Q. I am struggling with fatigue for the last two months. How can I be treated?

Answered by
Dr. Omnath Alvoor
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 08, 2018

Hello doctor,

I am a 38-year-old male. I have been struggling with fatigue for two months. I have never been like this before. I am a very active person. But, of late, there has been a lot of stress. I had started some multivitamins. After ruling out lots of possibilities, the doctor suggested it could possibly be adrenal fatigue. The symptoms seemed to fit the diagnosis. I did a few tests and got the results today. Saliva cortisol: 8 a.m. 0.97 (normal being between 0.61 and 1.31), 12 p.m. 0.50 (normal being between 0.26 and 0.75), 4 p.m. 0.16 (normal being between 0.13 and 0.51), 8 p.m. 0.14 (normal being between 0.08 to 0.40), DHEA 916 l (normal being between 436 and 1014), and TSH 3.69 (normal being between 0.60 and 2.49), mildly elevated. Please let me know your thoughts.



Welcome to

I understand your concern. I can assist you in this regard. But, before coming to any diagnosis, I would like to know the following.

  1. Have you checked your liver function tests
  2. Are you under any medications?
  3. Check your ESR, Hb count, and blood sugar level.
  4. Do you have any other symptoms like weight loss, vomiting, diarrhea, fever, chills, muscle weakness, or pain, etc.?
  5. You feel the fatigue only in the morning when you wake up or is it all throughout the day?

Let me know the details as early as possible.

For more information consult a naturopathy specialist online -->

Thank you doctor,

The ALT was mildly elevated at 38. All other liver tests were normal. I am on no medication except Zyrtec p.r.n. My HbA1c was 5.9 and fasting glucose was 86. My insulin was slightly high at 17(normal being between 4 to 9). I am an athletic. But, I have not been able to work out for a few months because of the plantar fasciitis. There is no family history of diabetes. No ESR was performed, but CRP was 0.7 (normal being <1). There are no other real symptoms. But, I do have to eat every two hours or so else my energy crashes. When this problem initially started, the fatigue was worse in the morning, and by evening, I felt pretty good. I started taking some proactive supplements of multivitamin, magnesium, and B12 about a month ago, and that has helped me a little. The energy is pretty even throughout the day now.



Welcome back to

I suggest you the following.

  • Based on your results, I doubt there is acute hepatitis. However, you should take the right amount of salt and oil, drink more boiled cumin water or tender coconut water and should stick to a bland vegetarian diet for a few days for better liver health. You can also use sugarcane juice.
  • As your CRP is increasing, it can be due to inflammation. It is very important to know the exact reason. So, I suggest you take a second opinion from a cardiologist too.
  • Your insulin is slightly elevated and that can also cause the symptoms you have described. I suggest you consult a diabetologist in this regard.
  • However, I suggest you the following yoga and pranayama techniques to cope up with these issues. They are Sheetali Pranayama, Nadi Shodhana Pranayam, Kapalbhati Pranayama, Ardha kati Chakrasana, Trikonasana, Parivrtta Trikonasana, Matsyasana, Ardha Matsyendrasana (vakrasana), Paschimottanasana, and Janu sirsasana.

I hope you will contact me further if you have any doubts.

For more information consult a naturopathy specialist online -->

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