Fatigue

Description

Fatigue may be a complex clinical syndrome of uncertain etiology.

The diagnostic terminology may also vary: chronic fatigue syndrome, chronic fatigue immune dysfunction syndrome (CFIDS), epidemic myalgia, myalgic encephalomyelitis (ME/EM), chronic viral syndrome and post-viral fatigue syndrome.

It is characterized by incapacitating fatigue: "TATT" (tired all the time); although the concert of accompanying symtpoms can mimic, or actually represent, a host of other conditions. The "Top Ten" may be itemized as follows:-

A laboratory assay may help to differentiate this condition from other fatigue producing diseases e.g. AIDS, cancer and bacterial infections.

Muscle fatigue (pain/tenderness/myalgia); low grade fever; memory loss; moodiness; sleep disorders; neuropathology; tachycardia; cold extremities; sweating; palor and sluggish pupils.

As can be expected from such a diverse range of symtpoms, there is probably not one single cause of this syndrome but viral infections and environmental exposures are prime candidates.

The variety of viruses implicated in the development of CFIDS includes: Coxsackie, Cytomegalovirus (CMV), Epstein Barr (EBV), Herpes Simplex (HHV) and Polio.

Exposures have included pesticides and organic solvents.

Fatigue is a state of decreased efficiency and increased discomfort due to prolonged or excessive physical or emotional exertion.

There are several states of fatigue: Acute, chronic, and muscular.

Acute fatigue has a sudden onset such as occurs following excessive exercise. It is cured by rest.

Chronic fatigue continues for a long period of time. It is not relieved by rest and is indicative of an underlying disorder which alters body metabolism.

It has recently been linked with myalgic encephalomyelitis (ME).

Muscular fatigue, one of the most common forms of fatigue, is the reduced capacity of a muscle to perform work. This is caused by repeated muscular contractions.

Causes

Buchwald and Garrity recently compared patients with chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivities, finding a common denominator in their mitochondrial oxidative phosphorylation disorders and oxidative stress, which produces lactate accumulation.

Bland proposes a number of nutritional modulators to bring about resuscitation of the mitochondria.

Any differential diagnosis must sort out the following factors:


Accumulation of metabolic waste products in the body for any reason;

Carbohydrate deficiency
Protein deficiency
Mineral deficiency
Vitamin deficiency

Circulatory disturbances which deal with delivery of oxygen and energy materials, such as: Anemia and Heart disorders;
Respiratory disturbances which diminish the supply of oxygen to tissues such as: Tuberculosis;

Infections in which toxic products are produced or body metabolism is altered;

Endocrine disturbances such as:

Hypothyroidism
Diabetes mellitus
Hyperinsulinemia
Menopause

Physical factors such as: excessive activity, disabilities or handicaps
Psychological factors such as:
Emotional conflict
Frustration
Anxiety
Nervousness
Boredom
Environmental noises and vibrations
Cerebral allergy

Signs & Symptoms

Fatigue is itself a symptom of another state. Identifying factors of fatigue are:

Tiredness
Weariness
Sleepiness
Irritability

Nutritional Supplements

Structure & Function:
        Immune System Support
        Support for Glucose Metabolism &
        Energy metabolism

---------------------------------
General Supplements
---------------------------------

	Adult	Child/Adolescent
B-Complex	hi-potency	hi-potency
Brewer's yeast*
Calcium	400 - 600 mg	200 - 300 mg
Ginkgo Biloba*
Magnesium	400 - 600 mg	200 - 300 mg
Niacin	100 - 500 mg	50 - 300 mg
Thiamine	50 - 100 mg	10 - 20 mg
Tyrosine	500 - 1,000 mg	200 - 800 mg

* Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

Fatigue may be caused by the following deficiencies: folacin, pantothenic acid and vitamin B-12. Fatigue can also result from excess intake of dietary supplements. Chronic manganese toxicity produces muscle fatigue at dosage levels of one gram per day. Intake of 25,000 to 1,000,000 IU of vitamin A per day gives rise to fatigue in both adults and children. A high fat intake may be responsible for feelings of fatigue and nausea. Adherence to a Dietary Goals Diet corrects these symptoms.

If fatigue is caused by cerebral allergy, an Elimination Diet is recommended.

