Waking up unrefreshed, crashing in the afternoon or feeling you can’t keep up with work, caregiving or daily life is something almost everyone goes through at some point. I explain fatigue as a signal rather than a diagnosis. Instead of only asking “How do we get you more energy?”, the more useful question is often “What is using up your energy, and what is preventing your body from restoring it?”
If you are looking for naturopathic support for fatigue and low energy in St. Catharines or Stoney Creek, Dr. Aoife Earls, ND, a naturopathic doctor with 17 years of clinical experience, sees patients in person in St. Catharines and virtually.
Sometimes fatigue is subtle and you simply feel you’re no longer functioning at your usual level. If concentration is your main concern, see my page on brain fog, mood and stress.
Low energy can come from disrupted or poor-quality sleep, chronic stress, hormonal changes, nutritional deficiencies, digestive or immune issues, illness, medications, emotional strain – or simply a long period of doing more than your body can sustain. I commonly see fatigue with burnout; hormonal changes postpartum, in perimenopause and menopause or before a period; nutritional gaps such as iron, B12 and vitamin D; thyroid concerns; immune or inflammatory issues; recovery after illness; and in the year after a major loss or change, like a death, divorce or move.
I also see people who have functioned at a very high level for a long time and gradually lost their ability to recover. They often don’t think of themselves as “burned out” – they just know they don’t feel like themselves anymore. Read common reasons for persistent fatigue.
I look at three areas together:
When pain is part of your fatigue, or other symptoms need looking into, I may recommend physiotherapy, osteopathy, chiropractic care, a pain clinic or other treatment, or imaging through your doctor.
We go through your full health history, your current goals and your short- and long-term plans, review any relevant labs and discuss whether more testing is needed. I also do a brief physical exam of the basics: heart, ears, nose and throat, digestion, musculoskeletal and nervous system.
Similar fatigue can have very different causes, so I listen carefully. When several symptoms overlap, we talk about your priorities – what you most want to resolve first – and build a plan together that is honest about how long different systems actually take to respond.
Testing that may be relevant includes thyroid markers, iron and ferritin, B12, vitamin D, blood sugar, inflammation, cortisol patterns, sex hormones and autoimmune markers. Most people need some testing, but not always through my office. Some tests can be ordered through naturopathic care, while others require a physician and may be covered by OHIP. I can access both standard and more specialized testing; additional testing is generally not covered by OHIP and may be partly covered by extended health insurance. I can recommend clinically useful tests, but I can’t require your physician to order them.
Bloodwork may be recommended to assess your overall health and identify factors that could be contributing to digestive symptoms, such as nutrient deficiencies, inflammation, thyroid dysfunction, liver function, or celiac disease.
These results can help identify areas that may require further support and guide treatment recommendations.
SIBO, or small intestinal bacterial overgrowth, breath testing measures hydrogen and methane gases produced by bacteria in the small intestine.
It may be recommended when symptoms suggest small intestinal bacterial overgrowth, including bloating, excessive reflux and gas, abdominal discomfort, or changes in bowel habits.
The results can help determine whether targeted treatment may be appropriate.
Depending on what we find, your plan may include:
Nutrition and lifestyle are important foundations but aren’t always enough on their own, and your budget is part of planning care.
Hormones, sleep, stress, mood and energy are closely connected through communication between the hypothalamus, pituitary and adrenal glands, which help coordinate your response to stress and changing demands. When stress, poor sleep or hormonal changes affect this system, it can influence mood, thinking, energy and recovery. The goal is to understand the whole picture rather than treat each symptom separately. Read could your fatigue, brain fog and mood changes be hormonal?
Bioidentical Hormone Prescribing
I’m licensed in hormone prescribing, and bioidentical hormones may be considered when there is a clear need or deficiency. Before that, we do standard blood testing, I may refer you to your GP for an ultrasound, and we discuss the pros and cons. Hormones may not be appropriate if you have migraines, chronic yeast infections, or a history of stroke or hormone-related cancer in your family. Hormones don’t “cure” anything – they complement a system. They don’t cause weight loss or stop weight gain, and they don’t always change mood or give energy. Learn more on my hormonal imbalance page.
I support people with fatigue from chronic stress, burnout and major life transitions every day. Postpartum hormone changes, grief, caregiving stress and thyroid concerns are all relevant, as are perimenopause and menopause, where low energy often comes with sleep disruption, brain fog, mood changes, menstrual changes and changes in libido. Resilience isn’t about tolerating unlimited stress – it also needs real recovery.
