In her famous “I Love Lucy” Vitameatavegamin routine, Lucy asked: Do you poop out at parties? (Well, who doesn’t from time to time?) Feeling tired because you’re sick is one thing. But when medical maladies have been ruled out, then what? It’s possible—just possible—that you can win the war on fatigue by following a few simple steps. Here are 12 suggestions.
1. Get your zzzzzzzzzz’s.
Seems obvious, doesn’t it? But most people don’t give enough thought to just how important sleep is in the energy sweepstakes, claims Lydia Wytrzes, M.D., a certified sleep specialist and director of Sutter Sleep Center in Sacramento. “When patients complain of fatigue, a tremendously unappreciated aspect of that complaint is inadequate sleep,” says Wytrzes (pronounced WHY’-tress). “Lack of energy is more likely due to a sleeping problem than any other cause.” About a third of all adult Americans routinely complain about sleep, says Wytrzes, and while medical problems are sometimes to blame, lack of sleep often has more to do with living in a society that rewards productivity at all costs. “We are sleeping less and less in this ‘technology on demand’ age of Internet and iPods,” says Wytrzes. “Sleep is greatly undervalued.” Most people need between seven and eight hours of shut-eye to feel rested and refreshed, says Wytrzes, who offers these sleep-savvy tips: Avoid excessive napping during the day; establish regular bed and rise times; get regular exercise; avoid caffeine and alcohol in the evening; and make your bedroom a peaceful oasis for serene slumber.
2. Monitor your magnesium and zinc.
Iron and B vitamins play such leading roles in the energy story that we tend to forget about supporting players such as magnesium and zinc—two minerals many are short on. “These deficiencies tend to happen in people who over a long period of time have rotten diets, or who have been dieting on and off for years,” says Monica Randel, a registered dietitian for Kaiser Permanente in Sacramento. Adults need about 400 mg of magnesium and 15 mg of zinc a day. To make sure you get enough, eat plenty of magnesium-rich foods such as nuts, halibut, soybeans and spinach. Red meat and poultry are especially good sources of zinc, but you also can get your fair share through nuts, beans and fortified cereals.
3. Include protein at every meal.
Otherwise, your energy will take a nose dive about three hours later, according to Randel. “People will eat a banana and call it breakfast,” she says. “But as far as your body is concerned, you skipped a meal because you didn’t have any protein.” For optimum energy, protein should be combined with complex carbohydrates and fat at every meal, Randel says. So smear that banana with peanut butter or slice it on top of cereal with a sprinkling of nuts, and you’re good to go.
4. Clean up the clutter.
Cleaning up your life is the first step toward freeing up your energy, says local life energy coach L. Nichole Carrington, Ph.D. Her tip: Start by identifying five areas to clean up and attack them, one by one. Tackling physical clutter—such as cleaning up your messy car or desk—is an obvious place to start, but we also need to clean up the emotional clutter that takes up space in our psyches, urges Carrington. “Emotional clutter could mean writing a letter to the father you never got to say goodbye to before he died or picking up the phone to clear up an unfinished argument you had with a friend,” she says. Until we deal with such life clutter, she says, it’s going to suck the energy out of us, whether we know it or not.
5. Drink more water.
Many people who complain of fatigue simply need to drink more water, says Kaiser’s Randel. The reason? “Water is hugely important in processing food, so when you’re not drinking enough, your body has to work harder, which causes fatigue,” she explains. So how much is enough? Check out your urine: If it’s clear, you’re drinking too much; dark yellow means you’re not getting enough. Straw-colored or a light-colored yellow is just right.
6. Take a five-minute exercise break—preferably outdoors.
“You’d be amazed at how just five minutes of brisk exercise can re-energize you,” says Maxine Barish-Wreden, M.D., an internist and medical director of Sutter Health’s Integrative Medicine program. Stepping outside to take that walk brings an added benefit: Exposure to sunlight triggers the release of the brain chemical serotonin, a mood- and energy-booster.
7. Go “ahhhh.”
It may sound silly. But simply taking a moment to breathe will revive your energy, says energy coach Carrington, whose Managing Your Energy class is regularly offered through the Learning Exchange. Carrington suggests taking a break at least once an hour, to “put your pen down, put your chair back and take a breath to acknowledge yourself and what you’re doing.” Deep breathing also is a key concept in Traditional Chinese Medicine, whose practitioners believe it increases qi (pronounced CHEE), or vital life energy.
