What are Root Causes for Chronic Fatigue?

What are the Root Causes of Chronic Fatigue?

Are you plagued by daily exhaustion? Is it difficult for you to do daily tasks? Are there days where it takes all of your energy to get out of bed? While it is normal to experience fatigue from acute stress, exercise, injuries, and viruses, it is not normal to experience fatigue everyday. If you struggle with chronic fatigue, the quality of your life may suffer as you may feel unable to do simple and mundane tasks.

To begin, what is chronic fatigue? This phenomenon occurs when our bodies' mitochondria are dysfunctional. The mitochondria are intracellular powerhouses that are within every cell of the human body that converts nutrients into available energy for our bodies to use. Every root cause of chronic fatigue affects the mitochondria, hence creating a generalized symptom of fatigue. If the mitochondria is unable to properly function, sustainable energy will not be made for our bodies to utilize.

Click here to read our article on mitochondrial health!

How Does Mitochondria Work?

Mitochondria converts glucose (sugar) and other nutrients from food and binds to them to oxygen to produce adenosine triphosphate (ATP), the energy currency of our cells. Essentially, fatigue is signaling that the mitochondria are asking for help.

If our cells are not producing enough ATP our bodies will encounter symptoms of chronic fatigue.

What Causes Mitochondrial Dysfunction and Chronic Fatigue?

1) Nutritional Deficiencies: Vitamins and minerals are essential to a variety of metabolic pathways that support fundamental cellular functions. Their involvement in metabolism, DNA synthesis, oxygen transportation, cognitive functions, and energy conversion are particularly important in the context of physical and mental fatigue. The most common nutritional deficiencies associated with chronic fatigue include: B vitamins, vitamin D, iron, magnesium, zinc, and glutathione.

Nutritional deficiencies happen three different ways:

Diet: A diet with inadequate vitamins and minerals may cause chronic fatigue. In humans, dietary macronutrients provide the fuel needed to maintain the biochemical and structural integrity of the body, to perform physical activity and to enable new tissue growth. If an individual has an unbalanced diet, this may lead to nutritional deficiencies.

Infections: Parasitic infections may rob the body of nutrients as these invaders take the nutrients for themselves. A 2004 review states that “parasitic infections are thought to contribute to malnutrition and micronutrient deficiency through subtle reduction in digestion and absorption, chronic inflammation and loss of nutrients.” It also states that “the most important parasites related to nutritional status are intestinal parasites especially soil transmitted helminths, Giardia duodenalis, Entamoeba histolytica, followed by other parasites such as the coccidia, Schistosoma sp. and malarial parasites.”

For example, a roundworm infection is known to create vitamin A deficiencies and iron-deficiency anemia.

The intestinal barrier may be altered by “pathogens, as well as usage of antibiotics, might disturb the intestinal mucus layer, either by enhancing mucus degradation, or by inhibiting the normal commensal triggers for mucus production.” This directly causes nutritional deficiencies and an inflamed gastrointestinal tract. Additionally, a 2018 study states that the “gut parasite-microbiota interactions may also play a role in the complex etiology of human malnutrition. Gut helminths, protozoa, and more recently the microbiota have all been implicated as part of the complex web of factors underpinning undernutrition.”

2) Malabsorption: If an individual has a clean and balanced diet but is still experiencing nutritional deficiencies, this may be due to malabsorption. As stated above, parasites contribute to malabsorption; however, there are other factors as well. For example Small Intestinal Bacterial Overgrowth (SIBO) “consumes part of the ingested macro- and micronutrients and may therefore cause malnutrition.”

Additionally, intestinal hyperpermeability (leaky gut) is common amongst those with chronic fatigue. This condition occurs when the tight junctions of the intestinal wall become loose. This allows toxins, bacteria, and other harmful substances able to sneak through the walls and invade the bloodstream and create gastrointestinal and systemic inflammation. Since the intestinal walls are damaged, they become unable to sustainably absorb healthy nutrients.

