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Fatigue: Causes and Management

Fatigue refers to a feeling of tiredness or lack of energy. This is distinct from the feeling of being drowsy or sleepy. Motivation and mental energy are often impaired in fatigue as well as phycial energy. Sleepiness can be a symptom of fatigue, but it’s not the same thing. Fatigue is an ongoing, persistant state and doesn’t necessarily make it any easier to fall asleep or give you the feeling that you want to fall asleep.

Many medical conditions can cause fatigue and it is important to rule out serious pathology. Additionally, it’s a natural result of some lifestyle choices, like not exercising, chronic sleep deprevation, or eating poorly. Many genetic polymorphisms can contribute to feelings of fatigue as well including MTHFR, MTRR, MAOA fast, and COMT fast.

Consult your doctor if your fatigue doesn’t improve with rest and nutrition, or if you suspect it may be caused by a physical or mental health condition. In order to treat your fatigue, your doctor will try to diagnose the underlying cause and work with you to find a solution.

Fatigue: what causes it?

Fatigue can be caused by a variety of physical, mental, and emotional factors and also lifestyle choices.

Some of the most common causes of fatigue include chronic lack of sleep, poor diet, stress, anxiety, depression, anemia, medication side effects, and more. In some cases, it can also be a symptom of a underlying medical condition.

If you have been experiencing fatigue that doesn’t change with improved sleep, diet, and self-care, please talk with your doctor. Many underlying medical conditions can cause fatigue including iron deficiency anemia, megaloblastic anemia, pernicious anemia, thyroid disorders, diabetes, insomnia, sleep apnea, autoimmune conditions, and many more. Also, if fatigue persists without clear causative factors, then a diagnosis of chronic fatigue may be given.

What are 3 types of fatigue?

There are three main types of fatigue: physical fatigue, mental fatigue, and emotional fatigue.

  • Physical fatigue: Physical fatigue is a physical feeling of exhaustion, weakness, or lack of energy. It is often caused by physical activity or exertion, such as exercising, manual labor, or long hours at work, but it can become chronic so that it is ongoing without physical activity. At the extreme end, even walking up a flight of stairs can be difficult with physical fatigue.
  • Mental fatigue: Mental fatigue is a feeling of mental exhaustion or burnout, often caused by prolonged mental effort, stress, or lack of sleep. It can lead to decreased motivation, loss of interest, difficulty concentrating, and forgetfulness.
  • Emotional fatigue: Emotional fatigue is a feeling of exhaustion or burnout caused by prolonged emotional stress or strain, such as caring for a loved one with a chronic illness, dealing with a difficult personal situation, or working in a high-pressure job. It can lead to feelings of hopelessness, depression, withdrawal and irritability.

It’s important to note that these types of fatigue can overlap and contribute to each other. For example, physical fatigue can lead to mental fatigue, and mental fatigue can lead to emotional fatigue. Additionally, underlying medical conditions can also contribute to fatigue, and it’s important to see a doctor to rule out any underlying health issues.

The cause of fatigue can be attributed to a number of factors. Generally, they fall into three categories:

  • Lifestyle and self-care
  • Medical conditions
  • Mental health issues

Fatigue can be caused by a variety of lifestyle factors, including:

  • Lack of sleep or poor sleep quality
  • Poor diet and dehydration
  • Sedentary lifestyle and lack of physical activity
  • Chronic stress and anxiety
  • Substance abuse, including alcohol and caffeine
  • Working long hours or irregular schedules such as shift work
  • Poor time management and high levels of daily stress.

Making changes to your lifestyle, such as improving your sleep habits, eating a balanced diet, and engaging in regular physical activity, can help reduce fatigue and improve overall health and well-being.

