When fatigue interferes with your life

Most of you know how tired you can feel after a particularly long or stressful day of work. But to feel run-down by mid-day or need a nap by early evening is not normal.

I hear this complaint often from patients, yet there are no safe medications to treat this. That’s why in these next few articles I’ll address the inter-related topics of chronic fatigue, chronic low energy, fibromyalgia, altered mitochondrial dysfunction, and how to return to feeling good.

Defining chronic fatigue syndrome

Fatigue can be severe. The severe form is known as chronic fatigue syndrome (CFS). Its causes are poorly understood according to medical scientific literature. Here are the diagnostic criteria for chronic fatigue syndrome (CFS). It begins with persistent fatigue for more than six months that is unexplained, plus four of the following seven symptoms:

  • Short-term memory loss/poor concentration.
  • Sore throat with enlarged, painful neck or axillary lymph nodes.
  • Unexplained muscle pain.
  • Pain of multiple joints without swelling or redness.
  • Headaches.
  • Inability to get restful sleep.
  • Feeling of exhaustion for more than 24 hours after physical/mental exercise.

If you look again at the above diagnostic criteria for CFS you’ll see a combination of symptoms of fibromyalgia (muscle pain, joint pain) and extreme physical and/or mental fatigue. As you can imagine, meeting these criteria is not so common, although an estimated 1 million to 4 million Americans have it. Furthermore, there are no diagnostic tests to prove CFS or definitive treatments for it. And while some people affected by CFS feel better in time, most remain functionally impaired for many years.

You may already know that there are no safe prescription drugs to treat CFS, only symptom treatment. Of course, there are treatable conditions that can give you the symptoms of CFS. It is important to identify and treat these whenever possible:

  • Any chronic illness such as failure of the heart, lungs, liver, kidney or intestines.
  • Connective tissue disorders (i.e. Lupus), arthritis, fibromyalgia, neurasthenia, multiple sclerosis.
  • Depression, anxiety, somatoform disorders, psychoses (bipolar, schizophrenia).
  • Sleep disorders or multiple chemical sensitivity disorder.
  • Low hormone function: thyroid, cortisol, or sex hormones (i.e. testosterone).
  • Infections such as Chlamydia pneumonia, Lyme disease, syphilis and viruses known as Epstein-Barr virus, Human herpes virus, coxsackievirus B, spuma virus, human immunodeficiency virus (HIV) or T-cell leukemia virus.
  • Medications.

Chronic low energy and what I call “pre-CFS”

Although CFS is relatively rare and debilitating, there is a somewhat similar but very common condition that I’d like to address in more detail. I simply call it chronic low energy. It’s on the other end of the CFS spectrum.

Let me describe this all too common condition in more detail for you. It’s when you routinely feel fatigued that you can’t explain or justify, such as preferring to take a nap during the day or sleep in every morning if you could. It’s when prolonged or excessive muscle pain results from moderate exercise — or if brain fog, low ambition, or low energy routinely limit you. Other signs include just feeling older than your age or having a poor immune system.

I’d like to explore the various contributors to chronic low energy and functional ways to restore a healthy energy level again.

What’s behind low energy?

Think about the last time you noticed you were more tired than you expected. Is there a commonality in previous episodes?

Often it is something as simple as identifying the foods you consumed in the previous few hours. I know for me, eating on an empty stomach a sweet dessert containing just enough refined sugar will put me into serious total-body fatigue with near delirium! You could call this an “allergy” to refined sugar, right? The foods you consume bear tremendously upon the way you feel. There are some lab tests you can have done to discover which foods are to blame for low energy and many other possible symptoms. I’ll cover those in subsequent articles on this subject.

What else bears heavily on your energy? Your mood does for sure, right?

Imagine you just found out that you offended a neighbor by what you said — and they don’t want to talk to you ever again. Or worse, you broke the law or someone wants to sue you. Notice that when those thoughts trigger such feelings of despair, your body feels a shift in energy. It literally drops your e-motion, or “energy in motion,” which resultants in that fatigue feeling. Certainly, acute mood changes or chronic low mood will spiral your energy level right to the basement.

On a microscopic level (or, as many now say, “on a cellular level”), our energy is produced by the mitochondria in each cell. The mitochondria are intracellular organelles that metabolize all the carbohydrates, proteins, and fats you consume. You should thank them for producing your energy. Yet altered mitochondrial function can result in cellular damage — which means tissue damage, chronic disease, and accelerated biological aging. It’s no secret that mitochondrial function and this energy-producing process is dependent on micronutrients you ingest: vitamins, minerals, omega-3 fatty acids, phytonutrients, and other anti-oxidant nutrients. Vitamin C and E, selenium, coenzyme Q10, alpha-lipoic acid, and N-acetylcysteine are some of these micronutrients known to protect against mitochondrial damage. And if you are not careful with what you ingest, insulin resistance (and type 2 diabetes), which are known to reduce mitochondrial function in brain cells and lead to dementia, will affect you as it has nearly one-third of American adults.

What else improves mitochondrial function? We know that strength-training and aerobic exercise (alternating) helps to strengthen mitochondrial function. It also improves cellular energy production.

In my next article I’ll take up the topic of how to treat chronic low energy — and to resuscitate your mitochondria so you can feel good again.

To feeling good and enjoying optimal energy,

Michael Cutler, M.D.
Easy Health Options

Sources:

  1. Klonoff DC. “Chronic fatigue syndrome” — Clin Infect Dis. 1992;15:812-23.
  2. Shafran SD. “The chronic fatigue syndrome” — Am J Med. 1991;90:730-9.
  3. Wilson A, Hickie I, Lloyd A, Wakefield D. “The treatment of chronic fatigue syndrome: science and speculation” — Am J Med. 1994;96:544-50.
  4. Wilson A, Hickie I, Lloyd A, Hadzi-Pavlovic D, Boughton C, Dwyer J, et al. “Longitudinal study of outcome of chronic fatigue syndrome” — BMJ. 1994;308:756-9.
  5. Peterson PK, Schenck CH, Sherman R. “Chronic fatigue syndrome in Minnesota” — Minn Med. 1991;74:21-6.

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Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.