By Dr Daniel Min, Naturopathic Doctor
Every November, a lot of men grow a moustache for a good cause. Far fewer book the appointment the moustache is supposed to remind them about.
Does this sound familiar? He falls asleep on the couch by 8:30. He's "fine," just busy. The coffee count has crept up, the gym bag hasn't moved in weeks, and he's shorter-fused than he used to be. Ask him about it and you'll hear some version of "I'm just getting older."
Getting older is real. But being tired all the time is not a normal part of being 40 or 50, and it's rarely just one thing. In my practice, persistent fatigue in men usually has a cause we can find, and often more than one. This Movember, let's talk about what those causes are, why men put off checking, and what you (or the man in your life) can actually do about it.
Why men don't get checked
Most men I see didn't come in on their own. A partner booked it, or nudged until they did. That's not a criticism. The reasons men delay are understandable:
Fatigue doesn't feel like a "real" symptom. There's no pain, no fever, nothing to point at. It feels like a character flaw to fix with more discipline.
"My bloodwork was normal." Many men had a basic panel years ago and took it as a clean bill of health for life.
Low energy creeps in slowly. When you lose a little each year, the new normal stops looking unusual.
Some of the causes feel embarrassing to discuss. Low libido, mood changes and poor sleep aren't easy topics over dinner, let alone with a doctor.
The cost of waiting is that small, fixable problems get time to compound. Poor sleep affects blood sugar, blood sugar affects energy, and low energy makes it harder to do the things that would help.
The thyroid: not just a women's issue
Thyroid problems are more common in women, which is exactly why they get missed in men. Your thyroid sets the pace of your metabolism. When it slows down, so does everything else.
Signs worth paying attention to:
Tired even after a full night's sleep
Feeling cold when others are comfortable
Weight gain without a change in diet
Brain fog, low mood or low motivation
Dry skin, constipation, thinning hair or eyebrows
Here's the catch. A standard screen usually checks one marker, TSH. That's a reasonable starting point, but it doesn't show the whole picture. Free T4 and Free T3 tell us how much active hormone is actually available, and thyroid antibodies (anti-TPO) can show an autoimmune process years before TSH moves out of range. A man can be told his thyroid is "fine" while the fuller picture says otherwise.
Testosterone: more than libido
Testosterone gets talked about mostly in terms of sex drive, but it does much more. It supports energy, muscle, mood, motivation and how well you recover. Levels tend to drift down gradually with age, and lifestyle factors like poor sleep, excess abdominal weight, chronic stress and heavy drinking can push them lower, faster.
Common signs of low testosterone include:
Persistent fatigue and low drive, in and out of the bedroom
Losing muscle or strength despite training
More belly fat
Irritability, flat mood or loss of competitiveness
Poorer sleep and slower recovery
Two things matter here. First, testing should be done properly: in the morning, when levels are highest, and ideally looking at free testosterone, not just total. Second, low testosterone is often a signal, not the root problem. Fixing sleep, blood sugar and body composition can bring levels up meaningfully. Jumping straight to replacement without asking why skips the most useful part of the conversation.
Bloodwork is the starting point, but it only shows how much testosterone is circulating. That's why I often pair it with EndoInsight PLUS, an at-home dried urine and saliva hormone test. It shows what the body is doing with its testosterone: how much is converted to the more potent DHT, how much heads toward estrogen, and how DHEA and the other building blocks look. It also maps cortisol and melatonin across the day, which tells us a lot about stress, sleep and why someone crashes at 3 p.m. Together, the two tests give a much clearer picture than either one alone.
The other usual suspects
Thyroid and testosterone get the headlines, but they're rarely the whole story. A few others show up again and again:
Sleep apnea. If he snores loudly, stops breathing at night or wakes unrefreshed, this deserves a proper look. It's common in men, often undiagnosed, and it drags down energy and testosterone alike.
Blood sugar. The 3 p.m. crash, needing something sweet after meals and weight settling around the middle can all point to blood sugar that's swinging more than it should, long before anyone says "diabetes."
Vitamin D. On the West Coast, most of us make very little from the sun between October and March. Low levels are linked with low energy and low mood.
Iron and B12. Less common in men than women, but still worth checking, especially with heavy endurance training, digestive issues, a plant-based diet or certain medications like metformin or acid blockers.
Stress and cortisol. Running on adrenaline for months leaves people "wired but tired": exhausted all day, then alert at 11 p.m.
The point isn't to self-diagnose from a list. It's that "tired" has many possible causes, and a thorough workup is how you stop guessing.
What to put in the cart this month
Food won't fix an underactive thyroid or sleep apnea on its own, but it builds the foundation everything else depends on. A few easy wins next time you're at Pomme:
Protein at breakfast. Eggs, Greek yogurt or a quality protein powder. Starting the day with 25 to 30 grams of protein steadies blood sugar and cuts the mid-afternoon crash.
Brazil nuts. Two a day covers selenium, which the thyroid needs to activate its hormones. More isn't better here, so stick to a couple.
Pumpkin seeds and oysters. Both are rich in zinc, a key mineral for testosterone production.
Wild salmon, sardines and mackerel. Omega-3s for mood and inflammation, plus a little vitamin D.
Leafy greens, beans and lentils. Fibre and magnesium for blood sugar control and better sleep.
A vitamin D supplement. Worth discussing with a practitioner, ideally after testing, so the dose fits.
And the non-grocery basics still matter most: seven to eight hours of uninterrupted sleep on a consistent schedule (timing matters as much as total hours), lifting something heavy two or three times a week, and fewer drinks than he thinks he's having.
For partners: how to bring it up
If you're reading this and thinking of someone specific, you're not alone. A few approaches that tend to land better than "you need to see a doctor":
Lead with what you've noticed, not a diagnosis. "You've seemed wiped out lately, and I miss the old you on weekends" opens a door. "I think your hormones are off" closes it.
Make it about performance, not illness. Many men respond better to "let's get your numbers dialed in" than to "something might be wrong."
Use Movember as the excuse. It's a natural, low-pressure reason to book a check-up this month.
Offer to handle the logistics. Finding the clinic and booking the time removes the most common barrier, which is simply getting around to it.
The bottom line
Being tired all the time is information, not a personality trait. When the full picture gets looked at, the cause is usually findable and usually fixable. It just needs someone to look beyond "your bloodwork is normal."
That's the idea behind CLARITY, my program for persistent fatigue. We run a comprehensive panel, including the fuller thyroid and hormone markers mentioned above, then build a plan around what the results actually show.
If this article made you think of yourself or someone you love, book a free health strategy session with me at the Pomme Clinic inside Pomme Natural Market. It's a relaxed conversation about what's going on and whether a deeper look makes sense.
Grow the moustache. Then book the check-up.
DR DANIEL MIN, ND
I help people uncover the root causes of fatigue, stress and burnout using a calm, evidence-informed approach that blends Eastern and Western principles. Growing up in a Korean-Canadian household, I learned firsthand how real food and regenerative practices support the body's natural ability to heal and thrive.
I translate complex health concepts into clear, actionable strategies, guiding clients step by step. Working with me feels structured, collaborative and empowering. Patients leave understanding the "why" behind each step and confident in building long-term health.
Serving Port Coquitlam and surrounding communities, I focus on practical, integrative care that combines nutrition, lifestyle and mindful practices to help you restore energy, focus and balance. If you're ready for a truly personalized approach to health, let's connect for a free health strategy session at EvokeLife.co at the Pomme Clinic inside Pomme Natural Market.
This article is for general education and isn't a substitute for individual medical advice.