Physical health conditions

There are many physical health conditions that can cause fatigue, including:

  • Anemia: a condition where the body doesn’t have enough red blood cells to carry oxygen. This can be the result of iron deficiency, B12 deficiency, folate deficiency, or a combination of those factors.
  • Diabetes: a condition where the body doesn’t produce or use insulin effectively and blood sugars are too high
  • Heart disease: a range of conditions that can affect the heart’s ability to function properly
  • Thyroid disorders: conditions that affect the thyroid gland, which regulates metabolism
  • Chronic fatigue syndrome: a condition characterized by severe, long-term fatigue that is not improved by rest
  • Fibromyalgia: a condition that causes widespread pain and tenderness in muscles and joints
  • Sleep apnea: a condition where a person stops breathing for short periods during sleep
  • Infections: such as the flu, pneumonia, or mononucleosis
  • Cancer and cancer treatments: such as chemotherapy and radiation therapy
  • Kidney disease: a condition where the kidneys can’t filter waste from the blood effectively.

It is important to consult with a healthcare professional if you are experiencing persistent or severe fatigue, as it may be a symptom of an underlying medical condition. Treatment will depend on the underlying cause of your fatigue.

Mental Health Issues

Many mental health conditions that can cause fatigue, including:

  • Depression: a condition characterized by persistent feelings of sadness, hopelessness, and low energy
  • Anxiety: a condition characterized by excessive worry and fear
  • Burnout: a state of physical, emotional, and mental exhaustion caused by prolonged stress
  • Bipolar disorder: a condition characterized by alternating periods of mania and depression
  • Seasonal affective disorder (SAD): a type of depression that occurs during the winter months
  • Attention-deficit/hyperactivity disorder (ADHD): a condition characterized by inattention, impulsiveness, and hyperactivity
  • Post-traumatic stress disorder (PTSD): a condition that can develop after a traumatic event
  • Schizophrenia: a severe mental illness characterized by delusions and hallucinations.

It is important to consult with a mental health professional if you are experiencing persistent or severe fatigue, as it may be a symptom of an underlying mental health condition. Treatment will depend on the underlying cause of your fatigue and may include therapy, medication, or a combination of both.

What is the best time to visit your doctor?

You should see a doctor if you are experiencing persistent or severe fatigue that is interfering with your daily activities and is not improved by changes to your lifestyle, such as getting more sleep or exercise, or if you have any other symptoms or medical concerns.

It is also a good idea to see a doctor if:

  • Your fatigue has lasted for an extended period of time, such as several weeks or months
  • Your fatigue is accompanied by other symptoms, such as pain, weakness, or difficulty breathing
  • Your fatigue is affecting your mood, mental health, or ability to perform daily tasks
  • You have recently started a new medication or the fatigue followed a medical procedure
  • You are not sure what is causing your fatigue.

A doctor can help determine the cause of your fatigue and recommend appropriate treatment, such as lifestyle changes, medications, or referral to a specialist. Early diagnosis and treatment can help reduce the impact of fatigue on your quality of life.

What treatment will your doctor recommend for fatigue?

The treatment for fatigue will depend on the underlying cause. Your doctor will first perform a thorough evaluation  to determine the cause, which may include a physical examination, medical history review, and possibly laboratory tests or imaging studies. If the doctor can find no physical cause for the fatigue they will likely recommend lifestyle and self-care modifications, but if those are ineffective and the fatigue continues to be an issue, then a diagnosis of chronic fatigue might become appropriate, which will suggest different treatments.

Based on the evaluation, your doctor may recommend one or more of the following treatments:

  • Lifestyle changes: such as improving sleep habits, exercise, diet, and reducing stress.
  • Medications: such as iron supplements for anemia, antidepressants for depression, hormones for thyroid disorders or medication to treat a specific medical condition that is causing fatigue.
  • Therapy: such as cognitive-behavioral therapy (CBT) or counseling to help manage stress, anxiety, or depression.
  • Specialized treatments: such as physical therapy, occupational therapy, or sleep studies for specific medical conditions.
  • Referral to a specialist: such as a cardiologist for heart disease or an endocrinologist for thyroid disorders.

