Fatigue

Fatigue

How to Restore Your Energy

You're up at the crack of dawn. You make breakfast. Get the kids off to school. Sprint to work, where you run around like a madwoman for nine or ten hours. Zoom home to rustle up dinner for the starving masses. Do the dishes. Help the kids with their homework. Throw a load of laundry in the washing machine. And somewhere around midnight, when you just can't move anymore, you limp down the hallway and collapse on the bed until the alarm clock rings and the fun starts all over again.

Is it any wonder that your get-up-and-go has gotten up and gone?

Fatigue is one of the top ten complaints doctors get from women. And why not? We cram a lot of living into every 24 hours. And that can leave our batteries drained.

Usually, it's something we can handle, and we have no problem bouncing back. But other times, an overwhelming sense of fatigue can sneak up on us and take us by surprise. We feel weak. Our bodies ache. Our faces droop. Our spirits sag. And before we know it, we've been transformed from active, vibrant lovers of life into washed-up, worn-out zombies who feel 100 years old.

"Fatigue's greatest impact is on human function and activity," says Lt. Col. Kurt Kroenke, M.D., associate professor of medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and an expert on fatigue. "When you don't have the strength or energy to move, even simple tasks become difficult. You become sedentary, your productivity drops, your motivation suffers. For some, this persistent weariness can be so debilitating that they can't even get out of bed."

Fatigue can take a toll on your mind as well, experts agree. Thinking becomes difficult and confused. Decisions come slowly. Even your outlook on life turns gloomy.

The result is that fatigue can lead to poor work performance, less interaction with friends and family and less participation in the sports and activities you enjoy.

That's bad news if you're used to being an active woman. But the good news is that with a little detective work, you can almost always get to the source of the problem and reclaim your energy and vitality.

What's Running You Down?

It's easy to shrug off a case of lethargy as just another sign that you're getting older or that you're coming down with something.

But for most of us, it's neither. "Most fatigue is not due to aging or to a serious medical problem," says Dr. Kroenke. "More often it's a signal that the body is getting too much or too little of something, and that's making you feel run down."

Most fatigue is caused by too much work, too much stress, too much weight, too much junk food and not enough exercise, doctors say.

"Most of us live and work in rapid, pressure-filled environments," explains Ralph LaForge, an exercise physiologist and instructor of health promotion and exercise science at the University of California, San Diego. "Much of the fatigue people experience is really due to the inability to pace themselves, to effectively stagger their workloads or to bring a sense of order to the chaos around them."

Just dealing with the pressures of everyday life takes a lot of energy, says Thomas Miller, Ph.D., professor of psychiatry at the University of Kentucky College of Medicine in Lexington. "One of the first things we look at whenever a patient complains of fatigue is stress. Whenever anyone has a hard time coping--with family problems, relationships, job pressure--there's usually a tremendous burnout factor, physically as well as emotionally."

Fatigue also is often a signal that you're not eating right, says Peter Miller, Ph.D., executive director of the Hilton Head Health Institute, a clinic in Hilton Head, South Carolina, that develops personal health programs. "The eating habits we established when we were younger are not suited for our middle years."

"Think of the body as a car and food as the fuel," says Dr. Peter Miller. "When you're young, you can put almost any kind of gasoline in your tank. But as you get older, the body has a harder time running on that low-octane stuff. So you need to fill up with high-test fuel and in the proper amounts."

If you're an overeater, for example, you're going to be storing more fuel than you need in the form of fat. And lugging around that excess body weight can make anyone feel sluggish. At the other extreme, undereating can also cause fatigue by depriving you of sufficient calories to propel your body through the day. That's why many women who go on "crash" or very low calorie diets often find their energy levels crashing: They're like cars running on empty.

Your activity level also has a direct effect on whether you feel fatigued, says LaForge. Lack of exercise can easily create a pattern of inactivity that is difficult to break. "A body at rest tends to remain at rest," says LaForge. "Generally, the more active and fit you are, the more stamina and energy you'll have on a day-to-day basis. Letter carriers, for example, are always on their feet. Yet they complain of fatigue much less than office workers."

On the other hand, too much exercise can have a negative effect. "Overexertion can send your energy level crashing," says LaForge. That's because when we exercise, the body produces lactic acid, a substance that accumulates in our muscles, producing weakness and body aches. This accumulation usually doesn't pose a problem when we avoid working ourselves to exhaustion and we follow our workouts with proper rest, because then our bodies are able to get rid of the lactic acid.

But when we push our bodies during workouts and don't allow our muscles time to recover, lactic acid accumulates faster than we can get rid of it. And this can leave us feeling fatigued all the time.

Other factors that can make us feel tired all the time? Smoking, so-called recreational drugs, alcohol and inconsistent eating and sleeping patterns put enormous strain on the mind and body. Sometimes, experts agree, fatigue is simply your body's cry that your lifestyle is not one that supports a healthy body.

But fatigue is also something that goes with the territory of being a woman. Both pregnancy and the post-delivery period can be the most exhaustive times of any woman's life. The physical and emotional stress of pregnancy and childbirth--plus the associated weight gain, morning sickness and breastfeeding--devour enormous sums of energy. So do the mood swings, headaches, diarrhea and hot flashes that some women experience with the hormonal changes of menstruation, premenstrual syndrome or menopause.

Get Back Your Vim and Vigor

Fatigue is a symptom of everything from the common cold to cancer. It's a symptom of hepatitis, diabetes, heart disease, tuberculosis, thyroid problems, Hodgkin's disease, multiple sclerosis, anemia, AIDS, anxiety and depression. And it's also a side effect of some of the medications used to treat these conditions.

