The Origin of Fatigue
Author: Aude Echalier (Ph.D.) practises at the Faringdon Wellbeing Clinic so please contact the clinic if you would like to book in with Aude.
Fatigue is a complex and multifaceted condition, often marked by persistent physical and mental exhaustion, which interferes with daily life. Unlike simple tiredness that can be resolved by rest or sleep, fatigue is more chronic in nature and doesn’t respond well to conventional recovery methods. It can stem from various causes, including lifestyle habits, emotional stress, or underlying health conditions.
One major cause of fatigue is nutritional deficiencies, particularly deficiencies in key micronutrients such as iron, vitamin B12, and vitamin D. These nutrients are essential for proper cellular energy production, especially in the mitochondria, which act as the energy generators of our cells. For instance, low iron levels can lead to anaemia, limiting the blood’s capacity to transport oxygen, resulting in profound fatigue.
Chronic stress is another leading contributor to fatigue. Prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis causes an overproduction of cortisol, which can place excessive strain on the adrenal glands and disturb the body’s natural circadian rhythm. This is particularly relevant for women approaching or undergoing menopause, as their adrenal glands are often under added pressure. In such cases, poor sleep and daytime fatigue are common. Mental health challenges such as anxiety and depression also contribute to fatigue by disrupting the balance of neurotransmitters.
Fatigue is also frequently linked to chronic illnesses like autoimmune diseases (e.g. rheumatoid arthritis, lupus), chronic infections (e.g. Lyme disease, Epstein-Barr virus) and hormonal conditions like hypothyroidism. In these situations, the body’s immune response and the resulting inflammation interfere with normal cellular functions, especially in energy production pathways. Chronic fatigue is often associated with mitochondrial dysfunction, where inflammation hampers the cells’ ability to produce energy efficiently.
How Medical Herbalism Can Help Resolve Fatigue
Medical herbalism, combined with the principles of functional medicine, provides a holistic and integrative approach to treating fatigue by targeting its root causes. The focus is on understanding the interconnected systems of the body, and practitioners assess how poor nutrition, stress, inflammation, or gut imbalances contribute to fatigue.
One core area of concern is adrenal fatigue, where chronic stress disrupts cortisol regulation. Restoring balance to the adrenal system often involves personalised lifestyle changes and nutritional plans. Another critical focus is the health of the mitochondria. As mitochondria are responsible for producing ATP (adenosine triphosphate), the energy currency of our cells, it’s crucial to address mitochondrial dysfunction through a combination of dietary adjustments, supplements, and lifestyle interventions to boost cellular energy production.
Herbs play a key role in restoring balance and vitality to the body. Many herbs, especially adaptogens, are excellent for managing both stress and fatigue. Adaptogens help the body cope with stress by regulating cortisol levels and supporting the adrenal glands. Some of the most effective herbs for combating fatigue include:
- Ashwagandha (Withania somnifera): Known for its ability to reduce stress and fatigue, Ashwagandha has been shown to lower cortisol levels, improve physical stamina, and enhance energy. Clinical studies demonstrate that those who take Ashwagandha experience a marked reduction in fatigue and greater resilience to stress.
- Eleutherococcus (Eleutherococcus senticosus): Often referred to as Siberian ginseng, Eleutherococcus is a potent adaptogen that helps combat fatigue by improving both mental and physical endurance. It enhances the body’s resistance to stress and promotes balanced energy levels, making it especially useful for managing fatigue during periods of physical or mental strain.
- Ginseng (Panax ginseng): A classic tonic, ginseng has long been revered for its ability to boost energy and overall stamina. Clinical research shows that ginseng enhances physical and cognitive performance, which is particularly beneficial for those suffering from chronic fatigue.
There are many other adaptogens, some of which are gentler and suitable even for individuals with severe depletion. The work with a qualified herbal practitioner helps to identify the best herbal combination tailored to the individual’s needs.
In addition to adaptogens, herbs that promote mitochondrial health and reduce oxidative stress are also valuable in addressing fatigue. For example, Cordyceps, a medicinal mushroom, improves cellular energy production by enhancing oxygen utilisation and ATP synthesis, making it particularly effective in chronic fatigue and improving exercise performance.
The nervous system also plays a crucial role, particularly when mental fatigue is involved. Herbs such as lemon balm (Melissa officinalis) and skullcap (Scutellaria lateriflora) are commonly used for their calming properties, helping to alleviate anxiety and promote restorative sleep.
Addressing nutritional deficiencies, chronic infections, hormonal imbalances, or gut health issues is essential for restoring vitality and strength. By addressing both the physical and emotional aspects of fatigue, this integrative approach provides long-term energy restoration and a better quality of life.
Though there is plenty of information available, it’s always advisable to consult with a qualified practitioner before starting any herbal treatment. A short consultation can be easily arranged to ensure you’re on the right path.
References
- Norheim et al. “Biological mechanisms of chronic fatigue.” Rheumatology, Volume 50, Issue 6, June 2011, Pages 1009–1018, https://doi.org/10.1093/rheumatology/keq454
- Chandrasekhar, et al. “A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety.” Indian Journal of Psychological Medicine, 34(3):255-262, 2012.
- Panossian, Wikman, “Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress-protective activity.” Pharmaceuticals, 3(1):188-224, 2010.
- Darbinyan et al. “Rhodiola rosea in stress-induced fatigue–a double-blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty.” Phytomedicine, 7(5):365-371, 2000.
- Das et al. “Cordyceps spp.: A Review on Its Immune-Stimulatory and Other Biological Potentials.” Front. Pharmacol. Sec. Ethnopharmacology. Volume 11 – 2020 | https://doi.org/10.3389/fphar.2020.602364
- Kennedy et al. “Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm).” Pharmacology Biochemistry and Behavior Volume 72, Issue 4, July 2002, Pages 953-964
- Luo et al. “Natural medicines for the treatment of fatigue: Bioactive components, pharmacology, and mechanisms.” Pharmacological Research Volume 148, October 2019, 104409