8. Turn your thoughts around.
If you constantly tell yourself you’re tired, you’ll be tired, notes Barish-Wreden. But you can change that tune. All it takes is awareness—and turning your thoughts around. “If you really pay attention to what your mind is doing, you’ll find it’s usually not supportive,” she says. “Our minds are constantly judging, evaluating, criticizing.” But you can choose to overrule those negative thoughts with positive self-talk. “Instead of reminding yourself how tired you are, just tell yourself, ‘At this moment, I’m feeling fatigue, but I’m going to be just fine today,’” suggests Barish-Wreden, who uses this little trick herself.
9. Have a power snack.
More than four hours without eating is too long, making an afternoon snack a must for most, says Michele Canny Gilles, a registered dietitian and the director of nutrition services for Wenmat Sports & Fitness Centers, a group of athletic clubs in the Sacramento region. Fresh fruit and low-fat cheese, yogurt and blueberries or a rice cake with peanut butter are all great choices, says Gilles, because they pair protein with a complex carbohydrate for sustained energy. “Sugary snacks may be tempting,” she says, “but they will bring you up and eventually bring you down.”
10. Just say no.
“Some people never make themselves a priority,” notes Canny Gilles. “They say ‘yes’ to everyone but themselves.” Establishing boundaries and learning to say “no” will preserve and protect your energy as no vitamin pill can. The advice is simple: Don’t overextend.
11. Refresh yourself with a nap.
But do it between 2 and 4 p.m., when energy naturally dips. Otherwise, warns Wytrzes, you’re asking for trouble. “It’s a disaster to nap in the early evening, because it tends to disrupt your nighttime sleep,” she explains. And keep it brief: A 15- to 20-minute nap is equally or more refreshing than a longer nap, she says, “because you don’t wake with that sluggishness.” Wytrzes hastens to add that most adults don’t need to nap if they get enough sleep at night—so make that your first order of business.
12. Feed your spirit.
Spiritual nourishment is as vital to our energy as the nourishment we get from food and water, says Carrington. “When we’re looking for more energy, it usually means we’re not feeding our spirit properly,” she says. Carrington advises starting your day with one to three “foundation actions”—things that fuel your spirit for the day ahead. “It could be reading a scripture, reading a poem, doing some stretches, listening to music, doing some meditation . . . it’s very individual,” says Carrington, whose own foundation actions include saying a little prayer at the beginning of every day. “It’s really simple,” she says. “But it helps me to center and align myself, and it’s like money in the bank: It builds energy.”
When Is Low Energy Serious?
Into every life, some fatigue must fall.
So how do you know when it’s time to see a doctor? First and foremost, says Helen Armstrong, M.D., trust your instincts.
“If you sense that something’s not right, see your doctor,” suggests Armstrong, an internist who commonly hears complaints such as “I’m tired” and “I’m exhausted” among her patients at Kaiser Permanente in Sacramento.
You would be surprised by how many of them don’t realize their chockablock schedules are to blame.
“They’ll tell me, ‘I have two kids, I work all day, I go to school at night,’” shares Armstrong. “People are sometimes so driven to succeed that they don’t stop to see that these are the reasons why they’re feeling worn out.” Major life stresses, such as the loss of a loved one or a job change, also are common reasons for fatigue, she says. “I think sometimes people don’t realize that when they’re going through major stress, they need extra rest.”
But fatigue also can be symptomatic of a long list of physical and psychological disorders, some of them relatively benign (such as allergies) and others potentially life-threatening, such as heart disease or cancer.
The following “red flag” questions may help you determine whether your weariness is serious:
• Have you felt constant fatigue for more than a month?
• Does it get better with exercise, or worsen? (If it worsens with activity, see a doctor.)
• Is it associated with any kind of pain in the body—chest pain, abdominal pain, back pain, joint pain, headache?
• Are you experiencing any unusual bleeding, e.g., rectal bleeding, blood in urine, abnormal periods?
• Are you feeling ill?
