🩸 Why You're Always Tired: 7 Tests That Explain Chronic Fatigue (Ferritin, T4, Cortisol, B12, Glucose, CRP, Magnesium)
Why You Always Want to Sleep: 7 Tests That Will Explain Chronic Fatigue, and What to Do About It
You wake up already tired. A double espresso works for exactly twenty minutes, and by lunchtime, your brain turns into a pumpkin. By the evening, there is only enough strength to scroll through the feed. Familiar?
The first thought of a modern person: “I’m just lazy” or “I need to sleep more”. The second thought: “I need to drink vitamins”. And so you buy a jar of multivitamins, drink them for a month, and the effect is zero.
Let’s face it: laziness is when you can, but don’t want to. And when you want to, but physically cannot—this is biochemistry. Your body does not work on willpower, it works on ATP, hormones, and enzymes. And if at least one gear is broken in this complex mechanism, no motivational training will help.
We at the MedAssist AI team can say with confidence: in 80% of cases, specific deficiencies or failures are hidden behind “chronic laziness”. We have selected 7 key indicators that need to be checked before signing up for a psychotherapist or personal growth coach.
1. Ferritin: The Hidden Reason Why You Are Suffocating from Fatigue
What Is It in Simple Terms
Ferritin is a protein “warehouse” of iron in the body. If hemoglobin is iron that is “at work” right now (carries oxygen), then ferritin is your strategic reserve for a rainy day.
Why the Indicator May Decrease
- Insufficient intake with food: vegetarianism without control, strict diets, just little red meat in the diet.
- Absorption problems: gastritis with low acidity, intestinal problems (SIBO, celiac disease), taking heartburn medications (proton pump inhibitors).
- Chronic losses: heavy menstruation in women, hidden bleeding in the gastrointestinal tract, donation, intense sports.
When Is It a Cause for Alarm
A classic mistake is to look only at hemoglobin. Hemoglobin can be normal (for example, 125 g/L), and ferritin is already at the bottom (below 30 µg/L). This is called latent iron deficiency. Symptoms: hair loss, brittle nails, desire to gnaw ice or chalk, shortness of breath when climbing to the second floor, tachycardia, and that very leaden fatigue. Guideline: The optimal ferritin level should be approximately equal to your ideal weight, but not lower than 40–50 µg/L.
2. TSH and Free T4: The Battery of Your Body
What Is It in Simple Terms
T4 (thyroxine) is the main hormone of the thyroid gland, responsible for the metabolic rate and energy production. TSH (thyroid-stimulating hormone) is the “boss” who sits in the pituitary gland (in the brain) and kicks the thyroid if it works poorly.
Why the Indicator May Change
- Autoimmune process (AIT): the immune system attacks the thyroid gland.
- Iodine and selenium deficiency: the thyroid simply has nothing to build hormones from.
- Chronic stress: high cortisol suppresses thyroid function.
When Is It a Cause for Alarm
If TSH creeps up (above 2.5–3.0 mIU/L), and T4 decreases or stays at the lower limit of normal—this is hypothyroidism (decreased function). Symptoms: you freeze when others are warm, gain weight from one look at food, dry skin, swelling in the morning, and thoughts flow slowly, like thick honey. This is a state of “power saving mode”.
3. Vitamin B12: Fuel for the Nervous System
What Is It in Simple Terms
Vitamin B12 (cyanocobalamin) is a key element for creating DNA, red blood cells, and myelin sheaths of nerve fibers. Without it, nerve impulses are transmitted slowly and with interference.
Why the Indicator May Decrease
- Refusal of animal food: B12 is found only in animal products.
- Atrophic gastritis: with age or due to illness, the stomach stops producing “Castle’s factor”, necessary for the absorption of B12.
- Taking metformin: a popular drug for diabetes reduces vitamin absorption.
When Is It a Cause for Alarm
Laboratory reference values often start from 180–200 pg/mL, but neurologists know: anything below 400–500 pg/mL can already give symptoms. Symptoms: “cotton” legs, tingling in the fingers, memory impairment (“went into the room and forgot why”), irritability, and depressive fatigue.
4. Glucose and Insulin: Energy Swings
What Is It in Simple Terms
Glucose is the main fuel for cells. Insulin is the key that opens the cell to let glucose in.
Why the Indicator May Increase
- Insulin resistance: cells stop “hearing” insulin, glucose does not get inside and floats in the blood, and the cell starves.
- Excess of simple carbohydrates: constant snacking on sweets.
- Hypodynamia: muscles are the main consumer of glucose; if they do not work, sugar is not utilized.
When Is It a Cause for Alarm
If fasting glucose is above 5.5–6.0 mmol/L—this is a “bell”. But even more important is your condition after eating. If 30–60 minutes after lunch you are inexorably drawn to sleep, this is a sign of “carbohydrate coma” and possible problems with insulin sensitivity. The body spends colossal resources on utilizing sugar, turning off other functions.
5. Cortisol: The Hormone That Doesn’t Let You Sleep (and Live)
What Is It in Simple Terms
Cortisol is a stress and adaptation hormone. Normally, it should be high in the morning (to wake you up) and low in the evening (to let you fall asleep).
Why the Indicator May Change
- Chronic stress: deadlines, mortgage, disturbing news keep cortisol high constantly.
