Tired? Exhausted? At the end of your tether? Join the club.

Busy lives divert our attention, early symptoms of overload ignored, tired person results.

Food chosen for speed and convenience, mostly items which have been through a factory or bakehouse, the vital minerals, vitamins and phytonutrients in short supply, our body chemistry slows down, fatigue results.

Sleep interrupted by apnoeic attacks, with reduced oxygen in the bloodstream during the night, one may wake unrefreshed and be liable to fall asleep during the day at the drop of a hat.

Exposed to environmental pollution from industry and motor vehicles, especially if one has inherited problems with detoxification and also if short of vital nutrients, our energy production slows.

Internal pollution can occur from accumulation of iron (haemochromatosis) or copper (Wilson's disease.)

So many possibilities.

Any long standing problem needs sorting out before treatment can be effective. Poisoning will not respond very well to counselling. Vitamins may not heal an unhealthy relationship.

It's a very common problem, usually mutifactorial and needing each aspect managed for a half way decent result.

Medications are seldom the answer.
If someone is already on multiple medications, my first ploy is frequently to stop them all. Some need tailing off to avoid withdrawal syndromes. The person needs careful watching in case some need to be re-started.

A plan of approach to chronic fatigue

Honesty with oneself is one good starting point.

Are you involved in lots of things because you think (or someone else thinks) you ought to be?

Are there some that you don't enjoy, that make you feel more tired?

Are you sitting on a committee which really doesn't have power to achieve its intended purpose?

This list could go on and on for a very long time.
If you knew you had six months to live, what would your life look like?

A bit of knowledge about your body is not dangerous.

You need to understand things in order to make sensible decisions, in partnership with your health professionals.

Ask a lot of questions. Take a list and have it prioritized in case time runs out - most important things first.

I'm delighted if people have studied up on the net, even if they are way off in their initial ideas.

Sites such as http://phoenixrising.me are very good value.

Don't rely only on doctors. Sadly, the medical profession relies too much on standard pathology tests and on pharmaceuticals.

It is very important to check for things like chronic kidney failure and cancer. Conventional medicine definitely has it's place.

In chronic fatigue, it is a small place.

Learn about nutrition and I don't just mean proprietary nutritional supplements.

If possible grow some of your own food, without chemicals. Even if you just have a jar for sprouting seeds for your salads, or a window box for chives or strawberries, it's valuable and enjoyable.

Swapping home grown vegetables and fruit, buying organic food, do whatever is possible.

"We are what we eat" plus masticate, digest³ and absorb. Indigestion is not just discomfort, but difficulty with assimilation so we may not get all the goodness out of our food.

A lot of ill health starts in the bowel, with dysbiosis and leaky gut. Inflammations, cancers and hormone disturbances are way further down the track.

Read, read, read, on sites such as SpectraCell and genova for specialized pathology, Dr. mercola's site, Naturalnews and GreenMedInfo for anything.

The cdc site is comprehensive, but biased against nutritional medicine.

If all this makes you tired just to think about it, enlist some help. We are not alone. Blogs and forums abound.

Medically unexplained physical symptoms (MUPS) simply means the medical practitioner lacks the knowledge or time to sort things out, not that there is no organic basis for the symptoms. Confronted with this assessment, go elsewhere. Very few symptoms are completely "in the  mind."

Tired old notes from case histories

1. Stomach problems and nutritional supplements

Mr. A had "Wind in stomach, blowing up, sore. Gurgling in throat, belching. Been to lot of doctors, had hiatus hernia operation 8 years ago without help."

When asked about general health..."Quite good in other ways, but tired all the time, lacking energy, wants to sit down all the time."

When examined, he was tender in the midline of his abdomen, just under his ribs. He looked depressed and admitted to feeling so.

A few visits later, I gave him an injection of multiple B group vitamins including vitamin B12.

The next note a week later was "got better next day - ever so much better."

The note after that was 4 months later again.."stomach back again." This time he had just vitamin B12 1mg, and later reported he'd improved again.

After that he was mainly seen for unrelated matters, plus B12 injections. There were no further notes about his stomach (or being tired.)

Blood tests for vitamins are expensive and often the best way to check for deficiency is to just give some. In a setting of obvious gastrointestinal malfunction, vitamins by mouth may not be the best way to do this "therapeutic trial." They may not be adequately nor uniformly absorbed, or may simply feed parasites.

A "therapeutic trial" is the suck it and see approach, often used in medicine with drugs as well - no matter how much I know about a drug, I can't know exactly what it will do in this person sitting in front of me - every new treatment is an experiment.

This person was seen over thirty yeas ago. I would always get a blood test for vitamin B12 and homocysteine first, these days. The comments still apply to the other vitamins of the B complex, however.

Injected vitamins can have much more rapid and obvious effects.

If you are in USA and can afford tests, spectracell.com micronutrient-testing is worth looking into.

2. Digestive enzyme supplements

Mr. B had been investigated in hospital for chronic fatigue syndrome. The only abnormality found had been that his blood sugar levels were all low. The highest was 3.8mmol/l (68mg/dl).