• Do you have the sense you need to slow down?
• Have you had to reduce your work schedule or stop participating in your normal social activities?
• Have you gained or lost weight?
• Is there a change in your skin or hair, such as hair loss?
• Do you have any other symptoms, such as fever, headaches or nausea?
• Do you awake during the night with symptoms, such as breathing difficulty or sweating?
• Are you experiencing emotional extremes? (Fatigue is often a symptom of depression.)
The word fatigue may bring to mind the much-talked-about chronic fatigue syndrome, but Armstrong says tiredness usually stems from other causes. “CFS patients are in the minority,” she says. A CFS diagnosis is usually made only after all other possible conditions have been ruled out.
One of the most common disorders underlying fatigue, especially in women, is hypothyroidism (underactive thyroid), though more than half of the estimated 12–18 percent of Americans who have it don’t know it. “If you’re over 35 and haven’t had a thyroid screening, it’s a good idea,” says Deborah Plante, M.D., an endocrinologist with Mercy Medical Group. Another endocrine disorder correlated with low energy is diabetes, which afflicts some 20 million Americans.
Heart disease also can bring on feelings of fatigue, especially in women, notes Maxine Barish-Wreden, M.D., an internist and medical director of Sutter Health’s Integrative Medicine Program. “Men typically get the crushing chest pain, and while most women may have chest pain as well, they are more likely to have atypical symptoms, such as feeling tired by the end of the day or not having enough energy to get work done,” she says. One University of Arkansas study found that 70 percent of women who had heart attacks experienced unusual fatigue for a month or more beforehand.
If heart disease isn’t the issue, says Barish-Wreden, there are plenty of other things to look for. At the top of her list: depression, anxiety, anemia (especially in women), thyroid disorders, arthritis, cancer and kidney or liver problems.
Oh, and let’s not forget sleep problems, which seriously affect some 30 million Americans, according to Lydia Wytrzes, M.D. (She should know: Wytrzes is the director of Sutter Sleep Center in Sacramento.)
“People who are fatigued and are otherwise healthy are more likely to have a sleep problem than any other cause,” according to Wytrzes, who lists insomnia, sleep apnea, restless legs syndrome and just good ol’ lack of sleep as common issues.
Women complain about sleep more during menopause than at any other time in their lives, she notes, and not just because of hormonal changes. “Often, there is the onset of age-related problems, such as chronic medical problems, that affect your sleep,” she says. “Menopause is also a time when life problems tend to accumulate—the empty-nest syndrome, for starters.”
The bottom line: If fatigue is negatively impacting your daily life, says Wytrzes, it’s time to do something about it.
There are many physical and psychological causes of fatigue. Some of the most common are:
• Anemia (including iron-deficiency anemia)
• Sleep disorders such as ongoing insomnia, obstructive sleep apnea or narcolepsy
• Chronic pain
• An allergy that leads to hay fever or asthma
• An underactive thyroid (hypothyroidism)
• Use of alcohol or illegal drugs such as cocaine (especially regular use)
• Depression or grief
Fatigue also can accompany the following illnesses:
• Infection, especially one that takes a long time to recover from or treat, such as bacterial endocarditis (infection of the heart muscle or valves), parasitic infections, AIDS, tuberculosis and mononucleosis
• Congestive heart failure
• Diabetes
• Chronic liver or kidney disease
• Addison’s disease
• Anorexia or other eating disorders
• Arthritis, including juvenile rheumatoid arthritis, which affects children and teens
• Autoimmune diseases, such as lupus
• Malnutrition
• Cancer
Source: MedlinePlus, a service of the U.S. National Library of Medicine and the National Institutes of Health
My Energy Makeover
By Cathy Cassinos-Carr
At 40-something and at least marginally well-educated, I should know better.
And I do.
So there is really no excusing the fact that I had fallen into the bad habit of chugging down coffee and toast and calling it breakfast. Or that my daily exercise had been reduced to a paltry 10 minutes on the stationary bike. Or that I wasn’t taking any vitamins or supplements.
Or that my quality of sleep is, at best, borderline atrocious.