Homeopathic Remedy

1. Gelsemium sempervirens	- 30C
2. Ambra grisea	- 30C
3.*Avena sativa tinct.	- 30C
4.*Alfalfa tinct.	- 30C

Advanced , by symptom:

1. Over-exertion	- Arnica montana tinct..
2. After mental effort, worry	- Kali phosphoricum.
3. Anxiety, restlessness	- Arsenicum Album.
4. Workaholic, intolerant	- Nux vomica.
5. Fatigued and anxious	- Calcarea carbonica

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

----------
Herbs
-----------

Bee pollen
Ginseng
Gotu kola

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Aromatherapy - Essential Oils

Exhaustion:

Basil Essence,	Bergamot Essence,
Cassia Essence,	Chamomile Essence,
Clary Sage Essence,	Clove Essence,
Frankincense Essence,	Lavender Essence,
Lemon Essence,	Neroli Essence,
Orange Essence,	Petitgrain Essence,
Rosemary Essence,	Sage Essence,
Thyme Essence.

Related Health Conditions

Anemia
Anxiety
Diabetes mellitus
Heart disorders
Hyperinsulinemia
Malnutrition
Menopause
Nervousness
Tuberculosis

Abstracts

References

Adams, E.J. & L.K. Mahan. 1984. Nutritional care in food allergy and food intolerance. Food, Nutrition, and Diet Therapy. M.V. Krause and L.K. Mahan eds.

Behan, P.O. et al: Effect of High Doses of Essential Fatty Acids on The Postviral Fatigue Syndrome. ACTA Neurol. Scand., 1990; 82:209-216.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey: New Perspectives in Nutritional Therapies: Improving Patient Outcomes. 1996. Health Comm.

Bolster-MB & Silver-RM: Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fasciitis with eosinophilia. Curr-Opin-Rheumatol; 1994 Nov; 6(6); P 642-9.

Buchwald, D. & Garrity, D. : Comparison of patients with chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivities. Arch. Int. Med. 1994, 154: 2049 - 2053.

Clark, : Eating For Energy. The Physician and Sports Medicine, April 1991;19(4):45-48.

Davis JM & Bailey SP: Possible mechanisms of central nervous system fatigue during exercise. Med Sci Sports Exerc, 1997 Jan, 29:1, 45-57.

Davis JM: Central and peripheral factors in fatigue. J Sports Sci, 1995 Summer, 13 Spec No:, S49-53.

Driskell-WJ et al: Identification of decomposition products of 1,1'-ethylidenebis [L-tryptophan], a compound associated with eosinophilia-myalgia syndrome Bull.-Environ.-Contam.-Toxicol. vol. 48, no. 5, pp. 679-687, 1992.

Eagles, J.A. & M.N. Randall. 1980. Handbook of Normal and Therapeutic Nutrition. Raven Press, New York. 323 pp.

Eichner ER: Overtraining: consequences and prevention. J Sports Sci, 1995 Summer, 13 Spec No:, S41-8.

Grindel CG: Fatigue and nutrition. Medsurg Nurs, 1994 Dec, 3:6, 475-81, 499.

Howe, P.S. 1981. Basic Nutrition in Health and Disease, 7th ed. W.B. Saunders Co., Philadelphia.

Hui, Y.H. 1983. Human nutrition and diet therapy. Wadsworth, Inc; Belmont, California. 1039 pp.

Ingelfinger, F.J. 1980. Dorland's Medical Dictionary. Saunders Press Pub., Philadelphia. 740 pp.

Machlin, L. The Handbook Of Vitamins. New York: Dekker, 1984.

Margolis, S. 1984. Food allergies Nutritional Management: The Johns Hopkins Handbook. M. Walser, A.L. Imbembo, S. Margolis and G.A. Elfert, eds. W.B. Saunders Co., Philadelphia.

Murray, M.T., & J.E. Pizzorno. 1991. Encyclopedia of Natural Medicine. Rocklin, Ca; Prima Publishing.

Patmas-MA: Eosinophilia-myalgia syndrome not associated with L-tryptophan. N-J-Med; 1992 Apr; 89(4); P 285-6.

Peters, D. et al: Clinical Forum: Chronic Fatigue. Complementary Therapies in Medicine, 1996(4): 31 - 38.

Pike, Ruth L. & Myrtle L. Brown. Nutrition: An Integrated Approach. New York: Wiley, 1971.

Robinson, C.H. & M.R. Lawler. 1982. Normal and Therapeutic Nutrition. 16th ed. MacMillan Publishing Company, Inc., New York. 849

Stedman, Thomas Lathrop. Stedman's Medical Dictionary. 24th edition. Baltimore: Williams and Wilkins, 1982.

Thomas, C.L. 1985. Taber's Cyclopedic Medical Dictionary. F.A. Davis Co. Pub., Philadelphia. 2170 pp.

Valesini-G et al: chronic fatigue syndrome: what factors trigger it off? [editorial] Clin-Exp-Rheumatol; 1994 Sep-Oct; 12(5); P 473-6.

Williams JH & Klug GA: Calcium exchange hypothesis of skeletal muscle fatigue: a brief review. Muscle Nerve, 1995 Apr, 18:4, 421-34.