“I’m soooooo tired!”

This is something I hear at least once a day in my practice. I spend the majority of the appointment listening for clues as to the root cause of the fatigue because there are so many factors and reasons why many of us, at one time or another, feel exhausted & burnt out.

 What may seem like a simple complaint such as fatigue can bring about a multitude of questions and thoughts that run through my head…

  • “Could it be a thyroid problem? We can run a few tests to check how it is functioning.”
  • “How much stress is this person experiencing or has experienced in the past?”  The adrenal glands are taxed when there is no relief from stress. “Our modern lifestyle is so calm & peaceful that stress-related problems are so rare.” Ha! We all know THAT isn’t true!
  • “What time of the day is the fatigue the worst or is it all day long? Do they feel tired all day and then as soon as they lay down to sleep at night, they are suddenly wide awake and can’t fall asleep for hours? “
  • If this is a woman who is still having a menstrual cycle, “How heavy are your periods? How frequently are they coming?” Have you ever had iron deficient or insufficient anemia?”
  • “How is this person’s sleep? Are they getting at least 7 hours of uninterrupted sleep? Are they practicing good ‘sleep hygiene’ by sleeping in as dark of a room as possible, no TV or computer on and no cell phone or other electronics near their bed?”
  • “What is this person’s current diet like and are there foods they are eating that could be contributing to their fatigue?”
  • “Are they a vegan or vegetarian and possibly not have enough vitamin B12 in their diet?”
  • “What other symptoms does this person exhibit that may or may not be related and under what time frame did all of these symptoms arise?”

After thoroughly examining these various aspects, I usually have a good idea where we should focus our attention & what labs might be a useful piece of the puzzle to rule in or rule out an area of concern. Most people assume fatigue is the result of an under-functioning thyroid gland since that seems to be what we hear the most about but as you can see, there can be many underlying reasons. Some of them can be discovered through more thorough blood work. Most conventional physicians order very basic, focused blood work which may not reveal the whole story or they may only look for values that are out-of-range. I am not only looking for high or low values but also where in the given range the value lies. In many instances, I am evaluating the numbers with a more narrow range in mind or an optimal range not just what is considered “normal” for a given group of people. For example, the given range for a thyroid lab called TSH is 0.45-4.5. That’s a huge range! Naturopathic doctors know that the thyroid should be functioning optimally with a TSH below 2. When it appears above 2, I know it is not performing at its best & I make decisions based on that knowledge.

Many times, basic blood work doesn’t give enough information and a few more in-depth labs may reveal the key. An example here that I see all of the time is that a doctor will run a serum (blood) iron level. It almost always comes back in the normal range because the body will do just about anything it can to keep the blood iron level within that range (even if it is in the low range) because it is so crucial for the body. The doctor will say, “Nope! It isn’t your iron. The iron numbers are just fine!” What is not often looked at is the serum ferritin level. Ferritin is generally the body’s iron storage level. I tell my patients that ferritin is like your overdraft or savings account. When the iron in the blood gets low, it dips into its “savings” to boost its numbers while the “savings” dwindles if it isn’t replenished. Just this one extra lab value helps me to identify an iron insufficiency that can be treated before it becomes extreme and the patient’s fatigue is relieved.

Many, many, many times I end up addressing the adrenal glands first as the underlying reason for feeling tired. The adrenals are highly overworked but highly under-appreciated and undernourished little glands that sit atop our kidneys. Conventional medicine practically sweeps their importance under the rug but we as Naturopathic Physicians are highly versed in the needs of the adrenals and we have just the right tools to implement to support them, help reduce the body’s response to stress and help to relieve fatigue at the foundational level.

The next blog will discuss the adrenal glands in more detail. Stay tuned!

If you are feeling fatigued and haven’t been able to get to the root of it, come in to see me and follow the natural path…

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First things first…


This is my first blog so let me introduce myself if you don’t know me already. I am Dr. Michelle Thatcher. I am a family practice Naturopathic Physician in Tucson, Arizona.

“You’re a Naturo-what?” I get that a lot.

