We all get phases of feeling tired but there is a big difference between occasional tiredness and the incapacitating effects of true fatigue. However, before chronic fatigue syndrome is diagnosed a number of easily fixable health issues can be addressed. Some will need you to work with your doctor while others will simply involve a few basic lifestyle changes.
If you or one of your family is suffering from fatigue work your way through our 10-point check list, you may discover one or more pointers that could make all the difference to your health and boost your natural energy levels again.
- Your sleeping, but are you?: If you feel that you are getting enough sleep but are still feeling fatigued and can’t fathom it may be worth considering a condition known as sleep apnoea. This problem causes interrupted breathing during sleep and as a result disturbs your sleep but does not necessarily to a point where you wake up. Because you body and brain need a certain amount of sleep to feel refreshed any disturbance of this delicate balance can result in unexplained fatigue if its not picked up on. In the UK, sleep apnoea affects 4 in 100 middle aged men and around 2 in 100 middle aged women with around 60% of the over 60’s experiencing the problem. One of the quick fixes for sleep apnoea is simply loosing weight especially is you carry fat around your neck.
- Could you be anaemic? If you are a women and having regular periods, the monthly blood loss can add up, especially If you are not obtaining enough dietary iron to help replace the losses. A low level of circulating red blood cells can cause profound fatigue because adequate oxygen levels will not reach the tissues of the body. There can be many causes for anaemia so its worth getting a blood test but you can easily top up your iron levels by eating iron-rich foods such as lean red meat, liver and shellfish. In general, vegetarian iron is not as easy to absorb but is available in beans, bran flakes, Tofu, figs, kale and lentils. If you feel you can’t get your iron up through diet alone supplements can help.
- One coffee too many? Many of us will reach for a mug of coffee to help fight off fatigue because we all know that coffee can boost alertness. However, the positive effects of this pick-me-up are seen in moderate intake levels but the effects tend to diminish the more we drink. In fact, with higher levels of intake coffee simply causes agitation, raised heart rate and blood pressure and, ironically, fatigue! If you are hitting the coffee more that you feel you should, start cutting back slowly to avoid withdrawals and headaches. Also be aware of the caffeine content of soft drinks. Dropping your coffee intake can actually boost energy!
- Check your sugars. It’s not uncommon for diabetes to become an issue the older we get. Type-2 diabetes can creep up on us in a rather stealthy manner and present itself with unexplained fatigue in the early stages. If the dietary sugars stay in the blood and don’t get into the cells we suffer from fatigue. Glucose is a key nutrient needed by the cells to generate energy. Having it circulating in the blood but not getting into the cells causes an energy crisis with fatigue as a prime symptom. A family history may point to Type-2 diabetes but a simple blood test is all that is needed to diagnose it. Adopting a whole food diet and avoiding the cakes and sweeties is a must. Cinnamon or fenugreek supplements can help regulate sugar metabolism and are worth considering.
- The wrong or not enough of the right foods. Skipping meals or not eating enough will contribute to an energy crisis within the body. Even at rest, our bodies burn food to keep the metabolic fires burning in each and every cell. Not enough food makes us feel fatigued and can adversely affect our ability to function physically and emotionally. Equally as bad is existing on junk food which tends to be sugar high and nutrient low. Getting your sugar fix will play havoc with your blood chemistry that further contributes to fatigue. Try and eat regularly and make sure that your complex (unrefined) carbohydrates and proteins are at the centre of your meals; poached eggs on whole meal toast is a great start to the day!
- The hormone connection. Sitting in the front of our neck is a special gland that is at the heart of regulating our metabolic rate. Known as the thyroid gland, it produces the hormone thyroxin, which, in turn, keeps our metabolic rate on the right tracks. If this gland starts to fail the hormone level drops and our overall metabolic rate shows and we can experience severe fatigue. Getting a blood test will confirm what type of thyroid problem you may have but in some cases very early cases can be overlooked. Borderline low thyroid function may be an issue in those with medically unexplained fatigue. To help determine if this is the case a simple body temperature test can help. Despite being quite controversial the Barns Temperature test may uncover a sub-clinical low thyroid condition.
- Check your water works. When we are ill we tend to want to go to bed and sleep it off. To a lesser degree, a background non-acute infection can cause unexplained fatigue. Bladder infections may be a cause of fatigue especially if the infection is not at an acute level but grumbling away as a chronic infection. Testing a sample of urine is easy and can help detect these infections. While antibiotics may be needed by some, using a slow release cranberry and d-mannose supplement can help keep the bladder clear.
- Feeling low? While feeling low can be thought of as an emotional issue depression does affect the body on a physical level. Those suffering from depression will commonly complain of fatigue as a key feature of the problem. Because of the complex nature of depression, other factors such as poor appetite and sleep disturbance all add up and compound the feelings of fatigue and tiredness. For those with mild to moderate depression a course of St Johns wort may help lift the mood but care is needed if you are taking other medications. In general, you should seek professional support of you feel depression could be an issue.
