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Most Overlooked Female Health Issues & What to Do

By Dr. Jessi Grajczyk, DO, OB/GYN

June 24, 2026

When it comes to the female body, the harsh reality is that many things can go wrong. Disease, injury, allergy and much more.

If a malady comes your way, hopefully it gets noticed early by you, a loved one or, most importantly, your healthcare professional. The sooner the diagnosis and treatment, the better … always.

However, what about the health issues that often get missed by not just you but also healthcare professionals? Or symptoms of a health issue that you present to your doctor but nothing is done? It’s more common than one thinks, I’m sorry to say.

Below I present the most commonly overlooked health issues for women, including their symptoms, how common they are, why they get missed, and then what you can do about them, including diagnosis and how to deal with them, including dietary suggestions.

1. PMOS (formally PCOS)

The Endocrine Society recently announced that Polycystic Ovary Syndrome (PCOS) has been officially renamed to Polyendocrine Metabolic Ovarian Syndrome (PMOS). The old name implied that abnormal cysts grew on the ovaries, but not everyone with PMOS has ovarian cysts. It’s actually a complex, systemic hormonal and metabolic disorder.

PMOS is one of the most common hormonal disorders affecting women of reproductive age. It is characterized by hormonal imbalances that can affect ovulation, metabolism, fertility and overall health.

I recognize four kinds of PMOS: insulin resistance, post-pill PMOS, inflammatory and then adrenal.

Symptoms

Symptoms can vary from person to person, but often include:

• Irregular or missed periods

• Difficulty ovulating

• Infertility or difficulty becoming pregnant

• Excess facial or body hair

• Acne or oily skin

• Thinning hair or hair loss on the scalp

• Weight gain or difficulty losing weight

• Fatigue

• Mood changes

Why is PMOS commonly overlooked?

PMOS is often overlooked because it can present very differently from person to person. While many people associate PMOS with symptoms such as weight gain, irregular periods, and excess facial hair, some women have regular cycles, appear lean or experience more subtle symptoms that make the condition harder to recognize.

Research and clinical experience suggest there may be multiple underlying drivers of PCOS, including insulin resistance, inflammation, hormonal imbalances and post-birth control changes. Because there is no single "PMOS profile," many women may go undiagnosed or misdiagnosed for years.

Relevant statistics

PMOS affects an estimated 6% to 13% of women of reproductive age, making it one of the most common endocrine disorders in women. Note that many cases may go undiagnosed.

How does one get diagnosed?

Healthcare providers often use the Rotterdam criteria, which require at least two of the following:

• Irregular or absent ovulation

• Elevated androgen levels or symptoms of excess androgens

• Polycystic ovaries visible on ultrasound

What is conventionally recommended for dealing with PMOS?

Conventional PMOS treatment depends on symptoms and goals, but often includes lifestyle changes such as nutrition and exercise, weight management when appropriate, hormonal birth control to regulate cycles, medications like metformin to support insulin sensitivity, and fertility treatments for those trying to conceive.

Standard care may also evaluate excess androgens, such as testosterone, and screen for insulin resistance using markers like hemoglobin A1C, though fasting insulin is not always checked.

PMOS can be more complex than ovarian cysts alone, and some practitioners look deeper at possible contributors such as inflammation, gut health, environmental exposures, autoimmune factors and metabolic dysfunction. Because PMOS is closely tied to endocrine and metabolic health, a more comprehensive approach may help identify underlying drivers that standard testing can sometimes miss.

What are my tips to address PMOS in terms of nutrition and lifestyle changes?

A functional medicine approach typically looks deeper at the potential root causes contributing to hormonal imbalances, including blood sugar dysregulation, inflammation, adrenal and stress-related factors, and other metabolic concerns.

Addressing PMOS often involves a combination of nutrition and lifestyle strategies that support overall hormonal and metabolic health. Many women benefit from prioritizing protein at meals, eating fiber-rich foods, limiting highly processed foods and added sugars, and supporting healthy blood sugar balance throughout the day.

Regular physical activity, quality sleep, and effective stress management are also important components of a comprehensive approach. In some cases, additional testing and targeted supplementation may be recommended based on an individual's unique needs and underlying health factors.

