Persistent
fatigue which is not alleviated by sleep is a characteristic of
many chronic conditions. Debilitating fatigue can also occur
without an obvious illness and, after six months, is classified as
chronic fatigue syndrome (CFS). Milder forms have been dubbed
‘TATT’ (tired all the time).
Fatigue can often be traced back to a viral infection, but this
may not be the only culprit. It usually results from a combination
of several factors, such as poor diet, overwork, a viral or
bacterial infection, bereavement, stress, physical exhaustion,
exposure to toxins etc. Its does not respond readily to modern
drugs, so many sufferers turn towards alternative and complementary
medicine in their quest for a solution. In this article, I discuss
the nutritional and herbal approaches which I have used with
fatigued patients with considerable success, provided that a
moderate lifestyle, in terms of paced exercise and adequate rest,
is also adopted.
Symptoms of fatigue
Fatigue can manifest as a puzzling array of seemingly unconnected
symptoms, spread throughout the body’s systems. At its worse,
sufferers may feel joint or muscle pain or tingling sensations in
the legs and muscle weakness. The most obvious signs in the nervous
system can be poor concentration and memory, but intolerance to
bright lights and loud music is also common, as is low mood.
Dizziness and headaches can be experienced and these symptoms may
or may not be associated with nausea. Many sufferers also complain
of a sore throat or tender, raised glands, particularly when tired
and continual catarrh is commonly experienced. Research indicates
that fatigue which is not alleviated by rest is associated with
subtle alterations in the immune system1 and these may be features
central to the condition.
Boosting recovery
The immune system is a complex, delicate system, whose proper
functioning can be undermined by a lack of any nutrient. We know
from studies on people of all ages that even relatively mild
deficiencies of zinc, selenium, iron, copper, folic acid and
vitamins A, C, E and B6 can cause reduced immune function.2 Indeed,
the few studies which have been undertaken on fatigued subjects
have concentrated on individual nutrient supplements such as
omega-3 fatty acids and magnesium.3/4 However, from clinical
experience, I am certain that the best nutritional approach to
effect recovery from fatigue is to tackle it on all fronts. A
mistake often made by sufferers is to use one supplement after
another, when, in fact, they would be far more effective if used
together.
The treatment strategy which has worked with my patients is to
close all possible avenues where diet or lifestyle may be
inadequate by using a multi-dimensional approach. This means making
an effort to ensure an above-average nutrient-intake by eating a
healthy diet coupled with taking a range of good-quality
supplements. In addition, I prescribe herbal medicine with
immune-stimulating properties.
Nutrition
It is especially important for people with fatigue to choose a
healthy diet. However, even when eating in this way, a person with
fatigue may not reach daily nutrient-intake targets because of poor
absorption and poor appetite due to lack of exercise. Hence,
nutrient supplementation is an important, essential strategy to
augment a healthy diet. A supplement programme for fatigue should
start with a basic ‘multi’. This will provide most of
the vitamins and minerals needed by the body at essential
requirement levels. However, it will not contain enough calcium and
magnesium, because these are required in much higher quantities
than will fit into a single ‘multi’. Extra calcium will
be required if fewer than three portions of dairy products are
eaten per day. More magnesium is required if the intake of
wholegrains, nuts, beans and seeds is low. (In fact, magnesium
deficiency is very common in fatigue.) It is best to take these two
minerals together in a good bone formula in the ratio of 2:1
calcium to magnesium.
A group of symptoms often accompanying fatigue is related to
inflammation. This shows up as catarrh, skin rash, dry skin or
eadaches. There are two approaches to reduce inflammation:
increasing intake of (a) antioxidants and (b) omega-3 fatty acids
found in fish oil. Therefore, extra vitamin C is likely to be
useful. For optimal nutrition, take at least 500mg daily as a
supplement which, again, is much higher than will go into a single
‘multi’ tablet.
I have written about the importance of getting the right balance
of essential fatty acids in a previous Healthspan magazine.5 For
fatigue sufferers, as well as having anti-inflammatory properties,
it is the direct benefit that omega-3 fatty acids have on boosting
normal immune function that is particularly important.
Herbs
For those with CFS, herbal medicine seems to have a very special
role in normalising the immune system, which cannot be effected by
essential nutrients alone. In fact, the more severe and persistent
the fatigue, the more important it seems to be to augment the
nutritional approach above with immune-supportive herbs. Since
herbal treatments for CFS have to be individually prescribed, a
visit to a professional is necessary. Contact the College of
Practitioners (01424 776780) or the National Institute of Medical
Herbalists (01392 426022) to find a registered herbal practitioner
in your area. Herbal prescriptions normally include those with
outspoken traditional use for supporting the immune and nervous
systems. St John’s Wort is particularly useful, since it
appears to act in both domains. Echinacea, which can be used to
help overcome exposure to viruses and to reduce the number of
relapses, does not raise vitality in the same way. Other
vitality-raising herbs for immune support include astragalus,
ashwaganda, siberian ginseng, sarsaparilla and liquorice and useful
nerve tonics include vervain and scullcap.
Conclusion
If you suffer from a mild form of persistent fatigue like
‘TATT’, then there is a lot that you can do for
yourself to ensure that you have an adequate intake of all
nutrients. A good diet and a supplement regime can go a long way
towards recovery. Although people with TATT can respond quite
quickly, CFS takes much longer. If this is the problem, I would
strongly recommend that professional advice is sought, as the
condition varies so widely. But you must be patient: remember that
it takes at least three months for nutrients to get fully into the
body’s cells and longer than that for immune-system repair.
The approach I have discussed in this article is not instant, like
the wave of a magic wand, but it offers a steady route to renewed
vitality.
1Rasmussen AK et al. 1994, J Rheumatol 21 1527. 2Chandra RK 2002
Eur J Clin Nutr 56 Suppl 3, S73. 3Behan PO et al. 1990, Acta Neurol
Scand 82, 209. 4Cox IM et al.1991 Lancet 337, 757. 5Healthspan
Magazine, March 2003.
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