Fatigue

‘Low on iron’ causes and anaemia

Iron deficiency is one of the most common nutritional deficiencies in Australia and it is significantly under-diagnosed. For example, 34% of Australian women of child bearing age are iron deficient.

If you’re feeling exhausted and rundown, it can be a sign that you may not be getting enough iron for your needs. Iron is an essential mineral that has a number of jobs in the body, including making healthy red blood cells. These deliver oxygen to all of your other cells where it is used to create energy – so it is not surprising that you can feel extremely fatigued if you are low in iron.

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Do you need your iron levels checked?

Symptoms that may indicate you are experiencing iron deficiency or anaemia include:

  • Dizziness
  • Frequent colds or flu
  • Impaired cognitive (brain) function
  • Paleness on the inside of lower eyelids
  • Restless legs
  • Poor response to thyroid medication
  • Pregnant or menstruating women

The following groups of people may experience iron deficiency more commonly than the general population:

  • Vegetarians and vegans
  • Athletes
  • The elderly

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What are Your Iron Numbers?

It is essential to know your iron level before taking an iron supplement as having too much iron can be dangerous. It is also important for your doctor to check if there are other causes of low iron to be sure that the right treatment is prescribed.

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Foods High in Iron

Your diet should always be the first place you obtain iron. Animal sources of iron (haem iron) include beef, fish, chicken, kangaroo, lamb and sardines. Vegetarian sources of (non haem) iron include dark leafy greens such as spinach, silver beet and kale.

Symptoms such as bloating, diarrhoea and constipation are warnings that your digestive system may not be healthy and can indicate that you need to make dietary changes so that you can absorb the nutrition that your body needs.

‍Read more: What Is Your Gut Trying to Tell You? | How to Deal with Diarrhoea Caused By Taking Antibiotics

What This Means To You

Blood tests for iron levels are easily requested if you have any of the above symptoms or lifestyle risks.  You need to know that your results are at an optimal level as distinct from just average and take well-tolerated and well-absorbed iron supplements if appropriate. You are welcome to book an appointment to discuss iron deficiency or if you are feeling unwell or tired and would like to investigate the cause.

Related: All in the gut: Why your health problems may have started in the digestive system

Quality rest is an important part of getting through the daily grind, yet nearly 50% of Australian adults experience two or more sleep-related problems, including difficulty falling asleep, staying asleep and daytime sleepiness. Find out how a sleep hygiene overhaul may help you secure a blissful date with your pillow…

Do you yearn for a good night’s sleep, only to find that sleep does not yearn for you? Quality rest is an important part of getting through the daily grind, yet nearly 50% of Australian adults experience two or more sleep-related problems, including difficulty falling asleep, staying asleep and daytime sleepiness.

While the occasional night of poor sleep is annoying, ongoing sleep disturbances can lead to bigger issues including emotional difficulties, brain fog, poor job performance, and even accidents or injury. Even more alarming, long-standing insomnia is associated with many chronic diseases, including diabetes, cardiovascular disease, obesity, and mood disorders.

The good news is, catching more z’s may be as simple as changing your habits. For many people, bad habits in the lead-up to bedtime, also known as poor sleep hygiene, are a major contributor to a restless night. Read on to find out if a sleep hygiene overhaul may help you secure a blissful date with your pillow, and a solid night’s sleep.

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Check Yourself Before You Wreck Yourself

Unfortunately, modern life predisposes us to poor sleep hygiene. A busy social calendar may keep you out late, high-stake stress at work can cause sleepless worry, and a burning desire to stay up late watching your favourite reality TV show (Keeping Up With the Kardashians, anyone?) may keep you on the couch into the wee hours. The occasional blowout is okay, but when these pastimes become regular patterns, it becomes harder to cement a consistent sleep schedule, making it difficult to sleep well.

If you spend every night struggling to sleep, you probably already know that your sleep habits need attention. However, if your issue is more subtle, or less frequent, you may be wondering whether it’s worth taking action. Using the checklist below may help you decide.

Regularly experiencing one or more of the following may be a sign of a disrupted sleeping pattern:

✔ It takes over 30 minutes to fall asleep after getting into bed.

✔ You wake up more than once per night.

✔ You awaken for over 20 minutes during the night.

✔ You spend less than 85% of your time spent in bed asleep.

✔ You wake most mornings feeling unrefreshed.

