If you wake up tired, push through the day on caffeine, and crash by 4pm, that's not normal aging or a productivity problem. It's almost always a measurable hormonal or metabolic deficit. Here are the four most common causes and how to confirm yours.
Energy, motivation, drive, these are testosterone-coded. A total T below 400 ng/dL in men, or low free T at any age in women, will manifest as fatigue first.
TSH at 3-4 with low free T3 is “normal” on most labs but absolutely not optimal. T3 is the active hormone, and it's the one driving cellular energy.
Fasting glucose can be normal while fasting insulin is elevated. The mitochondrial cost of insulin resistance shows up first as afternoon crashes and brain-foggy fatigue.
Ferritin under 50 ng/mL, even with “normal” hemoglobin, drives fatigue, especially in women and high-mileage athletes.
Flat or reversed cortisol curve (low AM, OK PM) is classic burnout fatigue. Worth testing if you've been on chronic stress for 6+ months.
$229 panel covers everything in the cause list above. Upload existing labs from the past 6 months if you have them.
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