• Dr. Sarah Moore

Understanding your Fatigue


Photo by Abbie Bernet on Unsplash

I recently attended a Metagenics seminar titled "The Modern Maladies of Maternity: Fatigue, Stress and Thyroid Dysfunction". These are common presentations that I see in my practice, so I thought it would be useful to share my reflections on this seminar with my readers.


Fatigue is a useful way for the body to communicate to our mind that we’ve expended our cells’ energy requirements and it is time to rest. However, when fatigue becomes the dominant message that our body receives day in day out, this is abnormal, signalling that it’s time to look deeper and examine the root cause for this symptom.


One concept that was explained during the seminar that resonated strongly with me was that of the Cell Danger Response (CDR). This is an important messaging process that occurs within the cells of our body when cell damage occurs. When the body is functioning and healthy, the CDR moves through three phases to recover from cell damage and healing ensues. In chronic conditions where fatigue is a dominant symptom, it seems that the CDR has been impaired and incomplete, leading to persistent inflammation, which requires ongoing depletion of energy stores. Healthy mitochondria (energy generators) within our cells are essential for a normal functioning CDR; therefore, by supporting the mitochondria with good nutrition and supplements where necessary, the CDR can be restored and symptoms of chronic disease resolved.


Supplements that have been shown to support mitochondrial function in patients with fatigue include magnesium bisglycinate and coenzyme Q10. These products can be prescribed by your integrative health practitioner.


Another important approach to managing fatigue is recognising and eliminating the triggers for the CDR. The challenge often arises when it becomes obvious that there is not just one trigger but in fact a complex array of factors contributing to your symptom of fatigue. One way to simplify this idea is to consider the model of allostatic load.


Allostasis is a term that describes how the body stays in balance despite the constantly changing environment. The body employs a team of hormones and other messengers to communicate between the various systems within the body, including the thyroid, brain, adrenals, reproductive organs, pancreas and the autonomic nervous system. The modern world has increased the amount of environmental stress that our bodies need to manage, and consequently this can lead to a state of allostatic overload, where the homeostasis is lost and body systems begin to malfunction.


Allostatic overload can therefore present in a number of ways, depending on which system loses its state of equilibrium first. This is often related to your genetic predisposition for particular diseases. This being said, fatigue is a symptom that is common to a number of system imbalances, so it’s important to consider and investigate each system to identify potential causes for your symptoms.


One way to help determine the driving forces behind the symptom of fatigue is to take a full history of each body system. This should include:

  • pain

  • immune-related symptoms

  • gastrointestinal symptoms

  • mood symptoms

  • metabolic symptoms

  • menstrual cycle symptoms

It is also important to consider diet, lifestyle and environmental exposures as these can have a significant impact on mitochondrial function. Circadian hygiene, including when you sleep and eat, is also critical to a thorough assessment of fatigue.


Once you have a clear map of your symptoms and potential stressors, the next step is to investigate. An integrative medical practitioner will be able to discuss and order appropriate tests with you. I would consider the following investigations in a patient presenting with symptoms of fatigue:

  • full blood picture

  • iron studies

  • vitamin D

  • zinc

  • magnesium

  • thyroid function tests

  • glucose and HbA1c

  • lipids

  • insulin

  • reproductive-hormones

  • inflammatory markers

  • liver function

  • kidney function

  • serum antibodies for potential viruses

  • stool PCR for parasites

It is very common that patients presenting with fatigue identify a number of stressors that are underlying their symptoms. Consequently, there are a number of steps that everyone with fatigue should consider working on as part of your treatment plan.


1. Nutrition

If iron, B12 and vitamin D levels are inadequate, replacement through diet, sunshine and supplementation will be important for recovering energy levels.


2. Circadian rhythm

Establishing a healthy eating and sleeping routine, rising and retiring with the sun and avoiding eating between sunset and sunrise, will help your body find its natural rhythm.


3. Electromagnetic Fields (EMFs)

A simple EMF minimisation trial by switching off devices one hour before bedtime, turning off your wifi router overnight and keeping electronic devices out of the bedroom could lead to a significant improvement in your energy levels.


4. Digital detox

Try switching off all electronics for a whole weekend and getting out in nature.


5. Gut microbiome

Consider a general gut cleanse protocol to support the gut microbiome. This will help boost your immunity, reduce inflammation and reduce overall allostatic load. For a list of tips on how to support your gut microbiome visit this site.


6. Quiet time

Try sitting quietly for just 5 minutes each day. There are a number of great meditation apps available for free that you can use to guide your sitting practice. My personal favourite is Insight Timer. If you find it difficult to sit still, then a gentle movement practice such as Qi Gong may be a great alternative for you.


If you are suffering with fatigue and you’re ready to get to the root cause of your symptoms, I encourage you to find an integrative medical practitioner who can work together with you to complete of full and thorough assessment and prescribe a holistic management plan. If you live in the South West of Western Australia, you can book in for a consultation with me at Broadwater Medical Centre on 9751 0400.


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