✔ You rely on caffeinated beverages to get you through the day.

Adapted from the National Sleep Foundation

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When Counting Sheep Doesn’t Work, Try This
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If you are fed up with moving through life like a character from ‘The Walking Dead’, these simple tweaks to your sleep hygiene may help you shake off sleepless misery. Incorporate the following habits to help you fall asleep faster, sleep soundly through the night, and wake feeling refreshed and rested:

  • Go to bed when you feel sleepy. While this may seem like a no-brainer, climbing into bed when you feel alert can create a negative association between being in bed and struggling to sleep, making it harder for you to relax.
  • Establish a sleep routine, which will help condition your body to feel sleepy at a regular time. This may be difficult initially, particularly if you don’t feel tired at the same time each night. However, you can help your body synchronise to a consistent schedule by going to bed at roughly the same time each night and waking at the same time each morning.
  • Steer clear of electronic devices for at least 30 minutes before sleep and avoid using these in bed. Night-time exposure to blue light from digital screens is stimulating and can interfere with your brain’s production of melatonin, the hormone responsible for making you feel sleepy.
  • Do not use your bed as an activity centre. Your bed is for sleeping and sexual activity only. Avoid other pursuits, such as watching TV or working from bed, to train your brain to associate bed with sleep.
  • Avoid stimulants such as caffeine and cigarettes, which can keep you awake or disrupt your sleep during the night.
  • Create a pre-sleep ritual. Relaxing activities can help you unwind before hitting the sack and gradually transition your body from a wakeful state into a state of sleep. Your ritual may include stretches, breathing exercises, a hot bath, or sipping on a cup of caffeine-free tea.
  • Ditch the alcohol. Many people use alcohol to help them fall asleep faster. However, drinking alcohol inhibits restorative sleep and increases the likelihood that you will feel groggy the next morning.
  • Get up. If you do not fall asleep within 20 minutes of lying down, get out of bed and perform a mundane activity until you feel sleepy enough to return to bed. Getting out of bed for a walk to the kitchen and a glass of water allows your mind to ‘switch off” and your body to cool down. There is nothing like a spot of ironing to bore you to sleep. Boredom is key; avoid activities that may stimulate you, such as watching TV, and avoid the use of bright lights, which suppress melatonin production.

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A Quick Fix for the Meantime

Changing your habits can take time, particularly if they have been months or years in the making. While you make changes, sleep-supporting herbs can fast track your journey to snoozeville. Remedies such as California poppy, passionflower, zizyphus, Jamaica dogwood, and lavender can enable you to fall asleep faster and sleep more soundly.

These herbs achieve their sleep-inducing effects by stimulating your body’s production of gamma-amino butyric acid (GABA). This neurotransmitter (chemical messenger) is made by your brain and sends signals to your brain cells that reduce their activity. It also carries signals to other cells in your body, such as your muscles, helping them to relax. GABA is involved in your body’s sleep cycles, with increased levels during the evening reducing stress, promoting calmness and relaxation, and helping ease you into sleep.

As an added bonus, unlike many pharmaceutical sleeping agents, herbal sleep remedies are unlikely to make you feel jet-lagged the next day.

 

Make Like a Log and Sleep

Straightening out your sleep hygiene can help you say “goodbye” to clock-watching and “hello” to a great night’s sleep.

While you work on changing your habits, herbal remedies can help you quickly get the rest you need. For more advice on how to achieve sound sleep, or for guidance around which herbs are best suited to your needs, make a time to see me.

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Dr Peter Holsman

Integrative Medical Doctor

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Sleeping well is essential for great health. Find out more in this blog

In our hyper-stimulated world, slowing down can be quite a challenge. Attached to our phones, computers and TV 24/7, it’s no wonder so many people struggle to wind down and get a good night’s rest! Interestingly, the poorer our quality of sleep, the less our body is able to cope with the daily stresses that we’re exposed to, creating a cycle in which we’re running in a hamster wheel, unable to take a break!

How deep sleep can help you cope with stress!

For the average person who gets around 8 hours sleep a night, around two hours of this will be deep sleep or REM cycle sleep.  During this time, your body is completely relaxed, in full repair mode, getting rid of waste products and preparing you for the day ahead.