2. Endometriosis

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus. These growths can develop on the ovaries, fallopian tubes, pelvic lining, bladder, bowel and other nearby tissues.

Like the uterine lining, this tissue responds to hormonal changes throughout the menstrual cycle. However, because it is located outside the uterus, it has no easy way to leave the body, which can contribute to inflammation, scar tissue formation and pain.

Symptoms

Symptoms can vary widely, but may include:

• Painful menstrual cramps

• Chronic pelvic pain

• Pain during or after intercourse

• Pain with bowel movements or urination

• Heavy menstrual bleeding

• Spotting between periods

• Bloating

• Fatigue

• Digestive symptoms such as constipation, diarrhea or nausea

• Difficulty becoming pregnant

It's important to note that the severity of symptoms does not always correlate with the severity of the disease.

Why is endometriosis commonly overlooked?

Endometriosis is often overlooked because its symptoms can vary dramatically from person to person, and the severity of pain does not always reflect the severity of the disease. Some women experience debilitating pain but have minimal visible endometriosis, while others have extensive endometriosis with few or no symptoms.

Additionally, the only definitive way to diagnose endometriosis is through laparoscopic surgery, which is an invasive procedure that carries risks. While imaging tests may detect more advanced cases, mild endometriosis can be difficult to identify without surgery, making diagnosis more challenging and sometimes leading to delays in treatment.

Relevant statistics

Endometriosis affects an estimated 1 in 10 women of reproductive age worldwide, making it one of the most common gynecological conditions.

How does one get diagnosed?

Endometriosis is typically diagnosed through a combination of medical history, symptom review, pelvic exams, and imaging tests such as ultrasound or MRI.

The gold standard for diagnosis is laparoscopic surgery, a minimally invasive procedure that allows a physician to directly view and confirm endometrial-like tissue growing outside the uterus.

What is conventionally recommended for dealing with endometriosis?

Conventional treatment for endometriosis is based on a woman's symptoms, age and fertility goals. Common approaches include pain-relieving medications, hormonal therapies such as birth control pills or hormonal IUDs, and medications that suppress estrogen production to help slow the growth of endometrial tissue.

In some cases, surgery may be recommended to remove endometrial lesions and scar tissue, while women who are trying to conceive may pursue fertility treatments to improve their chances of pregnancy.

What are my tips to address endometriosis in terms of nutrition, lifestyle changes and potential supplementation?

Nutrition and lifestyle strategies can focus on following a nutrient-dense, anti-inflammatory diet rich in fruits, vegetables, fiber and omega-3 fatty acids while limiting ultra-processed foods and added sugars. Regular exercise, quality sleep and stress management may also help support overall health and symptom management.

Some women may benefit from targeted supplementation and hormonal support based on their individual needs. Common recommendations can include omega-3 fatty acids and curcumin to help support a healthy inflammatory response, as well as evaluating hormone balance, including progesterone levels.

Supporting healthy estrogen metabolism through liver health, reducing chronic stress, and addressing other potential sources of inflammation may also be considered as part of a comprehensive approach. While these strategies do not cure endometriosis, they may help complement conventional treatment and support long-game wellness.

3. Heart disease

Heart disease is the leading cause of death among women in the United States, yet many women are unaware of their risk. The term heart disease refers to a range of conditions that affect the heart and blood vessels, including coronary artery disease, heart attacks, heart failure, arrhythmias and stroke-related cardiovascular conditions.

Although heart disease affects both men and women, women often experience different symptoms and may face unique challenges when it comes to diagnosis and treatment.

A woman's risk of heart disease is influenced not only by traditional factors such as high blood pressure, high cholesterol, diabetes, obesity, smoking, physical inactivity and family history, but also by hormonal changes throughout life.

Estrogen is thought to help support cardiovascular health during the reproductive years, which may offer some protection before menopause. But as estrogen levels decline during menopause, the risk of heart disease increases. Other female-specific risk factors — including pregnancy complications, PCOS, endometriosis, autoimmune diseases, and early menopause — can also play a role in overall heart health.

