You’re getting seven or even eight hours of sleep. You’ve scaled back your workouts, said no to more social events, and tried winding down earlier at night. And yet—you wake up already tired. Not just a bit sluggish, but bone-deep, heavy-limbed, can’t-focus, can’t-cope exhaustion. Sound familiar?
For many high-achieving professionals, especially women juggling careers, families, and ageing parents, this chronic fatigue doesn’t seem to make sense. It’s not laziness. It’s not burnout from just one hard week. It’s a consistent, creeping tiredness that rest doesn’t seem to fix.
So, what’s actually going on?
When Rest Isn’t Enough: The Hidden Driver Behind Your Fatigue
In functional medicine, we often look beyond symptoms to understand the underlying dysfunction. One of the most overlooked — yet incredibly common — contributors to this kind of persistent exhaustion is something called HPA axis dysregulation.
The HPA axis (hypothalamic-pituitary-adrenal axis) is your body’s central stress response system. Think of it like the command centre that controls how your body reacts to stress and recovers from it. When this system is working well, your body can release cortisol in healthy rhythms throughout the day: higher in the morning to wake you up, lower at night to help you wind down.
But when the demands of life exceed your capacity to recover — physically, mentally or emotionally — this system starts to falter. The result? Your cortisol rhythm flattens or flips entirely. You may feel wired at night but foggy in the morning, or you may crash completely in the afternoon. This is not simply “being tired” — it’s a form of internal breakdown.
The Science of Stress & Cortisol Disruption
Chronic stress (even the kind you’ve mentally adjusted to) keeps your sympathetic nervous system stuck in high gear. Over time, this taxes your adrenal glands, the organs that produce cortisol and other stress hormones.
In nutritional medicine, we assess not just the cortisol level at a single point in time, but the full diurnal rhythm — how it rises and falls across the day. This pattern tells us a lot about your resilience, your energy patterns, and how your body is coping overall.
If you want to understand exactly what your cortisol curve looks like (and whether your stress response system is broken down), a comprehensive test like the DUTCH Adrenal Profile is a powerful tool.
A Multi-Layered Functional Medicine Approach
So how do we fix this kind of exhaustion? There’s no single answer, and food alone — while important — isn’t always enough. This is where a functional medicine and nutritional medicine approach shines. We look at multiple levels: from biochemistry and hormones to lifestyle, nervous system tone, and even past trauma.
Here’s how we approach it.
1. Targeted Nutrients to Support Stress Recovery
To rebuild a broken stress response, we often start with correcting underlying nutrient depletions:
- Magnesium (especially glycinate or threonate): critical for nervous system regulation, muscle relaxation and sleep.
- Vitamin B5 and B6: essential for adrenal hormone production.
- Vitamin C: highly concentrated in the adrenal glands and quickly depleted by stress.
- Zinc: involved in over 300 enzyme processes including cortisol modulation.
These nutrients help buffer the effects of chronic stress and give your adrenal glands what they need to function.
2. Adaptogenic Herbs to Restore HPA Axis Function
Adaptogens are herbs that help the body adapt to stress — but they’re not one-size-fits-all. In fact, some adaptogens are stimulating, while others are calming. A personalised approach is key.
- Ashwagandha: excellent for reducing cortisol and calming anxiety; best for those who feel wired-but-tired.
- Rhodiola: energising and uplifting; useful for morning fatigue and brain fog.
- Holy Basil (Tulsi): calming, anti-inflammatory, and good for evening use.
- Licorice Root: can help prolong cortisol action in those with low cortisol but must be used carefully, especially in those with high blood pressure.
Each herb has its own profile and must be matched to the individual’s symptom picture and cortisol rhythm.
3. Nervous System Regulation & Lifestyle Interventions
It’s not just about supplements. Long-term recovery depends on retraining your nervous system out of chronic survival mode.
- Deep breathing practices, such as box breathing or 4-7-8 breath, engage the parasympathetic system and signal safety to the brain.
- Vagus nerve stimulation through cold exposure, gargling, humming or singing can help rewire stress pathways.
- Gentle movement, especially walking outdoors, yin yoga, or tai chi, promotes nervous system balance without adding physical stress.
Sleep hygiene is also critical. That means keeping a consistent bedtime, reducing blue light exposure before bed, and possibly using herbs like passionflower, valerian, or L-theanine to support a healthy wind-down.
4. Psychological Recovery & Boundaries
No supplement can replace what’s truly needed: rest, reflection, and redefining your boundaries.
Many clients I work with reach a point where they’ve been in a cycle of high-performance for so long that they no longer recognise when their bodies are asking for pause. Functional medicine doesn’t just correct deficiencies; it helps you reframe your relationship with stress and productivity.
Consider:
- Are you over-committing socially or professionally?
- Do you struggle to say no?
- Are you operating from obligation rather than alignment?
These patterns can keep your HPA axis locked in fight-or-flight mode, even if you’re physically still.
When to Get Help
If you’ve tried the usual advice — more sleep, less coffee, better food — and still feel constantly tired, flat, and emotionally fragile, it may be time to look deeper. A targeted assessment of your HPA axis using tools like the DUTCH Adrenal Profile can give you clarity, not guesswork.
Functional medicine allows us to understand your stress response through a wider lens biochemical, emotional, and environmental. Nutritional medicine helps us choose the right tools to support recovery at the cellular level.
You don’t have to accept this bone-deep exhaustion as your new normal.
Ready to Recover Your Energy?
If you’re tired of band-aid advice and want a more tailored, evidence-based way to restore your energy, focus and vitality, I can guide you through functional testing and build a personalised plan.
You deserve to wake up feeling refreshed — not just surviving, but truly thriving.
Let’s get to the root of it.