- Dehydrated? You don’t have to be a sports fanatic to take control of your fluid intake. Your body just sitting at a desk, at a PC or driving a car required adequate hydration for optimal health and performance. Drinking coffee in addition to the comments in point 3, also stimulated the need to have a wee. Coffee is a strong diuretic. However, sipping bottled water is the way to maintain adequate hydration. Even mild dehydration can be associated with fatigue. You can check your hydration level by looking at the colour of your urine; it should be light in colour. Dark urine can be a sign of dehydration and an indication that you need to drink more water.
- Are you a shift worker? We all have an internal body clock that tells us when it’s time for bed. Forcing this system to adjust to shift work can cause the body to become confused regarding the sleep-wake cycle so you have trouble sleeping during the day while you find it difficult to concentrate and function when you should really be sleeping. Although we can manage for a while, prolonged exposure to this can be a cause of fatigue. To help ease the effects of shift work try to limit your exposure to daylight after a night shift and make your bedroom as dark and as quiet as possible.
Dr Jacob Teitelbaum MD., expert on chronic fatigue syndrome
Health supplements recommended by Dr Teitelbaum
A recently published study had thrown some help and light for those suffering sleep disturbance as part of the ADHD spectrum of behavioural disorders.
The study is entitled: The effects of L-Theanine (Suntheanine) on Objective Sleep Quality in Boys with Attention Deficit Hyperactivity Disorder (ADHD): a Randomized, Double-blind, Placebo-controlled Clinical Trial.
The study concludes: “This study demonstrates that 400 mg daily of L-theanine is safe and effective in improving some aspects of sleep quality in boys diagnosed with ADHD. Since sleep problems are a common co-morbidity associated with ADHD, and because disturbed sleep may be linked etiologically to this disorder, L-theanine may represent a safe and important adjunctive therapy in childhood ADHD. Larger, long-term studies looking at the wider therapeutic role of this agent in this population are warranted.”
The open source journal article is available if you want to read the scientific background.
Product link: Elthea-100 (pure Suntheanine branded L-Theanine)
On the surface of it, a good nights sleep would appear to be one of those fundamental processes that should simply happen when your head hits the pillow. After all, of you feel tired or fatigued it would make perfect sense that you should welcome the chance to have a sleep but as so many fibromyalgia and chronic fatigue (FM/CFS) sufferers will testify, you can be fatigued but at the same time suffer paradoxically severe insomnia. As the American comedian W C Fields so aptly quipped “The best cure for insomnia is to get a lot of sleep”… if only it was that simple!
Before we look at ways of promoting sleep understanding some sleep basics is a good idea. Broadly speaking, sleep can be split into two main categories; the deep sleep state known as rapid eye movement sleep (REM sleep) and the stages of lighter sleep known as non-REM sleep. During a typical night, a good sleeper will cycle between REM and non-REM sleep 4-5 times interspersed by occasional mini-wakes lasting 1-2 minutes every couple of hours. The loss of the ability to migrate into REM sleep or return to sleep after a mini-wake typically characterises the condition known as non-restorative sleep disorder, a common ‘bed-fellow’ in cases of FM/CFS. Stress and anxiety os a very common factor that underlies this pattern of disturbed sleep and one that is known to have a severe impact on night time cortisol levels. Cortisol is a key sleep regulating hormone and one that is commonly out of balance in FM/CFS cases.
In health, cortisol levels normally decline at bedtime. This helps to facilitate a calmer brain and nervous system and encourages the sleep process to begin. When we are anxious or stressed cortisol is released in higher amounts and this level does not drop at bedtime. As a result, sleep becomes deregulated when we are stressed and we lie awake in a state of hyper-vigilance; after all, your body would not want you to sleep when running from a tiger! Simply taking sedatives to force a state of drugged sleep is not really the answer but there may be a solution in the form of a natural agent known as phosphatidyl serine (PS). Originally, PS was isolated from animal tissue but modern extraction methods now ensure that supplements supply ultra pure PS derived from soya beans making it suitable for vegetarians.
When scientists were investigating the effects of PS on the stress response they noted something quite amazing. In healthy volunteers exposed to a biological stressor such as using an exercise bike their levels of stress hormones (including cortisol) shot up. However, when the same volunteers took PS before their cycling task there was a significant drop in the release of cortisol. See the graph above. They concluded that PS can influence the complex chemical cascade that ultimately results in elevated cortisol. Armed with this knowledge, PS was rapidly adopted by those with stress-related sleep disturbance with some very positive outcomes. It would appear that a single capsule of a 500mg dose of PS complex (containing 100mg of actual PS) 30-60 minutes before bed works well but some may need to use PS on an ongoing basis for a few weeks before the full benefit can be appreciated. This dose can be increased to 2-3 capsules if needed. In general, PS is a safe supplement with minimal risk of drug-nutrient interactions. However, drugs taken for Alzheimers disease (Acetylcholinesterase (AChE) inhibitors) can interact with PS since PS and the drugs both increase the levels of acetylcholine. Similar cautions should be extended to drugs that manage glaucoma. If in doubt, you should always talk to your pharmacist or doctor.
