What do YOU mean by Fatigue?
“Fatigue” is a very vague term which means different things to different people. Some people have severe fatigue, and qualify to be diagnosed with the most extreme form known as “Chronic fatigue syndrome,” others are further up the spectrum nearer “tired all the time” or suffering milder forms of feeling “stressed” and “burnt out”. There are different TYPES of fatigue as well as different levels of severity along the spectrum from severe chronic fatigue syndrome up to normal healthy tiredness.
As a very first step, if you have a form of fatigue – always go to your medically qualified doctor first – read why this is so important here.
Some Examples of Types of Fatigue
Wired but tired fatigue – this is where you feel hyped up, can’t sleep, are over-stimulated and yet are exhausted and have limitations on activity levels. This suggests either a psychological, chemical, electrical or pathogenic stresser is over-stimulating the limbic system in the brain, leading to lowered cortisol output which causes first high cortisol then excessively low levels (adrenal stress). It can simultaneously cause raised levels of stimulatory neurotransmitters and brain inflammation: – classic exhaustion coupled with over-stimulation.
Possible causes: gluten and other undiagnosed food sensitivities/gut permeability and imbalances gut microbiota, mercury fillings and other undiagnosed chemical sensitivities, excess electromagnetic exposure (wifi, cell phone etc), untreated/undiagnosed emotional trauma, energy depleting personality tendencies, difficulties with boundaries – doing work not suited to you (creatively suppressed) or being in a non-supportive family or work environment.
Flu-like fatigue – most people have had the classic flu. Remember how tired you get – sometimes we just stay in bed for a few days then recover? Sometimes low level symptoms of sickness, fever, pain and fatigue become chronic, classic symptoms of Chronic Fatigue Syndrome/ME (Myalgic Encephalomyilitis).
Possible causes: Chronic immune system response (cytokines leading to sickness syndrome) resulting from a latent viral infection which may be reactivating, often due to other systems out of balance causing immune system deficiency (e.g. lack of IgG antibody production): imbalanced gut microbiotia, chemical and food sensitivities, chronic emotional stress (from emotional trauma, energy depleting personality or poor boundaries)
Post-exertional Fatigue – this is the type of fatigue which MOST defines specifically Chronic fatigue syndrome. It specifically means a person becomes excessively exhausted after activity. Sometimes it is delayed onset – it can take a day or so to appear after the original physical activity. If this persists for 6 months or more and there are other symptoms like memory and concentration problems, joint pain, sore throat, tender lymph nodes, headache digestive problems and difficulty sleeping which significantly impact daily life, then this could qualify for a diagnosis of chronic fatigue syndrome (note there is currently no formal biological test marker – it is based on patient self-reported symptoms).
Possible causes: this type of fatigue is most linked with poor mitochondrial function (part of the body’s cell which produce ATP) and is usually correlated with an inflammatory pro-oxidative response to activity. The underlying causes of this are the usual suspects: imbalanced gut microbiota, undiagnosed food and chemical sensitivities, unresolved emotional stress, latent co-infections reactivating due to immune system deficiency all leading to excess oxidative stress and poor mitochondrial function.
Depression secondary to Chronic Fatigue – Depression and Chronic Fatigue are very different things both psychologically and biologically. Someone may have chronic fatigue (any combination of the types of above) and be leading a limited life/restricted life because of this. It is natural to have some depression in response to having a chronic illness for example, the same way someone will need to process grief in response to death of a loved one. This emotional depression is not something to be medicated away, it needs simply time and emotional support. This is different from fatigue which is secondary to major depression.
Fatigue Secondary to Major Depression – Major Depression is very different from chronic fatigue. Psychologically they are different: ask a depressed person what they want to do with their lives, they would reply: “I don’t know” the general feeling being a type of apathy and deep lack of motivation (which results in behaviour that looks like someone is tired). Ask a chronic fatigue person what they want to do with their lives: they would usually come up with a whole list and point out their bodies just can’t do it.
Biologically, major depression is associated with low serotonin and enlarged adrenals, in fatigue, serotonin has been found to be high (causing agitation) rather than low and adrenals are smaller suggesting burnout.
It can certainly be the case that co-morbid conditions exist in a person – they may have both depression and chronic fatigue. One known biological cause of depression is a change in the gut microbiota and/or heavy metal toxicity – something that we also know occurs in chronic fatigue too – so there may be overlap.
This section just gives a few examples of types of fatigue. Other types might be primarily sex hormone related (tiredness around periods, or low testosterone in men), other types may have more of a focus on neurotoxins, manifesting a symptoms of Lyme’s disease, still others manifest as a limbic hypersensitivity to chemicals or EMFs resulting in Multiple Chemical Sensitivity or Electrosensitivity, and finally limbic hypersensitivity to neuronal pain signals from muscles leading to Fibromyalgia – all of which lead to limbic and adrenal stress – leading to fatigue.
Understand your Body is a Complex Adaptive System
Understanding your body is a complex adaptive system which needs a systems biology approach is vital to either recover from an illness or to prevent it. To understand more about this read the 7 Steps to Optimum Energy – it contains the top reasons I have found people either don’t recover from fatigue or practitioners loose their patients.
Generally fatigue is known as a “threshold” illness meaning overtime a person experiences a number of stressors or “loads” on the boat using a boat analogy. Once there are too many loads, a tipping point is reached and the boat sinks (the person becomes ill). Some boats have a greater propensity to sink more quickly than others – there are “predisposing factors” which means there were already holes in the boat which when faced with additional loads, the boat’s water pumping system couldn’t keep up.
In cases of fatigue, predisposing factors include:
- Emotional trauma in childhood which can create a permanent change in gene expression in the brain unless treated
- Poor pre and post natal and childhood diet which can lead to immune deficiency
- Inheritance of imbalanced microbiota from mother which can be linked with undiagnosed food sensitivities, gut permeability and immune system imbalance
- Inheritance of chemical load from mother (e.g. mother had leaking amalgam fillings during pregnancy)
- Structural issues can include those which impact lymph flow, cyst in the spine blocking lymph detox, jaw imbalance leading to jaw infections
- Genetic mutations which may affect efficiency at detoxifying heavy metals and microbes, proneness to emotional stress, gut dysbiosis, slow methylation and circulatory issues
- Inherited emotional trauma (e.g. third generation of the holocaust survivors show the same physiological imbalances as their grandparents)
- Patent foramen ovale (PFO) this is a hole in the heart that all foetuses have during pregnancy as they rely on mother’s lungs for oxygenation. In about 33% of the population, the hole dose not heal properly allowing shunting of de-oxygenated blood between the top two atria.
An example of a threshold illness is: not all people with PFO have chronic fatigue, there has to be other stressors which affect mitochondrial function in the heart muscle. Poor left ventricular function has been found in chronic fatigue patients – this would allow the flap between the top two atria to open – then the PFO which was not a problem before, becomes a problem.
This also explains why some people with multiple stressors (loads on the boat) don’t get ill with chronic fatigue: they didn’t have PFO, they inherited good microbiota and had fewer genetic mutations making them able to recover and deal with stressors better.
Summary of Overall Approach
1/ Remove the loads on the boat: Test for and remove environmental psychological and physical stressors. TEST DON’T GUESS!
2/ Patch up the “holes” in the boat: Test and assess for predisposing factors, heal them and bypass genetic mutations
3/ Rebuild the engine and pump out the water! Take a systems biology personalized approach to optimizing core physiological and psychological systems