Symptoms

Women can experience the classic symptoms of a heart attack, such as chest pain or pressure, but they are also more likely to experience less obvious symptoms such as:

• Shortness of breath

• Unusual fatigue

• Nausea or indigestion

• Dizziness or lightheadedness

• Pain in the jaw, neck, back or shoulders

• Sleep disturbances

• Anxiety or a feeling that something isn't right

Because these symptoms may be subtle, women sometimes delay seeking medical attention.

Why is heart disease among women commonly overlooked?

Heart disease in women is often overlooked because symptoms can be more subtle or different than the classic chest pain many people associate with heart problems. Women may experience fatigue, nausea, shortness of breath, indigestion, or general discomfort, which can be easier to dismiss or misattribute.

Hormonal shifts during perimenopause and menopause may also increase risk, but those changes are not always fully recognized as important factors in women’s heart health.

Relevant statistics

Heart disease is the leading cause of death for women in the U.S., affecting millions of women each year. According to the Centers for Disease Control and Prevention (CDC), about 1 in 16 women age 20 and older has coronary heart disease, and heart disease is responsible for approximately 1 in every 5 female deaths in the U.S.

How does one get diagnosed?

Heart disease in women is typically diagnosed through a combination of medical history, symptom evaluation, physical exams, blood tests and cardiovascular testing. In conventional medicine, routine screening often includes checking blood pressure, cholesterol levels, blood sugar markers such as hemoglobin A1C, and other cardiovascular risk factors.

If heart disease is suspected, additional testing may include an electrocardiogram (EKG), stress test, echocardiogram, coronary calcium scan or other imaging studies. Heart attacks and other acute cardiac events are typically diagnosed in an emergency setting.

Some practitioners may also evaluate additional factors that can influence cardiovascular health, including inflammation, insulin resistance, oxidative stress, hormone changes and other metabolic markers. This can be especially relevant for women, as cardiovascular risk often increases after menopause when estrogen levels decline. Because women may experience different symptoms and risk patterns than men, a comprehensive evaluation can help provide a more complete picture of heart health.

What is conventionally recommended for dealing with heart disease for women?

Conventional treatment for heart disease in women depends on the type and severity of the condition but often includes a combination of dietary adjustments, lifestyle changes and medications. Common recommendations include following a heart-healthy diet, increasing physical activity, maintaining a healthy weight, quitting smoking, managing stress and controlling risk factors such as high blood pressure, high cholesterol and diabetes. Medications may be prescribed to lower cholesterol, reduce blood pressure, prevent blood clots or help the heart function more effectively.

In some cases, more advanced treatments may be needed, including procedures such as angioplasty, stent placement or bypass surgery to improve blood flow to the heart. Because women can experience different symptoms and risk factors than men, early detection and regular cardiovascular screenings are important for helping prevent complications and supporting long-term heart health.

What are my tips to address heart disease in terms of nutrition, lifestyle changes and potential supplementation?

Supporting heart health often starts with foundational lifestyle habits, including eating a nutrient-dense diet rich in fruits, vegetables, fiber, healthy fats and adequate protein while limiting ultra-processed foods and added sugars.

Regular physical activity, maintaining a healthy weight, managing stress, prioritizing sleep, staying hydrated, and avoiding smoking can all help support cardiovascular wellness. Monitoring important health markers such as blood pressure, cholesterol, blood sugar and insulin resistance may also provide valuable insights into overall heart health.

In addition to these lifestyle strategies, I recommend targeted nutritional support based on an individual's needs. Common supplements used to support cardiovascular health include omega-3 fatty acids, CoQ10, magnesium and berberine.

A comprehensive approach may also involve evaluating other factors that can influence heart health, such as inflammation, gut health, hormone balance and metabolic function. For women, particularly during perimenopause and menopause, addressing hormonal changes may be an important part of supporting long-game cardiovascular wellness.

Ultimately, prevention and early intervention are key, with a focus on reducing inflammation and supporting overall metabolic and cardiovascular health before more serious issues develop.

