Fatigue is by far the most common complaint that I hear from my patients, day after day, week after week. Not only is it a symptom of many health conditions, it is also a result of lifestyle factors such as poor diet, dehydration, high stress and too little sleep.
So, it is not surprising that reporting fatigue as a symptom often sends both practitioners and their patients on a scavenger hunt for a diagnosis, especially when fatigue occurs in conjunction with other generalized symptoms such as pain, trouble sleeping and "brain fog."
Chronic fatigue is very real, as is chronic fatigue syndrome (CFS). Just ask the more than 1,000,000 adults (approximately 80% women) that the Centers for Disease Control and Prevention (CDC) now believe may be affected by CFS, plus the over five million adults (as reported by the CDC in 2005) who may suffer from chronic fatigue associated with fibromyalgia syndrome (FMS), and the millions more that have symptoms of chronic fatigue but do not quite meet the CDC guidelines for a CFS diagnosis.
What seems to be the major culprits that create such a severe hampering of personal quality of life?
The most common contributing factor is a high calorie/low nutrient diet, which is very common for a lot of Americans. There are many nutrients that are critical for our energy-producing machinery, and without these, fats and other calories cannot be converted into energy. This leaves people both overweight and exhausted.
The second energy drain is sleep deficiency. With the addition of electricity, light bulbs, television, and computers that keep us awake after dark, the average night's sleep has been reduced from over nine hours per night to under seven hours per night. We are pushing our bodies to do more, with less sleep. In addition, restless leg syndrome and sleep apnea are also much more common in people with CFS/FMS, which further diminishes good, solid sleep.
An overburdened immune system is the third factor. Our ancestors did not have to deal with the abundance of environmental toxins that now exist and which constantly bombard our immune system. Any "foreign invader" triggers the immune system to respond, gradually depleting our adrenal glands, potentially to the point of exhaustion.
In addition to nutritional deficiencies and an over-taxed immune system, poor digestion or absorption due to the use of antibiotics and acid blockers, "leaky gut," candida overgrowth, and other gastrointestinal flora imbalances compound the problem.
Hormone imbalances or deficiencies are another major factor contributing to the fatigue epidemic. Increased stress not only exhausts our adrenal glands, but also suppresses the hypothalamus and pituitary gland, which are the hormone control centers.
This scenario leads to a major "energy crisis" throughout the body, causing the hormonal controls to eventually shut down the biological equivalent of the circuit breaker, "blowing a fuse" and leaving us feeling exhausted.
Why Are These Conditions So H
ard To Diagnose?
One of the reasons is that lab values for people with CFS often come back within the "normal" range. Think of this as like buying
socks: they are made to fit a range of sizes, say size 9-11. This is fine for socks (because they stretch!), but hormones are involved in a "conversation" with each other: one hormone will send out a signal, which another hormone will respond to. There is a complex dance between them, which doesn't necessarily reflect what "normal" lab results are indicating.
Working with a trained practitioner who knows how to "hear" the whole hormonal conversation (along with a reliable lab) to establish your baseline and monitor hormone levels is well worth the effort.
How Do You Treat Fatigue?
Considerable research over the past fifty years supports a theory that acquired mitochondrial dysfunction (as opposed to inherited or genetic mitochondrial dysfunction) may be an underlying cause of not only CFS and FMS, but also of a wide range of seemingly unrelated disorders including, but not limited to: diabetes, Parkinson's disease, coronary artery disease, Alzheimer's disease, migraine headaches, epilepsy, and hepatitis C, as well as mental disorders such as bipolar disease and schizophrenia
As you might remember from biology class, the mitochondria are the "power house" part of the cell that turns nutrients into energy so that the various cells in the body can do their jobs. Our c
ells harvest the energy stored in food through a multi-step biochemical process called cellular respiration. In simple terms, cells burn food in the presence of oxygen to produce a "high-energy" molecule called adenosine triphosphate (ATP), the primary energy "currency" in the body. The chemical energy stored in ATP molecules is used to drive various metabolic processes such as biosynthesis and cell division.
If the mitochondria are not healthy or are damaged by toxins from infections, heavy metals, pollutants and solvents, the energy supply suffers, the cells don't function properly, and fatigue sets in at all levels--from the cellular level on up.
Damaged mitochondria require additional energy to "heal" or repair, adding to the mitochondrial dysfunction and further compounding the energy crisis.
Protocols That Support Mitochondrial Function
- Eating a Garden of Eden diet: Think about what we have naturally-occurring in nature--lots of veggies, fruits, nuts, seeds, eggs, and small amounts of meat and fish. Avoiding processed foods, sugar and GMO's.
- Taking nutritional supplements, including CoQ10, acetyl-L-carnitine, D-ribose, magnesium and niacinamide (Vitamin B3). This can kick-start the mitochondria.
- Getting a good night's sleep on a regular basis, with the goal of eight to nine hours of solid, deep sleep per night.
- Achieving a balance between work, exercise and rest. Things like meditation, prayer, and 3-second vacations throughout the day all help to bring you out of stress mode and into a more relaxed state.
- Hormone therapy, with the goal of optimizing the adrenals (cortisol and DHEA), thyroid (T3 and T4), testosterone, estrogens and progesterone, using bioidentical supplements as needed. Vitamin D, which is actually a hormone, is critical for regulating immune function. A vitamin D deficiency can trigger autoimmune illness and increase the risk of infection, also contributing to reduced energy.
- Immune Support, with the goal of clearing the body of yeast, candida and fungal infections that can lead to a "leaky gut," and adding probiotics to keep the gut healthy.
- Exercise, as one is able, with the goal of reconditioning, so that the body of someone with CFS or FMS can gradually make the energy needed to do conditioning exercise.
Diagnosing and treating CFS, fibromyalgia, and related disorders may be challenging, but don't give up hope! If you or someone you know are experiencing fatigue-related symptoms and are looking for answers, give us a call and schedule an appointment with one of our doctors--we're here to help!
Blessings,
Susan Godman, N.M.D.
