The default explanation for fatigue is sleep, and the default advice is to get more of it. For a good proportion of the people who walk into our clinics, that advice is not wrong so much as incomplete — they are sleeping seven or eight hours and still running on empty.
Magnesium is the most common culprit we find, and the most commonly missed, because serum magnesium is a poor reflection of what is actually stored in tissue. Iron and ferritin come next, particularly in menstruating women, where a ferritin in the low-normal range is often reported as "fine" while the person feels anything but.
Then there are the B vitamins — B12 and folate especially — which sit at the centre of energy metabolism and are quietly depleted by everything from metformin and PPIs to alcohol and a plant-only diet without supplementation.
None of this is exotic. It is all testable, all correctable, and all far more likely than the vague diagnoses people give themselves. Start with the blood panel, not the supplement aisle.
Advanced laparoscopy and cancer surgeon, TEDx speaker, and director of the 200-bed NABH-accredited Jeevan Jyoti Hospital.