- Sleep disturbance: night shifts or the habit of going to bed at 2 am.
- Adrenal exhaustion: (a controversial term, but the condition is real)—when after a long period of hyper-activity, cortisol falls below the plinth.
When Is It a Cause for Alarm
Here, not so much the level is important, but the rhythm. Scenario 1: In the morning you cannot wake up (low cortisol), and in the evening you cannot fall asleep, thoughts jump (high evening cortisol). Scenario 2: You constantly feel “on edge”, but there is no strength. Important: Cortisol in the blood is a capricious indicator (fear of injection increases it). For diagnosing fatigue, cortisol in saliva (4 points during the day) is more informative.
6. C-Reactive Protein (CRP): Who Steals Your Energy?
What Is It in Simple Terms
C-reactive protein (ultrasensitive) is the fastest and most accurate marker of inflammation in the body.
Why the Indicator May Increase
- Hidden infections: from caries to chronic tonsillitis.
- Systemic inflammation: metabolic syndrome, autoimmune processes.
- Tissue damage: even after intense training, it can grow briefly.
When Is It a Cause for Alarm
Inflammation is a very energy-consuming process. The immune system takes the lion’s share of ATP to fight the “enemy”. If CRP is stably above 1–3 mg/L (provided that you are not sick with ARVI right now), it means that a fire is smoldering in the body, which sucks out your strength. You feel aches, weakness, “fog in the head”.
7. Magnesium: The Main Relaxant
What Is It in Simple Terms
Magnesium is involved in more than 300 biochemical reactions, including energy production in mitochondria and muscle relaxation.
Why the Indicator May Decrease
- Stress: under stress, magnesium “burns out” at cosmic speed, being excreted by the kidneys.
- Coffee and alcohol: diuretics wash out minerals.
- Refined food: there is critically little magnesium in the modern diet.
When Is It a Cause for Alarm
A blood test for magnesium is often uninformative, since the body will pull magnesium from bones and muscles to the last to maintain its level in the blood (homeostasis). Therefore, we focus on the clinic. Symptoms: eye twitches, calves cramp at night, you are irritable, sleep poorly, sensitive to loud sounds. Without magnesium, the ATP (energy) molecule simply cannot be stabilized and used by the cell.
What to Do Step by Step: Instructions for Returning to Life
You read the list and found symptoms of everything at once. No panic. We act systematically.
- Adjust the mode for at least a week. Try to sleep for 7–8 hours. If fatigue does not go away—it’s not about lack of sleep.
- Take tests. It is not necessary to take everything in a row for a million rubles. Start with the base: Complete Blood Count, Ferritin, TSH, Glucose (or glycated hemoglobin), Vitamin D (we did not mention it in the top 7, but it is also important), B12.
- Upload results to MedAssist AI. Here the magic begins. It is difficult for a person without medical education to understand how low ferritin and slightly elevated TSH are connected. And our algorithm sees patterns.
Example from life: You see that ferritin is 30 (seems normal), and TSH is 3.5 (also normal). The doctor in the clinic will say: “Healthy”. MedAssist AI will suggest that for a quality life, ferritin is low, and it is iron deficiency that can slow down the work of the thyroid gland, causing an increase in TSH.
- Go to the doctor prepared. With a report from MedAssist, you come to a therapist or endocrinologist not with a complaint “I feel bad”, but with specific data and questions. This saves time and money.
Frequent Mistakes and Myths
- Myth 1: “Fatigue is normal, everyone lives like this.” No, this is not normal. Evolutionarily, man is a hardy creature. If it is hard for you to get out of bed—the body is screaming for help.
- Myth 2: “Reference values in the form are the norm of health.” Reference is the average temperature in the hospital, including the sick and the old. The optimum of health (functional norm) is often narrower and stricter. Ferritin 12 is a reference, but it is impossible to live with it.
- Myth 3: “I’ll drink iron/iodine/vitamins just like that.” Bad idea. Excess iron is more toxic than its deficiency (oxidative stress). Iodine in the presence of antibodies to the thyroid can “blow up” the gland. First diagnostics—then treatment.
Mini-FAQ
Q: Can I take all these tests in one day? A: Yes, all these indicators are taken by venous blood on an empty stomach. Cortisol is better taken in saliva, but for primary screening, blood is also suitable (strictly in the morning, at rest).
Q: Why do I drink coffee, but want to sleep even more? A: Caffeine blocks fatigue receptors (adenosine), but does not give energy. When the action passes, all the accumulated fatigue falls on you like an avalanche. Plus coffee washes out magnesium.
Q: Can fatigue be from depression? A: Yes, but the diagnosis of “depression” is made only by exclusion. First you need to make sure that you do not have hypothyroidism and anemia. Symptoms are almost identical.
Conclusion
Your body is an amazingly smart system. Chronic fatigue is not your character, it is an emergency light on the dashboard. Do not seal it with a plaster of coffee and energy drinks.
Deal with biochemistry. This is the shortest path to productivity and joy of life. And in order not to drown in numbers and complex terms, use modern tools.
Upload your tests to MedAssist AI. The system will help find relationships that are not obvious at first glance, assess the urgency of the situation, and understand which specialist to go to first. Stop guessing and start managing your health competently.
