When it’s working properly, your thyroid—a hormone-producing gland at the base of your throat—is an unsung hero of metabolism regulation, affecting the body’s energy usage, temperature, heart rate and more. When you have hypothyroidism, however, the gland may not produce enough hormone, which slows metabolism and may cause fatigue.

According to Rachel Nutting, PA-C, a Certified Physician Assistant at West Valley Medical Center in Nampa, Idaho, fatigue is one of the most common complaints of people with hypothyroidism. “Generally, people come in with fatigue that’s not easily explained by other diseases,” she says. “Testing for thyroid dysfunction is one of the top tests I do.”

The hallmarks of thyroid-related fatigue are that it’s ever-present, no matter what you might do to combat it, and that your fatigue is accompanied by other symptoms related to slowed metabolism. These can include constipation, cold intolerance, depression and weight gain, says Nutting.

So, what can you do to fight the fatigue? Nutting offers some practical tips for getting back your energy and rejoining the “Can-do!” ranks.