Chronic Fatigue

 

Overview

Fatigue or feeling ‘tired all the time’ is common. 45% of American women reported feeling chronically fatigued due to stress in a 2012 Stress survey. More than half of us experience feelings of constant tiredness during the day. Indeed, 24% of American adults report having fatigue lasting 2 weeks or longer, and two thirds of these persons cannot identify the cause of their fatigue. Research has shown that among adults older than 60 years old, nearly 1 in 3 have severe chronic fatigue.

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The spectrum of fatigue, from general tiredness to chronic:

Fatigue runs on a spectrum from mild to severe.

  • Sometimes people may just notice that they are not as energetic as they used to be;
  • Others may feel fatigued during the day or at specific times such as early morning, mid-afternoon or may experience post-exercise malaise;
  • Sometimes people experience a general tiredness that is constant or shows up without warning;
  • 1-4+ million Americans suffer from full-blown Chronic Fatigue Syndrome (CFS) and another roughly 10 million Americans suffer from Fibromyalgia.
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Common Symptoms

Your symptoms may be mild or extremely debilitating and may affect one or more of your body systems. The more symptoms you experience, the greater the impact upon your health. Indeed, research has shown that when your energy and brain function are poor, everything in your life will suffer: your motivation to pursue your goals in life, your health, your confidence, self-care habits and even your overall happiness.

Symptoms include:

  • Severe fatigue. Feeling tired or exhausted during the day, most days for more than just a few days, sometimes months or even years. Many may crave stimulants such as caffeine, sugar, chocolate or energy pills to maintain energy levels;
  • Brain symptoms. This may include anxiety, depression, brain fog, brain related fatigue (e.g. after reading, driving, working or doing other mental tasks);
  • Physical fatigue: poor stamina, pain, inflammation, reduced muscle power;
  • Gut symptoms: bloating, gas, abdominal pain, food intolerances;
  • Immune symptoms / weakened immunity;
  • Sleep problems: difficulty sleeping, even when fatigued;
  • Body aches / pains: this may include widespread pain;
  • Post exertional malaise;
  • Heart symptoms such as dysrhythmias, chest pain (angina), low blood pressure or POTS;
  • Skin: heat intolerance or cold intolerance and poor skin quality;
  • Changes in your vision and intolerance to light and / or noise.

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How is fatigue managed medically?

The medical profession does not have an assessment or test that is diagnostic for CFS. Therefore, if you have long-term fatigue, it is likely that you have had many appointments with your GP and various blood tests. However, many of the blood-tests used by GP’s cannot explain the cause of your fatigue, with only 5% of patients blood tests highlighting anything from a GP’s point of view.  As a consequence, 95% of people with ongoing long-term fatigue are left with the following treatment options in an attempt to relieve your symptoms:

  • Exercise therapy. This may include encouraging individuals to go for 30 minutes exercise a day, such as a walk;
  • Antidepressants such as Prozac. A six-week trial is recommended;
  • Cognitive Behavioural Therapy (CBT). This is a form of Psychotherapy which aims to change negative thought patterns;
  • The use of prescription stimulants;
  • The use of prescription medication for the relief of symptoms such as insomnia.

Although medications may alleviate your symptoms, they cannot reverse your condition, may be associated with a host of adverse side-effects and do not address the root cause of your fatigue.

 

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My approach

Having long-term fatigue can be both devastating and overwhelming. Your symptoms and condition can affect your ability to work, your home life, leisure pursuits, holidays, social life, relationships, motivation and mental well-being. There is, however, a lot that you can do to support and help improve your body’s ability to repair and heal.

Imagine that you are standing on a tack. How would you treat the pain and inflammation? The obvious answer is that you would take the tack out of your foot. You wouldn’t just take aspirin or painkillers until it felt better, you would address the root cause of the problem. The question should always be: ‘Why do I have these symptoms and this diagnosis’?

The symptoms of those struggling with fatigue or Chronic Fatigue Syndrome manifest due to poor energy delivery within the body.  The cause of impaired energy delivery may be due to a variety of factors such as a vitamin deficiency, food intolerance, thyroid disorder or toxin exposure.  You can take medication to suppress your symptoms, however if your vitamin deficiency or sluggish thyroid are not restored to optimal levels or your food intolerance or toxic exposure not detected and removed, you will not return to full health.

If energy delivery is impaired, then your cells work far more slowly. If your cells work slowly, then so too will your organs – all organs: the brain, heart, immune system, hormone production, liver, kidney and gut among others. If our organs work slowly, this can result in a host of symptoms that you experience, many of which may seem unrelated.  There are many systems in our body. How well each of these is working can dramatically affect our energy levels.

Dozens of factors in our lifestyle and environment can affect our energy levels because they can trigger dysfunction in the structure and function of the energy producing organelle found in every cell in our body: the mitochondria. If the structure and function of the mitochondria is affected, this can cause further dysfunction in the body such as increased leaky gut and increased production of toxins in our body. This can affect our sleep and impair our ability to repair at night.