4. Autoimmune disease

An autoimmune disease is a condition in which the immune system mistakenly attacks the body's own healthy cells, tissues or organs instead of protecting them from harmful invaders such as bacteria and viruses. This abnormal immune response can lead to inflammation, tissue damage and a wide range of symptoms depending on which part of the body is affected.

There are more than 80 known autoimmune diseases, including rheumatoid arthritis, lupus, multiple sclerosis, Hashimoto's thyroiditis, celiac disease, psoriasis and type 1 diabetes. While the exact cause of autoimmune diseases is not fully understood, factors such as genetics, environmental triggers, infections, hormones and lifestyle factors may play a role in their development.

Symptoms

Common symptoms can include:

• fatigue

• joint pain

• muscle aches

• digestive issues

• skin problems

• recurring inflammation

Because symptoms often overlap with other conditions, autoimmune diseases can sometimes be difficult to diagnose.

Why is autoimmune disease commonly overlooked?

Autoimmune disease is often overlooked because symptoms can be vague, overlapping and difficult to connect to one clear cause. Fatigue, brain fog, joint pain, digestive issues, inflammation and hormone-related symptoms can easily be attributed to stress, aging or lifestyle factors, so autoimmune screening is not always included in routine blood work.

In many cases, more specific testing — such as ANA screening, thyroid antibodies or other autoimmune markers — is only ordered when symptoms become more obvious or persistent. Because autoimmune risk can be influenced by genetics, inflammation, environmental exposures and immune system stress, identifying it often requires a deeper evaluation beyond standard labs.

Relevant statistics

Autoimmune diseases are significantly more common in women than in men. In fact, it is estimated that about 78% of people living with autoimmune diseases are women, making female sex one of the strongest risk factors for developing many autoimmune conditions.

Researchers estimate that approximately 8%–10% of the U.S. population has an autoimmune disease, and the majority of these cases occur in women.

How does one get diagnosed?

Diagnosing an autoimmune disease often involves reviewing symptoms, medical history, family history and laboratory testing. Common symptoms such as fatigue, joint pain, digestive issues, skin changes and inflammation can overlap with many other conditions, making diagnosis challenging.

Healthcare providers may use blood tests to look for signs of inflammation and abnormal immune activity, including ANA, rheumatoid factor, thyroid antibodies, ESR, CRP and other disease-specific markers. In some cases, imaging studies or biopsies may also be needed. Because no single test can diagnose all autoimmune diseases, diagnosis typically involves evaluating symptoms alongside test results and ruling out other possible causes.

What is conventionally recommended for dealing with autoimmune disease ?

Conventional treatment for autoimmune diseases focuses on reducing inflammation, managing symptoms, slowing disease progression, and preventing damage to tissues and organs. Depending on the condition, treatment may include anti-inflammatory medications, corticosteroids, immunosuppressive drugs or targeted biologic therapies that help regulate immune system activity.

Because autoimmune diseases vary widely, treatment is typically personalized and aimed at controlling symptoms, reducing flare-ups, and supporting overall health and quality of life.

What are my tips to address autoimmune disease in terms of nutrition, lifestyle changes and potential supplementation?

In addition to medical treatment, many experts recommend supporting overall health through a nutrient-dense diet, regular physical activity, stress management, quality sleep and avoiding smoking. These lifestyle habits may help support immune function, reduce inflammation and improve quality of life.

Because autoimmune diseases are typically chronic conditions, the focus is often on long-term management rather than cure. Working closely with a healthcare provider and making sustainable nutrition and lifestyle changes can help manage symptoms, reduce flare-ups and support overall well-being.

5. Perimenopause

The transitional phase (often starting 40s) with fluctuating hormones leading to irregular cycles, symptoms and increased risks for other issues (heart, bone, mood).

Symptoms

• Joint and muscle pain

• Dry eyes and dry skin

• Itchy ears

• Heart palpitations

• Anxiety and mood changes

• Brain fog and difficulty concentrating

• Sleep disturbances

• Heavier, lighter, or irregular periods

• Weight gain or changes in body composition

• Fatigue and low energy

• Hot flashes and night sweats

• Reduced stress resilience

• Changes in libido

• Headaches or migraines

• Increased urinary urgency or frequency

Why is perimenopause commonly overlooked?