But fatigue is rarely anything to worry about unless it's accompanied by other symptoms such as pain, swelling or fever or it lasts longer than a week. If your fatigue has lasted that long or you have other symptoms, see your doctor.

Otherwise, here are some tips to re-energize your life.

Pace yourself. "Fatigue is the price we pay for pushing ourselves beyond the point where our minds and bodies say no," says Dr. Kroenke. So think about where you might be pushing yourself past your natural limits. Cut back on some of your activities. Don't work or exercise as hard, as fast or as long as you have been. Take frequent breaks. And make sure you get a good night's sleep every night--meaning you sleep well enough and long enough to wake up refreshed.

Focus your energy. Agonizing over situations beyond your control only eats up personal energy, says Dr. Thomas Miller. Learn to let go of things you cannot change and focus your energies on those that you can.

Clear the clutter. Does a list of tasks leave you feeling zapped before you even begin? Clear the clutter out of your life bit by bit, says LaForge. Start your day with a list of four or five tasks you can definitely accomplish and work on them alone. The next day, try four or five more. What at first seemed like a mountain you couldn't climb then becomes a series of small hills you step over with ease.

Play. All work and no play puts more stress on the mind and body than they can handle, says Dr. Thomas Miller. Mixing your daily schedule with a combination of social experiences and enjoyable activities provides a needed break in the action and relieves those stresses before they can drain your energy systems.

Hit the road. According to a study by Robert Thayer, Ph.D., professor of psychology at California State University, Long Beach, a brisk ten-minute walk causes a shift in mood that quickly raises energy levels and keeps them high for up to two hours.

And an after-meal stroll can counteract the energy drop you experience after eating a big meal, adds Dr. Peter Miller. Digesting large meals increases blood and oxygen flow to the stomach and intestines, and this draws energy away from muscles and the brain. But a walk will keep blood and oxygen circulating evenly throughout the body.

Balance your diet. A junk food diet high in sugar, fat and processed foods gives your body few or none of the basic vitamins, minerals and nutrients it needs to perform at normal levels. And sometimes just the slightest deficiency of any one nutrient is all it takes to send energy levels plummeting.

The answer, says Dr. Peter Miller, is to find a balance in both the amount and the types of food that you eat. "It's important to hit all the major food groups--fruits, vegetables, grains and cereals, dairy, nuts and meats--every day to guarantee that you're giving your body the right combination of fuel and basic nutrients to keep on running at peak levels," says Dr. Miller.

Ideally, every day you should be getting 60 percent (or more) of your calories from carbohydrate-rich foods such as pasta, bread, potatoes and beans, 25 percent (or less) of your calories from the fat found in foods such as canola oil, olive oil and peanut butter and 15 percent of your calories from protein-rich foods such as chicken and fish.

Focus on the carbs. Of the three energy-supplying nutrients--carbohydrates, fat and protein--carbohydrates pack the most fatigue-fighting punch. "Carbohydrates provide an efficient, long-lasting energy source," says Dr. Peter Miller. To produce an abundant reservoir of carbohydrate energy, add some of these foods to your plate whenever you sit down for a meal.

Eat more frequently. Skipping meals can leave your fuel reserves dangerously low, and digesting big meals can be an enormous energy drain. Unfortunately, the traditional three meals per day may contribute to the problem.

"Your body needs fuel in moderate doses throughout the day to keep performing at optimal levels," says Dr. Peter Miller. He recommends eating four or five small meals each day. "Reducing the amount of food you eat at any one time and spreading your calorie consumption more evenly over the day make more energy available to your body throughout the day," he says.

Snack wisely. When your stomach's growling and your energy's waning, the best pick-me-ups are of the natural variety, says Dr. Peter Miller. Fruits, raw vegetables, nuts and unbuttered popcorn--all which are low in energy-draining fat--are some excellent energizers.

Avoid a quick fix. Sugar-loaded foods such as candy and soda may zip up your energy level for a while, but they also cause blood sugar levels to increase and then sharply drop. Unfortunately, the result is that your energy level will dip even lower than it was before, says Dr. Peter Miller.

Drink coffee. Studies at the Massachusetts Institute of Technology have discovered that the caffeine in a single cup of coffee can boost your energy level for up to six hours, researchers report. But don't overdo it.

Stay wet. Feeling run-down is often the first sign of dehydration, says Dr. Peter Miller. Drinking at least six glasses of water every day--more if you're active or trying to lose weight--will prevent this type of fatigue.

Avoid booze and pills. Regular use of alcohol, sleeping pills and tranquilizers will make anybody act like a zombie, says Dr. Kroenke. And believe it or not, stimulants and pep pills can take you from way, way up to way, way down after their immediate effects have worn off.

Check your medicine cabinet. Antihistamines and alcohol, both which are found in a wide variety of over-the-counter and prescription cold medications, can make you feel groggy, says Dr. Kroenke. Ask your doctor or pharmacist if she can recommend a non-fatiguing alternative.

Explore alternative approaches. Many people fight fatigue by going beyond the traditional limits of Western science, says LaForge. Meditation, yoga and massage are just a few of the nontraditional options that practitioners say will energize, refresh and revive both body and mind.

Studies at Harvard Medical School show that taking a deep breath, exhaling, then sitting quietly for 20 minutes as you focus on a word that reflects your personal faith--God, Allah, Krishna or shalom, for example--will relax and re-energize both mind and body.

Check the Yellow Pages of your local telephone book for organizations that teach these techniques. In many cases, you'll also find them at your local YMCA.

Ask your doctor about supplements. In addition to a balanced diet, a multivitamin/mineral supplement should ensure that you're getting all the vitamins and minerals that you need, says Dr. Kroenke. Talk to your doctor about which one is right for you.