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that means your cells dont respond well to insulin, the hormone that tells them to use glucose (a.k.a sugar) from food as energy, Christina Boots, MD, a board-certified reproductive endocrinologist at Northwestern Medical Group and associate professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF

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Patients who experience persistent fatigue beyond 6 weeks may have underlying contributors such as inadequate calorie or nutrient intake, undiagnosed thyroid dysfunction, or depression related to rapid lifestyle changes

10.1016/j.freeradbiomed.2006.01.035 Free Radic Biol Med