June 2022

Fatigue be Gone

Fatigue presents with many faces

Fatigue is governed by a complex interaction between the physical, occupational, psychosocial and for some spiritual factors in our lives. Elements in our life that are distorted in the person who experiences fatigue often include but are not limited to our sleep habits, our food choices/diet to include alcohol and other recreational drugs of choice, deconditioning (lack of exercise and fitness) or over-exertional conditioning, dehydration, the multitude of life stressors and very importantly-being consistently connected to our tribe and support systems, to include friends and/or family and therapeutic resources such as counselors, church and community. The many medical diagnoses such as Obesity, Diabetes, Cardiovascular health issues and more that contribute to fatigue are not reviewed in this newsletter because they ultimately are related to the elements of our life that I have listed.


Unfortunately, we can eat right, get enough sleep, remain hydrated, reduce our stressors and even keep ourselves in a routine with exercise and still feel fatigue. Which highlights one of the hardest aspects of fatigue: the fact that one never knows when it will be relieved. Fatigue is very anxiety provoking and anxiety is fatiguing. It is a vicious cycle.


In 2015, The Institute of Medicine (IOM) determined that “chronic fatigue syndrome" (CFS) in the United States, (called "myalgic encephalomyelitis"-ME- in other countries and consequently known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome “ME/CFS” globally), should be considered a "serious, complex, multisystem disease" that physicians need to view as "real" and diagnose. In this same 2015 report, IOM states "It's time to stop saying that this is a just figment of people's imagination. This is a real disease, with real physical manifestations that need to be identified and cared for”.



The Institute of Medicine (IOM) committee recommended that the name Systemic Exertion Intolerance Disease (SEID) be used for this disease for two reasons:

1.             In this country, the term “chronic fatigue syndrome” affects patients’ perceptions of their illness as well as the reactions of others, including medical personnel, family members, and colleagues. This label can trivialize the seriousness of the condition and promote misunderstanding of the illness. 

2.             Also, the new name captures a central characteristic of this disease— the fact that exertion of any sort (physical, cognitive, or emotional)—can adversely affect patients in many organ systems and in many aspects of their lives.


 Systemic Exertion Intolerance Disease is defined in both adults and children by the following:


  1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest.
  2. Post exertional malaise (often described by patients as a "crash" or "collapse" after even minor physical or mental exertion);
  3. Unrefreshing sleep.
  4. Cognitive impairment and/or orthostatic intolerance.


The issue I have with IOM and the medical profession is that there are no curative measures instituted to treat fatigue. NONE. 


Very few people in the medical community take FATIGUE seriously and it is often medically treated as depression, especially because there is a greater percentage of women who present to the doctor with fatigue (DON’T GET ME STARTED!).


Attestation to the fact that we do not know how to medically treat fatigue is substantiated by the number of adults (especially adult women between 35-55 years old) prescribed amphetamines in this country - which is soaring. Mark my words, it is the new medically induced prescribed drug addiction epidemic in the country; amphetamines. Often patients being treated with amphetamines in this country are women diagnosed with “Adult Onset ADD”, Depression, undesired weight gain and yes, FATIGUE.


I have treated Fatigue naturally since 1989 with very good success.


I very carefully review the patient’s lifestyle to especially include their support systems and connections to friends and family, diet, sleep habits, life stressors to include but not limited to occupation, family and friends, as well as their exercise routine on the spectrum from no exercise to over-exertional exercise routines.


Patients present their fatigue with a plethora of symptoms and often have at least one of these three:

  "lack of energy," "no motivation," "difficulty concentrating”


They also often have all the SEID symptoms listed above:

  1. a substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest.
  2. post-exertional malaise (often described by patients as a "crash" or "collapse" after even minor physical or mental exertion).
  3. unrefreshing sleep.
  4. cognitive impairment and/or orthostatic intolerance.


Because the medical community never looks for Adrenal Fatigue, they do not find that their Systemic Exertional Intolerance Disease IS often ADRENAL FATIGUE.

If you don’t look for it, you won’t find it. Many of my patients who present with fatigue also have mild to profound Adrenal Fatigue. The good news is I look for it and know how to treat it. 

Especially since COVID, I really need to express the importance of our psychosocial connections in life in supporting our total health. There are many disconnected people right now suffering from disabling fatigue, because they have been removed from their tribe. Whether it be the impact of the virus itself (such as post-COVID residual or worse, Long-Hauler Syndrome), or the destruction of family and social dynamics imposed upon us by the vaccination quandry/war/conundrum or life on life’s terms that just leaves us feeling lonely, even if when we are in a room full of people, it is very important to identify how tiring it can be to feel tired from loneliness.  

On the topic of Adrenal Support

I use adrenal adaptogens to tonify and nourish the adrenal glands which are responsible for your physical and mental energy as well as your muscular, mental and psychological stamina, endurance and strength.

When we feel connected to our inner strength, the journey has begun to return us back to ourselves.


Adrenal Support Program

the program is well described on the website

Adrenal Response 2 daily in the am

ADR 1 daily in the am

Remember to stay connected. It can be  a game changer. Re-connect.    

As always, to your health and wellness

Cheers,

Ariane Cometa MD

your holistic doc