Why Your Labs Look Normal—but You’re Still Exhausted

Every day, I ask the same question.

“So, what brings you in today?”

Or maybe: “How can I help?”

Or just: “Tell me—what’s going on?”

And every day, I hear a version of the same answer.

“I’m exhausted.”

“I think my thyroid’s off.”

“I think my hormones are off.”

“I can’t stop gaining weight, no matter what I do.”

“I think I have early-onset Alzheimer’s.  I’m losing my mind.  Forgetting things.  Having the worst brain fog…”

They’re almost always women.  Often in their 30s, 40s, 50s.  Juggling caregiving, working, managing households, and showing up for everyone.  And somewhere in all of that—they started running on fumes.

So I do what I’ve been trained to do.  I listen.  I ask questions.  I gather the story—the stressors, the schedule, the transitions, the losses, the expectations.

And then I say, “Let’s check your labs.”

What I Look For

I order:

• Thyroid function tests
• Inflammatory markers
• Advanced cholesterol panel
• Insulin and glucose markers
• B vitamins and iron studies
• Sex hormones

We book the follow-up.

And 90% of the time?  The labs come back with the same pattern.

What I Usually Find

• Elevated small dense LDL (the kind that drives plaque formation)
• Decreased HDL (the protective, anti-inflammatory kind)
• Elevated high-sensitivity CRP, sed rate, or ferritin → markers of systemic inflammation
• Nearly universal signs of insulin resistance (often even before pre-diabetes levels—evident in elevated fasting insulin or C-peptide)
• Maybe a slightly low B12 or ferritin
• Occasionally thyroid dysfunction, like hypothyroidism or Hashimoto’s

But what’s most common?  Metabolic dysfunction.  Not dramatic enough to flag as a disease.  But absolutely enough to feel miserable.  Not enough to warrant medication (by insurance standards), but 1000% enough to make lifestyle changes essential—if we want to prevent full-blown disease in the decade to come.

And Yet—The Labs Are Basically “Okay”

They’re technically in range.  Not optimal.  Not alarming.  Just… enough to get waved off.

Which means many women are left holding a folder of “normal” results, still no energy, no answers, and a creeping fear that maybe this is just how life is now.

Spoiler: It’s not.

Primary Care Isn’t Set Up for This

I’ve worked in primary care for years.  We’re asked to screen, prevent, counsel, refer, diagnose, manage, explain, and soothe.  All in 15-minute increments.

It’s one extreme to the next:

From calming a frustrated patient with a head cold who “just needs something to get back to work”…

To delivering a metastatic cancer diagnosis to a stoic soul who waited too long to be seen because life wouldn’t slow down.

We’re told to practice “preventive care,” but the system is structured around crisis management and coding—not actual prevention or healing.

We simply don’t have the capacity to meet what women are carrying.

It’s More Than Labs.  It’s Brain Wiring.

Over time, I started to realize: these women weren’t just tired from low B12.  (Trust me—It’s not often a supplement moves the needle and gives sustainable energy.)  They weren’t just stressed.  Their entire nervous systems were stuck in a survival state.

This wasn’t about “just eat more vegetables and walk more.”

This was about early conditioning, patterns of over-functioning, generational trauma, and chronic overdrive.  Their salience systems—the brain circuits that decide what’s important—were hijacked by decades of pushing through.

This is neuroscience.  Not weakness.

The Science of Burnout

Here’s what the research tells us:

• Chronic stress and over-responsibility rewire the brain—particularly the salience and reward circuits.
• This often results in increased serotonin activity that can create feelings of fog, disconnection, and sluggishness.  Eventually, dopamine—the drive chemical—begins to flatline, which causes motivation, pleasure, and drive to dwindle.
• The Cell Danger Response (CDR), a protective mitochondrial state, can get stuck on.  This means the mitochondria stop producing ATP for energy and instead shift into releasing danger signals—literally expelling ATP outside the cell to alert the system that something isn’t safe.
• The nervous system learns to prioritize urgency over recovery, reinforcing a loop that drains energy further and further. Leaving women feeling tired but wired.

And here’s the kicker:

This can’t be reversed by willpower.

No amount of pep talks, planners, or protein bowls will shift a system stuck in survival.

It requires a different structure.  Not an exam room.

What Women Need Is Not More Willpower

They need:

• Education to understand what’s happening in their biology
• Coaching and tools to regulate their nervous systems
• Community that mirrors rest, safety, and enoughness
• A new model of care that treats burnout as the neuro-metabolic condition it is—not a character flaw

That’s why we created the Energy Reset and Energy Generator programs.  Because primary care wasn’t enough.  It couldn’t be.

Even when I had the time—an hour-long appointment here or there—it was never going to be enough.

Because no amount of kale or cardio can unwind a brain stuck in survival mode.

If This Is You

If you’ve been told your labs are fine but you feel anything but fine—please hear this:

You are not broken.

You are not lazy.

You are not imagining it.

Your body is telling the truth, even if the lab results don’t.

And healing is possible.  But it starts by stepping out of the exam room—and into a new kind of care.