Malabsorption is also common in those with Celiac Disease. A complete gluten allergy creates inflammation that may cause malabsorption. On the other hand, a gluten intolerance may be caused by intestinal hyperpermeability and glyphosate.

The inability to absorb vitamins and minerals affects energy levels significantly.

3) Parasites: Parasites steal nutrients and heavily disrupt the intestinal microbiome, creating chronic fatigue, brain fog, lethargy, and weakness. Parasites harbor bacteria, viruses, mold, heavy metals, and other harmful substances and microbes that may directly cause chronic fatigue amongst other symptoms.

For example, hookworm is a parasite that can affect energy levels. This can lead to anemia, lack of vitamin/mineral absorption, GI tract issues, and fatigue. Another study states that a “giardia infection may be an important cause of chronic fatigue and myalgic encephalomyelitis (ME) in patients with minor digestive disturbances.”

Oftentimes, parasites can create biofilms. These brick-like, resistant walls protect them from being medically detected, making them able to endure various environmental conditions, such as changes in temperature, lack of water, extreme acids, and killing agents.

Click here to read our article on parasitic infections!

4) Lyme & Lyme Coinfections: Lyme disease is caused by a Borrelia burgdorferi infection that is transferred from various vectors to humans. Due to the countless amount of symptoms that Lyme Disease may present, it is often referred to as “the great imitator” as it displays itself in an array of mysteriously vast and generalized symptoms that can be misunderstood and misdiagnosed. Testing for Lyme Disease as well as its co-infections is infamously known for being inaccurate, so most practitioners rely heavily on diagnosis through a patient’s symptomatology.

Lyme disease rarely travels alone as it is associated with co-infections such as: Bartonella, Babesia, Rickettsia, Ehrlichia, Mycoplasma, etc. The greater the number of bacterial species within a person, the more prolonged or exacerbated a person’s Lyme Disease symptoms may last.

A 2016 study states that many Lyme patients “experience prolonged symptoms during convalescence from systemic infections, including symptoms of fibromyalgia and chronic fatigue.” According to the same study, “the most common complaints among such patients are arthralgias, myalgias, headache, neck and backache, fatigue, irritability, and cognitive dysfunction (particularly perceived difficulty with memory and concentration).”

Click here to read our article on Lyme disease!

Click here to read our article on kids and Lyme disease!

5) Mold & Mycotoxins: There is significant evidence that mold and mycotoxins directly cause chronic fatigue and various other symptoms including brain fog, insomnia, respiratory issues, mental disorders, excessive thirst, HPA axis dysregulation, joint pain, etc.

According to a 2013 study, it is reported that 104 of 112 (93%) patients with chronic fatigue syndrome were positive for at least one mycotoxin. This study states that “exposure histories indicated current and/or past exposure to WDB [water damaged buildings] in over 90% of cases” of chronic fatigue.

The common denominators in these studied patients include, additional symptoms, a water-damaged environment, indoor mold and urine specimens positive for mycotoxins. Ochratoxin A (OTA) was the most common mycotoxin detected in 83% of subjects followed by MT (44%) and Aflatoxin (AT) (13%).

Click here to read our in-depth article on the dangers of mold and mycotoxins!

Along with mold toxicities, an illness called MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staphylococci) is common amongst those infected with mold. MARCoNS is an antibiotic resistant staph infection that resides in the nasal passages that may create additional fatigue. Additionally, symptoms of MARCoNS do not always involve sinus issues. This bacteria may send endotoxins into the bloodstream that increase inflammation and decrease MSH levels in the blood, increase pro-inflammatory cytokines, and lower T-reg cells resulting in chronic fatigue. This infection is able to be resolved with the help of mold avoidance, mold protocols, and/or specialized nasal sprays.

Additionally, a combination of Lyme disease and mold toxicities can create exaggerated symptoms that may create debilitating symptoms. Not only does mold exposure make a person more susceptible to Lyme disease by lowering immune function, it can make chronic Lyme nearly impossible to resolve. Likewise, having chronic Lyme disease can make a person more susceptible to the negative consequences of mold exposure.

