Fatigue is a normal physiological response. When the body becomes temporarily tired after strenuous activity or stress, it can recover within a short period of time with proper rest. However, there are some conditions that make people tired easily; for example, chronic diseases such as high blood pressure, high blood cholesterol, and high blood sugar levels, chronic kidney failure, heart failure, liver cirrhosis, chronic obstructive pulmonary disease, and cancer.
However, some people without chronic diseases continue to have unexplained fatigue that isn’t relieved by getting more sleep or rest. Some of these cases become so severe that it affects their daily activities.
These individuals may also have sleep problems, such as insomnia and wakefulness. At the same time, there may be a lack of concentration or short-term memory difficulties, and some patients may feel that they have brain fog. Dizziness may be worse when they sit up or stand up straight. Some people may also experience headaches, muscle pain, or multiple joint pains.
Patients who have these symptoms are likely to have Chronic Fatigue Syndrome (CFS).
The causes of chronic fatigue syndrome are not fully understood at the moment, but may be related to lifestyle factors or viral infections.
Life factors include stress, work and rest schedule, and diet. Dr. Shih Heng Chang, director of Lohasiinfra Clinic, said that stress could cause hormonal fluctuations and imbalances, in particular, the fluctuation of cortisol, a hormone secreted by the adrenal cortex. Cortisol keeps people awake, so they’re not prone to deep sleep. When the secretion of cortisol is imbalanced, many body systems and functions are negatively affected.
Many people tend to stay up late, but the most appropriate time for one to go to bed is between 11:00 p.m. and midnight, or even earlier. If people do not sleep when they should, even if they sleep for the same amount of time, such as seven to eight hours, their sleep efficiency will decrease, so it won’t be as effective as people who go to bed at 10:30 p.m. to 11:00 p.m. In addition, some people may stay up late due to sleep disorders, such as sleep apnea, restless legs syndrome, or insomnia.
In addition, a nutritional imbalance can easily cause a lack of necessary trace elements for the body to function. The smallest functional unit of the human body is the cell, and each cell has a “generator,” the mitochondrion, which needs to be supplemented with sufficient vitamins and minerals for smooth functioning.
Viral infections can also cause chronic fatigue. Chronic fatigue is known to occur in some people infected with human herpes virus type 4. Now it has been discovered that patients who have had COVID-19 may also experience severe fatigue, known as long COVID.
By medical diagnostic standards, the symptoms of fatigue must last for six months or longer before chronic fatigue syndrome is recognized. However, Dr. Chang pointed out that when a patient has no energy for most of the day, they’re not going to want to wait six months to be given treatment.
Even if the diagnosis of chronic fatigue syndrome is confirmed, there is currently no medical cure for it, so the treatment focuses on relieving the symptoms. For instance, patients who are easily depressed may be prescribed low-dose antidepressants; some adolescents are prone to dizziness when standing and may be given medications to regulate their blood pressure or heartbeat; and some patients who are prone to muscle pain are provided with painkillers.
In addition to medications, there are a number of ways to improve chronic fatigue:
Supplementing Vitamin B Complex to Regulate Hormones
The lack of energy and fatigue during the day are related to cortisol.
Under normal circumstances, more cortisol should be secreted during the day than at night. In particular, cortisol secretion levels should be high when you first wake up in the morning, and very low when you go to bed at night.
However, people with chronic fatigue have a different situation. According to Dr. Chang, during physical examinations you’ll discover that the cortisol level of chronically fatigued patients is very low between 7:00 a.m. and 8:00 a.m.
There are no drugs that can directly regulate cortisol at the moment, but supplementing vitamin B complex can help.
Furthermore, the brain will also feel fatigued if it lacks oxygen. Vitamin B12 in the B complex is related to the body’s red blood cell production. Red blood cells help the body transport oxygen, so supplementing vitamin B12 can make the transport of oxygen more smoothly.