He had undergone a prolongued fast to ensure he hadn't a tumour in his pancreas.

He reported that he could get more tired 10 to 15 minutes after eating, especially after sugary things.

He was subject to dramatic mood swings. His bowel actions floated in the toilet water, rather than sank.

He had been tested for allergies in the past, and was "positive to everything" including the main cereals apart from rice.

Part of the treatment prescribed was to use a digestive enzyme supplement with his meals.

He reported later that if he missed taking the enzymes for a couple of consecutive meals he "gets inability to think clearly, no patience, very volatile."

Mostly, poo sinks. If it consistently floats the fat content may be high, a clue to suggest poor digestion.

Food allergy reactions can drop blood sugar levels. This is one of the tests used at Dr. William Rae's Environmental Health center in Dallas. See http://www.ehcd.com/

One way of dealing with food allergies is to speed up digestion, so there is less undigested or partly digested food to penetrate the wall of the intestine and lead to allergic reactions.

3. Later hormones get involved and hypoglycaemia can result.

Blood sugar drops are usually due to high high "glycaemic index" foods5, rather than allergy reactions. GI is a measure of disturbance of blood sugar from a given amount of carbohydrate in different foods - rapid digestion and absorption due to lack of fibre increase this.

The rapid rise in blood sugar is followed by just as rapid a fall, which overshoots the initial level.

One simple test for this condition is to give intravenous glucose and see if the person feels better.

Mrs. J felt "giddy, stupid in head, shifting headaches and palpitations" which improved after the glucose injection.

Mrs K had "high pitched ringing noises in head, ache in chest, nausea and indigestion." After the injection she felt less heavy in her chest and her ears weren't ringing.

This is a short lived benefit, and in fact Mrs J "got worse ++ later," which helped confirm the diagnosis.

Another similar diagnostic step is to have a long drink made of a tablespoon of glycerin with some lemon juice, in water.

Mrs L found this was too much and made her dizzy. A dessert spoon full still made her a bit light headed, but also gave her "a spurt of energy." She needed more water with the glycerin, as too thick it shrinks the brain (temporarily.)

To another page about hypoglycaemia

Adrenal gland weakness is usually behind such low blood sugar. This in turn can have developed due to stress and poor diet on top of inborn weakness of the gland.

Small ear lobes is a marker for the last factor, indicating need to keep stress down and nutrient supply up.

4. Tired or toxic?

Everyone has to deal with toxins. Most foods, no matter how well grown, have natural chemical compounds our body doesn't need nor want. Then add all the products of modern industrial society we inhale, ingest and absorb through out skin. Then add electromagnetic smog.

It's an impressive load.

Not all people are well endowed with inborn capacity to deal with it.

Not many people eat good enough food to realize their optimum inborn capacity to deal with it.

No wonder many people are tired, bone tired.

Other resources and treatments

The environmental Illness Resource at http://www.ei-resource.org/ is very extensive and very good.

Fatigue and pregnancy

Folate deficiency is quite common. Two thirds of a series of tired pregnant women in my country town, felt better after starting folic acid supplements. Most of their plasma folate levels were in the reference range.

Fatigue and sleepiness¹

Are you dragging yourself around wishing you could be asleep, or are you actually dropping off to sleep at the first opportunity. At the University of Maryland site, you can test yourself for sleepiness using the Epworth Sleepiness Scale.

In elderly men with type 2 diabetes plus obstructive sleep apnoea (median 20 events per hour,) and HbA1c 6.5% and 8.5%, the ESS was the only measure of sleep disturbance which correlated with sugar control².

It's a valuable tool.

Fatigue and eye strain

Quoting from Dr. W. H. Bates MD⁴...

"One of my patients with a high degree of myopia...(with exercises)...experienced a great feeling of relief. No words, she said, could adequately describe it. Every nerve seemed to be relaxed, and feeling of comfort and rest permeated her whole body. Afterwards her progress was rapid...and then she became able to read the letters at twenty feet."

Eye strain needs to be on the list of possibilities

Have A helpful tip to share, or an experience others can learn from?

You can have your own page on this site, be anonymous if you prefer, and help other people or get useful opinions from other readers.

It's very quick and easy

References and notes

1. http://www.smrv-journal.com/article/S1087-0792%2805%2900044-4/abstract
Fatigue is weariness - wanting to stop, get comfortable and rest - and possibly wishing one could sleep.
Sleepiness is needing to, being ready to and likely to fall asleep.

2. Aurora et al, Associated Professional Sleep Societies 25th Annual Meeting: Abstract O642. Presented June 15, 2011 Minneapolis

3. If you have any discomfort in your abdomen after eating, if it's recent get a medical check. Whatever transpires, "food combining" may be useful - eating combinations of foods at the one time, which are more easily handled by out stomach, such as meat with leafy greens rather than starchy vegetables.

4. Dr. Bates book is available at this site, as a pdf.


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5. What is the difference between glycemic index and glycemic load?


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