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  • Writer's pictureBrian Dooreck MD

The Big "F" Word: "Fatigue"

Updated: Sep 20, 2023


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Chronic fatigue may be induced by unbalanced gut microbiota

What is chronic fatigue?


Certainly, we've all felt tired at some point in our lives. However, there is a difference between being occasionally tired and chronically tired.


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Chronic fatigue syndrome, or myalgic encephalomyelitis, is a complex condition characterized by excessive exhaustion that lasts at least six months and cannot be explained by an underlying condition. Physical and mental activities typically exacerbate the fatigue and do not alleviate with rest.


Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is a complex condition characterized by excessive exhaustion that lasts at least 6 months and cannot be explained by an underlying condition.

The cause of this condition is unknown; however, environmental or genetic factors may play a role.


What may be some accompanying symptoms?


Extreme fatigue is the most common symptom of chronic fatigue syndrome, although it can also include muscle and joint pain, cognitive impairment, and sleep disturbances.


Moreover, many patients with chronic fatigue syndrome also have IBS.


Many patients with chronic fatigue syndrome also have IBS

What is the gut-brain axis?


The gut-brain axis is the connection between the gut and the brain. The digestive system consists of approximately 100 million nerve cells constantly sending signals to the brain.


The sympathetic nervous system (“fight or flight”) and parasympathetic nervous system (“rest and digest”) deliver bidirectional signals between the gastrointestinal (GI) tract and the brain.


Through the central nervous and immune systems, gut bacteria play a vital role in balancing our bodies. Therefore, unbalanced microbiota and metabolites may induce chronic fatigue syndrome by disrupting bidirectional communication between the brain and the stomach.


Unbalanced microbiota may induce chronic fatigue syndrome

How can an imbalanced gut bacteria contribute to chronic fatigue syndrome?


Specific quantity imbalances of bacterial species found in the intestine (such as Faecalibacterium, Roseburia, Dorea, Coprococcus, Clostridium, Ruminococcus, and Coprobacillus) have been linked to chronic fatigue syndrome. For example, the leading indicators of chronic fatigue syndrome with IBS were an increase in Alistipes gut bacteria and a decrease in Faecalibacterium gut bacteria. Researchers believe examining the fecal microbiota may enable clinicians to distinguish between gut imbalances and subtype patients with chronic fatigue syndrome.


How is chronic fatigue syndrome diagnosed?


There is no single test that can confirm a diagnosis of chronic fatigue syndrome.


Symptoms can mimic illnesses like sleep disorders, medical problems, and mental health issues. Thus, different tests may be required to rule out other diseases before a chronic fatigue syndrome diagnosis can be made.


Nevertheless, compared to healthy adults who did not have the condition, people with chronic fatigue syndrome typically show an imbalance in gut bacteria, with higher levels of specific gut bacteria and lower levels of others.


There is no single test that can confirm a diagnosis of chronic fatigue syndrome.

Here is a video from the CDC "Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education"



How can symptoms be alleviated?


Presently, chronic fatigue syndrome has no known cure or treatment. Some symptoms, however, can be relieved and managed, which may include:


  • Healthy diet: A well-balanced diet can give the body the necessary nutrients.

  • Talk to a specialized physician: Doctors may run different tests to identify whether patients are deficient in essential nutrients and may recommend appropriate supplements.

  • Professional counseling: A licensed therapist can help process and develop practical coping skills for the illness and its influence on daily life and relationships.

  • Relaxation activities: Gentle massages, meditation, and deep breathing exercises may help relax the body by stimulating the vagus nerve, which reduces the "fight or flight" mode.

  • Patients should discuss all potential remedies with their doctors to determine if they suit their conditions.


Presently, chronic fatigue syndrome has no known cure or treatment.

Personally


I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.


"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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