Why So Many Women Feel Exhausted —Even When Their Blood Tests Are“Normal”
- Thrive Collective
- Nov 28, 2025
- 3 min read
Updated: Nov 28, 2025
Feeling constantly tired, foggy, overwhelmed, or simply “not yourself” — even though your GP says your blood tests are normal — is one of the most common concerns we see in women
between the ages of 35 and 60.
If this sounds familiar, you’re not imagining it.
Many women experience significant changes in hormones, thyroid function, metabolism,
cortisol, and neurochemistry years before standard medical tests detect anything unusual.
And because traditional medicine only checks a small number of markers, countless women are
left without answers.
During her upcoming visit from 3–11 December, Dr Susan Ward will be working with women
who want real explanations and personalised solutions for their fatigue, weight changes, mood
shifts, cognitive challenges, and neurodivergent experiences.
Below, she explains the key reasons why so many women feel exhausted — and what can be
done to fix it.
1. Cortisol Rhythm Dysregulation (The Silent Exhaustion Pattern)
Chronic stress gradually disrupts your natural cortisol pattern, leaving you:
wired in the evening
exhausted in the morning
anxious or irritable
unable to fall asleep or stay asleep
reliant on caffeine for energy
Standard blood tests don’t measure your daily cortisol rhythm, only total cortisol. Functional
testing looks at your morning peak, afternoon dip, and evening decline, which is essential for
restoring energy.
2. Perimenopause & Menopause Hormone Shifts
Hormonal changes often begin in the mid-to-late 30s — long before periods stop. Even subtle
changes can have profound effects.
Lower oestrogen → anxiety, hot flushes, night sweats, brain fog, reduced memory
Lower progesterone → irritability, poor stress tolerance, sleep problems
Lower testosterone → loss of motivation, weaker muscles, lower libido, low energy
These shifts can be misdiagnosed as depression, burnout, or “normal ageing”. Functional
hormone testing reveals the true picture.
3. Thyroid Issues That Are Missed or Undertreated
Thyroid disorders are extremely common in women, especially after 40 — yet many cases are
overlooked.
A normal TSH does not guarantee optimal thyroid function.
Women can have:
low T3 conversion
elevated reverse T3
early autoimmune thyroid disease (TPO antibodies)
subclinical hypothyroidism
post-pregnancy thyroid dysfunction
Symptoms include fatigue, weight gain, brain fog, hair loss, constipation, low mood and cold
intolerance and many others.
Dr Susan has advanced training in diagnosing complex thyroid conditions, particularly when
symptoms persist despite “normal” test results.
4. Neurodivergence, ADHD & Autism in Women
Symptoms of neurodivergence often become more noticeable in midlife, especially when
combined with hormonal shifts.
Neurodivergent women may experience:
dopamine-driven fatigue
sensory overload
emotional dysregulation
chronic overwhelm
difficulty with executive function
burnout cycles
rejection sensitivity
fluctuating motivation
These patterns interact strongly with hormones, thyroid function and metabolic health.
At Thrive Collective we offer assessments and support that
take the whole picture into account.
5. Blood Sugar Instability & Hidden Insulin Resistance
Even women who eat well and exercise can develop insulin resistance, especially after 40 or
after menopause.
Common signs include:
stubborn abdominal fat
carb cravings
energy crashes
poor stress tolerance
slow recovery
weight plateaus
Balancing glucose stabilises mood, sleep, hormones and metabolism.
6. Nutrient & Neurotransmitter Deficiencies
Low levels of key nutrients can mimic mental health disorders or ADHD:
iron
B12
folate
vitamin D
magnesium
omega-3s
Deficiencies can cause low mood, anxiety, poor concentration, fatigue and brain fog.
Supporting neurotransmitters (serotonin, dopamine, GABA) plays a crucial role in restoring
wellbeing.
How Dr Susan Works: The Thrive Collective Approach
Dr Susan integrates functional medicine with evidence-based women’s health, thyroid
optimisation, metabolic analysis and neurodivergent-informed care.
Her consultations may include:
Functional hormone panels
Full thyroid assessment (T3, T4, rT3, antibodies)
Cortisol rhythm testing
Menopause & perimenopause support
ADHD & autism-informed strategies
Advanced metabolic testing
Mood & neurotransmitter support
Personalised HRT when appropriate
Nutrient and peptide therapy
GLP-1 weight optimisation and muscle-sparing strategies
This is personalised, whole-person medicine — far beyond “your tests look fine”.
If You Don’t Feel Like Yourself... There Is a Reason
Fatigue, weight changes, anxiety, low motivation, and brain fog are not things you need to
simply accept.
They are signs your body is asking for support.
And with thorough assessment and targeted treatment, the majority of women feel dramatically
better within weeks.
Dr Susan Ward Appointments (3–11 December, 2025)
Consultations are limited and her previous visit was fully booked.
📍 Thrive Collective, 41 Gough Street, Central
📞 +852 9177 1562
Comments