If you’re dragging through the day, feel like your brain’s running on fumes, or constantly need caffeine to function — but you’re not sad, withdrawn, or hopeless — it may not be depression.
Low energy can be caused by many things. And at Fishtown Medicine, we take the time to figure out which ones matter for you.
⚠️ When low energy is not depression:
You might feel:
Mentally foggy or slow
Physically drained, no matter how much you sleep
Unmotivated but not emotionally numb
Easily overwhelmed by simple tasks
Like your body just can’t “get into gear”
But you’re still laughing sometimes. You’re still connected to people. You still want to feel better — you just don’t have the fuel.
🧪 What we check when fatigue is the main issue:
Thyroid health (TSH, Free T4, Reverse T3, antibodies)
Iron and ferritin (especially in menstruating people)
B12 and methylation markers
Sleep quality and apnea screening
Adrenal rhythm / cortisol imbalance
Sex hormones (low testosterone, estrogen/progesterone imbalance)
Mitochondrial function and inflammation markers
Insulin resistance or blood sugar swings
Post-viral fatigue or long COVID patterns
🧠 It’s not all about labs either.
We also explore:
Overtraining or under-recovery
Trauma-related exhaustion or burnout masking as laziness
Sleep timing and circadian mismatch
Poor fit between your routine and your energy profile
Medications or supplements that may be draining you
🔄 What we do instead of guesswork:
Track your symptoms over time (energy logs, wearable data)
Pair labs with how you actually feel day-to-day
Adjust movement, nutrition, and rhythms in a way that respects your energy — rather than overriding it
Deprescribe when appropriate
Build a care plan that supports your mitochondria, nervous system, and hormones — not just your mood
💡 The bottom line:
Just because you're tired doesn't mean you're depressed.
And just because your labs are “normal” doesn’t mean you’re fine.
Low energy deserves real investigation — and a real plan.
If this sounds familiar, we can walk through what might be driving your fatigue and what we can do about it.