It is important to follow your doctor’s recommendations and to keep them informed of any changes in your symptoms or concerns. Working together with your doctor can help you manage your fatigue and improve your quality of life.

The best foods to beat fatigue

There are several foods that can help boost energy levels and reduce fatigue, including:

  • Whole grains: such as brown rice, quinoa, oats, and whole-grain breads and pastas, which provide sustained energy, fiber, and more nutrients than refined grains.
  • Fruits and vegetables: such as bananas, berries, leafy greens, and carrots, which are high in vitamins and minerals, including vitamin C, iron, and potassium.
  • Lean protein: such as chicken, fish, tofu, beans and legumes, which provide essential nutrients for growth and repair of the body along with fiber and complex carbohydrates with provide sustained energy.
  • Nuts and seeds: such as almonds, sunflower seeds, and pumpkin seeds, which are high in healthy fats and protein.
  • Hydrating foods and drinks: such as water, coconut water, and herbal teas, which can help improve energy levels and reduce fatigue caused by dehydration.

It’s also important to avoid foods and drinks that can cause fatigue, such as processed foods, high-sugar foods, and excessive amounts of caffeine or alcohol. Eating a well-balanced diet that includes a variety of nutrient-dense foods can help improve energy levels and reduce fatigue.

Avoid foods if you have fatigue

If you are experiencing fatigue, you may want to avoid the following foods and drinks:

  • Processed and high-sugar foods: such as candy, pastries, and soft drinks, which can cause a rapid spike in blood sugar followed by a crash, leading to fatigue.
  • Caffeine: excessive caffeine can cause dehydration, jitters, and interfere with sleep, leading to fatigue.
  • Alcohol: while alcohol may help you fall asleep initially, it can cause disrupted sleep and dehydration, leading to fatigue.
  • Fried and greasy foods: which can slow down digestion and cause feelings of sluggishness.
  • Foods high in artificial additives and preservatives: which can tax the body and contribute to fatigue.

It’s also important to eat at regular intervals and to avoid skipping meals, as this can cause blood sugar levels to drop, leading to fatigue. Additionally, consuming plenty of water throughout the day can help prevent dehydration, which often contributes to fatigue.

Is exercise good if you have fatigue ?

Yes, exercise can be beneficial for reducing fatigue, especially if it is caused by a sedentary lifestyle or stress. Even though exercise is the last thing you feel like doing when you are struggling with fatigue, regular physical activity can improve physical fitness, boost energy levels, improve circulation, and enhance mood. It can also help improve sleep quality and promote feelings of well-being.

However, it is important to start with small amounts of low-impact activities, such as walking or yoga, and gradually increase the intensity and duration of the exercise. Overdoing it with intense exercise or working out for long periods of time can actually cause fatigue and make it worse.

It is also important to listen to your body and not push yourself too hard. If you are feeling very fatigued, it may be best to rest and allow your body to recover before starting or continuing with physical activity.

Working with a doctor or physical therapist can help determine the best exercise plan for your specific needs and medical conditions, and ensure that you are exercising in a safe and effective manner.

In addition to low-impact exercises such as walking and yoga, other forms of exercise that can help reduce fatigue and increase energy levels include:

  • Aerobic exercise: such as running, cycling, and swimming, which can help improve cardiovascular fitness and boost energy levels.
  • Strength training: such as weightlifting and resistance band exercises, which can help build muscle strength and improve endurance.
  • Stretching and flexibility exercises: such as yoga, tai chi, and Pilates, which can help improve flexibility and reduce stress.
  • High-intensity interval training (HIIT): which involves short bursts of intense exercise followed by periods of rest, can be an effective way to improve cardiovascular fitness and energy levels.

It’s also important to keep in mind that while exercise can help reduce fatigue, it is not a cure-all solution. A combination of regular physical activity, a well-balanced diet, good sleep habits, and stress management techniques can help improve energy levels and reduce fatigue.  Also, while exercise is beneficial for almost every health condition known, it is typically not enough to fix any underlying medical conditions by itself.