Ann Caird, postnatal Doula and infant sleep consultant
The festive season is approaching and preparations are underway! Excitement mounts as anticipation of the big day snowballs… Little ones can easily become over tired with all the extra excitement surrounding the festive season; so here are some practical tips to help maintain good sleep for your little ones – that’ll help keep everyone rested over the holidays!
- Try to maintain your bedtime routine; your familiar routine is a clear series of predictable steps to sleep time which helps little ones wind down and prepare for sleep… amongst all the excitement it will keep bedtime calm and predictable for them. See my October post for more details.
- Use a nap time routine; shorter than your bedtime routine, but containing all the important predictable cues that will help the wind down to much needed naps!
- Try to keep consistent wake-ups and bedtimes – weekends and holidays too! This helps to keep baby and young children’s sleep and daily routines as consistent as possible, which in turn helps maintain and reset their biological clock daily, supporting regular healthy sleep.
- Maximise the impact of light and dark; exposing little ones to light first thing in the mornings will also help set their biological clock. The sleepy hormone melatonin is triggered by darkness, so make sure lights are dimmed during your pre-sleep routines.
- Activity and playtime in the fresh air every day helps release tension and prepares growing bodies for sleep!
- Be aware of how food may influence sleep; highly processed foods can stimulate and fatty foods may cause digestive difficulties. Sleep inducing foods include healthy carbohydrates, foods containing calcium and tryptophan, so good sleepy food options include eggs, wholemeal toast, turkey, whole grain cereal, milk, bananas, pitta breads…
- Think about using white noise!! This is just brilliant for masking all those unusual festive noises… whether they are parties next door, friends in for drinks, reindeers on the roof, sleigh bells and Santa coming down the chimney!
- Reduce stimulation at bedtime by keeping the bedroom a calm place;
avoid lots of colourful decorations and putting exciting new toys in the bedroom… keep it calm and relaxing.
For more information about food and children’s sleep:
Pantley, E. (2005). The No-cry Sleep Solution for Toddlers and Preschoolers. New York: McGraw Hill.
They say time heals all wounds, and new research from the University of California, Berkeley, indicates that time spent in dream sleep can help.
“The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day’s emotional experiences,” said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and senior author of the study published in the journal Current Biology.
During REM Sleep Stress Chemicals Shut Down And The Brain Processes Emotional Experiences.
Ann Caird, postnatal Doula and infant sleep consultant
One of the easiest ways to help your little one sleep well is by establishing a relaxing bedtime routine. Babies and toddlers naturally enjoy routines – and establishing a consistent bedtime routine from about 3 months of age can have huge benefits for you and your baby throughout her childhood!
A well planned, relaxing bedtime routine ‘sets the scene’ for sleep. Research has demonstrated that establishing a consistent bedtime routine can reduce the time it takes for babies to fall asleep and decrease night wakings. But that’s not all – a routine can help prevent bedtime battles later in childhood because once established, it provides valuable wind-down time and clear, predictable steps to bedtime which communicate that it’s nearly time to sleep.
Top bedtime routine tips:
- Reduce activity levels and encourage quieter play after tea and before the bedtime routine starts.
- Plan a routine that works for you; one that you know you can manage and maintain consistently.
- Keep it simple, about 30-45 minutes; for example bath, massage, into comfy nightwear, feed/drink, picture book/story, cuddles, lullaby….
- Include massage; massage is relaxing and calming. It prepares your baby for sleep and it will help her associate her feelings of calmness and relaxation with sleep and her cot.
- Think about context; start your routine in the bathroom and complete it in the bedroom, keep lighting low. Low lighting and darkness triggers the release of oxytocin and the sleepy hormone melatonin that helps to calm the brain.
- Avoid feeding your baby to sleep; ensure feeding isn’t the last stage of your routine. Put your baby into the cot drowsy, relaxed and calm ready to fall asleep by herself.
- Use a shorter version of your bedtime routine for daytime naps; nappy change, into sleep clothes (comfy sleepwear = comfy sleep!) drink/feed, book, cuddle and into the cot to settle to sleep.
- Consistency is key! Little ones thrive on familiar, predictable routines, because routines communicate to them what it’s time to do and what’s happening next. So, your relaxing bedtime routine will help your little one feel emotionally safe and secure; feelings of emotional wellbeing at bedtime is the foundation of happy, sound sleep!
Mindell, J, Telofski, L., Wiegand, B and Kurtz, E. A Nightly Bedtime Routine: Impact on Sleep in Young Children and Maternal Mood. Sleep Vol 32; No 5. 2009.