Share story

On Health

Hardly a day of clinical practice goes by without a patient concerned about “low metabolism,” with symptoms such as fatigue, brain fog, poor endurance, muscle weakness, always cold, difficulty losing weight and poor sleep quality.

In order to sort out what’s really going on, let’s take a quick look at how our bodies control energy use. Metabolism is governed by a complex group of interacting hormones that are affected by diet, activity, environment and our brains. Thyroid hormones, affecting our resting metabolism, and adrenal hormones, providing extra energy in times of stress, are key players in the energy equation and a good place to start.

Low thyroid function, hypothyroidism, is increasingly common and can be detected with a simple blood test. As low-salt diets have become more popular, iodine intake, a requirement for proper thyroid function, has been reduced; if your test comes up low, you can try supplemental iodine (300 mcg temporarily for an adult, if you are not on thyroid medication or have other health issues) for 30 days and retest. If that doesn’t solve the problem, then thyroid replacement may be needed to get you back moving again.

This week, save 90% on digital access.

Adrenal fatigue, once dismissed as a bogus diagnosis, has gained new credibility. Our adrenal glands are designed to provide adrenaline for a short burst in times of fight or flight, but then require time to recharge between events. Everyday stress, however, can trigger an adrenaline response that continues without respite, eventually running your adrenals to empty with no time to recharge.

The solution, of course, is to eliminate stress. Good luck with that! Plan B is to earnestly look at strategies to keep jobs, finances, relationships and other stressors from affecting you as much. Try accepting that there are some dysfunctional parts of life that we can’t change, so as they say in my native New York, just forget about it.

Diet and nutrition, including B vitamins, may be helpful. I find that a short course of intravenous nutrition can be effective, especially if there are absorption problems.

Other common culprits to consider are current medications, blood-sugar metabolism, being overweight, allergies, a high-carb diet, anemia, depression, anxiety, lack of exercise and the stimulants you use to combat low energy, which can cause a rebound of even lower energy after the boost wears off. You can do much of the investigation on your own, but a doctor can help you get to the answer more quickly and offer treatments that you might not have available.

Go for the answer before you go for the cure. While many of the treatments advertised on the Internet and elsewhere may make you feel better for a while, they can also mask the underlying cause of your low energy, and it’s easy to become too reliant on them.

Whether you are 35 or 85, your innate metabolism can keep you feeling energetic if you treat it right. The answer is usually a simple one, and the results can be life-altering.

Dan Labriola, N.D.: Labriola is director of the Northwest Natural Health Specialty Care Clinic and medical director for naturopathic services, Swedish Medical Center’s Cancer Institute; the clinic website is

Custom-curated news highlights, delivered weekday mornings.