Perimenopause is often overlooked because many of its symptoms are dismissed as a normal part of aging or attributed to stress, poor sleep or a busy lifestyle. Women may experience fatigue, mood changes, brain fog, anxiety, sleep disturbances, weight changes, irregular periods and reduced stress resilience for years before menopause, yet these symptoms are not always recognized as being related to shifting hormone levels.

Another challenge is that perimenopause has historically received less research attention and clinical training than menopause itself.

Relevant statistics

Affects most women; up to 90% seek help for symptoms like hot flashes, mood changes, sleep issues.

How does one get diagnosed?

Perimenopause is typically diagnosed based on a woman's age, symptoms, menstrual cycle changes and medical history. Healthcare providers may also order hormone testing — including FSH, estradiol, progesterone, thyroid markers and cortisol levels — to help assess hormonal changes and rule out other potential causes of symptoms.

Tracking menstrual cycles and symptom patterns can also provide valuable clues, and in some cases, a DEXA scan may be recommended to establish a baseline for bone health.

What is conventionally recommended for dealing with perimenopause?

Conventional treatment for perimenopause typically focuses on managing symptoms and supporting quality of life. Common approaches may include hormone replacement therapy (HRT) when appropriate, hormonal birth control to help regulate cycles, and medications to address specific symptoms such as hot flashes, sleep disturbances, mood changes or vaginal dryness.

Healthcare providers also often recommend lifestyle strategies such as regular exercise, a balanced diet, stress management and adequate sleep to support overall health during the transition.

What are my tips to address perimenopause in terms of nutrition, lifestyle changes and potential supplementation or medication?

A comprehensive approach to perimenopause often focuses on supporting hormonal balance, reducing symptoms and promoting long-term health. Key lifestyle strategies include eating a nutrient-dense diet rich in protein, fiber, healthy fats and phytoestrogen-containing foods, along with regular movement, strength training, quality sleep and stress management. These habits can help support healthy energy levels, body composition, metabolic health, and overall well-being during the hormonal transition.

Depending on individual needs, supplementation may include magnesium, B vitamins, omega-3 fatty acids, adaptogenic herbs or other targeted nutrients.

For women experiencing more significant symptoms, menopausal hormone therapy (MHT), including bioidentical progesterone and estrogen when appropriate, may be considered through a shared decision-making process with a healthcare provider. Other conventional options may include medications for hot flashes, mood changes or sleep concerns.

Because every woman's hormonal profile and symptom pattern is unique, personalized treatment plans often provide the most effective support during perimenopause.

6. Bone density loss (osteoporosis/osteopenia)

Bone density loss occurs when bones become weaker and less dense over time, increasing the risk of fractures. In women, this process often accelerates during perimenopause and menopause as estrogen levels decline.

Additional factors such as chronic inflammation, inadequate intake of key nutrients, physical inactivity, and certain lifestyle habits can further contribute to bone loss and increase the risk of developing osteopenia or osteoporosis.

Symptoms

As bone loss progresses, symptoms may include:

• Frequent fractures or broken bones from minor falls or injuries

• Loss of height over time

• Stooped posture or a hunched back (kyphosis)

• Back pain caused by vertebral fractures

• Reduced strength and mobility

• Weakened grip strength

Because symptoms often do not appear until significant bone loss has occurred, routine screening and preventive measures are important, particularly for women during and after menopause.

Why is bone density loss commonly overlooked?

Bone density loss is commonly overlooked because it is often silent until a fracture occurs. Screening may be delayed, and care often focuses on medication after bone loss is already present rather than earlier prevention and root-cause support, such as hormone balance, gut health, nutrient status, inflammation, and lifestyle factors.

Relevant statistics

Bone loss can accelerate significantly during the menopause transition, with women losing up to 20% of their bone density during this period. Osteoporosis and related fractures are also extremely common, with approximately 1 in 2 women over age 50 expected to experience an osteoporosis-related fracture during their lifetime. Due largely to hormonal changes, women are affected by osteopenia and osteoporosis far more frequently than men.

How does one get diagnosed?

