Chronic fatigue that significantly impacts a person’s sense of well-being is a common health complaint that can have many possible underlying causes. A detailed health history and physical examination assesses for potential causes of fatigue including poor circulation, anemia, chronic infection and/or inflammation, nutrient deficiencies, food allergens, stress (from physical as well as emotional causes), trauma, toxins, hormonal dysfunction, and sleep disorders.
At the heart of energy production is the mitochondrion, an organelle within all cells (save for red blood cells) that is responsible for converting food to fuel for our body’s multiple needs. This fuel is known as ATP, adenosine triphosphate. We make an equivalent of our body’s weight in ATP daily! At any one time we have roughly about a pound of ATP in us. Anything that disrupts this energy production process will result in fatigue among other symptoms. The health of our mitochondria is essential to our overall well-being. The cells of some organs that are particularly metabolically active (in other words, they require a great deal of energy to function) can have thousands of mitochondria per cell. The following diagram depicts where most of the energy is consumed in the body.

diagram showing what parts of the body use the most energy
With the brain and muscles consuming a large share of the energy produced, we can now understand why people who are fatigued most often complain of “brain fog”, memory/concentration problems, weakness, and easy fatigability with minimal exertion. Common diseases associated with mitochondrial dysfunction and disease include obesity, type 2 diabetes, non-alcoholic fatty liver disease, cardiovascular disease, cancer, neurodegenerative disorders (such as dementia and Parkinson’s disease), mood disorders, multiple chemical sensitivity disorder, chronic fatigue syndrome, and fibromyalgia syndrome.
A healthy diet is very important in energy production. We need to consume sufficient macronutrients – fats, carbohydrates, and protein – and micronutrients – B vitamins, iron, magnesium, and many others – to support energy production. Unhealthy diets, among other things, can contribute to increased production of free radicals (oxidative stress) that can ultimately lead to disease if our body does not have sufficient repair capabilities.
So, what can we do to support mitochondrial function and thereby improve vitality?

  • We can support ways to:
  • Improve circulation and oxygenation of our tissues
  • Get adequate macro- and micronutrients
  • Modified Paleo-Mediterranean Diet
  • Hydration
  • “5 R Gut Program”
  • Remove, Replace, Re-inoculate, Repair, Rebalance
  • Get adequate sleep
  • Get sufficient exercise
  • Manage stress effectively
  • Treat underlying infections and inflammation
  • Correct hormonal imbalances
  • Avoid toxins
  • Avoid unnecessary drugs (never stop any medication without first talking to your doctor)
  • Stimulate various centres of the brain with specific activities (neuroplasticity)
  • Support mitochondrial function through use of selected supplements (when appropriate and with advice from a knowledgeable practitioner)
  • CoQ-10
  • Omega-3 Fatty Acids
  • B Vitamins (particularly B2 and B3)
  • Magnesium
  • Vitamin C
  • Alpha-Lipoic Acid
  • Nrf2 Activators – see the figure below

energy and fatigue diagramA summary of the key concepts from a presentation at the Public Library on March 14, 2016.

by Dr. Joseph Schnurr, Family Physician

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