Expect an hour-long assessment covering your history, goals and plans, a review of labs, a discussion of further testing and a brief physical exam. We agree on priorities and a plan of action.
Your second visit is usually 2 to 4 weeks after the first. After that, we check in several times a year, or more often, depending on how long-standing and important the concern is.
Bring whatever you have easily accessible – you don’t need everything.
I’ve been a naturopathic doctor for 17 years. I have a background in neuroscience with a mind-body and hormone focus, I’m a certified grief educator, I hold a certificate in CBT for mindfulness, and I’m licensed in hormone prescribing. Learn more about me.
Naturopathic care looks at the whole person and all the systems that might be contributing to one or two symptoms. That can help you get more out of conventional care and support areas it may struggle with. I work with your family doctor, therapist or specialist through communication and letters, working with your medications and supporting your treatment plan, and I refer often – for imaging or when other skills such as osteopathy or physiotherapy are needed. Some conditions, including those that are advanced or influenced by genetics, have limits to what naturopathic treatment can safely address on its own.
Please see a physician promptly, or call 911 in an emergency, if fatigue comes with:
Symptoms of bipolar disorder or mania need psychiatric care. If you are thinking about harming yourself, call or text 9-8-8.
Dr. Aoife Earls, ND offers fatigue appointments in person in St. Catharines and virtually for patients from Stoney Creek, Grimsby and nearby communities.
In-person appointments are at Dalhousie Health & Wellness Clinic, 581 Ontario St, St. Catharines, ON L2N 4N8. Virtual appointments are also available. The office is about 5 minutes from the Ontario Street exit off the highway, and I also regularly see patients from Fonthill, Pelham, Thorold, Hamilton, Fort Erie and Welland.
Patients from Stoney Creek can see me in person in St. Catharines or book a virtual appointment, depending on current appointment options and the type of care needed.
Patients from Grimsby can see me in person in St. Catharines or book a virtual appointment, depending on current appointment options and the type of care needed.
Fatigue can show up as feeling tired despite enough sleep, waking unrefreshed, afternoon crashes, brain fog, difficulty concentrating, low motivation, reduced stress tolerance or feeling unable to keep up with work and daily responsibilities. Sometimes it is subtle, and you simply feel you’re no longer functioning at your usual level.
Fatigue can have many contributors, including sleep quality, chronic stress, hormonal changes, nutrition, digestive or immune health, thyroid function, medications and underlying illness. A thorough assessment looks at the whole picture rather than assuming there is one cause.
Yes. A naturopathic doctor can help identify possible contributors, decide whether further investigation or testing is appropriate, and build an individualized plan to support sleep, stress, nutrition, hormones and overall health. Naturopathic care can work alongside conventional medical care.
Fatigue can result from disrupted sleep, chronic stress, hormonal changes, nutritional deficiencies, thyroid concerns, digestive or immune issues, illness, medications and periods of heavy emotional or physical demand. Often more than one factor is involved.
Not necessarily – it depends on your symptoms, history and assessment. Some testing can be ordered through naturopathic care, while other investigations need a physician and may be covered by OHIP. Specialized testing is generally not covered by OHIP and may be covered by extended health insurance.
Absolutely. Prolonged stress can affect sleep, mood, concentration, hormone regulation and your ability to recover, which can leave you feeling depleted. Resilience isn’t about tolerating unlimited stress – it also requires adequate recovery.
Yes. Hormonal changes during perimenopause and menopause can affect sleep, temperature regulation, mood, thinking and energy. Naturopathic care looks at the broader picture and may include individualized nutrition, lifestyle and therapeutic approaches, including a discussion of hormone therapy when appropriate.
Not necessarily. Fatigue alone doesn’t mean hormone therapy is appropriate. Decisions are based on your symptoms, life stage, health history, risks and goals, and other possible causes of fatigue are considered as well.
We start with a detailed discussion of your symptoms, sleep, stress, menstrual or menopausal history when relevant, nutrition, digestion, medications and medical history. Then we decide whether further investigation or testing is appropriate and build a plan for your needs.
Yes. I work with patients from Hamilton, Stoney Creek, Grimsby and surrounding areas, with virtual and in-person appointments depending on current clinic availability.
Fatigue is common, but it deserves a proper look. Reach out to see whether naturopathic care is the right next step for you.
Medical disclaimer: This page is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment. Speak with a qualified healthcare professional about your individual health concerns. If you are in crisis or thinking about harming yourself, call or text 9-8-8 or call 911.