All About Chronic Fatigue + How To Restore Your Energy
We’re a country bogged down by extreme exhaustion. Chronic fatigue syndrome affects more than 1 million Americans – more people than multiple sclerosis, lupus, and some forms of cancer. Plus, an estimated 70 million people in the United States currently live with insomnia and sleep disorders, fueling debilitating fatigue and many more suffer from undiagnosed fatigue disorders.
Chronic fatigue is characterized by a number of related symptoms, including:
- Constant or recurrent extreme fatigue
- Fatigue that’s not significantly alleviated by sleep
- Fatigue that interferes with daily activities and work
- Exhaustion and body aches after physical activitiies
- Impaired memory or concentration
- Waking up tired, even after a full night’s sleep
- Frequent headaches
- Muscle or joint pain
- Constant or recurrent sore throat
- Tender or swollen lymph nodes in the neck or armpits
If you’re experiencing at least four of these symptoms, chronic fatigue syndrome (CFS) might be to blame. The problem is, “chronic fatigue” doesn’t have a known cause. There are plenty of theories, from viral infections to hormonal imbalances, but we don’t know for certain what causes chronic fatigue in general.
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The 10 Common Causes Of Chronic Fatigue
1. Thyroid problems
Around 20 million Americans struggle with thyroid issues, and low thyroid function, or hypothyroidism, is one common problem. Every cell of your body needs the thyroid hormone for energy. Sadly, there are many underlying thyroid problems that go undiagnosed.
What to do: If you suspect you have a thyroid problem, the first step is to ask your doctor about complete lab testing to find out for sure. Thyroid conversion dysfunctions, thyroid resistance, and autoimmune attacks on the thyroid, such as Hashimoto’s disease, all require different approaches. Take our quiz here to help you find out if you are likely struggling with thyroid problems.
2. Insulin resistance
Metabolic syndrome and diabetes are two different manifestations of the same problem: insulin resistance. When your body is resistant to insulin, glucose cannot get into your cells to create ATP, your body’s gasoline. This can leave you feeling tired and irritable. This problem is also associated with sleep apnea, (1) which can further fuel fatigue.
What to do: In addition to eating a clean diet filled with fruits, vegetables, meats, and healthy fats, I also recommend natural medicines such as alpha-lipoic acid, cinnamon, and chromium – some of my favorite blood sugar balancers.
3. Adrenal fatigue
Your brain tells your adrenal glands what to do through a complex web of communication called the hypothalamic-pituitary-adrenal axis (HPA axis,) or simply the brain-adrenal axis. Adrenal fatigue happens when that brain-adrenal communication isn’t working well, causing your stress hormone, cortisol, to be too high or too low. This leaves you feeling exhausted and cranky and not sleeping well.
What to do: Focus on things that activate your resting, parasympathetic system. Adaptogenic herbs like maca, ashwagandha, holy basil, and rhodiola are some of my favorite tools to help balance cortisol levels. I also rehabbed my own adrenal fatigue with consistent mindfulness meditation. Take our quiz here to help you find out if you are likely struggling with adrenal problems.
4. Viral infections
Low-grade viral infections, especially herpes viruses like the Epstein-Barr virus (EBV) and human herpes virus 6 (HHV-6) and HHV-7 have been linked (2) in some studies to chronic fatigue.
What to do: Try attacking viruses naturally with antiviral herbs and vitamins such as astragalus, olive leaf, larrea tridentata, bee propolis, zinc, vitamin C, melissa Officinalis, and L-lysine. A functional medicine doctor can help you determine the best ones for you.
The food we eat, the water we drink, and the air we breathe are not what they used to be, thanks to pervasive environmental toxins. One study (3) published in the journal Science of the Total Environment showed an association between exposure to environmental toxins and an increase in chronic fatigue.
What to do: Include detoxing foods in your daily diet, especially garlic, cilantro, parsley, plantain leaf, spirulina, sage, and red clover blossom. Whether you use them in smoothies, include them on salads, or enjoy them with your main-course meals, rotating these foods throughout your week is a great way to make every meal a detox experience.
6. Nutrient deficiencies
Any nutritional deficiency could potentially cause fatigue, but deficiencies in vitamin D, iron, and B vitamins are especially likely to leave you feeling groggy and spent.
What to do: Run labs to check your levels and confirm which nutrients you might be missing. Supplementing and focusing on foods that contain these nutrients can help address any deficiencies.
