While menopause fatigue can be a debilitating symptom during this season of life, it doesn’t have to be! With the right support in place, including vitamins, minerals, and nutrients, you can restore energy, stabilize your mood, and support your body’s natural transition into menopause and beyond! 

Reading Time: 13 minutes

If you’re navigating perimenopause or menopause, you likely know exactly how “menopause fatigue” feels. That feeling of waking up exhausted and drained, no matter how much you eat. But let me be clear: it’s not just “getting older.” It’s your body’s way of signaling deeper imbalances—hormonal shifts, nutrient depletion, and higher stress loads that make your cells work overtime.

While menopause fatigue can be a debilitating symptom during this season of life, it doesn’t have to be! The good news? With the right support in place, including vitamins, minerals, and nutrients, you can restore energy, stabilize your mood, and support your body’s natural transition into menopause and beyond! 

Let’s dive into the top nutrients that can ease menopause fatigue and why they matter.

WHAT IS MENOPAUSE FATIGUE?

Menopause fatigue is not as simple as feeling tired frequently. Menopause-related fatigue takes it to the next level. You might be “doing all the right things,” yet still feeling debilitating fatigue. Why does this happen?

During menopause, the ovaries produce fewer hormones. In response, your body turns to the adrenal glands to amp up hormone production. As the adrenals work overtime, menopause fatigue is a typical result. This also explains the night sweats and insomnia that often accompany menopause.

Menopause also marks the natural decline in estrogen and progesterone, but what most women aren’t told is how this impacts cellular energy, neurotransmitters, and detox pathways. Hormonal changes during perimenopause and menopause place extra stress on not only the adrenals but also the liver, increasing inflammation and often leading to blood sugar fluctuations. On top of that, this season of life (ages 35–55) is already full of demands—career, family, aging parents—which only increases nutrient drain further. 

OTHER COMMON MENOPAUSE SYMPTOMS

Menopause typically affects women between the ages of 45 and 55. However, menopause is not defined by age. Symptoms of menopause can start as early as 35. The transition into menopause is known as perimenopause and is a season where many early symptoms can begin when areas are out of balance. 

The most common earlier signs of menopause (that may indicate perimenopause) include:

• Sudden PMS changes (heavier, more irregular, or more symptomatic cycles)
• Night wakings, especially between 2:00 and 4:00 a.m.
• Rapid weight gain despite healthy eating and exercise 
• New or worsening mood swings, anxiety, or irritability
• Brain fog or memory glitches
• A sudden wave of fatigue, even with healthy habits
• Increased sensitivity to stress or foods you once tolerated
  

Many women blame this on “just stress” or “mom brain,” but in reality, it’s often your nervous system and hormones signaling for deeper support. Additionally, if you’re experiencing the following symptoms, you might be approaching menopause or already in menopause. 

The most common symptoms of menopause are:

• Profound fatigue and exhaustion 
• Hot flashes
• Night sweats
• Irregular periods
• Vaginal dryness
• Mood changes or irritability
• Sleep disturbances
• Brain fog or difficulty concentrating
• Rapid weight gain (especially around the midsection)
• Decreased libido

As previously mentioned, a lot of these symptoms have to do with the decline in hormone production during menopause. However, there are ways to support the body and minimize symptoms during this time.

THE KEY DRIVERS AND ROOT CAUSES OF MENOPAUSE FATIGUE 

Before we discuss the vitamins, it’s essential to understand what’s causing your energy drain. Functional medicine prioritizes identifying the root cause of symptoms to support the body as a whole. 

The most common root causes of menopause fatigue include:

Hormonal Changes

During menopause, estrogen and progesterone levels begin to decline. In fact, progesterone levels actually are the first to see a decline during perimenopause (the period of time before menopause). Cortisol, known as the “stress hormone,” often increases during menopause and can exacerbate symptoms, like fatigue.

Common hormone patterns in menopause include: 

Estrogen dominance – Too much estrogen compared to progesterone, often worsened by toxins, gut imbalances, and poor detox pathways.

Progesterone deficiency – Often tied to low healthy fat intake, over-exercising, or chronic stress.

Poor estrogen metabolism – A sluggish liver or genetic SNPs, such as COMT, can make it harder to clear estrogen.

