What is fatigue?

Fatigue is a feeling of tiredness or exhaustion due to a lack of energy. Fatigue may result from poor sleep, overwork, worry, or lack of exercise. It's a symptom that could be due to illness, medication, or medical treatment like chemotherapy. Stress or depression can also lead to fatigue.

Both weakness and fatigue are symptoms, not diseases. Because several other health issues may cause these symptoms, the value of fatigue and weakness can be determined only when other symptoms are evaluated. Some critical illnesses, such as stroke or cancer, or recovering from medical treatments can make you drowsy. However, other disorders can also leave you feeling washed out, or feeling like you have brain fog.

See: Functional Medicine For Brain Fog Treatment

See: DNA Testing For Stress And Food

What causes fatigue?

All of us experience tiredness occasionally, which can be alleviated by rest and sleep. Fatigue occurs when the exhaustion is often overwhelming and is not relieved by rest and sleep. Symptoms can include headaches, allergies, acne, or gastrointestinal problems like abdominal gas and bloating. If you need to determine what's causing it, getting to the root cause is critical. This can include testing for food sensitivities and healing inflammation by causing your body to reset for a few weeks. This is because your immune system may not stop responding to a food you ate for some time to experience an entire de-escalation of inflammation. The body's primary immune response to antigen happens on the first occasion it's encountered. It can take up to 14 days to contribute to the generation of memory cells with high specificity for the inducing antigen. Here are some possible sources of fatigue to look at:

- Gluten intolerance: Food intolerance occurs when your body can't digest a specific food component, like the protein called gluten. When you truly have a food intolerance such as celiac disease or are non-celiac gluten sensitive, the gluten may cause your small intestines to become inflamed. After the small intestines become damaged from inflammation, the body cannot absorb nutrients into the blood, resulting in malnourishment and fatigue. Remove all forms of gluten sources like wheat, rye, and barley out of your daily diet, as gluten may be damaging the intestines. Look for gluten-free alternatives and make certain to read food labels carefully.

Thyroid disorders: The thyroid is a tiny butterfly-shaped gland situated at the base of the throat, which controls the functioning of lots of the body's organs, including the brain, heart, liver, kidneys, and skin. When a person's thyroid levels are reduced, it affects energy levels.  Explain your symptoms to your doctor, especially if you've been feeling tired and miserable, and ask for a thyroid test. 

- Anemia: Anemia can occur when your body is not producing enough red blood cells or not containing enough iron-rich hemoglobin. That absence of oxygen-rich blood in your body can cause you to feel weak and tired.  If you suspect that your fatigue may be due to anemia, ask a medical professional to check your iron levels.

Lack of sleep: If you increased your exercise routine or you are experiencing difficulty falling asleep at night, it could be an indicator that you are overdoing it. If you do not supply your body with adequate rest and nutrition, muscles and cells break down, eventually resulting in exhaustion. The remedy is to sleep at least eight hours every night and try to go to bed at exactly the exact same time to maintain your internal clock in check.

Allergies: Allergies are a frequent culprit behind fatigue. Allergies can take a big toll on energy when congestion interferes with your breathing and ability to get a good night's sleep or when the antihistamine meds you are taking to alleviate symptoms make you feel foggy. It is vital to find the root cause of your allergies so it is possible to remedy it. If you suffer from outward symptoms because of pollen and mold spores, take over-the-counter medication to assist and limit your outdoor activities on high pollen count days.

- Insulin resistance: Insulin resistance means the hormone insulin cannot acquire nutrients, especially glucose or sugar, in the body's cells. Since your cells are not adequately absorbing blood glucose, they can not transfer energy throughout the entire body satisfactorily. Get a fasting glucose test during your regular screenings. You should adopt healthy lifestyle changes, such as making and exercising healthier food choices to decrease your body weight.

See: Gluten Sensitivity & Intolerance

See: Gluten Sensitivity & Intolerance Natural Remedies

Fatigue related medical conditions

Listed below are some of the health conditions that are known to cause fatigue:

- Sleep apnea: Sleep apnea is a condition where your throat narrows or closes during sleep and interrupts your breathing. This leads to loud snoring and a drop in your blood glucose levels. The difficulty in breathing means you wake up frequently in the evening and feel exhausted the following day. It is most common in obese middle-aged guys. Drinking alcohol and smoking makes it worse.

- Underactive thyroid: An underactive thyroid gland means you have too little thyroid hormone (thyroxine) in your body. This makes you feel tired. You are also likely to put on weight and have aching muscles and dry skin. It is most common in women and occurs more frequently as you get older. Your doctor can diagnose an underactive thyroid by taking a blood test.

Anemia: Among the most common medical causes of feeling always run down is iron deficiency anemia. Women with heavy periods and pregnant women are particularly prone to anemia. However, it can also affect men and postmenopausal women. The cause is more likely to suffer from the stomach and intestines, like an ulcer or taking non-steroidal anti-inflammatory medications (NSAIDs). Ordinarily, you feel you can not be bothered to do anything, your muscles feel heavy, and you get tired very fast. It is possible to have an excessive amount of iron, which could also lead to tiredness called iron-overload disease (hemochromatosis).