Vitamin B12 can also help produce another hormone–melatonin. Melatonin can make people feel sleepy and is secreted in high volumes at night, allowing people to fall into a deep sleep and promoting energy restoration. The body’s tryptophan can synthesize melatonin. And this synthesis process needs the help of vitamin B12.
Generally speaking, taking vitamin B complex during the day can make you feel energized. However, some people will want to sleep if they take vitamin B complex in the morning, though taking it at night will help them sleep. Therefore, it is recommended to adjust the time of vitamin intake, according to the individual’s particular situation.
Other nutrients that need to be supplemented are:
High quality proteins: Tryptophan can be replenished from protein-rich foods.
Minerals: such as copper, iron, zinc, calcium, and magnesium. Iron can synthesize red blood cells; zinc is involved in many chemical reactions in the body; copper is associated with red blood cells and the nervous system; and calcium and magnesium can relax the muscles.
Fish oil: Chronic inflammation can also cause fatigue, and the main component of fish oil, omega-3, has an anti-inflammatory effect.
Improving Sleep Can Reduce Fatigue by Half
A good night’s sleep can eliminate fatigue. Clinical treatment for chronic fatigue will start with improving the patient’s sleep. “The other side of fatigue is poor sleep quality,” said Dr. Chang, “and these two are often combined.”
People who have trouble sleeping and snore easily can be checked for sleep apnea. This disease causes lack of oxygen, reduces sleep quality, and makes people tired and sleepy during the day.
For people with chronic fatigue, it is best to go to bed at 10:30 to 11:00 p.m., and to go to bed at a fixed time. Their sleeping environment should be ventilated, dark, and without lights. Dr. Chang added that if there is light during sleep, the chance of developing type 2 diabetes can increase.
Also, taking a bath before bed helps you fall asleep. A study published by the University of Texas at Austin in 2019 showed that taking a hot bath one to two hours before bedtime and keeping the water temperature between 40°C and 42.8°C (104°F and 109°F) helped people fall into a deep sleep and increase the average speed of falling asleep by 10 minutes.
Dr. Chang emphasized that we should not drink alcoholic beverages before bedtime. This causes people to end up in light sleep state during most of the night.
Appropriate Exercises Can Help Improve Sleep Quality
Fatigue is also related to dysfunctional work and sleep schedules. Normally, the body is energetic during the day and tired at night, but in this case, the patient is not energetic during the day. Thus, exercise can help adjust the body’s physiological clock.
Although patients with chronic fatigue syndrome may experience more fatigue if they immediately engage in higher-intensity exercise, they can start with very low-intensity exercise, such as walking, and gradually increase the amount of exercise.
Patients can also consider slow exercises, such as qigong, which not only reduces fatigue symptoms, but also calms the individual’s mind. A study in the medical journal Evidence-Based Complementary and Alternative Medicine discovered that chronic fatigue patients who practiced qigong experienced significant improvements in their overall fatigue, physical fatigue, and depression.
Adjusting Indoor Lighting With the Seasons
Daytime fatigue is more likely to occur in the winter. Due to the short winter days and long dark nights, the body will produce more melatonin. Melatonin can help with people’s sleep, but too much of it will make people tired and depressed.
Therefore, it is best to increase indoor lighting during the winter days to enhance the brightness of the room. In the evening, turn on the lights early to avoid a dim room.
Using Acupuncture and Massage to Improve Overall Health
The Mayo Clinic, which has been ranked number one in the United States for six consecutive years, also mentions acupuncture and massage therapy in its summary of treatments for chronic fatigue syndrome.
Acupuncture is one of the therapeutic techniques used in traditional Chinese medicine to promote the circulation of qi, blood, and meridians. It is a technique to balance the flow of energy or vitality by stimulating acupuncture points (places where nerves, muscles, and connective tissues are located) to improve overall health and reduce stress.
Massage performed by a professional massage therapist can help reduce stress, relieve pain and muscle tension, help the body relax, and improve immune function.