7. A diet unbalanced in macronutrients
The foods you eat are your medicine as well as your fuel. I oftentimes see fatigue occur when patients are not eating the right ratio of fat, protein, and carbohydrates, or drastically limiting any of these macronutrients.
What to do: I recommend starting with a macronutrient ratio of 20 percent carbohydrates (coming from fruits and starchy vegetables) 65 percent fat (coming primarily from coconut products, avocados, olive oil, and grass-fed meats,) and 15 percent protein (coming primarily from clean organic meats.) Then, adjust over time to see where you feel the best. Everyone is different, so this is just a starting point.
8. Gut problems
“Leaky gut” is a term for what happens when your intestinal lining is damaged, allowing undigested food proteins and bacteria to pass into the bloodstream. This can cause a misplaced immune response and consequential inflammation throughout the body. One study (4) in the Journal of Affective Disorders showed a link with increased intestinal permeability and chronic fatigue.
Candida overgrowth and undiagnosed food intolerances, also gut-related, can contribute to you feeling drained.
What to do: Healing your gut involved a comprehensive approach. The elimination diet is the gold standard for this. I also like to use natural medicines such as probiotic therapy, L-glutamine, and bone broth to help heal the gut. Take our quiz here to help find out if you are likely struggling with gut problems.
Most health problems involve at least some chronic inflammation, which can weaken your body’s ability to handle stress, leading to brain fog and fatigue.
What to do: Turmeric, green tea, astragalus, and skullcap are some of my favorite tools to help soothe inflammation and modulate the immune system.
Every pharmaceutical drug has side effects, and fatigue is one of the most common. It amazes me how little people know about the side effects of the drugs they take every day.
What to do: If you take any medications, find out if fatigue is one of the side effects. If you think your medication is causing or adding to your fatigue, talk with your doctor about other potential options.
8 Next-Level Ways To Reverse Chronic Fatigue
1. Fuel your mitochondria
Your body is made up of trillions of cells. The energy factory of your cells is the mitochondria, and several studies have found evidence of mitochondrial dysfunction in those with chronic fatigue. Another study, (5) published in NMR in Biomedicine, found low levels of the powerfully healing antioxidant glutathione in the brains of patients with CFS.
What to do: Supplementing with L-arginine, alpha lipoic acid (ALA), and CoQ10 are three natural ways to help increase glutathione as well as protect and boost your mitochondria and the production of adenosine triphosphate (ATP), your cell’s high-energy fuel.
2. Get more BCAAs
Branched Chain Amino Acids (BCAAs) refers to three amino acids: leucine, isoleucine, and valine. BCAAs compete (6) with your “sleepy-time” amino acid tryptophan and prevent its transport into the blood, thus decreasing fatigue.
What to do: Talk to your health care practitioner about supplementing with BCAA to fight fatigue. A typical daily dose of BCAAs is around 20 to 30 grams of the three combined amino acids one to three times per day.
3. Heal your leaky gut
Your gut is your second brain. In fact, your gut and brain were formed from the same fetal tissue and are inextricably linked for the rest of your life through the vagus nerve and the gut-brain axis. Most of your serotonin, the “happy” neurotransmitter, is made and stored in the gut.
Leaky gut syndrome, or increased intestinal permeability, happens when your intestinal lining is damaged, allowing undigested food proteins and bacterial endotoxins to pass into the bloodstream, causing an immune response and inflammation throughout the body.
A study (7) published in the Journal of Nuclear Medicine found an increase in symptoms of fatigue and depression after endotoxin administration, so leaky gut could be a culprit.
What to do: I recommend having labs done to evaluate your gut health. Endotoxins will raise immune labs, such as white blood cell count and inflammatory proteins such as C-reactive protein and IL-6.
Research shows (8) that probiotics such as bifidobacterium and lactobacillus can improve microbiome health. Bone broth is rich in collagen and glutamine, which are both helpful in healing the gut. Bone broth is also rich in glycine, (9) which has likewise been shown to improve brain performance and energy.
4. Manage stress and increase restorative sleep
Most of us are stressed, overly busy, and sleep deprived, but you can manage these problems.
An amino acid called theanine has also been shown (10) to improve sleep and allows you to feel rested and rejuvenated when you wake up. Low-caffeine teas like white tea or decaf green tea are great food sources for this sleepy-time medicine. I have a cup every night.
