9b. Fatigue

Question 1

Definition of fatigue

Answer 1

Physical and mental exhaustion not relieved by rest

Question 2

What is fatigue the symptom of?

Answer 2

When energy demands exceed energy delivery
Dysfunction of cellular energy systems

Question 3

What makes over 90% of the body’s energy?

Answer 3

Mitochondria

Question 4

Which two metabolic processes result in mitochondrial energy?

Answer 4

Krebs cycle
Electron transport chain

Question 5

What is the result of cells functioning slowly?

Answer 5

Organs function slowly
Leads to heart failure, dementia etc

Question 6

What is the result of the immune system functioning slowly?

Answer 6

Slow healing and repair
Increased risk of infection, cancer

Question 7

What are mitochondria highly susceptible to?

Answer 7

Nutrient deficiencies
Environmental toxins
Oxidative damage
Hyperglycaemia
Inflammation
Prescription drugs
Ageing

Question 8

How does mitochondrial damage occur through oxidative stress?

Answer 8

Mitochondria produce ROS which leaks out of cells
Damage occurs when ROS production outpaces AO activity

Question 9

How are mitochondria damaged by hyperglycaemia?

Answer 9

Hyperglycaemia induces superoxide production in the mitochondria
This initiates changes in the mitochondrial membrane that leads to mitochondrial dysfunction

Question 10

How are mitochondria damaged by inflammation?

Answer 10

Inflammation can be raised by LPS leakage, pro-inflammatory diet, glucose dysregulation, raised homocysteine, smoking, obesity etc
Inflammatory mediators are associated with mitochondrial dysfunction and increased ROS production

Question 11

Primary enzymes/nutrients that protect mitochondria from oxidative stress

Answer 11

Superoxide dismutase (Mn)
Glutathione peroxidase (Se)
Glutathione reductase (B3)
Catalase (Fe)
CoQ10
Vit E

Question 12

Nutrients needed for glycolysis

Answer 12

Mg
B3

Question 13

Nutrients needed for acetyl-CoA production

Answer 13

B1
B5
Alpha lipoic acid

Question 14

Nutrients needed for Krebs cycle

Answer 14

B1
B2
B3
Mn
Mg
Fe

Question 15

Nutrients needed for electron transport chain

Answer 15

Fe, S, B2
CoQ10
Fe
Cu

Question 16

Nutrient needed for the b-oxidation of fats

Answer 16

Carnitine

Question 17

Nutrients needed to carry energy/ATP

Answer 17

B2
B3

Question 18

Key strategies for improving mitochondrial function

Answer 18

Optimise nutrients for ATP production
Blood glucose regulation
Reduce inflammatory mediators
Decrease toxin exposure
Strength training

Question 19

Role of CoQ10 in mitochondrial function

Answer 19

Transportation of electrons in ETC
Neutralising ROS

Question 20

Dosage of CoQ10 for mitochondrial function

Answer 20

100-300mg/day

Question 21

Role of ALA in mitochondrial function

Answer 21

Co-factor for several mitochondrial enzymes involved in glucose oxidation and ATP generation
AO

Question 22

Dosage of ALA for mitochondrial function

Answer 22

300-600mg/day

Question 23

Role of acetyl L-carnitine in mitochondrial function

Answer 23

Transport of long chain fatty acids across the mitochondrial membrane

Question 24

Dosage of acetyl L-carnitine for mitochondrial function

Answer 24

500-2000mg/day

Question 25

Role of Mg in mitochondrial function

Answer 25

Transfers phosphate groups between ADP and ATP

Question 26

Signs and symptoms of CFS/ME

Answer 26

Long-term physical and cognitive fatigue
Fatigue not alleviated by rest
Muscle and joint pain
Unrefreshing sleep
Flu-like symptoms

Question 27

Possible causes of CFS/ME

Answer 27

Infectious organisms - EBV, herpes
Poor immune system
Abnormal HPA axis functioning
Mitochondrial dysfunction