Chronic Fatigue — Get Your Energy Back!
- Severe chronic fatigue for six months or longer, unrelated to any other known medical conditions AND four or more of the following symptoms simultaneously:
Sore throat
Tender lymph nodes
Muscle pain
Diffuse and migratory multi-joint pain without swelling or redness
Headaches of a new type, pattern or severity
Unrestorative sleep
Aching and listlessness lasting more than 24 hours after exertion
The Center for Disease Control estimates that over half a million American adults suffer CFS. Importantly, it often goes hand in hand with fibromyalgia and multiple chemical sensitivities (MCS). According to the CDC, chronic fatigue syndrome is more common in women, is not contagious, and tends to affect black women more than white or asian women. In one San Francisco study, the condition was greater in people with incomes under $40,000 per year. While CFS has been the subject of a great deal of research and study, it is difficult to say with certainty what causes it. The fact is, CFS is a useful umbrella term for what will most probably turn out to be a highly individualized and varied condition with many overlapping causes.
Many patients with CFS can point to a “trigger event,” either a bout with illness or a traumatic life event that set them on a downward spiral. Most scientists believe that the trigger somehow compromises the immune system in such a way that pathogens are able to invade cells and damage mitochondria. Mitochondria are the mini-power plants in every cell in your body. If their function is impaired, the cell is weakened and can’t do its job. If enough cells are affected, all of the body’s mechanisms start to wilt.
Infectious agents like Epstein–Barr and Lyme disease have not been proven as of yet to cause CFS. However, research has not ruled out the possibility that a microbial threat or nutritional deficiency could be tied to the triggering event.
Some research indicates that the trigger may set off a cascading breakdown in the central nervous system, specifically the HPA axis — the hypothalamus, pituitary and adrenal glands. Another theory suggests that chronic low blood pressure, also called neurally mediated hypotension, may contribute to the condition. What is most likely is that CFS may not have one single cause, but represents the body’s response to cumulative physical and emotional stress. Why some people get it and others do not is still not understood.
In my experience, patients with CFS improve when they address all of the following: nutrition, GI function, hormonal balance, adrenal function, detoxification, and their emotional state. Women with CFS often find that underlying emotional baggage may be figuratively “crippling” them with fatigue. Sometimes emotional trauma is too painful for the waking mind to deal with; instead, the pain and exhaustion are expressed physically. For this reason, many CFS patients have found success through emotional coaching. I recommend the Hoffman Quadrinity Process — it has done wonders for many women in my care.
Joseph Teitelbaum, MD, author of From Fatigued to Fantastic, has made CFS his life work. He provides an abundance of information at his website, EndFatigue.com. His integrated treatment protocol is also one I encourage you to read more about.
The Women to Women approach
For most women, it is possible to reverse the downward spiral of fatigue with some work and the help of a caring practitioner. Depending on the level of your fatigue, you may be able to restore balance to your life with some simple positive changes.
- Get testing. If your symptoms of fatigue persist for more than two weeks or come on suddenly and relentlessly, talk to your practitioner about performing the tests I described above. At the very least, get a blood test to rule out anemia, infection or disease.
- Examine your stress levels and emotional burden. This is probably the most valuable at-home fatigue–reducer I can think of. It can also be the most difficult thing to do. If you are burning the candle at both ends, running to and fro to be everything for everyone, take a step back and examine why. What are you staying so busy for? Is there anything you can let go of? The truth is, if you don’t take a conscious step back, your body will ultimately force you to put the brakes on. Talk to a trusted friend or doctor, or again, investigate the Quadrinity Process. The method known as Emotional Freedom Techniques, while less therapeutic, may also very helpful and is certainly inexpensive.
- Establish a bedtime ritual that includes a regular bedtime. Get 7–9 hours of sleep every night. Go to bed early enough that you can rise naturally when the alarm goes off (not after pushing the snooze-button over and over). Your room needs to be dark to trigger melatonin release, which regulates your circadian rhythm. If you have a streetlight outside your window, get black-out shades. Remove any clock radios or other gadgets that shed unwanted light.
- Investigate the possibility of a sleep disorder. If sleep does not refresh you, there may be a problem with the quality of your sleep. Sleep apnea can interfere with REM sleep, the deep sleep that restores you. Sleep apnea is most common in people who are overweight, but thin people can have it too! Excessive snoring and/or mouth-breathing (common in back sleepers) can be a sign of TMJ syndrome, which can disrupt your sleep too. If you sleep with a partner, ask for their opinion. Or look into a sleep clinic. Most major metro-area hospitals have them.
- Clean up your diet. Refer to our nutritional and lifestyle guidelines for tips on how to make better nutritional choices. This alone can help boost your adrenals and energy, as well as dim your cravings for caffeine and sugar. Try not to eat after 7:00 pm. Limit or avoid caffeine and alcohol. One ounce of alcohol can decrease REM sleep by an hour. If you need a daily glass or two of wine just to relax, ask yourself why. So many of us use alcohol in the evening to relax, but that tends to escalate. Better to get at the underlying stress or find another way to unwind from the day.
- Investigate any possible food sensitivities by starting a Food Diary. Track what you eat and your reactions. If you notice a negative pattern, try the elimination diet for a week and see if you are more energetic. Or experiment with a gentle detox by eating only fresh fruit and vegetables for 3-4 days.
- Drink eight to ten 8–oz glasses of filtered water per day.
- Take a rich pharmaceutical–grade multivitamin daily, with calcium, magnesium, and essential fatty acids to fill in any nutritional gaps and nourish your cellular function.
- Explore the natural ways to cool any inflammation. There are specific supplements that will help soothe inflammation, balance your intestinal flora and purge your system of excess cortisol, so talk to your healthcare practitioner if inflammation is a concern. Acne and rosacea are two external signs of dysbiosis, and both of these can benefit from a daily dose of probiotics — in food or supplement form.
- Incorporate physical activity into each day. Exercise is the best antidote to stress, and weary muscles make for a clear head and better sleep! I recommend at least 30 minutes of moderate exercise, 3–4 times per week, but any movement is helpful.
- Consider a detox if you suspect heavy metal overload or experience chemical sensitivities. A regular cleansing detox of your house and body may help rejuvenate you. Be conscious of the fact that heavy metals are not easily cleared and should be addressed by a practitioner of complementary medicine with experience in medical detox.
- Be patient with yourself. Beating your fatigue may be simple or more complicated, depending on the interdependent state of your physiology and emotions. Take pride in whatever measures you put into place to give yourself support, but don’t expect an instant miracle. It has probably taken you years to become so tired, so it may take a little time and some work to recoup your energy. But have faith — you will!
A time for rest
As you look around you, you will see that everything in nature has a period of dormancy. There would be no spring without winter, no sunrise without sunset. Equally, your body needs balance — with downtime to restore and renew.
Energy and wellness are not infinite resources by right; they must be cared for as you would any precious asset. If you are experiencing fatigue, slow down and listen to what your body is saying. Then take the proper steps — before you know it, they will be leaps and bounds.