Fatigue

 Tiredness and Fatigue: A Crisis in Modern Society

Are you just tired or are you fatigued.

Fatigue can be defined as a generalised malaise that impacts on a person’s physical and mental health. People often lack motivation (and the energy) tocomplete even simple day to day tasks.

People with fatigue may experience:

·         Low energy and vitality

·         Poor physical performance, along with low stamina and strength

·         Mood disorders such as low mood and/or depression

·         Poor memory, inability to concentrate

The interplay between physical and cognitive performance is disrupted, and a cycle of physical fatigue leading to cognitive fatigue leading to physical fatigue – the cycle can go on and on.

When defining fatigue, it’s essential to differentiate between daytime sleepiness and fatigue. People with fatigue often say things like ‘I’m exhausted allthe time’, or ‘I can’t concentrate on anything’.

Mitochondria and Fatigue

Fatigue and mitochondria are linked. 

Mitochondria are tiny organelles found in most cells of the body that are responsible for energy production.

Mitochondria produce energy. No matter whether you are at rest or exercising vigorously you need energy to function properly. Energy production is a complex process that relies on the Krebs or Citric Acid Cycle, and the Electron Transport Chain. Simply put, glucose goes in one end and energy comes out the other.

Adequate amounts of energy are needed by cells and organs in order to function properly and maintain metabolism.

Many drivers of fatigue impact on the health and function of mitochondria.

Drivers of Fatigue

The underlying causes of fatigue are many and varied. Most people who have fatigue often have more than one reason why they are fatigued. Causes include:

·         Infection – microbial and/or viral. It’s worth noting that post-viral fatigue is a well-known phenomenon in Naturopathy. Naturopaths and Herbalists have been helping patients overcome post-infection fatigue for decades.

·         Nutritional deficiencies can play a major role in fatigue. Mitochondria need more than just glucose to make energy. To make energy each mitochondria needs a mix of B vitamins, magnesium, manganese, cysteine, lipoic acid, iron, copper and Coenzyme Q10. These nutrients need to be in the right proportion – too little and your mitochondria can’t do their job, too much can cause toxic stress. Mitochondria can be damaged by oxidative stress, drugs and alcohol, environmental toxins, ageing and genetic vulnerabilities.

·         Low iron, which leads to low cellular oxygen (iron in haemoglobin carries oxygen around the body distributing it to cells)

·         Lifestyle factors such as poor sleep habits, lack of exercise, and lack of fresh air can all lead to fatigue.

·         Hormonal changes – stress hormones such as cortisol and DHEA, sex hormones such as testosterone

·         Gastrointestinal issues – malabsorption, dysbiosis

A major driver of fatigue is thyroid dysfunction. Low levels of thyroid hormones (T4 and T3), poor conversion of T4 to T3, and cellular hypothyroidism are key drivers of thyroid related fatigue. Thyroid and fatigue is a topic in itself, so I won’t cover it in this Blog.

Helping patients with ongoing fatigue is a matter of peeling away at the layers that make up the cause. It is rare that there is one clear driver of fatigue.

Treating Fatigue

Pathology testing is often used to detect changes to biochemistry and nutrient levels which may provide valuable clues to the underlying cause of fatigue. Once nutritional abnormalities are identified, a tailored prescription of nutritional supplements can make a significant change to energy levels.

Common supplements prescribed to help patients with fatigue include magnesium, B vitamins, vitamin D, carnitine, CoQ10, and lipoic acid.

Eating the right food can help as well. Including good fats, fibre, vegetables and fruits (6-9 cups daily), and good sources of protein can provide your body with the nutrients and fuel it needs to function better.

Avoiding refined food, particularly added sugar, and alcohol can be of great benefit.

Specific medicinal herbs can help with fatigue. Different herbs are prescribed depending on what fatigue signs and symptoms to patient has. There is no ‘one size fits all’ herbal prescription for fatigue. What suits one patient, won’t suit another.

Adrenal Fatigue – an overused and misunderstood term

There is a need to move away from the term adrenal fatigue as this does not really describe what is happening. Adrenal insufficiency may be a better description as it does address the completely exhausted phase of fatigue where the adrenal glands do not produce adequate amounts of cortisol. Adrenal dysfunction may better describe what is happening in the adrenal glands. However, as the adrenal glands do not work alone, they are part of the hypothalamus-pituitary-adrenal (HPA) axis. All three have a role to play in fatigue.

It doesn’t matter what we call it, millions of people with fatigue suffer from similar signs and symptoms. Naming a disease doesn’t necessarily change the treatment.

How Long Before I Feel Better?

Most patients who come to see me for fatigue are looking for a quick fix. While it’s possible to have people starting to feel better in a short time, the reversal of fatigue can take some time, and is often dependent on the patient making some diet and lifestyle changes. Many patients need to look at and change their working and sleep habits, for example, before they can truly start to feel better.

It’s essential to find and address the underlying causeof the fatigue. Without doing this it’s an uphill struggle to reverse fatigue.

Seek advice from an accredited and registered Naturopath – they will guide you through the changes needed to address your fatigue, as well as prescribing personalised herbs and nutritional supplements to help you feel better faster. Their professional advice is invaluable.