Chances are that you are one of the millions of Americans suffering from fatigue . Depending on the duration of symptoms, how debilitating the symptoms are, and the concurrence of various other issues like sleep problems or cognitive impairment, the official medical diagnosis that one might be given by a medical doctor is generally either “idiopathic chronic fatigue” or “chronic fatigue syndrome/systemic exertion intolerance disease.”
Let’s break down the basics of exactly what chronic fatigue is, why it’s so common today, and the approach we use at Parsley Health to help our members regain their energy and find their optimal well-being.
The prevalence of fatigue in America is on the rise. A study done in 2007, and published in the Journal of Occupational and Environmental Medicine, showed that the prevalence of fatigue in the US workforce was almost 40% and that workers with fatigue cost employers $136.4 billion annually in health-related lost productive time.
Symptoms of chronic fatigue can mimic a number of disorders and aren’t always easily recognizable. Below are some of the most common causes and symptoms that are associated with chronic fatigue.
A patient named Josie recently came to Parsley Health with a long-standing history of fatigue. She had symptoms since graduating from college 7 years ago and clearly qualified for the diagnosis of “chronic fatigue syndrome/systemic exertion intolerance disease”.
In conventional medicine, the treatments that are recommended for chronic fatigue consist of cognitive behavioral therapy, anti-depressant pharmaceutical medications, graded exercise therapy, sleep hygiene, discouraging over-sleeping, and referrals to support groups. Unfortunately, none of these treatments effectively address the root cause of what the fatigue is. It’s no wonder that more than half of patients with chronic fatigue don’t improve after a year of therapy.
Not only did Josie suffer from fatigue, she was also suffering from chronic digestive issues, irritable bowel syndrome, autoimmune thyroiditis and hypothyroidism (treated by an endocrinologist), insomnia , body aches, cystic acne, weight gain, PMS, anxiety , and depression. In a standard conventional model, she probably would have been referred to a rheumatologist, sleep specialist, psychiatrist and dermatologist, in addition to her endocrinologist.
Luckily for Josie, at Parsley Health, we understand the interconnectedness of the body and treat people as a whole, instead of breaking them down by organ system. We were able to partner with her in addressing all of her problems. There are usually other symptoms that accompany fatigue. This is due to the fact that fatigue is usually just a down-stream symptom of imbalances in the body that tend to present in a multitude of ways. The investigative work of figuring out the root cause of Josie’s fatigue was just beginning.
In order to figure out what was causing her symptoms, in addition to regular conventional blood testing, we ordered Josie more extensive blood work, salivary hormone testing, digestive testing consisting of a stool and breath tests, and genetic testing. She was found to have yeast overgrowth in her intestines, positive autoimmune inflammatory tests, hormonal imbalance, and nutrient deficiencies .
First, Josie was given supplements and medications to treat her yeast overgrowth. Addressing this chronic intestinal infection in her microbiome (the compilation of trillions of bacteria that live within our intestines) not only corrected her digestion but also helped to heal her leaky gut .
Leaky gut, or intestinal permeability, is caused by inflammation in the cells that line the digestive tract. This inflammation can be caused by an infection, chronic stress, inflammatory foods like gluten and sugar, or medications like ibuprofen. Leaky gut leads to auto-immunity (when the immune system attacks part of our own bodies) by disrupting the barrier between the contents of our intestines and our bloodstream. When this barrier is disrupted, the bacteria, food, and immune complexes within our digestive tracts can seep into our bloodstream and cause chronic inflammation, and even hyper-reactivity of the immune system against part of our own body.
Most people with symptoms of fatigue will also present with some evidence of leaky gut. Not only does leaky gut lead to autoimmunity, but it also leads to nutrient deficiencies , because of the subsequent inability to absorb nutrients from the food we eat.
Josie was also encouraged to begin a regular meditation practice and to harness thoughts of gratitude, compassion, and peace, and to picture herself in a healthy state six months from that time. These types of visualizations and emotions are necessary on a daily basis in order for our bodies to heal.
When we spend much of our time with negative thinking and anxiety, our bodies perceive that we are in survival mode. If we live in a chronic state of survival, then our brains will be surrounded by high levels of cortisol and adrenaline which can eventually cause the size of our hippocampus (aka the memory center) to decrease and can even shrink our muscles. These effects contribute to feelings of fatigue. Meditation on a regular basis switches the brain from survival into healing and resting mode and will counteract these effects.
We also addressed Josie’s various nutrient deficiencies. She was given supplements and a nutritional plan that would replenish her levels of vitamin D , B vitamins, and magnesium.
These nutrients are low in most people in our country. We are not outside in the sunshine every day, and therefore lack vitamin D. Our soil is over-farmed by the farming industry, and practices like crop rotating are no longer performed to replenish nutrients into the soil. Therefore, even when eating a seemingly nutritious diet, we still lack minerals like magnesium, zinc, and iodine.
We also gave Josie supplements to aid in lowering inflammation and encourage detoxification, like omega 3 fatty acids and vitamin C. Always work with your provider to understand your specific deficiencies and the best supplements and dosages to help address these.
Finally, Josie was given a nutrition plan that focused on anti-inflammatory and detoxifying foods. Given her existing auto-immune condition, we needed to try to calm her immune system down. An auto-immune condition is one where the immune system attacks proteins in the body that are essential for function. Over time, if left unchecked, it can potentially cause deterioration of organs and even organ failure.
Because modern day life exposes us to hundreds of toxic chemicals daily, our immune systems are living in hyper-reactivity mode. Therefore, part of the solution often involves removing as many things from our diets that might be seen as foreign invaders by our immune systems.
Since 75% of our immune cells are made in our intestinal lining, it’s imperative that we minimize the number of chemicals that our digestive lining comes into contact with, in order to calm the immune system.
So what does this look like? Start by eating organic foods as much as possible, and removing large proteins from the diet that are seen as foreign by our immune systems like gluten from wheat and casein found in dairy . Excessive refined sugar in the diet also adds to inflammation and fatigue. Refined sugar intake leads to rapid spikes of insulin and results in rapidly plummeting blood sugar levels and feelings of fatigue, irritability, and more sugar cravings.