In today’s fast-paced world, many individuals find themselves grappling with a condition that transcends ordinary tiredness. Chronic fatigue, a perplexing and persistent ailment, that has become a silent epidemic affecting people of all walks of life. Lauren Windas, Nutritional Therapist and author of “Chronic Fatigue Syndrome – Your route to recovery“, helps demystify chronic fatigue to better understand it.
What is chronic fatigue syndrome (CFS)?
Chronic fatigue syndrome (CFS) is a complex, chronic illness that significantly impacts the lives of those who experience it. It affects multiple body systems, including the nervous, neuroendocrine, immune and digestive systems, with evidence that there is a dysregulation between them, helping to explain the complex picture of symptoms seen in the illness.
The symptoms of CFS include:
- Post-exertional malaise (also referred to as PEM – this is the hallmark symptom that medical experts look for when diagnosing the condition, which is the feeling of fatigue or other CFS symptoms worsening following any form of exercise, activity or exertion)
- Cognitive impairment, including brain fog, memory problems and lapses in concentration
- Painful muscles and joints (myalgia)
- Gastrointestinal symptoms, such as those common in IBS (bloating, indigestion, constipation, diarrhoea)
- Food and alcohol intolerance
- Increased sensitivity to chemicals, smells, temperatures, sounds or light
- Heart palpitations
- Vertigo or dizziness
- Repeated flu-like symptoms
- Orthostatic intolerance (where symptoms worsen upon standing)
CFS has also had other names attributed to it, including Myalgic Encephalomyelitis (M.E), post-viral fatigue syndrome, whilst also being colloquially referred to as “Yuppie flu” back in the 1980s. Recently, the term Long COVID has entered this arena since the worldwide pandemic in 2020, after the medical system saw huge surges of chronically unwell patients reporting symptoms following an (often mild) SARS-CoV-2 infection, experiencing the classic symptoms common to CFS. Experts are still working to understand whether Long COVID is a separate condition to CFS, but there is no denying that there is a huge overlap.
How does chronic fatigue syndrome differ from general fatigue?
Unlike generalised fatigue, chronic fatigue syndrome is a medical condition which involves severe fatigue as well as a vast array of other symptoms in addition to the fatigue. CFS is a diagnosis of exclusion which occurs once all other potential causes of your fatigue have been ruled out and if you fulfil a symptom criteria list (Note: diagnostic criteria lists can vary across the world). There is currently no medical test for CFS.
Generalised fatigue is the symptom of extreme tiredness which can have various causes, for example:
- High levels of stress
- A severe lack of sleep or insomnia
In addition to generalised fatigue, terms such as burnout have been rife in this arena as well. Burnout can be classified as a form of fatigue and exhaustion that results from severe stress and high ideals, induced by a professional setting. Burnout is therefore singularised by its job-related character and therefore major health organisations suggest that it is an occupational phenomenon and not a bona fide medical condition, even though it shares many similarities to conditions such as CFS.
What causes chronic fatigue syndrome?
Currently, we do not know precisely what causes CFS. However, emerging evidence is starting to provide some fascinating insights about the factors at play in this condition.
CFS has a three-pronged structure, broken down into three Ps:
- Predisposition – Genetic factors
- Precipitating trigger(s) – Infectious illness, traumatic event, or stressful life events
- Perpetuating factor(s) – Such as dysregulation of physiological systems or chronic stressors (deficiencies and/or toxicities)
Speaking more generally, what contributes to feeling fatigued and lacklustre?
On a more general level, fatigue can caused by various different factors:
- Nutritional deficiencies: e.g. iron, B vitamins (such as B12 or folate), or magnesium
- A lack of rest
- Stress (whether this is physical, emotional or environmental)
What are your top tips to achieving a healthy night’s sleep to help with fatigue?
Here are some tips if you want to achieve a healthy night’s sleep to support your energy levels:
- Create a sleep-supportive environment: keep your bedroom cool (around 18 ̊C) and ensure that your room is free from harsh bright lights and loud noises. If it helps, invest in some blackout curtains, an eye mask or ear plugs to get the most out of your slumber and also ensure that your mattress and pillow are comfortable and will support your sleep-position preference.
- Unplug: we have analogue bodies trying to live a digital life, so to enjoy a good night’s sleep stay clear of technology at least one hour before hitting the pillow. Technology can act as a stimulant (the blue light that is emitted from these devices can inhibit the release of melatonin interfering with sleep onset). Switch your devices to ‘night-shift’ mode or wear some blue-light-blocking glasses to avoid exposure.
- Avoid nicotine and alcohol: these substances can impact the quality of your sleep, meaning we spend less time in deep sleep and as a result feel more tired the next day. Alcohol, for example, can disrupt the stage of sleep most associated with repairing damaged cells, restoring brain function and renewing energy within the body.
- Avoid heavy exercise before bed: strenuous exercise up to three hours before bed can spike cortisol levels (which should be at their lowest at night), making it hard to fall asleep. Yoga and Pilates are more restorative options to try instead.
- Keep a routine: try to go to bed when you are sleepy and wake up at the same time every day. This is because your body like routine and responds well to habit.
How can people improve their energy and enhance their longevity?
Some of the key ways I work with fatigue clients in my clinic is through an eclectic mix of lifestyle principles that build energy and longevity. These include:
- Pacing (which is all about finding the balance between activity and rest and finding solutions to ration daily activities in order for energy levels to recoup over time. Once activity levels have been rationed for a period and health has improved, it is then possible to gently and slowly ‘grade’ up activity levels by listening to the body to see what levels it can handle, without CFS symptoms being triggered.
- Supporting gut health through a diverse and colourful diet, rich in phytonutrients and fibre to feed the gut microbiome and lower inflammation within the body. This involves removing ultra-processed foods (UPFs), alcohol and sugar whilst focussing on whole foods and protein-rich meals that are abundant with plant fibres.
- Nervous system restoration (this involves working on relaxation and mindfulness principles in order to get the body into a healing state where restoration and homeostasis can occur)
What’s a delicious fatigue-friendly recipe?
My beetroot and chickpea tabbouleh is a superb fatigue-friendly dish which is delicious, easy to make and can be made in batches, which is great when energy is poor!
Beetroot and quinoa are excellent sources of betaine (an amino acid that can support liver detoxification and the methylation cycle), while chickpeas can also support energy as they are rich in folate (vitamin B9), as well as plant proteins, keeping blood sugar and energy levels stable throughout the day.
Total time: 20 minutes
1 x 400g tin chickpeas, drained
200g radishes, grated
2 beetroots, grated
1 apple, cored and grated
25g flat-leaf parsley, chopped
25g mint, chopped
Juice of 2 lemons
2 tbsp olive oil
Generous pinch of salt and pepper
- Add the quinoa to a saucepan with some hot water. Bring to the boil, then simmer for 10–15 minutes, until cooked through and soft. Drain and allow to cool in a sieve.
- Meanwhile, combine the chickpeas, radishes, beetroots, apple, parsley and mint in a large mixing bowl and stir. Mix in the lemon juice and olive oil, along with the salt and pepper, and stir again.
- Once the quinoa has cooled, stir into the tabbouleh and serve.
Lauren Windas knows the feeling of being a medical enigma all too well after becoming unwell with CFS whilst at university. Ever since, she has devoted herself to reclaiming her health and now lives a full life, having gained expertise in this area after recovering from this mysterious, debilitating illness.
Now a nutritionist and naturopath, Lauren works in her clinic to help others with CFS, inspiring hope and providing solutions to lift the fog and light the way. This is the book that Lauren wishes she had at her fingertips during her own health journey.