It’s funny—not ha-ha funny, but mildly ironic funny—how easily these unhealthy practices can creep into your life without your even realizing it. Then one day, you notice that your afternoon nap has become not a luxury but a necessity and instead of blaming yourself, you chalk it up to getting old(er).
As one who believes everything happens for a reason—within reason, anyway—I do believe this assignment came into my life as both an intervention and wake-up call.
My editor asked me to try a three-week “energy boosting” plan and report the results. Once I enlisted the help of Michele Canny Gilles—a registered dietitian and director of nutrition services for Wenmat Sports & Fitness Centers—I was off and running.
After reviewing my pre-makeover four-day food, exercise and sleep diary, Canny Gilles devised a plan specifically tailored for me. But many of her mantras are basics for everyone, and are, furthermore, basics for life.
Some of these basics included:
Power up with protein.
This was a biggie for me, especially at breakfast, when my intake of protein was inconsistent at best and often nil. Gilles advised protein and complex carbs at every meal, plus fruit at breakfast and vegetables at lunch and dinner.
Increase fruits and vegetables.
“We will have to work on increasing the fruits and vegetables,” said Gilles, and she wasn’t kidding: My food diary revealed I’d eaten only 5 ½ servings as compared to the 20 recommended servings for a four-day period. (Ouch!) Fruit would be mandatory with breakfast, with another serving later in the day; vegetables, preferably fresh, would be eaten at lunch and dinner daily.
Eat at regular intervals.
“It appears you are a grazer,” Gilles noted. (Guilty as charged: I tend to eat sporadically—a spoonful of tuna salad here, a few peanuts there—throughout the day.) Gilles suggested “fueling” every four hours, including a light afternoon snack, preferably a carb/protein combo such as fruit and yogurt or low-fat cheese and crackers. “Nutritious food is the super-unleaded gasoline that will allow your body to run more efficiently,” she said. “Treat your body like a Porsche, not some beat-up old car.”
Invert the (calorie) pyramid.
Because I usually skimped at breakfast, I often made up for it by pigging out at the end of the day—a big, fat nutritional no-no. Gilles recommended redistributing my calories by beefing up breakfast and lunch and lightening the load at dinner.
Increase exercise.
Although my wrists and fingers get a frantic aerobic workout on the computer keyboard every day, the rest of my body hadn’t been moving much. Gilles suggested I start with 30 to 40 minutes of brisk walking or biking, five days a week. Strength training, she added, “would be great.” But she was realistic. “Whatever exercise you can get is always good,” she said. I can live with that.
Keep emotional energy up with a positive attitude.
“This, I believe, is the hardest change, as we are so influenced by the people who raised us and who we surround ourselves with,” said Gilles. Surrounding yourself with positive people and seeing the cup as half full may sound trite, but Gilles swears by it (and I think she’s got a point).
Aim for eight hours of sleep every night.
Was she kidding? With a demanding bladder that wakes me up at least twice a night, plus a snoring boyfriend, solid shut-eye is a rarity for me. But Gilles had some sensible ideas: Limit liquids in the evening and use earplugs.
Take a daily multivitamin.
Gilles called it a “good form of nutrient insurance.” Because I’m lactose intolerant and eat a limited amount of dairy, Gilles also recommended a calcium supplement (at least 800 mg) with vitamin D. (True confession: My doctor had suggested exactly the same thing. But had I followed doctor’s orders? No.)
So, how did I do during the three weeks? I can’t say I lived up to every single recommendation. Exercise and sleep, in particular, tended to get the shaft, though I managed to increase my walking/biking time from 10 minutes to a whopping 20. It’s a small change. But it’s progress.
Still, I’m proud to report that I followed the food plan nearly to a T, and miraculously enough, it made a real difference. If I had to wager a guess, I’d say it’s the protein in the morning that has benefited me most, as I no longer sit bleary-eyed in front of the computer waiting for the caffeine to kick in. My energy level also is more stable throughout the day, which is a big leap for someone who had come to depend on a midday nap—followed by a huge mug of Peet’s Italian Roast—to provide the jolt that would power me through my afternoon workload.
OK, I’ll be honest: I still occasionally rely on the nap-plus-coffee combo. But I’m a heck of a lot zippier in the morning than I used to be, and for this 40-something gal, that’s pretty exciting stuff.
