29/09/2026
👋 Hi Pracs! 😴 Fatigue is one of the most common presentations you'll see, and one of the least specific. When standard bloods come back unremarkable, these four areas are worth a closer look.
🩸 B12 and folate. Symptoms can arrive before the anaemia does. Watch for a sore, beefy tongue, brain fog and poor memory, low mood that doesn't lift, dropping things more often, breathlessness on light exertion, balance feeling slightly off, pins and needles in the hands or feet, and pallor despite a normal blood count.
🌙 Cortisol rhythm. It's the shape of the curve that matters, not a single number. Think salt cravings, wired but tired at night, dizziness standing up too fast, small things feeling overwhelming, needing coffee to function, every bug taking weeks to shake, exhausted at 3pm but awake at 10pm, and waking unrefreshed after eight hours.
🍄 Mould and mycotoxins. These symptoms track buildings rather than seasons. Dry, irritated eyes, headaches most days, itchy skin or new rashes, new sensitivity to smells, worse at home and better away, a blocked or runny nose all year, brain fog and poor concentration, and recurrent sinus or chest infections.
⚡ Cellular energy. The fuel arrives, but it isn't being converted to ATP. Fatigue that rest doesn't fix, crashes the day after exercise, heavy limbs by early afternoon, recovery from illness dragging on, sugar cravings by mid-afternoon, poor stamina rather than poor motivation, aching muscles after light activity, and brain fog with word-finding trouble.
🔍 The overlap between these four is what makes fatigue so difficult to work up on history alone. Nutritional, adrenal, mycotoxin and organic acids testing together tell you which mechanism is actually driving it.
Information is a courtesy of Dr. Onah, ND.
Nutritional: https://bit.ly/4ydIwEj
Hormones (includes cortisol): https://bit.ly/46MJCuD
Mycotoxins: https://bit.ly/4yQE8eb
Organic Acids: https://bit.ly/4yNKawi
