Shaun Ward MSc ANutr
Fatigue is a broad term that is used to describe problems in starting or maintaining voluntary activity.
Although fatigue is typically defined as tiredness from an overexertion of muscle and brain function that can be relieved by periods of rest, chronic fatigue is a long-term consequence of consistent periods of acute fatigue that is not easily reversed.
Fatigue can be separated into two distinct categories:
- Physical fatigue: from depletion of muscular energy stores, or a dysfunction of neuromuscular transmission
- Mental fatigue: from long periods of cognitive activity, or from nutritional deficiencies and blood sugar fluctuations
In medical settings, it is given a simple definition to describe when a patient is in a state of tiredness or “low energy.”.
In any case, fatigue can seriously reduce ones quality of life and negatively affect a person’s physical and mental performance.
For this reason, considering the intake of anti-fatigue supplements may be one of many options to improve symptoms of fatigue.
Ginseng, a regularly top-selling herbal supplement, comes from the root part of several plant species in the Panax genus. The most common type of ginseng supplement comes from Panax ginseng, which roughly translates to "all-healing man-root".
Human studies are available that indicate ginseng consumption can increase cognitive performance.
This may possibly be related to the glycemic properties of ginseng, although the exact mechanisms are not yet known .
Some evidence suggests it works by increasing the amount of dopamine, adrenaline, and seratonin within the body .
Lab studies also mention that ginseng increases energy produced aerobically in the brain, which could have knock-on effects to improving mental clarity .
However, when ginseng has been reviewed in large meta-analysis of randomized controlled trials, there has not been consistent enough positive evidence to conclude its efficacy for preventing or reversing chronic fatigue .
As current knowledge of ginseng mainly comes from preclinical or lab-based studies, they may not best represent ginsengs mode of action in the humans and more humans studies are needed .
2. B Vitamins
B vitamins are coenzymes for a lot of the metabolic reactions underpinning cellular physiological functioning.
Many B vitamins are also precursors for metabolic substrates, such as Coenzyme A, that are intermediates for the production of cellular energy and other bioactive compounds.
Experts even state that B vitamins are involved in every aspect of the absolutely essential catabolic processes needed to generate energy within cells, and that deficiencies commonly result in severe negative consequences for energy production .
Of particular relevance, thiamine, riboflavin, niacin, and pantothenic acid (types of B vitamins) are essential in energy production via their direct roles in the energy-producing cycles, such as the citric acid cycle and the electron transport chain, that result in the formation of ATP - the cells energy currency.
In addition, thiamine, biotin, and vitamin B12 play essential roles in the mitochondrial metabolism of glucose, fatty acids and amino acids .
Although there are not reliable studies on how vitamin B supplementation may prevent or treat chronic fatigue syndrome, based on its metabolic role it is likely to only be beneficial, especially in people who are vitamin B deficient.
3. Coenzyme Q10
Coenzyme Q10 is a fat-soluble vitamin-like compound with a key role in energy metabolism to transport electrons into the inner mitochondrial membrane, which is a necessary process before converting fatty acids and carbohydrates into ATP .
Deficiencies in coenzyme Q10 lead to the impairment of oxidative phosphorylation (ATP production) which reduces the activity of mitochondrial metabolism and may contribute to the progression of chronic fatigue .
Unsurprisingly, when assessing people with chronic fatigue syndrome, they tend to have significantly lower concentrations of CoQ10 in their blood. This is thought to be a contributor towards fatigue, as opposed to a consequence of it .
Based on this, it is assumed that increasing coenzyme Q10 intake through food or supplementation may protect against the onset of chronic fatigue .
However, the scientific reviews that are currently published are not able to definitively conclude a benefit of coenzyme Q10 consumption within healthy populations, and far more studies are needed to better assess the relationship .
As a side note, as statin drugs inhibit the activity of enzymes needed for coenzyme Q10 biosynthesis, this could explain the clear link between statins, coenzyme Q10 deficiency, and increased rates of chronic fatigue within statin users .
4. Vitamin D
Vitamin D is a secosteroid that is necessary for controlling calcium and phosphorus absorption in the body.
Prospective studies conclude that populations with a very high prevalence of vitamin D deficiency are those that report more signs of fatigue, and conversely those with a low prevalence of vitamin D deficiency in addition have a reduced incidence of fatigue .
Even in healthy individuals, fatigue can easily result from low vitamin D levels by reducing the functioning capabilities of skeletal muscles .
The reason why low vitamin D levels reduce muscle function is due to reducing total and ionized calcium levels, which decreases bone density, and increases bone turnover and calcium excretion. Ultimately, this upregulates skeletal demineralization and causes muscle weakness – which many report as a sign of physical fatigue.
Additionally, vitamin D influences the innate immune system (nonspecific defense mechanisms) and modulates the adaptive immune system by controlling the responses of inflammatory molecules.
A dyregulation of these mechanisms from low vitamin D levels may therefore be associated with inflammatory fatigue, as is commonly seen in cancer patients .
Carnitine is an ammonium compound that is found in nearly every cell in the body.
It plays an important role in energy metabolism, and is critical for the metabolism of fatty acids within cells.
This is because carnitine availability is the rate-limiting step for transporting fatty acid derivatives into the mitochondria where they needed for energy production .
Depending on an individuals metabolism, it is possible that some people may have inadequate carnitine availability to efficiently use fat as a fuel source. This is particularly the case in people with thyroid issues, as the thyroid hormone has been shown to promote the urinary excretion of carnitine and result in carnitine deficiencies.
In turn, carnitine deficiencies reduce fatty acid metabolism and may cause many symptoms of fatigue , as skeletal and cardiac muscles use fatty acids as their primary source of energy throughout the day.
The research specifically on this area is lacking, however l-carnitine supplementation in cancer patients has shown to reduce the occurrence of fatigue , with many chemotherapy procedures known to interfere with the homeostasis and reabsorption of carnitine .
Fatigue is a serious issue that can damage a persons physical and mental performance.
Nutrition and the diet are closely related to fatigue, which usually stems from chronic inflammation.
Supplements which may help to overcome such issues are ginseng, B vitamin complex, coenzyme Q10, vitamin D, and l-carnitine.
However, more important nutrition and lifestyle changes should remain a persons priority, with supplementation acting as an additional boost when everything else is already in place.