Chronic fatigue syndrome (CFS): Chronic fatigue syndrome (also called myalgic encephalomyelitis, or ME) is serious and disabling fatigue for at least four weeks. There may be other symptoms, such as joint or muscle pain.

Diabetes: One of the critical symptoms of type 1 and type 2 diabetes is feeling quite tired. Other important symptoms are feeling very hungry, peeing a lot (especially at night), and weight loss. Speak to a doctor if you think you may have diabetes symptoms.

- Celiac disease: This is a lifelong disorder caused by the immune system reacting to gluten. Gluten is a protein found in cakes, bread, and cereals. Other symptoms of celiac disease, besides fatigue, are diarrhea, bloating, anemia, and weight loss. Your doctor can perform a blood test to check if you might have celiac disease.

- Glandular fever: Glandular fever is a common viral infection that causes fatigue, together with fever, sore throat, and swollen glands. Most instances happen in teens and young adults. Symptoms usually clear up within 4 to 6 months, but the fatigue can linger for a few more months.

- Depression: In addition to making you feel really sad, melancholy may also make you feel drained of energy. It can prevent you from falling asleep or allow you to wake up early in the morning, making you feel tired during the day.

- Restless legs: This is when you get an overwhelming urge to move your legs, which may keep you awake at night. You may also have an unpleasant crawling feeling or a deep ache in your legs. Or your legs may jerk spontaneously through the evening. Whatever your symptoms, your sleep will be disrupted and bad quality, so you will feel very tired during the day.

- Anxiety: Feeling anxious is sometimes perfectly ordinary. But some individuals have persistent, uncontrollable feelings of stress that are so powerful they affect their everyday life.

See: Ashwagandha benefits for anxiety

See: Ayurveda for Anxiety & Depression

Natural remedies for exhaustion

You can try some simple natural remedies when feeling exhausted:

- Exercise: Whenever you feel stressed, tired, anxious, or depressed, try to exercise. Exercise arouses the parasympathetic nervous system and allows the body to heal. The digestive tract can absorb nutrients from the food, the immune system can operate normally, and the adrenal glands function properly. 

- Healthy diet: While diet will not cure chronic fatigue syndrome, eating to improve your power and address potential nutrient deficiencies can allow you to experience less muscle pain, minimize intense and continuing fatigue, and feel better overall. Get a diet focused on eating more balanced and nutrient-rich snacks and meals. Avoid certain foods and beverages that may be worsening your symptoms. It may take some experimenting to find what works best for you, which begins with learning everything you can about how food might be impacting your symptoms.

- Essential Fatty Acids: Research indicates that individuals with chronic fatigue syndrome have imbalanced levels of essential fatty acids (omega-3s and omega-6s), which might contribute to symptoms like fatigue and body aches. The body has to get essential fatty acids through nourishment since it can't manufacture them on its own.

- Vitamin B12 & Folic Acid: Researchers have been investigating whether vitamin B12 injection or other means of supplementation, together with folic acid, can alleviate CFS symptoms.

- Coenzyme Q10: Coenzyme Q10 (CoQ10) is a chemical found naturally in our cells' energy-producing center, the mitochondria. CoQ10 helps in ATP production, the principal energy source of cells. CoQ10 has been explored as a possible treatment for chronic fatigue syndrome.

- L-Carnitine: Carnitine, found in almost all body cells, is responsible for hauling long-chain fatty acids into mitochondria and allows fatty acids to be converted to energy.

- D-Ribose: D-ribose is a sort of sugar produced by the body which helps generate energy. It also helps in building RNA genetic material. A review of research found that it might have positive benefits for people who have chronic fatigue syndrome, but that decision has been based on a single small, elderly study.

- Traditional Chinese Medicine

Chronic fatigue syndrome is associated with the following syndromes in traditional Chinese medicine (TCM):

Kidney yang deficiency

Spleen qi deficiency

Kidney yin deficiency

TCM interventions like Chinese herbal medicine, acupuncture, qigong, moxibustion, and acupoint program are beneficial for treating chronic fatigue syndrome.

- Acupuncture

While acupuncture may be one modality used in TCM treatment programs, it's been analyzed independently as a treatment for CFS. The CDC notes that acupuncture, even if provided by a qualified practitioner, may be helpful for pain related to CFS.

- Mind-Body Therapies

People with CFS may have anxiety and depression, but the CDC notes that drugs for these conditions can worsen CFS symptoms. Thus, they suggest trying non-drug therapies like deep breathing with muscle relaxation, massage, yoga, or tai chi.

- Meditation: Anxiety and fatigue work on a feedback loop. So when you're struggling with yourself, it is inevitable that you will have issues with the other. Meditation reduces stress. Stress inhibits your body's ability to make the ideal quantity of melatonin, and without this crucial compound, your sleep quality suffers a good deal. Meditation induces a state of relaxation, allowing your body to make the ideal quantity of melatonin and causing sleep through the night. Meditation and similar practices boost self-control so that you can be more objective about anxiety. Subsequently, you will have more energy.

