Recharging Your Batteries

Between job duties and household chores you can’t remember the last time
you felt full of energy, yet every doctor you see says the same thing:
“Your tests are normal...everything is fine.” But you’re in a multitasking meltdown—
the fatigue, memory loss and mild depression aren’t just figments of your imagination.
Here’s how to reverse the power shortage and get your engine running again.

By Lisa James

November 2006

Gretchen Le Fever knows what tired feels like. “For several years I had been getting sick: the flu, pneumonia, chronic bronchitis, sinus infections, yeast infections, Epstein-Barr virus, colds,” says the hair stylist from Joliet, Illinois. “I had muscular pain; I also could not sleep soundly and was always tired.” She saw several doctors, but they were all left scratching their heads: “I had test after test and they came back negative.” Eventually she was told she had rheumatoid arthritis and was put on medication. That didn’t help, either.

The common factor in all of Le Fever’s woes was fatigue—not the type of tiredness that goes away after a good night’s sleep but the type that lingers, depressing the immune system and is in turn arising from the ailments that attack when immunity flags. Fatigue is the new plague of our 24/7 age, a time when drowsy drivers pose as much of a hazard as tipsy ones and tired brains can experience “senior moments” at all ages.

Women are especially prone to that who-let-all-the-energy-out feeling: Many are the fulcrums of their families even if they also have full-time jobs. “I work four days a week and I am booked all day long,” says Le Fever. “I get up at 6:30 a.m., get my daughter ready for school and depending on the day I either go to work or do errands such as grocery shopping, cleaning and laundry. My sister has four children, so I help her when I can. I also have continuing education for my job and teach the other girls in the salon. I go to bed around 12 midnight.”

But there’s more to female fatigue than too much to do and too little time, including too little time spent asleep. What all this adds up to is a load of stress, more stress than a woman’s body is designed to handle.

Living on Overload

The link between stress and fatigue starts with the brain chemical serotonin, which David Edelberg, MD, medical director of Wholehealth Chicago and coauthor (with Heidi Hough) of The Triple Whammy Cure (Free Press), describes as “our factory-installed buffer against stress.” He adds, “Women’s levels of serotonin are a quarter of men’s, so they are biochemically much more vulnerable to stress. It’s been guessed that if you go back to prehistory, a man going out into the woods to hunt had to have a system in place so that he wouldn’t have a panic attack. The woman back at the cave with the kids didn’t need that system.” As any working mom can tell you, life ain’t that simple anymore.

Endless stress also depletes the adrenal glands, the ones that produce the picker-upper hormone cortisol. “Adrenal production is high in the morning and goes down as the day progresses,” Edelberg explains, “so the symptom is a crash in the afternoon—you need a nap around 2 or 3 p.m.” Eventually the thyroid gland, the body’s master energy controller, can become exhausted as well; this may cause a woman to feel fatigued even though her thyroid test results are in the normal range.

Estrogen, the primary female sex hormone, presents another challenge. “Serotonin and estrogen are linked like two cars in a roller coaster, with estrogen in the front yanking serotonin,” Edelberg says. Since serotonin also controls mood, this explains why a woman can feel so good in the first part of her menstrual cycle, when both chemicals peak—and so bad just before her period starts, when they both dip. It also explains why mood disorders become more common with the approach of menopause, when estrogen levels drop permanently. What’s more, since carbohydrates temporarily bump up serotonin levels, “women get depressed, eat carbs, gain weight, get more depressed, eat carbs—and then some women will go on antidepressants and gain even more weight,” notes Edelberg. “So things go from bad to worse.”

Poor sleep is also linked to fatigue…and can make getting out of bed feel like crawling out of a hole. But simply trying to get more shuteye doesn’t always help because “it is often the lack of energy that leads to sleep disturbances in the first place,” says Erika Schwartz, MD, integrative medicine specialist and author (with Carol Colman) of Natural Energy (Putnam). “Our minds are frazzled, our muscles are aching from underuse and we are too keyed up to sleep.”

Edelberg sees what all of this does to women like Gretchen Le Fever, and how often their multiple attempts to find relief fail. “The most important thing to understand is that the symptoms a woman is feeling—fatigue, muscle aches, headache—doesn’t mean she is a hypochondriac,” he says. “It’s infuriating the stories I hear women relate because no one has taken them seriously.”

