Calm but not Fatigued
For so many of my patients this seems to be a paradox. Seeking that morning “get up and go” energy with caffeine or sugar, feeling anxious and unsettled throughout the day, and finally collapsing after work with no energy left to exercise or enjoy the evening. Then, despite being exhausted, sleep does not come easy. The next day, they repeat the cycle.
Take heart because help is available. The key is figuring out what drives this wide range of feelings. A functional medicine approach will typically uncover the underlying issue and it’s not usually as obvious as it might seem. Like a “sleuth” on the trail of a crime, we look for clues; and while some are in clear sight, others are more hidden.
Rooting out the cause of fatigue
We start our investigation with the easy stuff. Is the diet quality less than desired? Cut out all sugar and processed foods. Avoid excess caffeine and alcohol. Simply eat a whole-foods diet based on fruits and veggies with limited amounts of grains and animal fats. Sometimes just changing the fuel we put in the body is all that is necessary.
But, even healthy foods can be an issue if you have food allergies — not the kind that will give you an immediate symptom, but the “delayed” allergies that will cause a response 12-72 hours later, thus being sneaky and defying easy identification. For example, when I eat pork I feel bad the next day, noting impatience and difficulty multi-tasking. Checking for delayed food allergies is done with a simple blood test.
“Leaky gut” occurs when cells that line the gut literally pull apart, opening the pathway for undigested foods, bacteria and toxins to slip right through the gut wall whereupon the immune system is stimulated, again leading to brain chemistry changes. The resulting inflammation can also cause the blood-brain barrier to become leaky, thus allowing even more toxins into the brain.
Believe it or not, bacteria in the gut plays a role in mood. Research is showing that “dysbiosis” or alterations in the good and bad bacteria in our gut can actually influence how we feel. Eliminating food allergens, healing leaky gut and restoring balance to gut bacteria commonly helps mood and energy.
Hormone imbalances or deficiencies are very common causes of disrupted brain function. Undiagnosed low thyroid equals brain fog and fatigue. High levels of cortisol, the stress hormone, will cause anxiety and sleep disturbances. After years of being overly taxed, the cortisol levels will plummet leading to fatigue and more severe anxiety.
Low sex hormones normally found in aging men and women will usually cause fatigue, low stamina, and very often symptoms of depression, anxiety and insomnia. Many women suffer from pre-menstrual symptoms of anxiety, irritability and poor sleep due to estrogen dominance. Replacing hormones, or fixing the reason they are out of balance, cures the symptoms.
Even the fat storage hormone, insulin, can play a role in how one feels. High insulin spikes after meals will cause fatigue and brain fog. How many of you have noted the “food coma” experienced after a huge meal. Imagine feeling that way after most every meal.
Chronic infections can cause inflammation and changes in brain function. As an example, Lyme disease is far more common than credited, terribly under diagnosed, and will cause all sorts of neurologic symptoms, including fatigue and mood changes. Even the ubiquitous fungus called Candida that is normally present in all of us can “overgrow” and cause mental symptoms.
We are awash in a sea of environmental toxins and heavy metals that are well known to disrupt metabolic, hormone, immune and neurologic function. We find them everywhere — in our food, air, water, and countless consumer products. If you touch, taste or smell it, you are getting a blood level of it. Testing and removing heavy metals is fairly simple. Avoiding toxic chemical exposures and doing a periodic cleanse and detox can effectively remove these brain-disrupting toxins.
Nutrient deficiencies can influence brain function and energy levels. Despite eating well, many people have low levels of specific vitamins or minerals. Certain medications, aging, or health problems predispose some to this problem. Measuring a wide variety of nutrients is as simple as getting a blood test that can alert you to the need for extra supplementation.
Our mood is also in our genes. In recent years we’ve learned that we all have millions of genetic mutations called “single nucleotide polymorphisms” or SNPs (pronounced snips). Some of these SNPs influence enzymes that play a role in production of the chemicals that give us energy or influence how the brain functions. From depression to mania to schizophrenia, SNPs are playing a role and can be compensated for with targeted nutrition and supplements. Just recently I had a patient improve her fatigue by using the results of her genetic testing to guide her to a simple change in the type of B12 supplement she was taking.
Of course lifestyle habits need be addressed in treating fatigue and mood disorders. Like cleaning up the diet, improving behaviors will influence how we feel. Get exercise every day, even just walking for 30 minutes. Have good sleep patterns such as getting to bed early, getting up at the same time every day, and allowing for plenty of time to sleep. Manage stress, which means avoiding toxic drains including people or situations that cause distress. Each of these is just as important as our medical interventions.
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.