Bottom Line/Health: Somehow Americans love to wear with pride our fatigue and exhaustion. And yet we’re always craving energy. So what are your best tips and tricks for fighting fatigue?

Dr. Brooke Kalanick, ND: Well of course, the things you already know to do: get enough sleep, enough quality sleep. Be in bed, asleep, for at least 8 hours, and wake up feeling refreshed. Getting enough water, getting some exercise. Those are the things you’ve already heard, right? You know you need to do those; they are important.

Bottom Line: Good luck with those 8 hours of sleep, but okay.

Dr. Kalanick: The most important thing is that you’re at least feeling rested. Some people do better on less, while some people need more. So making sleep a priority, managing your stress, like I said, getting some exercise, and drinking some water.

However, there are a couple of things that people forget to think about: one is that we so often don’t go into our doctor’s office and get any blood work. Maybe once a year. So often, we can catch things earlier that really help with fatigue, like catch an early thyroid problem, catch a low vitamin D, or even borderline deficiencies in things like B12 and iron that aren’t a full-blown anemia yet, but you’re starting to see that trend, can really impact your energy level. So make sure you’re getting screened at least once a year. If you’re feeling like you’re inappropriately rundown, get in and get tested.

The other two tips kind of go together, and they have a lot to do with balancing your energy in terms of your blood sugar. You’ve got two hormones that are kind of playing tug-of-war constantly: insulin to lower your blood sugar and cortisol to keep it up. There’s of course a lot more hormones, but you have a lot of control over these two, and they talk to you all day.

If you’re feeling low energy between your meals – you’ve had breakfast, it’s now 10:00, you’re irritable, cranky, tired, really low energy, you eat and really come alive – that probably means that you don’t have a really great cortisol and stress mechanism to keep you going. You may need more carbohydrate, more protein, more fat, or more fiber in that earlier meal. So when you’re looking for symptoms between meals, you’re looking for low blood sugar causes of fatigue.

When you’re getting fatigue after meals and you’re feeling sleepy, tired, you’re looking for Starbucks, you’re looking for caffeine and sugar, or if you’re just simply getting sugar cravings after you eat, those are signs that you’ve overshot your blood sugar lowering capacities. You’re having trouble with the hormone insulin. So look for if you’re getting symptoms between meals or after meals as far as fatigue goes, and play with your carb tolerance. There’s nothing more individual than the type or amount of carbs that people need – and how often they need to eat them.

So those are the other two tips: are you getting too many carbs that are causing you to have low energy after meals? Are you getting too few, which are causing you to have low energy between meals? Moreover, are you able to go an appropriate distance between meals for you, whether that’s 3 hours or 5 hours before you start to feel really low energy?

Bottom Line: Should some people think about either having a heavy snack in between or the classic six meals a day versus three big meals?