07 Apr Why Am I Tired All The Time? The Role of Inflammation, Part 1
While there are many causes of tiredness, fatigue remedies that combat inflammation are key.
As a doctor, I hear this question a lot. When a patient asks me, “Why am I tired all the time?” I think of inflammation. It may surprise you, as it does many of my patients, that you could have a problem with inflammation and not even know it, and that it could be the cause of your excessive tiredness. Fatigue remedies and a healthy diet that address inflammation are key to getting your energy back.
This type of inflammation is often described as “silent,” “low-grade,” “chronic,” and “systemic” because it is relatively mild and is present throughout the entire body for long stretches of time. Compare this to the kind of acute inflammation you would notice with, say, a severely sprained ankle, which is characterized by heat, redness, and swelling in the localized area around the ankle.
Medical researchers have known for some time now that low-level inflammation over time is deleterious and is connected to diabetes, increased risk of cardiovascular disease, cancer and other chronic illnesses. Newer evidence also links chronic inflammation to chronic fatigue syndrome, depression, and general fatigue. In fact, there has been an explosion in recent knowledge of the pathways and mechanisms by which inflammation can influence your body, brain, and even your behavior, leading to fatigue.
Numerous studies show that chronically fatigued individuals have significantly higher blood markers of inflammation, such as the protein known as C-reactive protein (CRP) and other pro-inflammatory compounds known as cytokines. In addition to general fatigue, higher levels of CRP and certain pro-inflammatory cytokines are associated with other symptoms linked with excessive tiredness, such as fatigue following physical exertion, as well as poorer physical performance and poorer self-rated health.
Compared to people who feel well, blood levels of CRP are higher both in those who meet the strict definition of chronic fatigue syndrome (CFS) and in those with chronic fatigue who do not meet the diagnostic criteria for CFS. In a sample of 70-year old women, CRP levels were 40% higher in those with fatigue compared to those without fatigue. Many other fatigue-related conditions, such as depression, type 2 diabetes, being a breast cancer survivor, and routinely getting inadequate (less than six hours) sleep, are also associated with higher CRP levels.
One interesting recent study showed one way in which inflammation likely interacts with the brain and the nervous system in causing fatigue. Researchers think inflammation may be the cause of the decreased activation of the brain’s reward center, known as the basal ganglia, seen in patients with CFS. In studying a group of CFS patients, they have found that the lower the basal ganglia’s activation, the higher the level of fatigue. The basal ganglia at the base of the brain help control motion and motivation and are vulnerable to the effects of pro-inflammatory compounds made by the body known as cytokines.
In addition to affecting the brain and nervous system, inflammation promotes fatigue through many biological pathways involving the immune system, mitochondria, oxidative stress, and the stress-response system known as the HPA axis (hypothalamus-pituitary-adrenal axis). Each of these systems has been implicated in chronic inflammation and the symptom of excessive tiredness.
So, in answer to your question, “Why am I tired all the time?” do not overlook inflammation as a primary underlying cause. The good news is that chronic inflammation is not only easy to test for, it is most effectively treated using natural and lifestyle therapies involving nutrition, stress reduction techniques, exercise, lifestyle changes, and supplements. No drugs or surgeries are typically needed. If you In part 2 of this article, I will explore some of the causes of chronic inflammation as well as some of these natural fatigue-beating, anti-inflammatory therapies in greater detail.
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