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Understanding and Overcoming Fatigue

The underlying principles of functional medicine work on such a basic level of physiology that when we apply them carefully it is quite possible to help patients suffering from a wide variety of conditions and imbalances. In fact, it seems that on a weekly basis I’m sitting down with a new patient who has been referred to our office from a friend or family member, who is suffering from a very complicated health condition.

Many times they have been to a variety of other physicians. In these cases I always believe that it is important to offer hope that they can heal and improve their condition but at the same time, I try not to over promise results. It is hard to hit “home runs” on these tough cases. Thankfully, these cases only make up about 15% of our patient population.

I’ve been paying attention to the types of cases that we consistently hit “home runs” with and what I’ve been able to track is that the other 85% of our patients have 1 or more of the following “top 5” conditions.

  1. Fatigue
  2. Weight issues
  3. Digestive complaints
  4. Hormone imbalances
  5. Musculoskeletal pain

As we focus on the unique functional medicine approach that we have developed and practice in our clinic to address the causes behind these common and life-disrupting conditions we see that these conditions are intimately connected and can impact many areas of health at the same time.

So let’s dive in today and start by talking about fatigue. Some of you may already know this but the #1 reason that patients visit their doctors in our country is fatigue. Why is that? Well, just about every state of dysfunction or disease in the body impacts the key cellular mechanisms that produce energy in your body.

Cellular Energy Production

Inside of each of our cells are tiny power stations called “mitochondria”. These organelles are primarily responsible for making energy for our cells. When these mitochondria aren’t working at 100%, we have less cellular energy available to run the body. Mitochondria are damaged by a variety of things including inflammation, toxicity, and oxidative stress due to insufficient antioxidants in the body. There are key nutrients that are needed for mitochondria to function well and for our bodies to detoxify and fight off “free radicals”.

Glutathione – Your body’s number 1 antioxidant and powerhouse molecule. Having enough glutathione in the body is crucial for health. This isn’t a nutrient that we generally get from food but nutrients that come from food have the ability to “recharge” our glutathione production. The amino acid called L-cysteine plays a huge role in the maintenance of our glutathione stores.

Acetyl L-carnitine – Another important amino acid that is found in red meat helps with glutathione production.

B Vitamins – B Vitamins act as key enzymes in critical processes inside of our cells. Many can be considered specialized antioxidants as well.

Alpha Lipoic Acid – Our bodies need adequate amounts of healthy fatty acids such as alpha lipoic acid have been shown to be particularly helpful in supporting the mitochondria in the brain and nerve system.

Co-enzyme Q10 – Another important antioxidant, CoQ10 is essential for mitochondrial function. In fact without it, there is no way to generate energy in our cells.

Other helpful nutrients include: Resveratrol, Omega-3 fatty acids, catechins from green tea and quercetin.

Other Energy Drains

As we move out from the cell towards the organ systems of the body we see many other potential levels of dysfunction. First and foremost, we should discuss the importance of the thyroid gland. Thyroid hormones are the main drivers of our basal metabolic rate. These hormones are produced throughout the day to give us the energy we need to accomplish all that is needed.

Often patients with low thyroid output won’t have enough energy to make it through the day. They can themselves to get things going but when they sit down between projects or errands, they are wiped out. Sometimes these symptoms are exacerbated with brain fog and a “heavy head” and even what some might consider depression. Getting your thyroid hormone levels checked can be a bit tricky. If you don’t look hard for the problems, you might get a “normal” lab report even though there is a definite problem.

Another major cause of fatigue is anemia. Low levels of iron and/or B12 can cause the body to have a hard time transporting oxygen to your cells. When there isn’t enough oxygen to the cells, they cannot create energy in the mitochondria. Getting to the root of where this anemic state is coming from becomes a primary solution in these cases.

I know it seems obvious but you’d be surprised how many times patients overlook sleep challenges as a trigger of fatigue throughout the day. We’ve become accustomed to getting 5-6 hours of sleep per night and thinking that it is “normal”. Well, it isn’t. We are biologically wired for more sleep than that and most people require at least 7-8 hours per night. If there are reasons that are causing sleep difficulties, they need to be addressed so that we can restore that vital component of repair and rejuvenation.

Last but not least, our sedentary lifestyles aren’t helping us create energy. In fact, when we are physically active through exercise we are creating a more efficient metabolic furnace to generate energy. Sure, when we are burned out because of anemia, thyroid problems, or mitochondrial dysfunction, even thinking about exercise is enough to make us tired but when these issues are ruled out, beginning a sensible physical fitness program including a baseline movement strategy and supplementing that with high-intensity interval training and weight lifting can actually create more energy.

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