In doing so, one of the things it does is help build your resilience and ability to cope with, process and manage stress. In fact, according to a study in the Journal of Neuroscience helps process and manage events that you may find particularly traumatizing. This is because REM sleep seems to reduce activity in the amygdala and it’s interaction with the prefrontal cortex and hippocampus, areas which process fear and retain memories.

How to get enough good quality deep sleep!

Getting a good night’s rest is tricky for many. Whether wired from a day at work or stresses of family life, it can be hard to slow down early enough to be able to both go to bed early and fall asleep early. Fortunately, there are a few easy things you can do to encourage your body to unwind and prepare for a good sleep.

If you know you’re the kind that struggles to get to sleep, try the following:

Take time to wind down

I know it’s hard to set boundaries when technology is at our fingertips but removing yourself from work when you leave the office is really helpful in encouraging you to relax. If possible, instead of turning to the TV, try and spend your time playing a game with family, listening to music or reading a book before bed. Similarly, I know there are some people who can drink a cup of coffee straight before bed without any effect but for most people, stimulants such as caffeine (in both tea and coffee) should ideally be avoided in the evenings.

Avoid using electronics for at least 1 hour before bed.

Not only does work keep you awake and focused on a task (the same goes for any TV show you may be binge watching), it also emits blue light which inhibits melatonin production needed to encourage sleep. If you must keep using your phone/laptop, find the setting that reduces blue light emission.

Reduce brightness in your home

As I used to tell my kids when they were younger, if the birdies are asleep, it’s time for you to go to bed as well! Once upon a time, before the invention of electricity (yes I know we’re talking a while back), people went to bed soon after the sun set because the only light remaining was that provided by the moon and stars. This naturally programmed the circadian clock and melatonin levels, encouraging good quality sleep for longer. Although we now have the ability to keep lights on 24/7, simulating twilight or dusk encourages your body to start varying the levels of melatonin in your body so that you can fall asleep more easily.

If you’re still struggling to get to sleep, feel free to raise this during your next consultation as there may be medical reasons for poor quality or lack of sleep.

Wishing you great health,

Dr Pete

PS. you are welcome to share this with friends and family

Find out about the power of language..

Twenty years ago I attended a professional speaking talk given by a little old lady in her seventies.

(At the time I thought that 70 was quite old, but have since revised that opinion!).

This lady described her morning ritual in delightful detail. She rolled out of bed, tottered to the bathroom, looked in the mirror and said out loud “Good morning Gorgeous” seven times.

Why seven times? Her answer was that there were often two or three challenging events in the average day, but rarely as many as seven. So seven repetitions were more than enough to keep her positive.

‍Read more: Are you compromising your life or living according to your strengths?

Why “Good Morning Gorgeous”?

Isn’t that a crazy extreme way to start the day? Her reply was that positive language set the tone for the day. It created and encouraged her positive mindset.

What will you choose?

I have suggested to multiple patients that they too can start their day in the bathroom with “Good Morning Gorgeous”. Most have been shocked and quite uncomfortable at the thought.

Why such a response? I suspect it is that many people do not feel lovable, worthy or deserving, often as a result of childhood programming.

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Self- Criticism or Self Praise?

Your mind responds to the language that you use in a yes or no manner. Whatever you say is understood as being true.

Words such as difficult, impossible, falling apart, exhausted or hopeless reinforce a negative outlook.

Saying that you are loveable, gorgeous, deserving, worthy, special, deserving, pretty, handsome, confident, strong, liberated or clever will help you enjoy and achieve much more in your life.

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What this means to you

If you find it difficult to have self praise or receive compliments in your life, it may well be a symptom of emotional blocks.

You can address these underlying emotional blocks. Whether you do or not is your choice. You might like to test yourself out with the little old lady’s bathroom mirror ritual and make a decision.

You are welcome to ask me for recommendations that will help you improve or modify some of your past programming. There are plenty of options including Journaling, EMDR, Hypnotherapy and counselling.

Related topic: Stand up and protect yourself from the harms of desk jobs

Chronic Fatigue – contributors, treatments and healing naturally

One of the hardest and most frustrating health challenges is where you know something is not right, but nobody can tell you what is actually wrong.

This is often the reality experienced by people with chronic fatigue syndrome (CFS) as most symptoms are invisible to others and this can make it very hard for other people to understand.