See: Sleeping on the left side health benefits

See: Digestion Sleep & Hormones Link

Ayurvedic therapies for fatigue

- Ayurvedic perspective of fatigue: Ayurveda views CFS as an imbalance of Vata Dosha (air and space components ) from the body. Some professionals also consider it as aggravated Pitta Dosha (fire and water elements). Chronic Fatigue Syndrome can also be a result of the accumulation of Ama in the body. Therefore it's a composite of imbalanced Vata (and Pitta) Dosha and gathered Ama. Ayurveda suggests that exhaustion is caused because of reduced gastric fire and weakness of the liver. This low gastric fire contributes to Ama formation, the main cause of all diseases in the body. 

As Vata is the principal Dosha involved, all facets such as the nervous systems (sleep, bone tissue, etc.), are treated for imbalance.

Ayurveda addresses the root cause of disease as opposed to simply treating the symptoms. As a holistic health system containing detoxification, herbal remedies, meditation, yoga, diet, massage, and a relaxed way of life, Ayurveda improves not just an individual's health but also their well-being, behavior, and frame of mind. This plays an essential role in treating Chronic Fatigue Syndrome since the root cause lies not simply in the physical component of the disease. Still, the psychological aspect also plays a crucial role. Ayurveda follows three significant steps in treating any illness:

- Detoxification: The body and brain undergo a detoxification process to help remove all of the Ama (toxins) in the body, which leads to the CFS. Ayurveda has gifted us with a unique detox procedure known as Panchakarma that involves five main activities: Therapeutic Emesis (Vamana), Therapeutic Purgation (Virechana), Medicated Enemas (Basti), Blood allowing (Raktamokshana), Nasal administration of Ayurvedic oils and herbal preparations (Nasya)

It might not be required to administer each of the five Karmas or activities. The primary detoxification activities are therapeutic purgation to eliminate excess Pitta in the body and medicated enemas to remove excess Vata. 

See: Panchakarma

See: Panchakarma Detox & Cleanse Benefits

References

1. Centers for Disease Control and Prevention. What is ME/CFS? Updated July 12, 2018.

2. Natural medicines in the clinical management of chronic fatigue syndrome. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. 

3. Brown BI. Chronic fatigue syndrome: A personalized integrative medicine approach. Alternative Therapies. 2014;20:29.

4. Rakel D, ed. Chronic fatigue syndrome. In: Integrative Medicine. 4th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. 

5. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/expert-answers/chronic-fatigue/faq-20058033

6. Jones K, Probst Y. Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review. Aust N Z J Public Health. 2017;41(4):338-344. doi:10.1111/1753-6405.12670

7. Wang YY, Li XX, Liu JP, Luo H, Ma LX, Alraek T. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014;22(4):826-33. doi:10.1016/j.ctim.2014.06.004

8. Arring NM, Millstine D, Marks LA, Nail LM. Ginseng as a treatment for fatigue: A systematic review. J Altern Complement Med. 2018;24(7):624-633. doi:10.1089/acm.2017.0361.

9. Kim HG, Cho JH, Yoo SR, et al. Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial. PLoS One. 2013;8(4):e61271. doi:10.1371/journal.pone.0061271

10. Centers for Disease Control and Prevention. Treatment of ME/CFS. Updated November 19, 2019.

11. Yin ZH, Wang LJ, Cheng Y, et al. Acupuncture for chronic fatigue syndrome: An overview of systematic reviews. Chin J Integr Med. 2020. doi:10.1007/s11655-020-3195-3

12. Castro-Marrero J, Cordero MD, Segundo MJ, et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015;22(8):679-85. doi:10.1089/ars.2014.6181.

13. Alraek T, Lee MS, Choi TY, Cao H, Liu J. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complement Altern Med. 2011;11:87. doi:10.1186/1472-6882-11-87

14. Campagnolo N, Johnston S, Collatz A, Staines D, Marshall-Gradisnik S. Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. J Hum Nutr Diet. 2017;30(3):247-259. doi:10.1111/jhn.12435.

15. Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neurosci. 2013;2013:784520. doi:10.1155/2013/784520

16. U.S. National Library of Medicine: MedlinePlus. DHEA. Updated March 16, 2020.

17. Castro-Marrero J, Zaragozá MC, Domingo JC, Martinez-Martinez A, Alegre J, von Schacky C. Low omega-3 index and polyunsaturated fatty acid status in patients with chronic fatigue syndrome/myalgic encephalomyelitis. Prostaglandins Leukot Essent Fatty Acids. 2018;139:20-24. doi:10.1016/j.plefa.2018.11.006

18. Bjørklund G, Dadar M, Pen JJ, Chirumbolo S, Aaseth J. Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach. Biomed Pharmacother. 2019;109:1000-1007. doi:10.1016/j.biopha.2018.10.076

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