Tired of Being Tired: What Your Fatigue Is Trying to Tell You

If you find yourself tired despite sleeping 8, 9, maybe even 10 hours a night... this one's for you.

Fatigue has become an almost accepted part of modern life — particularly among women navigating careers, relationships, and their health. It’s become so normalized to feel burnt out and exhausted, always reaching for more cups of coffee or matcha to fuel through the day. But persistent low energy is never just about being too busy or needing more caffeine. More often, it’s a signal that something deeper is out of sync.

In my clinical practice when I work with individuals struggling with low energy, afternoon crashes, brain fog, or that “tired but wired” sensation at night we start by understanding the underlying systems that regulate energy: hormonal rhythms, nervous system state, nutrient status, and emotional load. Because your energy isn’t random — it’s regulated.

The Cortisol & Circadian Connection

I know, I know, we talk about cortisol literally in every newsletter — you guys are probably so tired of me talking about it at this point! But how can I not shed light on one of the most important hormones when it comes to your energy?

When it comes to concerns about low or inconsistent energy, one of the first places I look at is cortisol, your body’s primary stress and energy hormone. Produced by the adrenal glands, cortisol follows a natural rhythm over a 24-hour cycle: ideally rising sharply in the early morning to help you wake and feel alert, then gradually tapering off throughout the day, allowing melatonin to rise in the evening and support deep, restorative sleep.

But that rhythm can be thrown off and lead to energy spikes and crashes or persistently low energy throughout the day. Irregular sleep patterns, chronic stress, under-eating, overtraining, and even prolonged screen time at night can flatten, reverse, or spike cortisol in ways that leave you feeling drained, anxious, or both.

When cortisol is low all day (what we sometimes refer to as a “flatline” pattern) energy feels nonexistent. You might wake up feeling just as tired as when you went to bed, rely on caffeine to push through the morning, and experience brain fog. This pattern is often seen in cases of burnout or long-term nervous system dysregulation.

Some people experience a reversed rhythm, where cortisol is sluggish in the morning but too high at night. These individuals often report difficulty waking up, only to find themselves fully alert and unable to unwind in the evening — caught in a frustrating cycle of insomnia and fatigue. Most often I hear them say, “I feel wired but tired at night and can’t fall asleep!”.

Others might show a spiky or erratic cortisol curve, where energy, mood, and focus fluctuate throughout the day. They might feel sharp in the early hours, crash by midday, and rebound again at night — leading to difficulty falling asleep and inconsistent performance.

These rhythms don’t just affect your energy either. They influence your mood, digestion, immunity, and hormonal balance. And while cortisol is often blamed for these issues, it’s not the villain — it’s the messenger. If this sounds like you — don’t worry, I have an in depth substack post on how to naturally support cortisol.

Blood Sugar & Energy

Blood sugar regulation plays a foundational role in maintaining stable energy throughout the day. When your blood glucose rises too quickly (often after a high-sugar or refined carbohydrate meal) insulin is released to bring it back down. However, if that rise is too steep or the insulin response is exaggerated (which is common with insulin resistance or imbalanced meals), it can lead to a rapid blood sugar drop. This “crash” is not just uncomfortable — it’s interpreted by the body as a form of stress. In response, the adrenal glands release cortisol and adrenaline to help bring glucose back into the bloodstream. This survival mechanism is helpful in true emergencies, but when it’s happening several times a day due to poor blood sugar control, it places a chronic burden on your adrenal system.

This is where the vicious cycle begins. Frequent blood sugar crashes trigger repeated cortisol spikes. Over time, this not only exhausts your adrenals but also disrupts your natural cortisol rhythm. What begins as occasional fatigue can quickly evolve into a pattern of unstable energy, sleep disturbances, irritability, and hormonal imbalances — all rooted in blood sugar instability. If this sounds like it’s the root of your energy issues, don’t worry because I have an in depth substack post on supporting blood sugar naturally too!

Hormones Beyond Cortisol & Insulin

While cortisol and blood sugar are major players in energy production, thyroid hormones and reproductive hormones (like estrogen and progesterone) are equally important and often overlooked in cases of persistent fatigue.

