Fatigue

Question 1

Fatigue

Answer 1

Fatigue = physical and mental exhaustion that is not relieved by rest.
* Fatigue is the symptom experienced when energy demand exceeds energy delivery. If more energy is spent than can be generated, it will lead to death!
* Thus, the body manifests uncomfortable symptoms to prevent this happening.
* While mild fatigue can be caused by a range of factors, moderate to severe persistent fatigue involves cellular energy systems —the hallmark of chronic fatigue syndrome and other intractable fatigue states.

Question 2

Key strategies to improve mitochondrial function

Answer 2

• Optimise nutrients required for ATP production and antioxidant properties to protect the mitochondria from oxidative stress.
• Focus on blood sugar regulation (prevent chronic hyperglycaemia).
• Reduce levels of inflammatory mediators —optimise intestinal health, anti-inflammatory foods, optimise weight etc.
• Decrease toxin exposure e.g., consume organic food, avoid plastic packaging, carefully select cleaning products, cosmetics and personal care items; avoid alcohol and pharmaceuticals.
• Strength training —increase muscle mass to increase mitochondria number and function

Question 3

Essential nutrients for mitochondrial function

Answer 3

• CoQ10 - Electron transport chain
• Alpha lipoic acid (ALA) - cofactor of enzymes
• Acetyl L-carnitine - Essential for the transport of long chain fatty acids across the mitochondrial membrane
• Magnesium - tranfers phosphate groups between ADP and ATP
• B comlpex - Krebs cycle and co-factor

Question 4

CFS and ME

Answer 4

CFS = chronic fatigue syndrome.
ME = myalgic encephalomyelitis.

CFS and ME are terms often used interchangeably though ME is sometimes defined as CFS + inflammation.
* Characterised by long-term physical and cognitive fatigue, not alleviated by rest.
* Other symptoms include post-exertional malaise, muscle and joint pain, unrefreshing sleep, flu-like symptoms with sore throat and tender lymph nodes, mood disturbances.
* While mitochondrial dysfunction is recognised as a key player, there are a number of proposed contributing factors.

Question 5

Herbal approach to CFS / ME

Answer 5

Liquorice
* Suboptimal HPAA function and low cortisol isa common feature of CFS / ME. Liquorice is an adrenal cortex restorative, supporting cortisol production and ↓fatigue.
*Anti-inflammatory activity—research indicates inhibitory effects on ROS-induced tissue inflammation and the COX, LOX and NF-κB inflammatory pathways.

Astralagus
* An adaptogen and tonic indicated for debility and CFS.
* Regulatory effect on immune function; supports aspects of innate immunity while promoting Th1 / Th2 balance.
* Reduces abnormal cytokine production.

Question 6

CFS and ME treatment

Answer 6

1. Fuel in the tank (paleo-ketogenic diet, basic package of nutritional supplements and good gut function).
2. Mitochondrial engine —servicing and repair (quality and quantity of sleep).
3. The control mechanisms:
   * Thyroid accelerator pedal.
   * Adrenal gear box.