Consulting with a doctor or physical therapist can help determine the best exercise plan for your specific needs and medical conditions. They can also provide guidance on the type, intensity, and frequency of exercise that is safe and effective for you. Also, if your fatigue isn’t improving with exercise and other lifestyle changes, be sure to talk to your doctor to help you rule out any underlying disease.

How can lifestyle changes help reduce fatigue?

There are several lifestyle changes can help you to reduce fatigue and improve energy levels. Focus on making the following changes and incorporating these habits into your lifestyle:

  • Get enough sleep: Aim for 7-9 hours of sleep each night and establish a consistent sleep schedule. Also, if you sleep for this amount of time but do not wake feeling rested, talk with your doctor about the possibility of an underlying condition such as sleep apnea.
  • Eat a balanced diet: Incorporate nutrient-dense foods such as whole grains, fruits and vegetables, lean protein, and healthy fats. Also work to eliminate and avoid processed foods, sugary drinks, refined grains, food additives, and excessive amounts of caffeine or alcohol.
  • Stay hydrated: Drink plenty of water and other hydrating fluids throughout the day. Remember that both coffee and alcohol are actually dehydrating.
  • Managing stress: Practice stress management techniques such as mindfulness meditation, deep breathing, and physical activity.
  • Avoiding sedentary behavior: Get up and move around regularly, and try to engage in physical activity for at least 30 minutes a day.
  • Limit exposure to electronic devices before bedtime: The blue light from electronic devices can interfere with sleep, so try to avoid using them for at least an hour before bedtime.
  • Seek medical attention: If fatigue persists despite lifestyle changes, see a doctor to rule out any underlying medical conditions.
  • Be joyful: Taking time to enjoy your life, your family, your friends, and your favorite activities can boost energy levels significantly.

Making small, gradual changes to your lifestyle can help improve energy levels and reduce fatigue over time. It’s also important to listen to your body and prioritize self-care, such as taking breaks when needed, and engaging in activities that bring joy and relaxation.

How MTHFR and Fatigue are related

MTHFR is related to fatigue in a number of ways.  MTHFR refers to a genetic variance in the gene that codes for the MTHFR enzyme. This enzyme is used to activate folate so that it can be used by the body.  The MTHFR enzyme is crucial for making the precursors for cellular energy, and if it isn’t functioning well then cellular energy production can be extremely limited. If your cells don’t have energy to function properly then you are likely to feel fatigued without any apparent cause.

Also, MTHFR is associated with a number of conditions that are known to cause fatigue including thyroid disorders, hyperhomocysteinemia, anemia, and even some cancers. MTHFR can also cause a functional folate deficiency which can produce symptoms of fatigue.

If you know or suspect that you have an MTHFR mutation, it is important to work with a practitioner who is knowlegable in this area who can help you to start a supplement program to ensure you have enough active folate, vitamin cofactors, and methyl donors. This type of work can help you to resolve symptoms of fatigue.

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MTHFR is a common genetic mutation that can contribute to anxiety, depression, fatigue, chronic pain, infertility, and more serious conditions like breast implant illness, heart attack, stroke, chronic fatigue syndrome, and some types of cancer. If you know or suspect you have an MTHFR variant, schedule a free 15-minute meet-and-greet appointment with MTHFR expert Dr. Amy today.

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Amy Neuzil
Amy Neuzil

Dr. Amy Neuzil, N.D. is a leading expert in MTHFR and epigenetics, and she is passionate about helping people achieve optimal health and wellness for their genetic picture. She has helped thousands of people overcome health challenges using a simple, step-by-step approach that starts with where they are today. Dr. Neuzil's unique approach to wellness has helped countless people improve their energy levels, lose weight, and feel better mentally and emotionally. If you're looking for a way to feel your best, Dr. Amy Neuzil can help. Contact her today to learn more about how she can help you achieve optimal health and wellness.

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