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  • Dr. Bettina

Tired at 28: the Elevator with Unwelcome Passengers

Updated: Aug 6



When I was in my late twenties I was very ill and very tired, during a time of life when I should have been vital and energetic. The effort to lift my arm, for instance, started long before my arm actually moved. That simple act was a near-Herculean struggle that seemed to take an eternity. I can’t say exactly when this state of never ending fatigue appeared. The transition from what most of us would call “normal” to a state of debilitating fatigue that defined my “new normal” was insidious.

I was the metaphoric frog put into cold water that slowly heated to boiling, because the change was slow and subtle the frog stayed put. I went from being well to unwell without noticing the actual transition!

Having been raised by strict European parents I naturally blamed myself. “I’m just lazy,” I thought daily. “This must be what other people feel and they are living normal lives.” However, when I described this to my therapist, she said 3 words that changed my life.

She said, “that’s not normal.”

Thus began my own healing journey and led to a happy ending to this suffering . I now had clarity and permission to pursue wellness. I found a wonderful physician, Tim Smith, MD, who used holistic methods, including nutrition and acupuncture, to treat my debilitating fatigue. It turned out I had sky-high Epstein-Barr antibodies, florid Candida and Hashimoto’s thyroiditis. No wonder I was tired! But the official diagnosis from traditional medicine was chronic fatigue. Such a general diagnosis makes it very difficult to tease apart the underlying causes. Had Dr. Smith not looked at likely causative factors, I might still be that woman who barely made it through the work day.


Dr. Smith looked at me with a holistic eye. Having originally trained as a psychiatrist, he understood that many factors are involved in becoming fatigued, including stress, and yes, that includes the stress of being chronically ill. He used nutrition, supplements, a recommendation for continued counseling, and acupuncture twice weekly to help me resolve the fatigue. It took 2 years because at that time (think young and dumb!), I didn’t understand the profound effect nutrition has on health. After 3 years, my Synthroid made me hyper and the antibodies of Hashimoto’s thyroiditis came down to a normal range. They remain that way today - 30 years later. I love telling prospective patients “I used to have Hashimoto’s.”


While traditional medicine has some outstanding treatments for serious, often acute, illness and trauma, patients often don’t fare so well when it comes to managing, much less healing, ‘chronic’ conditions. Yes, diabetes can be controlled with medications and insulin, high blood pressure may be managed by medications, hypothyroidism (like Hashimoto’s) can be augmented with thyroid medication, etc. However, managing symptoms (“disease management”) and creating wellness (“health care”) are two entirely different paradigms. That’s why the model for holistic (also known as natural, naturopathic, integrative, functional, or environmental medicine) treatments takes into account the whole human being.


Today we call the many factors Dr. Smith considered the ‘total load.’ It’s like the brass plaque in an elevator that says ‘maximum capacity 20 passengers.’ True, if there were 21 or 22 passengers, the elevator would, most likely, still go up and down. However with 40 passengers on board, it’s not going anywhere. In fact, most elevators sound an alarm when overloaded.


We become like the elevator that is not working when we have too many passengers on board. Our bodies sound alarm symptoms, like chronic fatigue. So who are those unwelcome passengers? They are divided into these broad categories:
  • Allergies

  • Toxins

  • Infections

  • Deficiencies

  • Stress


The effect of allergies or food intolerance is almost always underestimated. Allergies can manifest as just about anything, from fatigue after eating to mood changes, cravings, feeling unwell and, like me, reacting to one of my favorite foods, my homegrown tomatoes, by exhibiting inappropriate hunger. Yes, really. In the allergy testing lab, I told the technicians that I was willing to give up anything except tomatoes. I loved tomatoes so much that they were going to have to pry my dead fingers away from my homegrown, heirloom, organic tomatoes.


They tested me blind, so I wouldn’t know what substance was being tested. First the mischievous tester put cat extract on my arm, because she knew I had cats. No reaction. A few items down, I suddenly became ravenously hungry, literally looking around the testing room to see what I could sink my teeth into. Finally, highly embarrassed, I mumbled, “I'm so hungry.” When I repeated it (sure that my reputation as the new doc on the block would be forever damaged), the supervisor calmly looked at me and said, “inappropriate hunger is a sign of allergy.” That was my first introduction to the immense, almost unimaginable, range of symptoms that can be caused by allergies.


Since self-awareness is part of healing, here are some clues re potential food allergies you can use when an allergy testing room isn’t available. I hate to be the bearer of bad news, but, the food that

  • Tastes the best (as in, inordinately delicious, more so than other foods)

  • You eat the most (think at least once a day)

  • You crave (snacking under the influence of the ‘midnight monster’)

is probably a prime suspect on the allergy line-up. Now, back to my tomato story. Because vanity was the only thing stronger than my allergy/addiction to tomatoes, I stopped eating them. At three months I decided to test my progress with tortilla chips and tomato salsa. I don’t remember eating the whole basket of chips. The same thing happened at 6 months. At nine months, I ate one or two chips with salsa and was done. The down side was that the salsa did not taste nearly as good, but it was still tasty and that “loss” was a small price to pay for improved wellness!


Toxins, like weight on the elevator, can also affect almost every system. Mercury, for example, from coal-fired plants, old (misnamed silver) fillings and large fish (swordfish, tuna, etc.) can interfere with normal metabolism. The EPA notes that mercury found in fish may lead to:

  • Loss of peripheral vision

  • “Pins and needles” feelings, usually in the hands, feet and around the mouth

  • Lack of coordination of movements

  • Impairment of speech, hearing, walking and/or

  • Muscle weakness

High exposure to inorganic mercury may result in injury to the GI tract, kidneys and nervous system. You can be exposed in workplace conditions. Symptoms of high exposures to inorganic mercury include:

  • Mood swings

  • Memory disturbance

  • Dermatitis

  • Memory loss

  • Mental disturbances

  • Muscle weakness

You will find that decreased coordination, impaired walking and muscle weakness require huge expenditures of energy that may leave you exhausted.


