate fatigue the first step is to make sure the foundations of health are covered; adequate sleep, good nutrition and digestion, moderate exercise, and minimal stress. If the fatigue extends beyond that it’s time to investigate hormones.

The two most likely culprits of fatigue are the thyroid or the adrenal glands. A thorough intake with a licensed Naturopathic Doctor is the most efficient path forward, but to get you started, here is a list of symptoms which usually help to narrow down the root cause —


Thyroid-based fatigue

o fatigue thyroid naturopathicBody temp low and consistent
o Sluggish energy – persistent fatigue
o Difficulty losing fat
o BP normal to high
o Cholesterol high
o Facial colour – red
o Hairloss: lateral 3rd of eyebrow loss
o Intolerance to cold
o Muscle aches

Adrenal-based fatigue

o fatigue adrenal naturopathicBody temp low and fluctuates
o Wired and tired or sluggish in late stage
o Bursts of energy – inconsistent fatigue
o Tired in afternoon: second wind late
o Difficulty gaining muscle
o BP low
to normal
o Cholesterol low
o Colour – pale
o Bowel hyper/ibs
o Sparse body hair
o Intolerance to cold or heat
o Back ache and muscle aches
o Frequent urination
o Insomnia
o Weak knees/tired legs
o Hard to focus mind


Read my previous blog post about thyroid health to help determine if testing is warranted to determine the root cause of your fatigue.

Naturopathic health care accessibility

I am a Naturopathic Doctor in Sudbury, Ontario, and I see myself as a naturopathic health investigator. I also see myself as a vehicle for people to access natural but also more comprehensive health care.

My visit structure

naturopathic blood testI gather all relevant information (health history, medications, supplements, dietary habits, exercise, previous lab results, etc) and then sort through to determine the origin of the patient’s concern. This usually entails a 1 to 1.5 hour intake, blood work performed at LifeLabs and often some additional homework done by the patient (such as a diet and activity log like My Fitness Pal). Once all of the information is compiled the root cause if often quite obvious. It is then up to the patient (with my support of course) to put in the work required to turn things around. The sooner we catch it, the quicker the turn around. It is really rewarding to see such dramatic shifts in a patient’s health with such gentle interventions!

naturopathic checklistAfter the initial 1 to 1.5 hour naturopathic appointment I am almost always able to make some initial suggestions to get the ball rolling while we wait for the blood work results (be that dietary, lifestyle or supplement-based). I will then request a second appointment within an appropriate timeline (2-4 weeks depending on the initial suggestions), and it’s in this second appointment that I can really prescribe a comprehensive naturopathic treatment plan. The third visit is usually a quick check in to make sure we’re on the right path (often scheduled 4-6 weeks later), and after that visits are typically every 3 months if not longer… though many patients are completely better by the third appointment and I just ask them to come in if anything new arises.

Why it’s important to make naturopathic medicine accessible

I believe this is how naturopathic care should be. No, we can’t gather everything within a typical 15 minute appointment many of my patients are accustomed to with their family physician, but nor should our patients have to wait three full visits before receiving any recommendations. Naturopathic Doctors are well educated and that wisdom allows us to be able to have a good sense of what’s going on with the patient in the first visit based on the extensive intake. The labs and follow-up should be narrowing down and ruling out.

naturopathic diagnosisAs Naturopathic Doctors we are THE alternative diagnosticians to the conventional health care stream, and often times our first visit is a patient’s one foray into the natural health realm. We need to make our medicine accessible and useable. Having to wait until the third (often viewed as expensive – though covered by extended health care plans) visit for any sort of explanation of underlying cause or treatment can spook our patients, and more importantly limit their access to our knowledge.

If you have any questions or comments about this visit structure of style of practice please contact me at my practice Nickel Ridge in Sudbury, Ontario.

Entering a new phase of life + practice!

We are switching hats!

A new baby has shifted my priorities and I’m very happy to report that Matt Lynds, our cherished Registered Physiotherapist, is now the owner and operator of Nickel Ridge! This way I can focus more on my naturopathic practice (spending more time on patient research and continuing education) and I can have my weekends to hang out with my little munchkin. I couldn’t be more excited about going back to work with this clear setup, and I’m looking forward to digging deep into stagnant cases with fresh eyes.

Matt is going to mostly keep things the same, spiffing up the rough edges, add more reception hours and a small gym to support the physiotherapy offerings. You’ll see the clinic name change to Nickel Ridge Physiotherapy, but don’t be fooled, your Naturopathic Doctors and Massage Therapists are still here too.

Let us know if you have any questions or concerns, but we don’t expect any bumps in the road along this transition.

Over and out my friends! See you in the clinic!

All the best,
Dr. Sarah Goulding, Naturopathic Doctor
[email protected]