Low Cellular Energy Production

Mitochondria are the powerhouses that create energy (ATP) in the body. Estrogen acts as a mitochondrial protector, so when estrogen levels begin to drop, so does mitochondrial function. This has a drastic impact on physical energy levels during menopause.  

Blood Sugar Dysregulation 

Blood sugar dysregulation is one of the biggest hidden drivers of menopause fatigue. When estrogen and progesterone shift, the body becomes more sensitive to insulin. This means blood sugar spikes and crashes happen more easily, even with a healthy diet. 

Each spike in blood sugar can leave you feeling jittery, followed by a crash that brings brain fog, irritability, and exhaustion. Over time, this blood sugar “rollercoaster” drains your energy, disrupts sleep, and makes hot flashes and mood swings worse. 

Sluggish Thyroid and Adrenal Dysregulation

As hormone production decreases, the body relies more on the adrenal glands to produce hormones. This increase in demand can quickly lead to adrenal stress and dysregulation, causing not only fatigue but cortisol spikes that disrupt sleep and worsen hot flashes. 

Additionally, estrogen has a direct impact on thyroid function. When estrogen levels decrease, thyroid function often slows, which can sometimes lead to thyroid imbalances.

Vitamin B Depletion 

B vitamins, particularly B6 (pyridoxine)  and B12 (cyanocobalamin), are recognized for supporting healthy energy levels and alleviating brain fog. Methylation plays a crucial role in metabolizing B vitamins, regulating hormone balance, and other essential processes. 

When it comes to absorbing and utilizing B vitamins, the process of methylation is crucial. If B vitamins are deficient and methylation is impaired, liver detoxification is often sluggish, resulting in an increased toxin load and fatigue. 

Poor Detoxification and Sluggish Liver Function

When the liver is overburdened or sluggish due to high toxin load, the detoxification system is compromised. When it comes to estrogen, a sluggish liver can lead to estrogen dominance, characterized by an excessive amount of estrogen circulating in the body. Fatigue is a common consequence, along with bloating, weight gain (especially around the hips and thighs), and mood swings.

Inflammation and Oxidative Stress

The change in hormones during menopause often allows for inflammation in the body to increase. In fact, many common symptoms of menopause, like hot flashes and insomnia, are linked to increased levels of inflammation. 

Additionally, lower levels of estrogen lead to reduced protection against oxidative stress, which also increases inflammation. It’s a vicious cycle between oxidative stress and inflammation during menopause. 

Poor Sleep Quality

Hormonal changes and increased levels of inflammation are often to blame for disrupted sleep during menopause. Common sleep symptoms include insomnia, hot flashes, night sweats, and more. The change in hormones, such as the increase in cortisol and decrease in progesterone, can also have negative impacts on the body’s circadian rhythm. This can make it hard to maintain a regular sleep-wake cycle. 

If these drivers of hormone imbalance aren’t addressed, fatigue, mood swings, and brain fog become constant companions.

THE BEST NUTRIENTS AND VITAMINS FOR MENOPAUSE FATIGUE 

Nutrient deficiencies will only exacerbate symptoms of menopause, including menopause fatigue. It’s essential to ensure your body receives an adequate amount of vitamins and minerals not only to survive, but also to thrive, during this time. As always, test, don’t guess, so that you can correctly identify and address your unique deficiencies. 

That’s why strategic supplementation isn’t about “pills for energy”—it’s about filling the gaps created by hormonal changes and helping your body run the way it was designed to. 

These are the top vitamins and minerals to combat menopause fatigue:

Magnesium Supplements (Glycinate, Malate, or Threonate)

If there’s one nutrient every perimenopausal and menopausal woman should prioritize, it’s magnesium! This powerhouse is involved in over 300 enzymatic reactions, including the regulation of the nervous system, sleep cycles, blood sugar balance, and hormone detoxification. 

Magnesium is also known for its role in restoring mitochondrial energy. Unfortunately, stress and aging naturally (and quickly) deplete magnesium stores. As a result, most women in menopause are deficient in this area. 

There are several types of magnesium to consider. Magnesium glycinate calms the nervous system and promotes better sleep. Magnesium malate supports energy and muscle recovery, and magnesium threonate crosses the blood-brain barrier to support brain function and cognitive health.

