Smart Energy

Treating fatigue with smart energy

Have you been feeling unusually tired lately? Are you struggling to get up in the morning, struggling to find the energy for the gym, don’t respond to the exercise you do, lack motivation to see friends or talk to your partner in the evenings, struggling to stay awake let alone focused at work? Could you do with more energy?

Most of us fail to generate the energy we require at least some of the time but relatively few of us examine our diets to determine why we are lacking energy. The reasons for fatigue are usually evident, and energy generation can be measured. The following ‘quick’ guide to some of the causes of fatigue might help you to make some alterations to your diet and other behaviours, or seek advice about what you might do differently.

Tired all of the time

If you are ‘dragging’ yourself through your day without ever feeling energetic and have constantly low energy you might be anaemic. This is a set of conditions characterized by constant low energy, often with associated lethargy and depression. These conditions are often precipitated by increased blood loss, such as with trauma, surgery or menstruation or by progressive poor intake of iron, B vitamins, copper or vitamin C.

Iron deficiency anaemia is the most common of the anaemias and is most common among vegans and vegetarians. It applies to 89% of adult women in the UK and 100% of vegans, to at least some degree.

Recommendations
Seek medical assessment, especially if it does not appear to relate to a change in diet, and, if necessary, ask for referral to the ‘in house’ nutritional therapist for help with your diet.

Tiredness which progresses over the course of the day

This can be due to a number of reasons but is often due to dehydration and a lack of fuel. If you drink less than a litre and a half of water daily, pee less than 8 times a day, feel thirsty, suffer chronic headaches or have dry lips it is likely you are dehydrated.

If your tiredness is relieved by eating and you are typically hungry, having a rumbling tummy, have poor concentration and suffer headaches you might have taken insufficient fuel. This is more likely in those who skip meals, are restricting their food intake or who eat erratically during the day.

Recommendations
Try eating more food and drinking more water and do so more consistently during the day, rather than ‘back loading’ during the evenings. Aim to eat at least every 4 hours and drink at least a litre and a half of water daily.

Tiredness following a bout of stress

Over production of adrenaline can leave our adrenal glands depleted and us struggling to find the energy and motivation we once relied on, a condition called adrenal fatigue. This typically follows a period of intense stress but can also occur as a result of long periods of chronic stress.

It is characterized by unrefreshing sleep, low mood, muscular tension, weight gain around the midriff, lower body temperature, postural hypotension (headswim on getting up from a chair or bath) and often lowered immunity with a vulnerability to opportunistic infections.

This should not be confused with depression which can occur independently following difficult or challenging situations or an underactive thyroid gland which is characterized by chronic fatigue, weight gain, constipation and typically skin and hair changes.

Recommendations
If you suspect adrenal fatigue ask the nutritional therapist for an assessment and measurement of your adrenal stress index. You should also get more sleep, learn to relax effectively, balance your blood sugar levels and nourish your adrenal glands. If you think you might have an under-active thyroid gland or are depressed consult your doctor for medical assessment.

Peaks and troughs of energy

If your energy rises and falls throughout the day, with the highs typically following stimulation, with caffeine and sugar as well as stress, and the lows following an absence of stimulation or the over-consumption of carbohydrates, you are likely to have a blood sugar imbalance or dysglycaemia. This is a common by product of the use of dietary ‘uppers and downers’.

The consumption of relatively refined and concentrated sources of carbohydrates, as found in soft drinks, confectionary, cakes, biscuits, crisps and pastries causes a sudden rise in blood sugar which invokes a release of insulin in order to prevent the sugar having a toxic effect (glycation). The more rapidly blood sugar levels rise, the more insulin is released, and the more rapidly they fall.

A sudden fall in blood sugar deprives our brains of our only viable fuel source for mental function creating a panic release of adrenaline to stimulate the release of more sugar from our stores. This pattern typically continues in cycles of highs followed by lows until we fall asleep.

Recommendations
Eliminate the stimulants and refined sugars from your diet, eat frequently and regularly and increase the protein and fibre components of your meals by eating more meat, fish, eggs, pulses, nuts, seeds, fruit and vegetables.

Tired in the afternoons

This often relates to a lack of sleep and especially if sleep is disrupted or you are asleep less than 7 hours per night. Sleep loss is often associated with mood changes, typified by grumpiness and sleepiness. A return of energy following good sleep (more than 8 hours unbroken sleep) such as at the weekends, and on a restful holiday will confirm this.

This is common among people with busy and stressful lives where sleep is all too often sacrificed in order to get more done.

