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With our hectic lifestyles and less than optimal health habits, feeling like you have no energy is a modern day epidemic. For an ever-increasing number of individuals, however, feeling tired

Sleep

Sleep is essential to our body. It allows the brain to consolidate memories and thoughts, and to work more efficently. Poor or inadequate sleep can wreak havoc on your mental health by disrupting your circadian rhythm, and this, in turn, causes fatigue and brain fog just like chronic fatigue syndrome.

Check out our Sleep Optimization Checklist for a list of useful tips on how to improve your sleep quality.

Diet

The most common cause of fatigue is a poor diet. A good diet is not necessarily about losing weight, it’s about eating healthy food and feeling better. In this highly advanced and globalized society where you can buy and eat all kinds of delicious foods from all over the world, we are getting fatter and sicker compared to previous generations. Here’s why…

a. Nutritional deficiencies

Iron deficiency (often found with vegetarians and vegans) and lack of vitamin B12 can cause anemia, a common pathology where the blood cannot supply enough oxygen to the body due to a lack of important nutrients.

Low potassium and magnesium levels are also associated with low energy and fatigue. Low potassium can be easily treated by eating bananas: one banana contains around 425 mg of potassium , so eating two bananas a day for a week can easily replenish the potassium stores of the body.

Magnesium is a key nutrient. Over 300 enzymes require the presence of magnesium ions, including all enzymes synthesizing ATP (the primary source of energy in cells) as well as DNA and RNA. It is, unfortunately, becoming harder and harder to find in today’s highly-processed food. Because of this, the only method to replenish the magnesium ions in the body is to use a magnesium supplement. It’s essential to get a good magnesium supplement – most of the commercial magnesium brands contain “cheap” inorganic forms for economic reasons. These are usually magnesium oxide, magnesium chloride or sulfate, which have very low bioavailability and are often used as laxatives. The most effective magnesium forms are malate, glycinate, orotate, and taurate. We recommend the malate salt which is especially effective for pain and fatigue. A less expensive option is magnesium citrate.

b. Excessive carb intake

Other than nutritional deficiency, an excessive intake of carbohydrates is a very common cause of chronic fatigue.

First of all, we need to remember that the “modern” Western diet is full of carbohydrates, particularly refined carbs such as sugar, corn syrup, fructose, as well as refined flours, grains, and starches. Not all carbs are immediately used by the body. Excessive glucose (sugar) gets stored in the body for future use as glycogen and fat. However, there is one thing that all carbs do: they make the body secrete insulin, and insulin decreases plasma levels of large amino acids that would ordinarily compete with tryptophan for transport (particularly in the blood-brain barrier), therefore increasing tryptophan availability.

Tryptophan and its metabolite, serotonin, have a complex role in the brain, but the two things they are most known for is regulating mood and hunger. Low levels of serotonin have been associated with depression (even though this is recently being disputed) while high levels (especially its precursor, tryptophan ) have been correlated with fibromyalgia and chronic fatigue.

It should also be noted that an insulin spike is followed by a crash, which can further exacerbate symptoms of mental fatigue and depression. And that’s not all!

A group of researchers at the University of Bordeaux found that when rats were given a choice between a sugar substitute and intravenous cocaine, 94% of them chose the sugar substitute.

While the research on cardiovascular disease in the last fifty years has been focusing mainly on the dangers of fats, new research reveals that carbs are actually more dangerous to health than fats. A study showed that a high-carb diet increased blood fats level more than a high-fat diet!

If you crave carbohydrates as your primary source of energy, it’s time to cut them back. But the brain needs glucose to function, how can glucose be produced without carbs?

Luckily, this is not really a problem for the human body. If you think about it, the early human diet was made almost entirely of protein and fats. As a matter of fact, the body can produce glucose from proteins through a process called gluconeogenesis.

While this idea of a low carb diet may seem a crazy, it actually goes back to the 1920s . Originally developed to reduce symptoms of epilepsy, (back when anticonvulsant drugs did not exist), the ketogenic diet has helped millions people all over the world lose weight and overcome their chronic fatigue as of today.

Without getting too technical, the ketogenic diet forces the body to burn fats rather than carbohydrates. In this process, ketone bodies are created, and they replace glucose as the body’s primary source of energy. When there is a high blood level of ketones the body goes into a ketosis state, which leads to a reduction of the frequency of epileptic seizures.

But that’s not all! Without carbs to get in the way, the body starts burning fats at a much higher rate, and this helps those in overweight in shedding excessive fats and reach the desired weight.

For more information check the keto subreddit.

Parasites

Even though parasites may make you think of Third World countries, they are still fairly common in civilized nations. Tapeworms, hookworms, pin worms, liver flukes, giardia, these are just a few of the parasites that cause disease in humans.

Symptoms of parasitic infestation include:

fatigue and lethargy

abdominal pain and swelling

fever

vomiting

diarrhea

malnutrition and anemia

loss of appetite and blood

The severity of these symptoms depends on the type of parasite, the number of parasites, and the site of the infestation. Most infections are asymptomatic, especially in the early stages. Parasitic infections are usually treated with benzimidazoline drugs like mebendazole (Vermox) and albendazole (Albenza) while protozoan parasites (like giardia) are treated with nitroimidazole antibiotics like metronidazole (Flagyl) and tinidazole (Tindamax).

“Colon cleanse” supplements have never been proved to work, and they should not be used as a primary treatment but only to augment the efficacy of antiparasitic drugs.

Eating good amounts of garlic, papaya, and black pepper, and taking a zinc supplement, may reduce the severity of the infestation.