Additionally, there are no conclusive diagnostic tests to confirm Chronic Fatigue Syndrome (also referred to as Myalgic Encephalomyelitis). Thus many doctors think the illness does not really exist. So how do you know if CFS is the cause of your exhaustion, low energy levels and feeling unwell? Finding a doctor with expertise in chronic fatigue is a good place to start.

What is chronic fatigue syndrome (CFS)?

Chronic fatigue Syndrome (CFS) is a difficult, frustrating condition with no definitive diagnostic tests or visible signs.

It is estimated that approximately 17 million people worldwide are affected by CFS. Young adults are more commonly affected, with a peak age of onset between 20-40 years.  Women are 2-4 times more likely than men to be diagnosed.

The main symptom is fatigue that is consistent and intense enough to reduce normal daily activities by at least 50% for a minimum of six months.

Other symptoms associated with CFS include headaches, sore throat, non-refreshing sleep, post-exertion fatigue, impaired memory, attention or concentration, muscle pain, and tender neck or armpit glands.

These symptoms may come and go or they may last for weeks, months or years. Symptoms can also vary widely from person to person. Recent longitudinal studies suggest that some people affected by CFS improve with time but that most remain functionally impaired for several years.

Contributors to CFS development

Infection and immune dysfunction

CFS can start suddenly and seems that it is often initiated by an infection, for example glandular fever due to Epstein-Barr virus (EBV), herpes viruses, Candida albicans and parasitic agents or another immunological involvement. According to the research, viral infections seem to be the most common cause. There is also increasing evidence that CFS may have an autoimmune component.

Toxins

The condition of the immune system and its ability to function optimally can be impaired or effected by exposure to insults such as lipopolysaccharides from bacteria, moulds, candida, lyme and metabolic toxins.  A 2013 study showed a correlation in the detection of mycotoxins (mould) in patients with CFS, as well as an overlapping of symptoms occurring between CFS and multiple chemical sensitivity syndrome (MCS).

Digestive problems

If there is a problem with the digestive system (e.g. gut fermentation, lack of stomach acid or digestive enzymes, or pancreatic insufficiency) energy production will be impaired resulting in fatigue.

Mitochondrial dysfunction and oxidative stress

Mitochondria can be thought of as little batteries inside your cells. Mitochondrial dysfunction is directly related to fatigue and, therefore, is considered a fundamental factor in the syndrome. This is due to the mitochondria’s role in generating energy by oxidative metabolism in the form of adenosine triphosphate (ATP). This ATP is then hydrolysed to adenosine diphosphate (ADP) which releases energy to produce muscle contractions and nerve impulses. Outside of energy production, some of the primary functions of the mitochondria include cellular defence and immunity. These processes can therefore be compromised in CFS and are associated with oxidative stress, infection and chronic immune system activation.

Stress & mood disorders

Depression is common in CFS and can be one of the major causes of chronic fatigue. Associated with a disturbance of central nervous system functions, studies have shown abnormal function of the hypothalamic-pituitary- adrenocortical (HPA) axis. It can, however, be difficult to determine whether the depression or the chronic fatigue came first.

Learn more about our stress and mood services here.

7 nutrients that can assist in managing Chronic Fatigue Syndrome naturally

Let’s look at some popular nutritional supplements that can assist in managing CFS. For the most part, the nutrients discussed below are antioxidant and mitochondrial nutrients as the mitochondria are a major source of cellular reactive oxygen species (ROS) production and the metabolic efficiency of mitochondria is closely related to the degree of free radical production. Herbal medicines, food choices, spinal health, stress management and good sleep hygiene are also important as part of chronic fatigue treatment and have been discussed in earlier blogs.

Learn how to improve your sleep hygiene for a great night’s sleep. 

Co-enzyme Q10 (CoQ10)

Co-enzyme Q10 is a key mitochondrial nutrient for energy synthesis and regulation, and production of ATP. It also has significant antioxidant properties and is shown to be deficient in CFS.  As a result of chronic disease, including CFS, oxidative damage to mitochondrial membranes impairs mitochondrial function.

Alpha-lipoic acid

A fundamental nutrient in the mitochondria, alpha-lipoic acid is a cofactor for several mitochondrial enzymes. It assists in energy production, is a potent antioxidant and anti-inflammatory agent, and has the ability to increase cellular glutathione antioxidant levels and improve cognitive function.