Bone density loss is typically diagnosed with a DEXA scan, which measures bone mineral density and provides a T-score used to identify osteopenia or osteoporosis.

Even if you’re under age 65, you should get a DEXA scan if you have any of these risk factors: fracture history, low BMI, steroids, early menopause or family history.

Additional testing may include vitamin D, calcium, parathyroid hormone (PTH), hormone panels and inflammatory markers to help identify potential contributors to bone loss. In some cases, healthcare providers may also evaluate gut health or screen for conditions such as celiac disease that can affect nutrient absorption and bone health.

What is conventionally recommended for dealing with bone density loss?

Conventional treatment for bone density loss typically includes adequate calcium and vitamin D intake, regular weight-bearing exercise, fall-prevention strategies, and lifestyle changes such as avoiding smoking and limiting alcohol.

For individuals with osteoporosis or a high fracture risk, medications such as bisphosphonates may be prescribed to help slow bone loss and reduce fracture risk.

What are my tips to address bone density loss in terms of nutrition, lifestyle changes and potential supplementation or medication?

Addressing bone density loss starts with building and protecting bone through lifestyle. Weight-bearing exercise, resistance training and regular movement are key, especially during perimenopause and menopause when declining estrogen can accelerate bone loss. Nutrition should focus on adequate protein, calcium-rich foods, leafy greens, nuts, seeds, and an anti-inflammatory diet that supports gut health and nutrient absorption.

Targeted supplementation may include vitamin D3 with K2, magnesium, omega-3s, trace minerals such as boron, and possibly collagen or algae-based calcium formulas. Bioidentical hormone therapy may also be protective for bone health when appropriate and should be discussed with a healthcare provider.

7. Thyroid disorders (especially hypothyroidism/Hashimoto’s)

Thyroid disorders are among the most common hormonal conditions affecting women, particularly during midlife. Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone, while Hashimoto's thyroiditis is an autoimmune condition in which the immune system mistakenly attacks the thyroid gland, often leading to hypothyroidism over time.

Because thyroid hormones help regulate metabolism, energy production, mood, body temperature, digestion and weight, thyroid dysfunction can affect many aspects of health.

Symptoms

Common symptoms may include:

• fatigue

• brain fog

• weight gain

• depression

• dry skin

• hair thinning

• constipation

• difficulty tolerating cold temperatures

Why are thyroid disorders commonly overlooked?

Thyroid disorders are often overlooked because many of their symptoms — such as fatigue, weight gain, brain fog, hair thinning, mood changes, and low energy — are common and can easily be attributed to stress, aging or hormonal changes. In women, thyroid symptoms frequently overlap with perimenopause and menopause, making it difficult to identify the true underlying cause.

Another challenge is that routine thyroid screening often relies primarily on TSH testing, which may not always detect early, subclinical or autoimmune thyroid conditions such as Hashimoto's thyroiditis. As a result, some women may experience symptoms for years before receiving a comprehensive thyroid evaluation and diagnosis.

Relevant statistics

Thyroid disorders are significantly more common in women, who are estimated to be 5 to 10 times more likely than men to develop thyroid disease. Up to 1 in 8 women may experience a thyroid disorder during her lifetime, and many cases remain undiagnosed. Hashimoto’s thyroiditis, an autoimmune form of hypothyroidism, is the most common cause of underactive thyroid.

How does one get diagnosed?

Diagnosing a thyroid disorder typically involves a comprehensive evaluation of symptoms along with laboratory testing. While many routine screenings only measure TSH, a more complete assessment may include free T4, free T3, reverse T3, and thyroid antibody tests such as TPO and thyroglobulin (TG) antibodies to help identify autoimmune thyroid conditions like Hashimoto's thyroiditis.

Additional testing may evaluate nutrient levels that support healthy thyroid function, including iodine, selenium, zinc and iron. Some practitioners may also assess gut health, inflammation and other underlying factors that can influence thyroid function and overall metabolic health.

What is conventionally recommended for dealing with thyroid problems?