Thyroid

Hypothyroidism is a common condition caused by the thyroid not producing enough thyroid hormones (T4 and T3). This generally happens for two reasons: Iodine deficiency or Hashimoto’s thyroiditis.

Iodine deficiency is the most common form, and it is caused by an inadequate amount of iodine in the diet. This type of hypothyroidism is fairly widespread in second and third world countries. One of the ways in which governments have tried to prevent this is by promoting the use of iodized salt (table salt with additional potassium iodide).

Hashimoto’s thyroiditis, on the other hand, is an autoimmune disease in which the immune system sees the thyroid cells as an enemy and attacks them. It is one of the most common causes of hypothyroidism in the United States.

But fatigue is not only a symptom of hypothyroidism: it can, (even though it’s less prevalent), also be a symptom of hyperthyroidism, the opposite of hypothyroidism.

If your metabolism is too slow (or too fast), or if you can’t stand hot (or cold) temperatures, you should check TSH, T4, and T3 levels through a blood test.

It is a good idea to supplement the building blocks of thyroid cells: iodine and selenium (200 mcg each). Iodine can be supplemented with a potassium iodide supplement or Lugol’s iodine. Selenium should be supplemented in the selenomethionine form since sodium selenite is a pro-oxidant, which is not something we generally want (unless you have cancer).

Medications

A fairly common side effect of some medications (especially those that act on the brain) is fatigue. If you are taking supplements, it’s also a good idea to stop taking them one at a time for a couple days and see if there is an improvement.

In general, the worst offenders are antidepressants, antipsychotics, antihistamines, and beta blockers. Please consult a medical professional before you stop taking a psychiatric medication.

That being said said, here is a list of medications commonly associated with fatigue, sedation and brain fog:

Antidepressants: mirtazapine (Remeron), citalopram (Celexa), paroxetine (Paxil), trazodone (Desyrel), mianserin (Norval), amitriptyline (Elavil), imipramine (Tofranil), clomipramine (Anafranil) etc.

Antipsychotics: all of them

Antihistamines: diphenhydramine (Benadryl), promethazine (Phenergan), hydroxyzine (Atarax)

Beta-blockers: all of them

Benzodiazepines: alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin)

Adrenals

The adrenal glands are two small glands that sit on top of the kidneys. They produce a variety of hormones, including cortisol, adrenaline, and aldosterone, through a process called steroidogenesis.

The adrenals produce three types of hormones: mineralocorticoids, glucocorticoids, and androgens.

Mineralocorticoids help blood pressure regulation and electrolyte balance.

Glucocorticoids — including cortisol and corticosterone — regulate the immune system as well as metabolism.

Androgens are steroids that get converted to fully functional sex hormones in the gonads and other target organs.

There are a number of diseases that affect the adrenal glands. An overproduction of cortisol causes Cushing’s syndrome and a deficiency of cortisol causes Addison’s disease. Cortisol and adrenaline are implicated in the stress response (“fight-or-flight response“). Too much cortisol promotes stress and anxiety and not enough cortisol causes chronic fatigue.

But why do the adrenals stop working properly? Two common reasons are either stress or a over-consumption of drugs that affect the adrenal glands, like caffeine and amphetamines.

About caffeine and stimulants…

Seriously, who doesn’t love a cup of coffee in the morning? It tastes great, helps you wake up and stay focused, it’s full of antioxidants, and protects your liver — this “liquid gold” can truly be a lifesaver when used correctly. But an excessive or poorly timed use of coffee and other caffeine sources, on the other hand, can stress your adrenal glands and disrupt your sleep cycle (which by itself increases cortisol).

As a rule of thumb:

avoid taking caffeine after 5 pm

after 5 pm limit intake of caffeine to no more than 300 mg a day (a cup of coffee usually contains between 60 to 100 mg of caffeine )

to no more than 300 mg a day (a cup of coffee usually contains between 60 to 100 mg of ) do not mix caffeine p0wder or coffee with other stimulants

The same principles more or less apply to stimulants. They may seem like a good idea when you’re feeling exhausted and unmotivated, but if the fatigue is a symptom of a chronic condition they end up doing more harm than good.

Excessive use of stimulants may lead to burn-out, psychosis, and neurotoxicity.

Inflammation

Inflammation is part of the process that begins as a response of the body to harmful stimuli. Inflammation is usually caused by an infection, but that is not always the case – in some cases, the harm done by years of an unhealthy lifestyle (through smoking, drug abuse, over-consumption of alcohol, or an inadequate diet), can produce a chronic inflammatory state.

Chronic inflammation – whether caused by infection or a bad lifestyle – is associated with heart disease, muscle loss, cancer, depression (and other mood disorders), shortened lifespan, and autoimmune diseases.

Methylation cycle

The methylation cycle is a biochemical pathway that regulates a number of bodily functions, including detoxification, the immune system, energy production, and mood. Explaining the methylation cycle is a bit out of the scope of this article, and I’ll address it in a future one.

What is important to know is that individuals generally fall into two categories: under-methylators and over-methylators. Typically these genetic differences in methylation are discovered by genome testing, like 23andme.

Here you can read more about the methylation cycle, how it works and how is it linked to chronic fatigue and poor mental performance.

Conclusion

In the end, there are many conditions that cause or mimic chronic fatigue. As chronic fatigue is a relatively complex and still pretty unknown syndrome, it is a good idea to test for all the conditions we just explained, before giving up to the diagnosis.

As a matter of fact, there are other conditions that may cause this syndrome – like hypogonadism (low testosterone levels), or high blood ammonia – but we left those out to cover them in detail in future articles.

Have you enjoyed the article? Do you feel like you may have one of this conditions? Leave us a comment!

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