Finding Your On Switch

Fatigue should send you to a health practitioner’s office, since exhaustion is linked to a number of ailments. Fortunately very few tired people have an actual disease, so it helps to visit a practitioner who can help you dig deeper for a solution; contact either the American Association of Naturopathic Physicians at www. naturopathic.org or the American Association of Integrative Physicians at www.aaimedicine.com.

After the appropriate testing it’s time to decide how you can reenergize your existence. To raise serotonin levels, Edelberg recommends a diet based on such complex carbohydrates as fruits, veggies, legumes and whole grains to avoid the peak-and-crash effects of simple carbs such as sugar and refined grain; he advises cutting down on other processed foods, along with sugary drinks and salt. Fish, eggs and lean meat (preferably organic) are good protein sources. To avoid the midmorning blahs, be sure to eat breakfast every day.

Regular exercise and sun exposure also increase serotonin; try walking out in the sun for at least 15 minutes a day “without sunglasses—the light has to enter the eyes,” according to Edelberg. “Supplements that raise serotonin include St. John’s wort, an amino acid called 5-HTP, B complex and fish oil. And these are all very safe, although you can’t use St. John’s wort if you’re on an antidepressant.” (Your practitioner can help you safely move from a prescription med to this depression-fighting herb.) Other nutrients can help take the edge off of such hormonal dysfunctions as premenstrual syndrome (PMS); Edelberg uses the herbs chasteberry and black cohosh.

A proper diet and adequate exercise can make it easier to enter dreamland. Having a sleep ritual, such as reading, is also a calming activity that will help your mind downshift into sleep mode. A number of herbs—including valerian, passionflower and chamomile—have long been used to promote slumber; the hormone melatonin is another popular sleep aid.

Getting enough sleep can help cut through the “brain fog” that often accompanies persistent fatigue. Taking a little time to organize your day by keeping a to-do list helps, as does learning how to meditate. In addition, Edelberg recommends a high-quality multivitamin and omega-3 fatty acids (such as those found in fish or flax seed oil) for basic brain support. If your memory needs more of a direct assist, he suggests phosphatidylserine and DMAE, along with the herb ginkgo and the antioxidants coenzyme Q10 (CoQ10) and alpha lipoic acid.

Some nutrients, such as the B vitamins, boost energy creation on a cellular level. Erika Schwartz favors a combination of CoQ10 and the amino acid carnitine. “They are both critical to the production of energy in the body,” she says. “If you are lacking in either one, you will not be able to produce enough energy to maintain optimal health.” Some foods are especially dense with the nutrients a fully energized body requires, including bee pollen and royal jelly. The former, which consists of the pollen bees collect from flowering plants, is a rich protein source; the latter, a substance that transforms a common worker bee into an egg-laying queen, contains not only amino acids and B vitamins but also essential minerals and fatty acids. Adaptogens, such as ginseng and rhodiola, help the body cope with stress; research has shown that these herbs can improve both physical and mental performance.

One way to avoid being body-slammed by fatigue is by keeping your immune system up to snuff. Spirulina, a blue-green algae frequently used in green-food formulations and protein drink powders, has been found to regulate immunity; in a test-tube study at the UC Davis School of Medicine it increased the production of infection-fighting substances called cytokines (Journal of Medicinal Foods Fall 00). And a mushroom extract called AHCC helps power up natural killer cells, immune-system components that eliminate invasive microbes.

Defeating fatigue also requires a willingness to examine your own life—Edelberg suggests asking, “What is my body trying to tell me?” Don’t be afraid to schedule some downtime for yourself, even if it’s only an hour’s soak in the tub once or twice a week. And adopting a more positive attitude can help. As a well-known prayer counsels, change what needs changing—and let go of issues, such as the behavior of others, that are beyond your power to alter.

Gretchen Le Fever eventually found her way to Dr. Edelberg’s office. In addition to diet advice, some short-term physical therapy and a prescription muscle relaxant, Le Fever was given a supplementation program that includes omega-3, 5-HTP, a St. John’s wort formulation, a PMS formula based on chasteberry and support for both her thyroid and her adrenals.

The results? “I feel wonderful now—110% better!” Le Fever reports. “I can come home and make dinner after working a long day on the weekends, whereas before I would just go home and collapse, and have my husband get take-out. I am thinking clearer at work and I’m able to concentrate and solve problems. I am so thankful for Dr. Edelberg—he really understood what I was going through.”

Fatigue may seem endless, but it doesn’t have to be. Getting the help you need is well worth the effort. As Edelberg puts it, “Fatigue isn’t going to turn into a disease but if it isn’t taken care of you’ll feel crummy all your life.” Who needs that?

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