Sometimes I wake up in the morning with a feeling of RELAXED ENERGY. My mind is clear, I have no fatigue, and believe once more that the world is wonderful, and it’s great to be alive.
I St-re-tch, exercise my hands (I have Osteoarthritis, and they are stiff), take out my Nite guard ( I grind my teeth at night and would otherwise wear them away), take my beta blocker eye drops ( to lower my intraocular pressure) and wash down my Eliquis ( an anticoagulant to prevent stroke from my Atrial Fibrillation) with 16 oz. of water, while thinking about all of the delights awaiting me.
Yes, my body was in better shape 60 years ago; but I had much more responsibility then, and much less discretionary time. All things considered, I like to believe that I am happier now.
The KEY is to stay in GOOD HEALTH. GOOD SLEEP is critical, but it cannot be had by willpower alone. As I have discussed previously, you need a bedtime routine, good SLEEP HYGIENE.
You also need a…….. GOOD DIET. with lots of fruits, vegetables and whole grains. Fatty, spicy foods will stay in your stomach and bother you at night, particularly if you eat Late. I like to finish eating by 5 PM. Late dinner is also likely to produce GERD, and maybe Sleep Apnea.
GOOD EXERCISE is also critical. If you are not tired at the end of the day, it is hard to get good sleep. I always seem to sleep better on the day when I walk the hills for an hour, which is 3 days a week. Try not to exercise within 2 hours of bedtime. Assuming that you have a good base of SLEEP, DIET and EXERCISE, there are other mechanisms that can foul things up. INFLAMMATORY conditions often cause fatigue.
The most common inflammatory diseases are OBESITY, METABOLIC SYNDROME and DIABETES. OBESITY is the defining disease of our EXCESSIVE SOCIETY, where there is too much of everything, and excessive consumption is relentlessly advertised everywhere.
External correction is probably a pipe dream, since there is no will even to Tax Sugar-containing Beverages, the “low hanging fruit” of dietary excess. Internal correction is all that is left, and that takes WILL POWER, also in short supply.
INFECTIOUS DISEASES are a subset of inflammatory conditions. COVID 19 is the poster child of infection, and FATIGUE is one of the hallmarks of the disease. Interleukins, like TNF-alpha, IL-1, andIL-6 are some of the defense factors which cause the fatigue. AUTOIMMUNE Diseases like Rheumatoid Arthritis and Lupus are also associated with fatigue-producing interleukins.
Fatigue even has its own flagship disease, CHRONIC FATIGUE SYNDROME. Chronic viral disease has been suspected as the cause of this condition, and inflammatory cytokines may be elevated. This condition, and the similar GULF WAR SYNDROME are still poorly understood. Several CFS patients were sent to me when I was in practice, and I had some success in getting them to exercise regularly, which seemed to help. CANCER is another category of diseases where Fatigue is prominent.
Inflammation plays a role in these diseases, which also drain energy substrates from the Patients body; Cancer cells have a high metabolic requirement. MEDICATIONS, Cancer meds especially, but a variety of other Drugs are associated with FATIGUE. I went through MY MEDICATION LIST. Lo and behold, 3 of them are associated with fatigue.
Finasteride is a relic of my prostate operation, recommended to keep it from growing back. It causes fatigue, probably because of its ANTITESTOSTERONE effect. At least I can still pee, and am not bald. I take METFORMIN because of its fame in prolonging life. Its mechanism is that of interacting with the Sirtuin system, and increasing the inefficiency of mitochondria. Isn’t this surprising?
Like many other things in physiology, you place a stress on the body, and the body responds by improving its performance. If you are fatigued, you exercise. Respecting the body works with drugs as well. If you are drinking a ton of coffee and stop it, after a few weeks you will feel less fatigued.
And when you ARE FATIGUED, you drink a LITTLE coffee, and it wakes you right up. Caffeine works by displacing ADENOSINE, which causes Fatigue as it increases through the morning, peaking at SIESTA (or tea) time,at about 2 PM. OMEPRAZOLE, which I take to prevent HEARTBURN, also is related to fatigue especially if it blocks MAGNESIUM for long enough. DEPRESSION overlaps with fatigue, as does SLEEPINESS, to increase the complexity of the situation.
Many chronic LUNG, KIDNEY and LIVER diseases are associated with fatigue as a secondary concern. STAY HEALTHY!
Our Nervous system is much more than consciousness and free will. Our neural networks automatically go about the job of keeping us alive without entering our awareness- unless it fails to perform.
This is true of our intestinal system, and especially our cardiovascular system. We would not have time for anything else if we had to consciously take each breath, command each heart beat, and for this discussion, open up (dilate) the blood vessels to our brain, and constrict the blood vessels in our legs whenever we stand up.
Our brains demand a constant supply of Oxygen and Glucose in order to perform their complex duties. Between 20% and 40% of the 100 Watts of energy our bodies consume is in our brains.
Whenever we stand up, the force of gravity “wants” to force our blood to our legs and away from our head. Unless that tendency is counteracted, our brains would be deprived of essential factors, and we would all have orthostatic (upright position) hypotension every time we stand up.
Normally, when the blood pressure drops from ANY CAUSE, receptors near the base of the heart and great vessels signal the sympathetic branch of the autonomic nervous system to cause a speeding up of the heart and a dilation of the blood vessels in the brain. This compensates for the drop in blood pressure, which is determined by the blood flow and resistance to that flow.
The sympathetic nervous system is a reaction to STRESS, to a “flight or fight” decision. In the short term, it is beneficial, or adaptive. You may know the feeling, heart racing, cold hands (due to constriction of blood vessels), breathing rate increases, and sweating.
The asthmatic feels this from a shot of adrenalin, which delivers the sympathetic reaction to the whole body through the blood stream. The musculature of the bronchial tubes are relaxed, improving breathing, and improving the asthma.
What is adaptive in the short haul may be deleterious if it continues, felt as Anxiety if it lasts too long.
ORTHOSTATIC (postural) HYPOTENSION may be made worse by a variety of other influences, such as an abnormally slow heart, rate, dehydration, blood loss, certain medications and standing still too long.
Since the brain needs both Oxygen and Glucose, High altitude or a
low blood sugar will also facilitate faintness. If you have a tendency toward lightheadedness when you stand up, be careful lest you fall and injure yourself.
If you are unable to cope with these spells, a checkup with your Doctor may be in order; perhaps you have an underlying problem, such as with your heart, which is the next subject of discussion.