Vitamins C and E

Vitamin C provides antioxidant and immune support, and vitamin C therapy has been shown to reduce antibody levels of EBV, as well supporting adrenal health. Vitamin E contributes to mitochondrial membrane integrity and protects against mitochondrial membrane lipid peroxidation. It is an important mitochondrial antioxidant, which is further regenerated by vitamin C.

L-carnitine

CFS could be caused by deficiencies in a variety of nutrients, including carnitine. L-carnitine has a number of important functions regarding the maintenance of mitochondrial health and impaired mitochondrial function has been implicated in the pathogenesis of CFS.

Magnesium

An underlying magnesium deficiency can result in chronic fatigue and the symptoms similar to those of CFS. Magnesium is involved in the synthesis of ATP as well as contributing to the maintenance of cell and mitochondria membrane integrity. Magnesium has also been shown to assist pain management, as well as being an essential cofactor in enzymes of energy metabolism, hormone and neurotransmitter production and as a muscle tissue relaxant.

B vitamins

The benefits of a combination of all the B vitamins have been observed in individuals with CFS and include increased cellular energy production and mitochondrial function, neurotransmitter and hormonal balance, and methylation support. Additionally, the supplementation of a B vitamin complex positively interacts with omega-3s (fish oils) in supporting the prevention of cognitive decline, a feature which often presents in CFS. Most people do better with activated and / or methylated B vitamins.

Fish oil

Essential fatty acids (EFAs) have been shown to improve fatigue in CFS patients. They are a major component of cell and mitochondria membranes. Supplementing with EFAs may improve the clinical picture and membrane phospholipid profile of CFS patients.

Please note that these nutrients are only general examples which have been found to benefit some people with CFS. However, if you have been diagnosed with CFS, please consult a healthcare professional with experience in chronic fatigue syndrome about the best approach to managing your symptoms.

Related: Adrenal Fatigue Explained: Do you wake up feeling anxious and exhausted?

Functional Medicine aims to combine the best of conventional medicine with evidence-based complementary medicine, therapies and lifestyle interventions for the holistic treatment and prevention of disease. It enables medical practitioners and other health professionals to practice proactive, predictive, personalised medicine and empowers patients to take an active role in their own health.

When most people think of medicine, they think of conventional western medicine and heading to the GP. In fact, the term “Functional Medicine” is new to many people.

So what is functional medicine and how does it differ from conventional medicine?

First, let’s start with conventional medicine. This approach to health is great in cases of emergency and acute health problems such as pneumonia, appendicitis, heart attacks, broken bones and other emergenices.

This model uses surgery, drugs or hormones to treat chronic illnesses such as such as low thyroid, diabetes, high blood pressure, elevated cholesterol , allergies, digestive, hormonal, metabolic and neurological problems.

However, for many people, it is less effective in treating and preventing these chronic diseases and is often the point where people start looking for alternate solutions such as those offered by functional medicine.

What is Functional Medicine?

Functional or Melbourne integrative medicine understands that chronic diseases can’t be solved by drugs or surgery. The solution requires a shift away from suppression and management of symptoms to addressing their underlying causes. It therefore focuses not just on the symptomatic treatment of a problem but rather looks at the underlying drivers of illness.

Functional Medicine Doctors ask: “Why do you have this problem in the first place?” and “Why has function been lost?” and “What can we do to restore function?” In other words, what are the underlying causes or mechanisms for someone’s symptoms and illness?

Why does the distinction matter?

Human biology is complex. Gene expression is altered by lots of influences, including environment, lifestyle, diet, activity patterns, psycho-social-spiritual factors, and stress. Functional medicine therefore explores the interaction of genes, food choices, toxicity, environment and lifestyle. It explores how these factors can push us toward or away from disease by turning genes on or off and attempts to understand the underlying drivers of chronic diseases such as diabetes, arthritis, heart disease, obesity and dementia.

Functional Medicine aims to combine the best of conventional medicine with evidence-based complementary medicine, therapies and lifestyle interventions for the holistic treatment and prevention of disease. It enables medical practitioners and other health professionals to practice proactive, predictive, personalised medicine and empowers patients to take an active role in their own health.

Dr Peter Holsman is a qualified Medical Practitioner, Naturopath and Professional Speaker who specialises in treating people with fatigue related illnesses including chronic fatigue syndrome, thyroid and adrenal hormone problems.