Magnesium is supportive in menopause by: 

• Assisting in deep, restorative sleep
• Increasing energy 
• Calming anxiety and mood swings
• Reducing headaches and muscle tension
• Helping your body detox excess estrogen

Food sources of magnesium include spinach, pumpkin seeds, almonds, avocados, and dark chocolate.

B Vitamins (Especially B6, B9, and B12)

Think of B vitamins as your mitochondrial spark plugs. They drive energy production, methylation, neurotransmitter balance, and hormone detoxification. Signs you may be low in B Vitamins include fatigue, brain fog, irritability, poor sleep, and even elevated homocysteine (an inflammation marker linked to heart disease).

B12 is essential for the formation of red blood cells, nerve function, and maintaining a healthy mood. Specifically, methyl-B12, also known as methylcobalamin (the active form of B12), is essential for proper methylation, neurotransmitter production, and cellular energy production. 

Vitamin B6 (pyridoxine) aids estrogen metabolism, progesterone synthesis, mood regulation, and sleep regulation. Always opt for a B vitamin supplement that is active or methylated, such as methylfolate, methylcobalamin, or P5P. A good methyl B complex will cover this! 

B9 (Folate) helps methylation and estrogen detox (use methylated folate, not synthetic folic acid). Niacin & Riboflavin are B vitamins that offer additional support for cellular energy. 

The best food sources of B vitamins include quality proteins such as wild fish, eggs, poultry, and grass-fed beef. The best plant sources include leafy greens. 

Vitamin D3 + K2

Vitamins D3 and K2 work synergistically, supporting each other’s functions. They promote hormonal signaling, immune health, and bone strength. Specifically, Vitamin D helps regulate energy, immunity, and mood. 

Vitamin K2 supports calcium metabolism and complements vitamin D3 for bone and heart health. This support is especially crucial during and after menopause when estrogen declines. Keep in mind that adequate ranges in functional medicine are often higher than conventional norms.

Vitamin D deficiency is common among midlife women, especially those who spend less time outdoors. Pairing it with K2 ensures that calcium is directed to the bones—not to other areas, such as the arteries.

Why Vitamin D Matters for Menopause Fatigue:

• Supports immune health (less energy drain from illness)
• Improves mood and reduces the risk of depression
• Helps maintain bone density during hormone shifts

Food and lifestyle sources include morning sunshine, fatty fish, and pasture-raised eggs.

Supplement tip: Opt for D3 with K2 for optimal absorption and synergy.

Creatine

Creatine is a safe and effective supplement that boosts cellular energy, enhances brain clarity, and replenishes ATP stores to provide stable energy throughout the day. Creatine also supports mental clarity, stamina, and the preservation of lean muscle, which is key during hormonal shifts in menopause to support fat loss. In my clinical opinion, creatine is a secret weapon to ease through menopause! 

NOTE

Omega-3 Fatty Acids (EPA + DHA)

EPA and DHA from omega-3 fatty acids are naturally anti-inflammatory and hormone-balancing. They also improve brain function, regulate mood, and protect against cardiovascular dysfunction (which is especially important during and after menopause). 

Why EPA/DHA Matters for Menopause Fatigue:

• Reduce hot flashes and night sweats
• Improve brain fog and memory
• Stabilize mood and nervous system
• Support cardiovascular health as cholesterol shifts in menopause

The best food sources of omega-3 fatty acids include wild-caught fatty fish, such as salmon, sardines, and mackerel. Plant-based sources include chia seeds and walnuts. 

Supplement Tip: Aim for 500+ mg of combined EPA/DHA daily.

CoQ10 (Ubiquinol Form)

As estrogen declines, mitochondrial efficiency decreases. CoQ10 supports mitochondrial function and ATP production, thereby improving cellular energy production. CoQ10 is one of the most beneficial nutrients for women experiencing fatigue and brain fog. 

Additionally, CoQ10 is especially beneficial for women over 40 or those taking statins (common cholesterol-lowering medications), as its production and conversion decline with age. It is known for supporting the heart, brain, and energy metabolism. 