A Naturopathic doctor (ND or NMD in some states like AZ) is a licensed physician that functions as a family primary care doctor. I am a specialist in natural medicines such as herbal medicines, homeopathy, acupuncture, & nutrition to name a few. I treat primarily with natural medicines that are less toxic and, in many cases, more effective than pharmaceutical medications. Whenever we can use food as medicine, even better!

One of my favorite quotes from Hippocrates, “Let thy medicine be thy food & thy food be thy medicine”. Proof that Hippocrates was Naturopathically minded more than 2000 years ago!

I can write prescriptions for those times when they are necessary but they are typically not my first option. I can also order lab work that is another piece of information I use when considering how I am going to treat you as a whole person and not just your symptoms.

Another question I get a lot, “So, what inspired you to go into Naturopathic Medicine?”

My interest in natural medicine started in my early 20s when I worked at a store called Body & Soul. It was there I was first exposed to aromatherapy & I became increasingly aware of natural, alternative treatments. I was, for a short time, a pre-pharmacy student and I used to joke that I would probably not be a good Pharmacist because I would be telling people about natural alternatives to consider instead! I ended up as a research scientist at the University of Arizona College of Medicine. People were always encouraging me to apply to the medical school but I knew it wasn’t the right fit for me. After 10 years in the research lab, I began to think about my future & what I wanted to do with the rest of my life. A good friend of mine asked me one day, “What would you do with your life if nothing else mattered?” I don’t know where the thought came from but my first answer was a Naturopathic doctor. I went home that day & began researching Naturopaths on the Internet. I came across a school located in Tempe, Arizona (about 100 miles from me here in Tucson). It is one of 4 schools in the U.S. & 2 in Canada that are an accredited, rigorous, 4 year, Naturopathic medical program. One thing led to the next and after 4 years of traveling back & forth as well as living away from my family for most of every week, I graduated from Southwest College of Naturopathic Medicine (SCNM) in the summer of 2009. I took my board exams that summer & became licensed in the fall of 2009. I had a home-visit based practice for the first year and finally found the office location of my dreams and opened up my private practice in Sept 2010. I wake up every morning & go to bed every night with an incredible sense of happiness knowing I have chosen (or it chose me!) a truly rewarding profession. I love what I do every day!

Our Naturopathic tenants guide me with every patient and in many other areas of my life, actually.

Primum non nocere – First Do No Harm –

Naturopathic medicine uses therapies that are safe and effective.

Vis medicatrix naturae -The Healing Power of Nature –

The human body possesses the inherent ability to restore health. The physician’s role is to facilitate this process with the aid of natural, nontoxic therapies.

Tolle causam – Discover and Treat the Cause, Not Just the Effect

Physicians seek and treat the underlying cause of a disease. Symptoms are viewed as expressions of the body’s natural attempt to heal. The origin of disease is removed or treated so the patient can recover.

Tolle totum – Treat the Whole Person

The multiple factors in health and disease are considered while treating the whole person. Physicians provide flexible treatment programs to meet individual health care needs.

Docere – The Physician is a Teacher

The physician’s major role is to educate, empower, and motivate patients to take responsibility for their own health. Creating a healthy, cooperative relationship with the patient has a strong therapeutic value.

Praevenire – Prevention is the best “cure”

Naturopathic physicians are preventive medicine specialists. Physicians assess patient risk factors and heredity susceptibility and intervene appropriately to reduce risk and prevent illness. Prevention of disease is best accomplished through education and a lifestyle that supports health.

Add a dose of humor and many problems are solved!

I was recently inspired by a friend to start a blog as a way to educate people, talk about relevant topics, share food/recipe ideas, environmental issues, and whatever else pops in my head. I intend to make this a weekly blog so be on the lookout for them. Share whatever resonates with you and leave the rest.

Besides having the best profession, I have been married to my best friend and biggest supporter for 20 years. There are 3 pretty awesome kids that call me mom. None of them will likely follow in my footsteps & do anything science or health profession related. Wah! I would have loved a partner in crime. I just hope at least that all of my babbling about natural medicine and eating healthy rubbed off on them. I have 3 adopted children of the fur variety who have no choice in following the natural path.

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