The thyroid gland governs your metabolic rate, aka how efficiently your body converts food into usable energy. When thyroid hormone production is low, or when the active thyroid hormone (T3) isn’t properly converted or utilized, metabolism slows. This can lead to classic hypothyroid symptoms: fatigue, cold intolerance, weight gain (especially around the middle), dry skin, constipation, and slowed cognition or “brain fog.” What’s tricky is that even if your labs fall within the “normal” range, you can still experience symptoms if your thyroid is underperforming — a state often referred to as subclinical hypothyroidism. Since thyroid hormones directly impact mitochondrial activity (your cells' energy factories), any dysfunction in this system can lead to persistent exhaustion that sleep and coffee simply won’t fix. I got you covered too on a post all about thyroid health!

In women, estrogen and progesterone also influence energy — both directly and through their effects on sleep, mood, and brain chemistry. Estrogen is a stimulating hormone that can enhance mood, motivation, and focus when present in the right amounts. However, when estrogen levels are too high relative to progesterone (a pattern called estrogen dominance) it can lead to heavy periods, PMS, anxiety, irritability, and fatigue. This imbalance is especially common in women who are chronically stressed, on hormonal birth control, exposed to endocrine disruptors, or not ovulating regularly.

On the other hand, progesterone, which rises in the second half of the menstrual cycle after ovulation, is calming and sleep-promoting. It supports GABA (a calming neurotransmitter), reduces anxiety, and helps regulate fluid balance. Low progesterone can contribute to poor sleep quality, premenstrual anxiety, mood swings, and a sense of being easily overwhelmed. And because stress (via elevated cortisol) can suppress ovulation, chronic stress often leads to progesterone deficiency, further contributing to energy issues.

The menstrual cycle itself is inherently cyclical, and fluctuations in these hormones throughout the month naturally influence how you feel. But if you’re noticing more extreme fatigue during certain phases (especially the luteal) then it may be your sex hormones impacting your daily energy. And yes — I have a substack post on balancing estrogen and progesterone too 😉.

When Energy Loss Starts in the Gut

When we talk about low energy, the conversation often focuses on sleep, stress, or hormones — and while those are all valid, what’s happening at the level of your gut can be just as important. Many women are unknowingly struggling with impaired nutrient absorption, mitochondrial dysfunction, or low-grade inflammation in the gut — all of which directly compromise energy production.

Let’s start with the gut. Your digestive system is where you extract and absorb the nutrients that fuel your metabolism and cellular function. If digestion is suboptimal (whether due to low stomach acid, dysbiosis, leaky gut, or chronic constipation) then you may not be absorbing the vitamins and minerals your body needs to produce energy. Iron, B12, folate, zinc, magnesium, and CoQ10 are all critical players in energy and they all rely on a healthy gut lining and efficient digestion to be absorbed. Many women with fatigue may unknowingly have underlying gut issues which not only hinders nutrient absorption but also create systemic inflammation that drains the body's resources.

In addition to nutrient absorption, the gut also influences energy through its role in immune regulation and inflammation. Over 70% of your immune system resides in the gut and when the gut lining becomes compromised, immune activation increases — often leading to chronic, low-grade inflammation. This type of inflammation isn't always obvious, but it consumes energy at the cellular level, leaving you feeling sluggish, achy, and mentally foggy.

And then there’s the microbiome. The trillions of microbes in your gut don’t just help you digest food — they also produce key compounds like short-chain fatty acids, neurotransmitters (like serotonin and GABA), and B vitamins. When your microbiome is imbalanced you may experience fatigue, mood changes, and increased sensitivity to stress. In fact, there’s a growing body of research connecting gut health to brain energy and mental clarity, sometimes referred to as the gut-brain axis.

At the cellular level, energy is produced in the mitochondria, and these tiny organelles require a steady stream of nutrients, oxygen, and co-factors to operate efficiently. When your mitochondria are overwhelmed by oxidative stress, lacking essential nutrients, or under-functioning due to chronic inflammation, you may experience symptoms like profound fatigue, exercise intolerance, and slow recovery — even if you’re “doing everything right.”

Ultimately, if you’re feeling drained despite getting enough sleep and managing stress, your gut and cellular health may be at the root of the issue. Sadly, I don’t have an in depth post to share with you about all things gut health — but it’s coming soon!

Emotional and Mental Energy Leaks

While physical fatigue gets most of the attention, emotional and mental exhaustion are just as common. Many women move through their day in a state of quiet depletion, not because they’re physically overworked, but because they’re mentally overstimulated and emotionally overextended.

This kind of exhaustion often stems from lack of boundaries, perfectionism, people-pleasing, or the chronic mental load that comes with managing relationships, careers, health, and home life — often without adequate space to recharge. Even without major stressors, the accumulation of small daily pressures (unanswered texts, work demands, emotional caretaking, feeling behind) can trigger a state of constant low-grade stress. Over time, this increases cortisol, interferes with sleep, depletes neurotransmitters, and leads to the sensation of being tired even when you haven’t done “that much.”

