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How to Handle Chronic Fatigue According to Dr. Bomi Joseph

Chronic fatigue is an absolutely dreadful condition. Sufferers lack the energy to fully participate in life, and they are often forced to spend their days resting at home after “crashing” from overdoing physical activity. On bad days you might wake up feeling like you’ve been ‘hit by a truck’ and lack the energy to get […]

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Chronic fatigue is an absolutely dreadful condition. Sufferers lack the energy to fully participate in life, and they are often forced to spend their days resting at home after “crashing” from overdoing physical activity. On bad days you might wake up feeling like you’ve been ‘hit by a truck’ and lack the energy to get out of bed. You might be too tired to think or perform at work. There are a number of different loosely-related conditions such as Chronic Fatigue Syndrome (CFS), Myalgic encephalomyelitis (ME), Adrenal Fatigue Syndrome or simply “burnout.” These conditions were once rare but they are showing up throughout the general population with increasing frequency. “The Western medical establishment is rather poor at helping people with chronic fatigue because there is no specific therapy, prescription drug or ‘quick fix’ that is widely known or agreed upon,” says Dr. Bomi Joseph, Director of the Peak Health Center in California.   This leaves fatigue sufferers in the catch-22 of being too tired to function well, yet left completely on their own to research & treat themselves.  To make matters worse, the modern era subjects us to more stress and stimulation, with less authentic human connection, than at any other era in history.

Test Your Thyroid & Nutrient Status

Low thyroid function, or hypothyroidism, is one of the most common physiological causes of fatigue. If you are also experiencing other low thyroid symptoms like weight gain, depression, anxiety and insomnia, you should ask your doctor to check your blood for low thyroid hormones, low iron, magnesium, Vitamin D or B12, or a MTHFR folate deficiency. But be aware that there is a type of condition called subclinical hypothyroidism where bloodwork shows up normal but the thyroid itself isn’t quite functioning properly. Some primary care providers only know the bare basics of nutrition and thyroid, so you may want to visit an endocrinologist specializing in thyroid or an integrated medicine physician.

Do Graded Exercise

Graded exercise is an exercise program that is very gradually increased each week. This is important because it strengthens the heart, which pumps blood and oxygen to the tissues, that helps refresh the ATP the body uses up to make energy. Exercise also maintains and builds new muscle tissue, which is filled with mitochondria (cellular energy ‘power plants’). People with chronic fatigue may “crash” if they attempt vigorous exercise and be left sore, exhausted or even bedbound.  Depending on how fatigued someone is, they may need to start with as little as 5 minutes of gentle exercise per day and gradually increase the total duration by 5 minutes every week or two. Walking or bicycling is a good place to start. “Another great exercise for people with chronic fatigue is yoga… as it is moderate in intensity, strengthens ligaments, and it activates the parasympathetic nervous system to reduce stress,” says Dr. Joseph.  You can start at home with ‘gentle yoga’ videos on YouTube or Vimeo.

Avoid Stimulants

Stimulants like amphetamine or modafinil put oxidative stress on the body and can drive a fatigued person even deeper into energy ‘debt.” An exception to that, says UK chronic fatigue specialist Dr. Sarah Myhill, is that one morning cup of black coffee sweetened with 5 grams of a metabolic sugar called d-ribose can help kickstart an exhausted person’s energy metabolism. Other superior nutrients for increasing energy are:magnesium, astaxanthin, rhodiola, L-carnitine, ashwagandha & resveratrol.

As a person ages or experiences chronic stress, levels of crucial energy production coenzyme called NAD+ tend to decline,” says Dr. Joseph. That’s why the hottest trend in fatigue treatments right now are NAD+ boosters such as nicotinamide riboside, NMN and NAD3. Stacking a combination of resveratrol plus either NAD3 or NMN helps many people feel younger and more energetic with fewer side effects.

Keep a Circadian Rhythm

A lot of people with chronic fatigue have disturbed sleep patterns. They may stay up late watching television or texting, going to social events or parties, wake up in the middle of the night or take naps during the day. Or they can’t fall asleep and have insomnia that throws off their circadian rhythm or internal biological clock. Keeping a circadian rhythm means that you attempt to follow the natural sun-moon cycle our body is intrinsically programmed for. This means being social & active during the day and relaxing and sleeping at night. This is the opposite of social conventions where people like to go out and socialize at night and sleep all morning. You should:

  • Go to bed early and at a consistent time every night, 7 days per week.
  • Use blackout shades or curtains to sleep in complete darkness.
  • Dim all lights and use “blue light blocking” glasses for at least 2 hours before bed.
  • Turn off all cell phones, computers or digital screens at least 1 hour before bed.
  • Exercise and socialize during the daytime, not after dinner.
  • Don’t eat anything at least 4 hours before bed.

After keeping a circadian rhythm for a few months, many people with chronic fatigue report improvements in their overall energy levels, clarity, and nighttime sleep quality.

Feel Your Negative Emotions Fully & Let Them Dissipate

Here is a major and somewhat controversial secret: oftentimes chronic fatigue is caused or exacerbated by a buildup of suppressed negative emotions and blocked energy. Neither mainstream medicine or psychiatry understand this phenomena well and so they don’t offer good solutions for coping with it. Both anecdotal reports and scientific studies suggest that people with chronic fatigue have more PTSD & less ‘emotional coping strategies’ than healthy and unfatigued people.

 Say you are having a difficult day at work: a customer is very rude to you, there are frustrating technical computer issues and then your boss criticizes your performance on a project. These unpleasant stimuli can cause an ‘emotional flashback’ where all the unprocessed negative memories & emotions from your past that are stored in your psyche get awakened, start to subconsciously replay in the back of your mind. All kinds of negative and sad memories get subconsciously reactivated.  “This very often this happens without you even consciously realizing what is going on – you just feel stressed, agitated, depressed and more vigilant than usual,” says Dr. Bomi Joseph.

Your mind wants to keep you safe, so it works on overdrive to keep these negative, unprocessed experiences and impressions “pent up” and out of your thoughts. This process uses up an extraordinary amount of emotional energy that, after several hours or days, usually leaves you feeling drained and wiped out. Typically, a chronic fatigue sufferer will think something like “Oh no, I am really physically exhausted. I must lie down and rest. I can’t go out and visit friends this weekend or else I will be even more exhausted.” Then they become caught in a cycle of staying home, laying low, avoiding friends, work and activities because they think the fatigue has a physical rather than emotional origin. They rest frequently and intensively, sometimes for years, and become physically weaker while not improving their energy levels. In reality, when a person feels fatigued and it is not due to heavy physical exercise, it is most likely due to this ‘subconscious cognitive resistance’ dynamic. If the sufferer stops what they are doing and becomes mindful of everything that they are feeling under the surface and they dive deep into the negative thoughts and physical sensations – rather than trying to ‘block them out’ – the draining emotional charge that fuels the fatigue begins to dissipate. Then the fatigue itself begins to dissipate in a matter of hours or minutes.  The book “The Intelligent Body” by Kyle Davie explores this process of psychologically healing fatigue in depth.

With the proper lab tests, exercise, vitamins and sleep you may be able to improve your energy levels significantly. If you have done all of these physical tweaks and you are still feeling exhausted – you may want to explore emotional awareness and release techniques or PTSD/trauma therapy. Chronic fatigue is a terrible condition but there is hope: it can also be an amazing self-awareness journey and, in many cases, it can be dramatically improved or even cured.

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