Recommendations
Get into good sleep habits by getting exposure to daylight, become more active during the day, relax during the evening, don’t eat too much too late, eliminate caffeine after 4pm, avoid alcohol and take the office out of the bedroom. Do also make time to sleep for at least 6 hours and preferably by retiring to bed before midnight.

Tired after eating carbohydrates

This is a common response to the consumption of sugar and starch rich foods, such as bread, pasta, rice, potatoes, pastries and cakes/desserts. It is most likely to be due to the over-production of insulin which ‘locks away’ the food as potential energy. Eating more carbohydrate than you can handle at any one time will cause an over release of insulin and the removal of some of our more immediate energy supply. This fatigue is unlikely to last more than 30 minutes.

If your tiredness also occurs with refined sugars, alcoholic beverages and yeasty foods, such as vinegar, marmite, cheese, mushrooms and pistachios it might also be due to the effects of a yeast overgrowth. Yeast overgrowths are also characterized by gas and bloating with eating carbohydrates and often, temporary poor mental function. When the yeast overgrowth is more systemic (body wide) it can also cause thrush, sore throats, mouth ulcers, athlete’s foot and other conditions.

Recommendations
Try cutting your intake of carbohydrates in favour of eating more protein and salad. If your symptoms persist or you suspect a yeast overgrowth make an appointment with the ‘in house’ nutritional therapist.

Tired after eating

Adverse food reactions occur in all of us but are typically dose dependant. If your fatigue occurs only after eating it might be a sign of a reaction to a food you are eating. Although possible, it is rare for fatigue to be the only sign of an adverse food reaction.

Food intolerances can be grouped into classic allergies, where fatigue is not a primary symptom, masked allergies and enzyme deficiency intolerances where fatigue is common but often in association with gut symptoms and potentially more widespread symptoms and food sensitivities where fatigue occurs but often with dizziness, flushing and headache.

Recommendations
Make a food diary and mark on the diary when you have your fatigue. If it only occurs after eating certain foods, try eliminating that food for 3 weeks to see if the symptoms subside. If successful try then reintroducing the food to see if the fatigue returns. If you can find no common food/chemical from your food diary seek advice from the nutritional therapist.

Tired during exercise

If you only experience tiredness during or immediately after exercising you are either doing too much, you have failed to fuel and hydrate effectively for your exercise or you have nutritional deficiencies which impair energy generation.

Recommendations
Firstly talk to your PT to ensure the level of exercise is appropriate to you. The most important time to eat is 2-5 hours before you work out, depending on the speed of your digestion. If you haven’t eaten within that time you are likely to have too little fuel in the muscles, in which case alter the timing of your meals or exercise sessions accordingly.

For every 1% dehydration there is an estimated 5% reduction in performance, so be sure to have drank enough to pee clear urine just before you exercise. If you require more information about the best mix of fuel for your exercise or suspect chronic nutritional deficiencies ask your PT to refer you to the nutritional therapist for dietary analysis and cellular energy profiling.

Tired muscles

If your tiredness manifests as chronic muscular fatigue, including muscle tension, spasm and twitch and you have poor muscular endurance or exercise tolerance you might have magnesium deficiency. This is a common condition attributable to 72% of adults in the UK and is a common contributor to chronic fatigue conditions.

Magnesium is easily depleted as it is required for muscle relaxation and for replenishment of ATP, our primary cellular energy store. Postural tension, as occurs when spending too long in the same position, and poor muscular endurance during exercise are typical signs of magnesium deficiency.

Recommendations
Eat more magnesium rich foods, such as almonds, cashews, sunflower and sesame seeds, dark green leafy vegetables and meat. You might also seek guidance about balancing your calcium and magnesium levels and upregulating your absorption of magnesium.

Tired without explanation

If none of the above apply and especially if you are feeling unwell or have new symptoms, you might be ill.

Recommendations
Seek advice from your doctor.

Remember your tiredness might be due to multiple causes and the above guidelines do not replace medical assessment.

About The Author

Peter Cox is a Clinical Nutritionist located in Westminster, London. He typically sees clients from the surrounding areas of Kensington, Camden Town and Paddington.

For advice about testing including tests of nutritional status, adrenal stress indexing, testing for food intolerances and allergies, cellular energy profiling, hormonal testing and metabolic analysis please contact Peter at peter.cox@nuffieldhealth.com or on 07788 447843.

Find out more about Peter’s work by visiting his GoToSee profile page here

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Visit his website www.petercoxnutrition.co.uk


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