CoQ10 comes in two forms: ubiquinone and ubiquinol. Ubiquinol is the active form and is better absorbed by the body. 

Iron (If Deficient)

If you’ve struggled with low levels of iron, it can become very persistent during menopause. This is likely due to absorption issues or gut inflammation. Iron aids in oxygen transport and supports vitality, which is why it is crucial for maintaining physical energy. 

Why Iron Matters for Menopause Fatigue:

• Essential for hemoglobin and oxygen delivery
• Prevents brain fog and shortness of breath
• Supports resilience against burnout

When menstruation is still happening, heavy bleeding can cause low iron, a primary fatigue driver. On the other hand, after menopause, excess iron may accumulate, making testing crucial. Knowing the levels of ferritin, serum iron, and TIBC before supplementing can ensure proper use, as excessive iron intake can exacerbate inflammation. The golden rule with iron is to determine the root cause of low iron levels and address this issue alongside increasing the intake of iron-rich foods. 

Food sources of heme iron that will be best absorbed are liver, grass-fed beef, chicken, and lamb. Plant sources of non-heme iron include pumpkin seeds, leaky greens, and lentils. 

Calcium D-Glucorate 

Calcium D-glucorate is naturally produced by the body and is known for supporting estrogen metabolism and detoxification. It aids in estrogen metabolism by breaking it down in the liver. It can be especially helpful for symptoms of estrogen dominance, like irritability, breast tenderness, or heavy periods.

Found in cruciferous vegetables, this nutrient binds excess estrogen and helps your body safely eliminate it. That means less estrogen dominance and fewer fatigue-inducing symptoms.

DHEA 

DHEA is a hormone produced by the adrenal glands. It supports low estrogen and testosterone levels, as well as overall vitality. It has also been shown to support mood stability, libido, and energy levels. As always, confirm your DHEA levels with a functional medicine practitioner who can help you monitor levels before determining if supplementation is right for you! 

Zinc

Zinc is a mineral known for supporting hormone balance, particularly in boosting testosterone levels, which decline during menopause. It’s also a key component of a strong immune system, aiding in hair and skin health, as well as wound healing.

Often overlooked, zinc also plays a crucial role in gut function and hormone production. It’s commonly low in women dealing with stress, poor gut absorption, or chronic inflammation. While zinc is helpful for menopause, supplementation can be tricky if levels aren’t properly monitored to ensure an optimal zinc to copper ratio. 

Whenever possible, it is best to supplement zinc as part of a nutritionally balanced diet and add supplementation when paired with appropriate supplements. 

Top food sources of zinc include oysters, pumpkin seeds, grass-fed beef, and liver. 

NAC (N-Acetyl Cysteine) or Glutathione 

NAC can help support the accumulation of toxins during menopause to boost energy levels. As a precursor to glutathione, the body’s master antioxidant, it boosts antioxidant levels, supports methylation, enhances detoxification and cognitive function, and reduces oxidative stress. 

L-Theanine

L-theanine is an amino acid known for its calming effects. It’s naturally found in green tea leaves, but also comes in supplement form. It promotes alpha brain waves and reduces the edge of anxiety, which naturally supports the body’s response to stress.

Nutrient supplementation can be an effective and safe way to support your body’s energy levels during menopause. However, as always, it is crucial to work with a trusted healthcare practitioner to test your nutrient levels instead of relying on blind supplementation. 

WHAT ABOUT HERBAL REMEDIES FOR MENOPAUSE FATIGUE?

In addition to supplementing with nutrients, herbal remedies can be highly beneficial in fighting menopause fatigue. The top well-rounded herbal remedies include:

• Black Cohosh: I recommend Black Cohosh Plus by Metagenics
• Valerian Root for sleep support
• Rhubarb Root for Hormone Support: I recommend Her Wellness Estrovera by Metagenics 
• Saw Palmetto for testosterone metabolism
• Adaptogenic Herbs, such as Ashwagandha, Rhodiola, Eleuthero, and Cat’s Claw

WHY SUPPLEMENTS ALONE AREN’T ENOUGH FOR MENOPAUSE FATIGUE

While supplementing with nutrients and herbal remedies can be an effective way to support the body during menopause fatigue, it is also crucial to provide the body with the most fundamental foundations: a balanced diet and a healthy lifestyle. 