5. Correct hormonal imbalances
Underlying hormonal dysfunctions can wreck your energy levels. Adrenal fatigue, thyroid problems, and sex hormone imbalances of estrogen and testosterone can all fuel fatigue.
What to do: Your course of action largely depends on your specific issue. Read my article on the subject for a complete list, and talk to a functional medicine practitioner for a professional perspective on your specific health case.
6. Maximize your nutrients
Low levels of iron, vitamin D, B12, and folate can all contribute to fatigue.
What to do: Get labs to check your nutrient levels and address deficiencies with food. Focus on eating a clean diet with a wide variety of nutrient-dense whole foods such as vegetables, fruits, organic meats, and healthy fats.
7. Boost your immunity
Chronic infections (including Epstein-Barr virus, which causes mononucleosis, and Lyme disease) are a likely common cause of chronic fatigue but are widely undiagnosed.
What to do: In addition to getting tested for underlying infections, consider blends of Siberian ginseng, samento, sarsaparilla, guaiacum, astragalus, resveratrol, and cat’s claw for their immune-strengthening properties.
8. Make every meal a detox
What to do: Many food medicines can amp up the body’s natural detoxification mechanisms. Try adding more of these detoxing foods into your daily diet: Garlic, cilantro, parsley, plantain leaf, spirulina, sage, and red clover blossom. Whether you use them in smoothies, on salads, or with your meals, rotating these foods throughout your week is a great way to make every meal a detox.
If you want to learn more about your own health case please check out our consultation process. We offer in person as well as phone and webcam consultations for people across the country and around the world.
- Trakada G, Chrousos G, Pejovic S, Vgontzas A. Sleep Apnea and its association with the Stress System, Inflammation, Insulin Resistance and Visceral Obesity. Sleep Med Clin. 2007;2(2):251-261. doi:10.1016/j.jsmc.2007.04.003
- Komaroff AL. Is human herpesvirus-6 a trigger for chronic fatigue syndrome?. J Clin Virol. 2006;37 Suppl 1:S39-S46. doi:10.1016/S1386-6532(06)70010-5
- Racciatti D, Vecchiet J, Ceccomancini A, Ricci F, Pizzigallo E. Chronic fatigue syndrome following a toxic exposure. Sci Total Environ. 2001;270(1-3):27-31. doi:10.1016/s0048-9697(00)00777-4
- Maes M, Mihaylova I, Leunis JC. Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability. J Affect Disord. 2007;99(1-3):237-240. doi:10.1016/j.jad.2006.08.021
- Shungu DC, Weiduschat N, Murrough JW, et al. Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology. NMR Biomed. 2012;25(9):1073-1087. doi:10.1002/nbm.2772
- Blomstrand E. A role for branched-chain amino acids in reducing central fatigue. J Nutr. 2006;136(2):544S-547S. doi:10.1093/jn/136.2.544S
- Hannestad J, Subramanyam K, Dellagioia N, et al. Glucose metabolism in the insula and cingulate is affected by systemic inflammation in humans. J Nucl Med. 2012;53(4):601-607. doi:10.2967/jnumed.111.097014
- Choi CH, Chang SK. Alteration of gut microbiota and efficacy of probiotics in functional constipation. J Neurogastroenterol Motil. 2015;21(1):4-7. doi:10.5056/jnm14142
- Bannai M, Kawai N, Ono K, Nakahara K, Murakami N. The effects of glycine on subjective daytime performance in partially sleep-restricted healthy volunteers. Front Neurol. 2012;3:61. Published 2012 Apr 18. doi:10.3389/fneur.2012.00061
- Vuong QV, Bowyer MC, Roach PD. L-Theanine: properties, synthesis and isolation from tea. J Sci Food Agric. 2011;91(11):1931-1939. doi:10.1002/jsfa.4373
- Brewer JH, Thrasher JD, Straus DC, Madison RA, Hooper D. Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins (Basel). 2013;5(4):605-617. Published 2013 Apr 11. doi:10.3390/toxins5040605
- Shin SR, Han AL. Improved chronic fatigue symptoms after removal of mercury in patient with increased mercury concentration in hair toxic mineral assay: a case. Korean J Fam Med. 2012;33(5):320-325. doi:10.4082/kjfm.2012.33.5.320
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BY DR. WILL COLE
Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.
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