Another common drain is emotional suppression — the habit of pushing down feelings like resentment, frustration, grief, or anger in the name of staying productive or composed. Suppressed emotions don’t disappear; they simmer beneath the surface, often manifesting as physical symptoms, fatigue, irritability, or disconnection. Giving yourself permission to process and express what you feel without judgment can restore more energy than most realize.

Supporting emotional energy means creating space for rest, joy, solitude, and expression. It may involve protecting your time, saying no more often, simplifying your routines, or asking for help. It might also mean letting go of the pressure to do everything perfectly or to be constantly available to others. These shifts are not indulgent — they’re foundational to sustainable energy and wellbeing.

The Lifestyle Habits That Quietly Deplete You

Not all energy drains are dramatic or obvious. In fact, some of the most exhausting habits are the ones we hardly notice because they’ve become normalized in our culture. Things like late-night scrolling, skipping meals, over-relying on caffeine, and overcommitting to exercise routines can slowly wear down your energy reserves — even when the rest of your lifestyle looks “healthy.”

One of the biggest culprits is poor sleep hygiene, not just in quantity but quality. Many people go to bed late, scroll on their phones before sleep, or keep their bedrooms brightly lit — all of which suppress melatonin and delay true restorative sleep. Even subtle disruptions in sleep quality (from light exposure, blood sugar instability, or stress) can impair your body’s ability to repair and regulate hormones overnight, leaving you unrefreshed in the morning.

Over-exercising is another quiet energy thief. While movement is essential for energy production and mental clarity, there’s a tipping point where more is not better. If you’re doing intense workouts multiple times per week without adequate recovery, sleep, and nutrition, your body may interpret it as another form of stress. This is particularly common in women dealing with low cortisol or hormonal imbalances, where the body requires more restoration than stimulation.

Even multitasking, constant notifications, and lack of stillness can accumulate into a state of energetic drain. The brain was not designed to switch contexts as rapidly as modern life demands, and chronic distraction leaves little room for mental rest or clarity. Creating space in your day for focused presence, single-tasking, and digital breaks can go a long way in preserving mental energy.

Restoring Energy: Where to Begin

Supporting energy starts with how you begin your day. One of the most effective things you can do is expose your eyes to natural light within 30 minutes of waking. This simple act helps regulate your circadian rhythm, reinforce a healthy cortisol pattern, and improve alertness. Pair this with a nourishing, protein-rich breakfast (ideally within the first hour of waking) to stabilize blood sugar and prevent mid-morning crashes. Avoid reaching for caffeine on an empty stomach, as it can spike cortisol unnecessarily and set off a rollercoaster of energy dips and anxious tension throughout the day.

Midday, it’s important to remain consistent with nourishment and movement. Skipping meals or waiting until you’re overly hungry can lead to reactive eating, blood sugar fluctuations, and mental fatigue. Aim to eat every 4-5 hours with a balance of protein, healthy fats, fiber, and complex carbs. If possible, incorporate gentle movement like a walk after lunch or standing stretches during screen-heavy workdays — both support lymphatic flow, insulin sensitivity, and brain clarity. Hydration is another key factor: even mild dehydration can reduce focus and energy, so keep water nearby and consider adding electrolytes if you're especially active or under stress.

In the evening, begin to shift your environment to signal wind-down. Dim your lights, reduce screen time, and avoid stimulating content close to bedtime. Incorporating rituals like herbal tea (chamomile, lemon balm, or passionflower), magnesium glycinate, or journaling can help calm the nervous system and lower nighttime cortisol. Ideally, aim to be in bed before 11 PM to align with melatonin's natural peak. While it may sound basic, creating a consistent bedtime and wake time — even on weekends — is one of the most effective ways to restore energy and support hormone balance long-term.

Lastly, protect your emotional energy. Boundaries around technology, social obligations, and work hours matter just as much as diet and supplements. Fatigue often stems from being overextended — mentally, emotionally, and energetically. Begin noticing what drains you versus what restores you, and give yourself permission to recalibrate accordingly. Small changes, practiced consistently, can lead to profound improvements in how you feel day to day.

And of course, if you suspect a deeper underlying issue beyond lifestyle (like all the areas we explored earlier on) — consider working with a practitioner to investigate further!