Unlike conventional medicine (which carves your body into separate specialities such as your digestive or nervous system), I use a functional medicine approach. Functional medicine views your body as one whole, fully functioning, integrated system, rather than a host of isolated symptoms. It also takes into account your personal story. I aim to determine the root cause of your fatigue and then work with you to address the underlying imbalances. I look at ways of lowering the stress and number of insults and inflammation that you are exposed to, in order to protect the energy producing organelle (the mitochondria).  We then work to improve your nutrition and gut health, detoxify and remove waste and both repair and boost the vitality of your mitochondria. As a Nutritional Therapist, I am trained to consider your individual biochemical needs and to use food, and where relevant nutritional supplements and lifestyle changes, to address these needs.

Once your mitochondria are protected and your triggers and mediators removed, your bodily tissue can begin to repair and you can start to notice profound changes in your health and vitality: how you look, feel and think.
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Assessment

Rather than just addressing your diagnosis and related symptoms, I work with you to determine possible contributory risk factors that may be affecting your biochemistry and triggering the change in your immune system function.

An initial holistic assessment of your health, diet, lifestyle, symptoms, family history and medical needs will be conducted to identify any nutritional imbalances or factors which may be contributing to your health concerns and symptoms.

If potential causes remain unclear, I may advise GP or private functional laboratory testing (such as an evaluation of your gut function, nutritional deficiencies or bacterial overgrowth) to clarify any contributing underlying biochemical imbalances. Please see information on relevant diagnostic tests.

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Explanation

Once assessed, I will then help you understand the potential origins of your condition. Written handouts may be provided for you to read at your leisure after your consultation.
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Personalised Health Optimisation Plan

I will then work with you to design a bespoke nutritional and lifestyle programme using a wide variety of delicious food choices, to meet your health needs and help change your body’s biochemical environment.   Changes introduced will address the root cause of your symptoms, thereby enabling you to manage your symptoms and condition more effectively whilst empowering you to regain control over your own health and reach your health goals.

Every individual seen is unique and any advice provided is tailor-made to address your health concerns, dietary and lifestyle preferences, budget, medication, symptoms and needs at a pace that suits you. There is no ‘one-size-fits-all’ approach and no two programmes are the same. Changes are introduced gently and over time to ensure that they are achievable and that you do not feel overwhelmed. Your programme is reviewed and adjusted during follow-up consultations to support you on your journey to optimal health. Click here to read more about the  consultation programmes I offer.
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The 6 R’s

There are a wide range of approaches that may be of benefit to you. These can be explored to ensure that the right one is chosen to meet your specific needs. However, in general, I use the 6 R’s approach outlined below. The staging and timing of the protocol are essential to the success of the programme and although written as 6 steps, one or more of these may be undertaken simultaneously as required:

  1. Remove: I will work with you to remove factors that may be triggering your symptoms (such as foods, toxins, hidden or latent infections and stress).
  2. Replace: We will replace any foods and nutrients that your body may be lacking, to promote and support its ability to repair, metabolise, digest, detoxify, signal effectively and ensure our genes can express themselves appropriately. In some instances, nutritional supplements are recommended.
  3. Repair: We will help support bodily tissue that has been damaged by ensuring that the correct nutrients are in place to help it heal.
  4. Re-inoculate: Beneficial bacteria are vital to support not only our gut function but our overall health. At the correct time in your programme, we will ensure that these are introduced, using either probiotic food sources and / or supplementation if required.
  5. Re-balance: This stage addresses you as a whole to ensure that all relevant additional factors have been addressed to promote your health and well-being. This may include: your diet, lifestyle, family, hydration, sleep, stress levels and genes.
  6. Retest: Nutritional Therapy is a science and retesting is therefore a vital aspect of any nutritional programme. Retesting relevant components of your health helps determine the biochemical effectiveness of any intervention and also highlights any additional areas which may need to be addressed.

 

I hope that what I have written helps give you a brief overview of how making changes to your own diet and lifestyle can influence how well your body can work both physically and mentally and thereby can influence your overall health status.

 

If you would like more information or professional help to start improving your health, please contact me today.

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Please note: Nutritional Therapy is a complementary therapy that can work well alongside other medical or complementary therapies. It does not replace any medical advice. Clients are always encouraged to consult with their GP regarding any health concerns or for advice, diagnosis and treatment. To get the most out of dietary and lifestyle interventions, please seek professional advice, as there is a plethora of misleading information currently available which may not be beneficial or specifically intended to meet your own identified needs.  I am happy to work alongside other healthcare professionals or complementary therapists involved in your care to explain your Nutritional Therapy programme and to ensure it is safely and effectively implemented.

 

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