Balanced Diet for More Energy

Stabilizing glucose through balanced meals, protein at every sitting, and consistent eating rhythms is one of the fastest ways to reclaim steady energy during perimenopause and menopause.

A balanced diet that supports energy levels looks like:

• Anti-inflammatory fruits and vegetables 
• Microbiome friendly with prebiotics and probiotics 
• Quality protein-packed meals 
• Healthy animal fats for hormone production
• Wild-caught fish that are high in omega-3 fatty acids for reducing inflammation 
• Phytoestrogens from plants like tempeh, sesame, and berries
• Micronutrient-rich whole foods
• Adequate hydration 
• Low-glycemic and mineral-rich

Lifestyle Changes That Help Supplements Work Better

Healthy lifestyle changes that can further support your body’s energy production include:

• Good sleep hygiene and circadian rhythm repair
• Nervous system regulation: vagus nerve, breathwork, sunlight
• Gentle strength training and walking
• Gentle detox and lymphatic support
• Blood sugar regulation

PERSONALIZED TESTING + SYMPTOM INSIGHT FOR MENOPAUSE

As with all functional approaches, including supplementation, you should always test, not guess. This is where functional testing comes into play. It’s essential to identify where your body is specifically deficient, determine your baseline, and determine the proper supplementation dosage for you (if necessary). 

As a board-certified Registered Dietitian and IFMCP board-certified functional medicine practitioner, I utilize a variety of functional tests to personalize the best roadmap to help you achieve boundless energy and vitality. 

There’s no single lab that can definitively say “you’re in menopause.” But combining symptoms with testing gives the clearest picture. Helpful labs and assessments include:

• Hormone panels (estrogen, progesterone, FSH, LH, cortisol)
• Cycle tracking (to see shifts in luteal phase length or irregular bleeding)
• Glucose & insulin testing (most important for energy and hormone stability)
• Stool testing (markers like beta-glucuronidase show estrogen metabolism)
• Nutrient testing (micronutrient analysis for magnesium, B vitamins, zinc, omega-3s)
• Toxin evaluation (mold, heavy metals, and endocrine disruptors can worsen early perimenopause)

For menopause fatigue specifically, I find that micronutrient testing, Dutch hormone testing, GI map stool testing, and custom functional blood chemistry panels are the most helpful. After testing, we can develop an effective, customized, and targeted supplement plan, along with a 5-step approach, to help you regain your energy during menopause and for decades to come. 

WRAPPING IT ALL UP 

Perimenopause and menopause fatigue might be debilitating, but that doesn’t mean you have to stay in survival mode. When you understand the underlying hormone shifts and use the proper nutrients, you can reduce fatigue, restore energy, and show up fully for your family, work, and calling! 

Here’s the recap of the most impactful vitamins for menopause fatigue:

• Magnesium for nervous system balance
• Omega-3 fatty acids for inflammation and brain health
• B vitamins for energy and detox pathways
• Vitamin D + K2 for bone and mood stability
• Zinc for hormones and gut function
• DHEA for adrenal and hormone balance 
• Calcium-D-Glucarate for estrogen detox
• NAC and glutathione for liver detoxification and estrogen metabolism
• Theanine and adaptogens for stress resilience
• CoQ10 for cellular energy

Want the entire menopause supplement protocol, including brand recommendations? Sign up to claim it for free today and coast through menopause with ease and energy! 

Remember, fatigue is your body’s way of asking for deeper support—and the right practitioner, personalized plan, and proven process can make all the difference! 

Next step: Don’t just guess what is best for your body! Get your labs checked so you know exactly what your body needs! Apply to work with me 1:1, and we’ll create a personalized plan to restore your energy, balance your hormones, and help you thrive in this next chapter of life! 

READ THE LATEST BLOG POSTS:

• Vitamins for Menopause Fatigue: How to Boost Energy and Feel Your Best
• Pumpkin Pie Tarts: A Delicious Fall Recipe
• Inflammation and Weight Gain: Why It Matters + How to Heal
• What Are Biofilm Disruptors? How They Work and Why They Matter for Gut Health
• Best Anti-Inflammatory Smoothie Recipe for Better Gut Health