Click here to read our article on mold and Lyme disease!

6) Viruses: Viruses may remain dormant in the body for decades without symptoms. However, when these viruses are triggered by stress, infections, or toxicities, they may be triggered to affect the body and cause chronic fatigue. For example, a 2019 review states that viruses that “have been documented to trigger Chronic Fatigue/ME include EBV, enteroviruses, cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), human parvovirus B19, hepatitis C, Chlamydia pneumonia, and Coxiella burnetii.”

Another 2019 study states that chronic fatigue can “be triggered by infection with a variety of microorganisms, including Epstein-Barr virus (EBV).” One way EBV hijacks the body into creating chronic fatigue is through the EB12 gene. According to this study, “EBI2 is a gene which is induced by EBV infection and which has been found to be upregulated in a variety of autoimmune diseases. EBI2 is a critical gene in immunity and central nervous system function; it is a negative regulator of the innate immune response in monocytes.” However, EBV can be successfully put into remission if treated properly!

Overall, viruses are always present within our bodies and are typically asymptomatic until triggered by coexisting infections, toxicities, and chronic stress.

7) Gastrointestinal Infections / Imbalanced Gut Microbiota: Gastrointestinal infections may cause chronic fatigue due to the oxidative stress and inflammation. Like parasites, they thrive by stealing nutrients and by interrupting metabolic pathways. For example, a candida infection is a common contributor to chronic fatigue.

An imbalanced gut microbiota is also common amongst those dealing with chronic fatigue. A 2010 study states that it is “documented that there are marked alterations in the gut microbiota of chronic fatigue syndrome (CFS) patients, with lower levels of Bifidobacteria and higher levels of aerobic bacteria.” This study also found that harmful bacteria such as “Enterococcus and Streptococcus species were strongly over-represented in chronic fatigue syndrome patients… Prevotella was the most commonly overgrown bacteria. Moreover, it was shown that the higher the aerobic enterococcal count, the more severe the neurological and cognitive deficits including nervousness, memory loss, forgetfulness and confusion.”

Gastrointestinal infections and a disturbed gut microbiota may cause intestinal mucosal barrier dysfunction. This directly causes alterations in gut motility, abnormal secretion, and changes in visceral sensation that could contribute to chronic fatigue.

8) Heavy Metal Toxicities: There are a number of toxicities in food, water, and hygienic products that negatively impact health. Heavy metals specifically cause fatigue amongst other symptoms such as: mental disorders, joint pain, swollen lymph nodes, cancer, ADHD, etc. The five main heavy metals that wreak havoc on the body are arsenic, cadmium, lead, mercury, and aluminum. These metals can be toxic to organ systems, mitochondria, and the brain as they cause systemic inflammation.

A heavy metal toxicity is often associated with parasitic infections as heavy metals suppress the immune system.

According to a 2012 study, “clinical manifestations of chronic exposure to organic mercury usually have a gradual onset. As the primary target is the nervous system, chronic mercury exposure can cause symptoms such as fatigue, weakness, headache, and poor recall and concentration. In severe cases chronic exposure leads to intellectual deterioration and neurologic abnormality.” Later the study mentions that the subject's “toxic chronic fatigue symptoms improved after he was given mercury removal therapy.”

Another 2012 study states that “exposure to heavy metals, with particular reference to mercury and gold in dental amalgams, has been considered among the triggers of ME/CFS.”

Click here to read our article on toxicities in food and hygienic products!

8) Breast Implant Illness: Breast Implant Illness (BII) is a term used to describe symptoms associated with breast implants. These symptoms include: fibromyalgia, chronic fatigue, joint pain, anxiety, skin rashes, and brain fog.

A 2019 study states that “silicone breast implants (SBI) may induce systemic autoimmune disease as part of autoimmune syndrome induced by adjuvants (ASIA). This syndrome bears similarities to fibromyalgia and chronic fatigue syndrome (CFS).”

Healing from BII includes removing the implants and detoxifying the residual substances and reversing the damage.

