By Dr. Kritika Joshi, DO
Fatigue is one of the most common chief complaints I see in my practice— yet one of the most misunderstood. Too often, it’s brushed off as “stress,” “a busy life,” or “getting older.” But persistent, unexplained fatigue in women is rarely just about lifestyle.
I look deeper. Fatigue can be a powerful clue that your immune system, hormones, or cellular metabolism are under stress. For many women, that fatigue is an early signal of autoimmune disease.
Women are disproportionately affected by fatigue and autoimmune conditions. In fact, nearly 80% of autoimmune diseases occur in women, often during their 20s to 50s — the same years we’re juggling family, career, and self-care.
Several factors make women more susceptible:
Hormonal fluctuations (menstrual cycle, pregnancy, perimenopause, menopause)
Higher stress reactivity and cortisol sensitivity
Differences in immune system regulation driven by estrogen and progesterone
Genetic predisposition and epigenetic stress
These internal shifts can trigger inflammation and immune dysfunction — both key contributors to chronic fatigue.
Autoimmune diseases occur when the immune system mistakenly attacks the body’s own tissues. This ongoing immune activation causes systemic inflammation, mitochondrial stress, and hormonal disruption — all of which drain energy.
Common autoimmune conditions that cause fatigue include:
Hashimoto’s hypothyroidism (low thyroid function)
Rheumatoid arthritis
Lupus (SLE)
Celiac disease or gluten sensitivity
Sjogren’s syndrome
Multiple sclerosis (MS)
The immune system consumes massive amounts of energy when overactive.
Inflammation interferes with mitochondrial ATP production (your body’s “energy currency”).
Hormones like thyroid, cortisol, and insulin become dysregulated.
Sleep and recovery cycles are disrupted by cytokine imbalance.
Even without a diagnosed autoimmune condition, women can experience overlapping issues that amplify exhaustion:
Iron, B12, or vitamin D deficiency
Perimenopausal hormone shifts
Adrenal fatigue from chronic stress
Gut inflammation or dysbiosis
Poor blood sugar control
Hidden infections (EBV, Lyme, mold exposure)
My whole-body assessment helps distinguish between these causes so that treatment targets the root — not just the fatigue itself.
Autoimmune antibodies (ANA, TPO, RF, anti-CCP, and more)
Thyroid, adrenal, and sex hormones
Nutrient and mitochondrial markers
Inflammation and oxidative stress levels
Gut and microbiome health
Every patient’s fatigue story is unique. Plans may include:
Anti-inflammatory nutrition (autoimmune or Mediterranean-style diets)
Hormone optimization for thyroid, cortisol, estrogen, and progesterone
Targeted supplements like omega-3s, vitamin D, B-complex, CoQ10, and adaptogens
Gut healing protocols to reduce systemic inflammation
Lifestyle guidance on sleep, stress reduction, and mindful movement
I help patients regain sustainable energy — not through stimulants or temporary boosts, but by restoring balance in the immune and endocrine systems.
If you’ve been told “everything looks normal” but still feel exhausted, your body might be signaling something deeper.
You deserve more than reassurance — you deserve answers.
Don’t settle for just surviving, start thriving.
In good health,
Dr. Joshi
