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Feeling too Tired or Fatigued?

fatigue

Human body is a complex machinery that involves multiple physical, chemical and energetic networks functioning together to achieve a state of balance.  A fascinating part of my profession is being a mystery investigator trying to navigate through body’s’ mystery of interconnections in order to find the root cause.

Finding the root cause of the disease most times may not be as simple as it sounds. Let us take an example of ‘Fatigue’ – a top symptom often complained about. Fatigue usually comes along with other symptoms like aches and pains, sleep issues, digestive disturbances, weight gain, brain fog, frequent infections and allergies.  Fatigue is an indication that your body is depleted. .

There are multiple pathways that cause fatigue. To illustrate, here is one example as how these inter connections contribute to fatigue

Prolonged stress                                                                                      Genetic Mutations

                                                       FATIGUE CYCLE                                     ⇓⇑

  High Cortisol          Inflammation     Adrenal burn out        Nutrient depletion

 

Prolonged Stress is probably a starting point although it can be a vicious cycle.

Prolonged stress can be anything physical or emotional- Lack of happiness, emotional trauma, lingering infections, chronic disease or physical injury which all lead to increased workout on the adrenal glands to produce Cortisol .The normal response of the adrenal glands which is to produce cortisol that is highest in the morning and lowest at night can change during these periods of high stress  shifting to abnormal levels.

As stress becomes prolonged and unchecked, it reaches a state called adrenal burn out where– the cortisol levels can become higher during night keeping you awake and low in the morning making you feel depleted and tired during the day. These people tend to have fluctuations in Sugar balance further contributing to fatigue.

Nutrient depletion

The prolonged stress depletes body of nutrients needed for proper detoxification, repair and regeneration. People with autoimmunity and chronic conditions are always under physical stress as the body is constantly trying to heal. B vitamins, trace minerals and iron needed for many chemical reactions in the body that involves production of hormones like thyroid, adrenal and mitochondrial function get depleted.  The depletion of core nutrients further augments into other health concerns and a vicious cycle sets in causing more fatigue.

MTHFR and other Genetic Mutations

It is absolutely certain that exposure to stress -both emotional and physical stress including diet and toxins affects the way our genes are expressed.

One example, and often the first mutation tested, is MTHFR- methylenetetrahydrofolate reductase—an enzyme that activates folic acid by adding a methyl group to it. Activated folate (named 5MTHF) goes on to give its methyl group to other nutrients and substances—a process called “methylationThis reaction involving methylation is core to all reactions happening inside the body.

We also know that when someone with an MTHFR mutation(s) is not getting enough methyl folate, they will often have lower adrenaline (norepinephrine and epinephrine) levels which is associated with fatigue. This is because methylation is needed to produce adrenaline. Methylation is also required for production and breakdown serotonin and dopamine that influence mood. Certain mutations (MAO) can affect the breakdown of these neurotransmitters too. Both of these situations can affect mood and energy levels.

Another enzyme called COMT, is also negatively affected by a lack of methylfolate, resulting in elevated norephinephrine and depleted epinephrine. At the same time, histamine levels can increase, making you more susceptible to allergic responses. When we support methylation in the right way, all of these systems can improve.

Stress, in all its forms, inhibits this “methylation,” So when you are under stress, it is especially important to provide the nutrients necessary for these processes.

Over methylation can cause problems in some and so it is advisable to work with someone who is trained in this area to treat you overall and not just the particular genetic mutations.

Naturopathic Doctors are trained to look into this complex nature of interconnectivity of different systems when working with a patient. Through proper history and required tests, a customized treatment plan can help you in your overall journey to feeling energetic, healthy and well.  

Resources:

1.Nutritional and botanical interventions to assist with adaptation to stress Kelly GS, Altern Med Rev. 1999 Aug;4(4):249-65
Combinations of single nucleotide polymorphisms in neuroendocrine effector and receptor genes predict chronic fatigue syndrome.Goertzel BN  Pennachin C Pharmacogenomics. 2006 Apr;7(3):475-8
3.MTHFR polymorphisms and Disease,  Euland, Rozen, bioscience 2005
4.Cognitive effects of genetic variation in monoamine neurotransmitter systems: A population-based study ofCOMT,MAOA, and 5HTTLPR      AM J Med Genet B Neuropscychiatr Gen. 2011 March; 156 (2): 158-167
5.Monoamine oxidase inactivation: from pathophysiology to therapeutics.   Bortolato M1Chen KShih JC. Adv Drug Deliv Rev. 2008 Oct-Nov;60(13-14):1527-33.
6.The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress.  Smith SM1Vale WW. Dialogues Clin Neurosci. 2006;8(4):383-95.
7.The neuroendocrinology of chronic fatigue syndrome and fibromyalgia. Parker AJ1Wessely SCleare AJ. Psychol Med. 2001 Nov;31(8):1331-45.
8.Guyton, Textbook of Physiology