9) Infected Root Canals: Root canals can be a gateway for chronic illnesses. Root canals have two layers - the hard enamel that covers the outside of the tooth and the dentin. The dentin is inside of the tooth and although it looks solid, it actually contains microscopic tunnels where fluid flows.

It is impossible to completely disinfect these tubes daily. Since this area is dark, hard to access, and low in oxygen, it makes for a perfect environment for pathogens to thrive. The infection may actually continue to proliferate after a root canal procedure.

Toxins in the tooth are free to travel throughout the body as the mouth is directly connected to the immune system and nervous system. The metabolic waste generated by the pathogens and toxins within the tooth also directly damages the mitochondria as they create sulfur compounds such as mercaptans and thioethers to be expelled and circulated throughout the body. These may cause systemic inflammation and generate fatigue.

10) Blocked Drainage Pathways: Drainage pathways are our bodies built in detoxification systems that remove unwanted debris, pathogens, and toxins. These pathways include the colon, kidneys, liver, lymphatic system, and cells. If any of these systems are blocked, the body will have difficulty detoxing. This may cause fatigue as the body is not able to detoxify toxins as quickly as they are coming in.

For example, a sluggish lymphatic system may cause swollen lymph nodes, edema, and inflammation that coincides with fatigue as the body is struggling to drain toxins.

If a person attempts to detox prior to “pre-tox” by opening drainage pathways, they may experience herxheimer reactions, a mild to severe flu-like reaction to detoxing.

Click here to read our article on drainage pathways!

11) Vagus Nerve Dysfunction: The vagus nerve carries signals from the brain to the rest of the body as it is the “mother” nerve of the nervous system. It influences a variety of functions including digestion, heart rate, and the “fight-or-flight” response. It also controls the parasympathetic nervous system, the system responsible for calmness and relaxation.

If the vagus nerve and parasympathetic nervous system are not properly functioning whether this is due to chronic stress, food allergies, infections, toxicities, or physical/emotional trauma, it may cause fatigue, digestive disturbances, and increased anxiety.

For example, a 2012 study states that there is an “association between reduced cardiac vagal tone and cognitive impairment in CFS and confirms previous reports of diminished vagal activity.” Low vagal activity means that the vagus nerve is not optimally functioning and this results in feeling of being “wired and tired,” fatigue, and extreme anxiety.

Click here to read our article on how to stimulate the vagus nerve!

12) Unprocessed Emotional Trauma: Unhealed emotional trauma may make a person consistently be in the “fight-or-flight” mode which hinders the health of the autonomic nervous system.

The common notion that "too much stress makes you sick" is much more relevant than once thought. Because trauma is cellular and is held within the body, the molecular consequences of stress can transform into long-term disabilities like chronic illnesses, anxiety/depression, and post-traumatic stress disorder (PTSD). Historically, humans are known to suppress emotions, attempt to move on from traumatic memories, and maintain a fast-paced lifestyle after traumatic experiences. However, without properly processing these experiences, untreated trauma can have a large impact on the future of a person’s health and create fatigue along with a dysfunctional vagus nerve.

13) Physical Trauma / Injury: Physical trauma and injuries may cause fatigue as the body is in a state of inflammation. For example, concussions cause fatigue as specific areas of the brain may be damaged or inflamed. More severely, a 2006 study states that “fatigue is frequent and disabling in patients with traumatic brain injury (TBI).”

Working with practitioners that specialize in physical trauma such as physical therapists, chiropractors, acupuncturists, orthopedic doctors, etc. may be needed to address injuries.

In order to heal from chronic fatigue, it is important to uncover the root causes that are affecting your body.

If you believe you are dealing with fatigue and/or chronic illness, please contact a functional provider. Dr. Jaban Moore, a functional medicine provider, can help you if you are experiencing chronic symptoms.

Please reach out if you are interested in taking your health back! You can give our office a call at (816) 889-9801.

References:

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https://www.sciencedirect.com/science/article/abs/pii/S0165032705003125