Conventional treatment for thyroid disorders typically depends on the specific condition. Hypothyroidism is most commonly treated with thyroid hormone replacement medication, such as levothyroxine, while hyperthyroidism may be managed with medications, radioactive iodine therapy or, in some cases, surgery.

Healthcare providers also monitor thyroid hormone levels regularly and adjust treatment as needed to help relieve symptoms and restore normal thyroid function.

What are my tips for thyroid disorders in terms of nutrition, lifestyle changes and potential supplementation or medication?

A comprehensive approach to thyroid health often includes nutrition, lifestyle changes and targeted medical support when needed. Many practitioners recommend an anti-inflammatory, nutrient-dense diet that emphasizes whole foods while addressing potential food sensitivities.

Key nutrients that support thyroid function may include selenium, zinc, iodine (when appropriate) and iron. Supporting gut health, reducing inflammation and addressing autoimmune activity are also important considerations, particularly for individuals with Hashimoto's thyroiditis.

Lifestyle factors such as quality sleep, stress management, regular movement and maintaining healthy blood sugar balance can also play a significant role in supporting thyroid function and overall well-being. When medication is needed, treatment may include levothyroxine or, in some cases, thyroid hormone formulations that contain both T4 and T3.

Because thyroid symptoms can overlap with perimenopause and other hormonal conditions, the most effective approach is often personalized, taking into account symptoms, laboratory findings, nutrient status, gut health and individual goals in collaboration with a qualified healthcare provider.

8. Adrenal fatigue

Adrenal fatigue is a term commonly used in functional medicine to describe symptoms such as fatigue, brain fog, poor stress tolerance, sleep disturbances, low energy, and blood sugar instability. While chronic stress is believed to contribute to these symptoms, adrenal fatigue is not recognized as an official medical diagnosis by major medical organizations.

Symptoms

Common symptoms include:

• fatigue despite adequate sleep

• difficulty waking up

• afternoon energy crashes

• brain fog

• low motivation

• increased stress sensitivity

• sleep problems, sugar or salt cravings

• feeling generally worn down or unrested

Why is adrenal fatigue commonly overlooked?

Adrenal fatigue is often overlooked because its symptoms are vague and overlap with many other conditions, including sleep disorders, hormone imbalances, thyroid issues and chronic stress. There is also no standard medical test or diagnostic code for adrenal fatigue, making it difficult to identify within conventional healthcare.

Relevant statistics

Because adrenal fatigue is not a recognized medical diagnosis, reliable prevalence data does not exist. However, fatigue is one of the most common complaints in primary care, accounting for an estimated 20% of visits, and many adults report chronic stress, poor sleep, low energy and burnout.

How does one get diagnosed?

There is no standard medical test for adrenal fatigue. Conventional providers typically evaluate other causes of fatigue, while some functional medicine practitioners may use comprehensive hormone and cortisol testing, such as the Dried Urine Test for Comprehensive Hormones (DUTCH testing), as part of a broader assessment.

What is conventionally recommended for dealing with adrenal fatigue?

Rather than treating adrenal fatigue itself, conventional medicine focuses on identifying underlying causes of symptoms. This may include evaluating thyroid disorders, sleep problems, anemia, nutrient deficiencies, diabetes, hormone imbalances, chronic stress, depression, anxiety or adrenal insufficiency.

What are my tips for addressing adrenal fatigue in terms of nutrition, lifestyle changes and potential supplementation?

Supporting healthy energy levels often starts with prioritizing quality sleep, stress management, balanced blood sugar, hydration, and adequate protein intake. Gentle movement such as walking, yoga, stretching and breathing exercises may be beneficial, while excessive high-intensity exercise and stimulant overuse may be counterproductive.

I also emphasize supporting nutrient status, including electrolytes, magnesium and B vitamins.

As always, you should consult your healthcare professional prior to beginning any new dietary or lifestyle regimen.

Dr. Jessi Grajczyk, D.O. (doctor of osteopathic medicine) and OB/GYN (obstetrician-gynecologist), is a Wellness Roundtable member and Ancient Nutrition Paid Partner. Hailing from North Dakota, her strong family roots influenced her approach to practicing medicine, always seeking to find a balance between traditional and alternative methods of healing.