The hidden causes of fatigue
Definition of fatigue is extreme tiredness resulting from mental or physical exertion or illness.
We are part of the hi-tech society that suffers from an inability to switch off and relax. Tiredness has excitedly become adopted as an appropriate excuse for not participating in social and other events. And everybody understands the reason – as everyone is exhausted!
Worldwide statistics supports the statement that Fatigue is indeed an epidemic in a modern society, affecting everyone including children. According to recent National Health Interview Survey (USA) women are twice as likely to suffer from fatigue comparing to men. Chartered Management Institute (UK) report showed “that more than half of us experience feelings of constant tiredness at work and even more of us suffer from insomnia.”
Fatigue – underestimated medical concern
If fatigue is not part of conventionally recognized illnesses such as pneumonia, asthma, coronary heart disease, anemia, heart failure, chronic kidney and liver disease, electrolyte problems etc. often remain underdiagnosed by Conventional medicine.
Integrative and functional medicine understands that Fatigue is the same as lack of energy and energy comes from the basic metabolic process of the oxidation of food. Anything that can interfere with this process can be a reason for fatigue. One should always seek help from an integrative practitioner if :
- fatigue affects person’s ability to perform daily tusks and experience loss of quality of life
- fatigue that is not relieved by adequate rest and sleep
- fatigue that becomes chronic or extreme
- fatigue that is accompanied by unexplained symptoms
- Fatigue is experienced as physical, mental or emotional or a mixture of all. Sometimes depression is perceived as a tiredness and often lead to overdiagnosis and abuse of antidepressant even where there is another underlying cause.
Hidden and usual causes of fatigue in a modern society
1.Insomnia is a significant cause of fatigue, as it is so prevalent that is hard to find a person that genuinely sleeps well. From the lack of sleep hygiene to low progesterone, low pregnenolone, low estrogen, high night cortisol due to chronic stress, insulin resistance and sleep apnea, fast MAO-A gene activity, low serotonin, low melatonin, exposure to cell phone radiation, WiFi, etc. causes can be multifaceted. Instead of a sleeping pill that commonly gets prescribed by conventional doctors that treat the symptom the real cause must be found and corrected.
2.HPA Axis dysregulation– is a new term for “Adrenal fatigue” that happens in a prolonged stress. The term Adrenal Fatigue can in many ways be misleading because it is a descriptive term that does not represent true complexity of this disorder. During the various stages of this condition, hormone and neurotransmitter levels can oscillate dramatically representing a variety of the symptoms. These can be anything from intermittent tiredness and mild insomnia (in the Alarm stage), to dropping of DHAE, feeling of ‘wired and tired “during the second stage, and if stress continues it moves into the Resistant stage lasting from few months to many years. During this stage person is constantly tired, cortisol production continues at the expense of other hormones (“pregnenolone, progesterone, and DHEA steal”) insomnia gets worse, sex drive becomes low and frequent infections occur. If this continues extreme exhaustion sets in with hormonal deficiencies and neurotransmitters problems that can lead to anxiety, irritability, depression but also autoimmunity and cancers from altered immunity. It is a“Burnout” phase. Checking urinary cortisol metabolites and saliva cortisol to document daily fluctuation of cortisol level is essential as conventional tests are insufficient.
3.Gut issues. The main source of energy comes from the complete oxidation of glucose. Amino acids are an essential source for neurotransmitter production. The digestive system produces glucose, glycerol, fatty acids and amino acids. If there is a problem with the digestive system: low gastric acidity, pancreatic insufficiency, SIBO, lucky gut, food allergies sensitivities, etc. may result in fatigue. It also adds to the nutritional and chemical cause of stress and jeopardies detoxification.
4.CFS/ ME. Chronic fatigue syndrome (overleaping with ME and fibromyalgia) is an important cause of overwhelming tiredness. Recent studies concluded that Mitochondrial dysfunction either genetically determined or toxicity related are responsible for decreased energy (ATP) production. We use The Bell CFS ability scale to determine patient’s level of capacity to function from overwhelming fatigue.
5.Methylation issues can be a hidden cause of fatigue. Methylation is needed to produce a Methyl group donor necessary for many functions in the body: clearance of adrenaline, serotonin, dopamine, melatonin, DNA synthesis, switching on and off genes, production of creatine, attenuation of histamine production, free radicals clearing via glutathione, etc. Presence of specific genes, stress, gut issues, have metal toxicity, B12, B6, B2, folate deficiencies can alter smooth Methylation.
6.Hormonal disturbances are often accompanied by fatigue. Menopause and Andropause (Ageing) with low estrogen, progesterone, testosterone, and pregnenolone cause a fatigue through the day that aggravates during exercise, while underactive thyroid causes morning tiredness and tiredness at rest.Insulin resistance causes permanent tiredness that often worsens by Sleep Apnea and IR related Depression.
7.Chronic medication overuse is a hidden cause of fatigue as often interfere with primary cell energy production. Some antihypertensive drugs, statins, steroids, sedatives, antidepressants, antihistaminics can cause tiredness and drowsiness often perceived as a lack of energy.
8.Nutritional depletion: many microelements such as Zinc, Magnesium, Selenium, Molybdenum, Copper, Chromium are essential cofactors in energy production activities. It is so easy to miss it and very sufficient to treat once is recognized. The same applies to vitamins.
9.Impaired detoxification either from genetic predisposition or environmental overload can practically contribute to any of the causes mention above and demonstrate how everything in our body is interconnected into one cohesive system.
Finding the cause of fatigue and treating that particular cause respecting everyone biochemical and genetic individuality, their environmental uniqueness and interconnections in our body are paramount of Integrative medical approach.