Other poisons include toxic chemicals (petrochemicals, organophosphates, other pesticides, herbicides, fungicides). Among the most prominent toxins in the southeast US are toxins secreted by molds in water-damaged buildings. These can trigger a wide array of disruptions in the human body including:

  • Respiratory symptoms (like chronic sinusitis, bronchitis, and asthma)

  • Profound fatigue

  • Psychiatric disease - new onset corresponding with the time of the exposure

  • Musculoskeletal pain (seen in over 70% of people exposed)

  • Nervous system disruption - the nervous system can be affected directly or through immune cell activation, thus contributing to neurodevelopmental disorders

  • Immune system disruption (including mast cell activation syndrome, tick-borne disease activation (see blog dated June 26, 2020 ))

  • Gastrointestinal symptoms

  • Headaches, migraines, sleep disturbances (adding to fatigue)

  • Decreased cognition (memory, concentration, etc.) (In our office we call that ‘mold brain.’)

  • New onset sensitivity to chemicals, smells, foods and medications


Infections such as Epstein-Barr, Candida, Cytomegalovirus, Lyme (tick-borne disease) and many others, especially viral illnesses, can cause chronic fatigue. They may be hidden from plain sight and need specialized testing. If your immune system is constantly working hard to keep infections in check, there is less energy for all the other systems in your body. Chronic infection depletes the body’s energy. In addition, root canals are another potential source of hidden chronic infection, as there is no more blood supply to the area around the root. With root canals, regular maintenance with ozone from a biological dentist is often helpful.


Common exposures in our modern life to antibiotics (medical and in food), steroids, hormones in food and plastic, high stress and more, may disrupt the microbiome (gut bacteria). If, for instance, you took antibiotics, it can be like a tidal wave for those beneficial bacteria. When some of the good ones have been wiped out, the other types, less beneficial, can grow into the ‘empty real estate’ left as an aftermath of antibiotic therapy. Now there is bacterial overgrowth and often an infection or at least inflammation that allows bacteria and partially digested food to escape the confines of the gut and have unregulated access to the blood supply. This leads to inflammation, fatigue, the genesis of autoimmune disease and much more.


Deficiencies in key nutrients can also wreak havoc. As only one example of many essential nutrients, magnesium is a co-factor in over 300 reactions (via key enzymes) in the body. Magnesium levels are commonly low in the US. That means magnesium deficiency can also, like toxins and allergies, affect any system. Testing and supplementation are easy. In fact,

magnesium deficiency is the second most common cause of muscle cramping. (Spoiler alert: dehydration is the number one cause of muscle cramps.)


Digestion is key to good health. You are not only what you eat, but, more importantly, what you absorb. Attaining good absorption means a healthy microbiome (beneficial gut bacterial balance), an intact barrier between gut and blood stream, digestive enzymes, stomach acid and more. Deficiencies in these can have far-reaching effects in the body, including chronic inflammation and fatigue.




Stress is a huge topic - where to start? Let’s start by saying that many medical professionals name stress as the number one reason people go to the doctor. It just shows up in many different ways. Stress reactions include high blood pressure, headaches, muscle and back aches, rapid heart beats, trouble digesting food, fatigue, anxiety and disruption of basically any function that keeps us alive.


While the human body was designed for intermittent episodes of high stress (think running away from the saber-toothed tiger), we weren’t designed for the unremitting stress of modern life. The body cannot tell the difference between run-for-your-life stress and how we feel when stuck in traffic, or in the middle of a pandemic. The mechanism is the same. Over time, the adrenals will wear out if they are turned ‘on’ all the time, instead of just when the tiger has spotted us. When the adrenals wear out, cortisol levels are low, inflammation increases, thyroid function is not supported and the multi-system domino effect can often contribute to fatigue.


This describes the impact of emotional and spiritual stress. I also include biomechanical factors under the stress category - the cumulative impact of injuries and surgeries on the body over the years. Just think about how you compensate for a sprained ankle. Then an injured shoulder adds another layer. Then the orthodontic braces, the concussion or whiplash from a car accident, the fall from a bicycle, the scars after childbirth or a surgery add more layers. Soon the microcirculation that delivers nutrition to each cell and takes away the waste is compromised. Like a traffic jam that never clears, the effect keeps expanding over the years and the functioning part of the body works harder and harder, contributing to exhaustion.


Though this is controversial in some circles, the published data support the effect of electromagnetic fields on our nervous system. Based on my experience and much of the published data, we experience electromagnetic stress daily. The more smart devices that surround us, the greater the effect. After all, the nervous system (especially the brain) is an electrical circuit influenced by the electric and magnetic fields around it.

Back to our elevator: my like-minded colleagues and I have found that, in almost every instance, when the number of passengers on the elevator is reduced, it starts working better. So with a reduction in allergies, toxins, infections, deficiencies and stress (the five unwelcome passengers) the total load is reduced, the alarm stops sounding and the elevator can start moving again. Up, please!


Gesundheit Carolina is a multidisciplinary practice. We recognize that no two people are the same. It takes experience and knowledge to match a patient with the right therapy from the right discipline -- there are no one-size-fits-all solutions.

Becoming a Gesundheit Carolina patient is a process of understanding you fully as an individual then working with you to build your bridge to wellness. It starts with a complimentary phone evaluation. Schedule your call here.



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© 2020 Bettina Herbert 

Gesundheit Carolina

852 Lowcountry Blvd. Suite 102

Mt. Pleasant SC 29464