Tired?

Ignore it at your peril

More than a third of us suffer from chronic fatigue, and experts seem to agree on one point: we are not designed to cope with modern life. Could a treatment be
in sight?
Thursday, 24 February 2000
Three years ago, Carolyn Draper's life went on hold. Aged 35, she was in a highly stressful job, teaching in a tough inner-city secondary school. She dreaded
going into work and every day she came home and collapsed into a chair with exhaustion. Her limbs ached, she began to get headaches and she finally
succumbed to a nasty bout of flu. "From that day on my life was never really the same," Carolyn says. "I felt so shattered that I was going to bed really early but
waking up feeling more tired than ever. When I told my GP, he said I was depressed and that two weeks of counselling would have me feeling as right as rain. I
burst into tears. I began to think I was going round the bend."
Three years ago, Carolyn Draper's life went on hold. Aged 35, she was in a highly stressful job, teaching in a tough inner-city secondary school. She dreaded
going into work and every day she came home and collapsed into a chair with exhaustion. Her limbs ached, she began to get headaches and she finally
succumbed to a nasty bout of flu. "From that day on my life was never really the same," Carolyn says. "I felt so shattered that I was going to bed really early but
waking up feeling more tired than ever. When I told my GP, he said I was depressed and that two weeks of counselling would have me feeling as right as rain. I
burst into tears. I began to think I was going round the bend."
Most people know the symptoms of fatigue. They feel tired, go to bed early, take it easy during the day and start to feel better. Most experts believe that there is
a spectrum of fatigue that, if left untreated, can lead to chronic fatigue, which Carolyn is suffering from, and even ME, now known as chronic fatigue syndrome.
The terminology applied to fatigue is confusing for most lay people. "It's important not to confuse chronic fatigue with chronic fatigue syndrome, which is a
complex condition caused by a combination of factors," says Dr Trudie Chalder, who runs a clinic for chronic fatigue sufferers at King's College Hospital, London.
"Chronic fatigue syndrome is characterised by extreme exhaustion, muscle pain and a severe flu-like malaise," she says. Other symptoms include problems with
concentration and memory, loss of balance, digestive problems, visual disturbances, sleep disorders and mood swings.
If you are excessively tired or feel exhausted most of the time, you are in good company. Around 38 per cent of us suffer from that type of fatigue, and the
simple answer is that we are all doing too much. "We all have far more roles in today's society than we ever had in the past," says Dr Chalder. "Women in
particular are often struggling to look after children, working in the day and doing household chores in the evening. Add to that the fact they often have very high
standards and feel under pressure to do everything perfectly, and it's hardly surprising they end up with chronic fatigue."
If the quality of your sleep is poor, you may never quite recharge your batteries at the end of the day, which can also leave you feeling exhausted. "When I see
patients who are chronically tired I focus on their lifestyle, finding out what time they go to bed, what quality of sleep they get and whether they take time out to
relax and enjoy themselves. It may sound obvious, but people with chronic fatigue often work too hard. The key is to have a balance between work and leisure,"
Dr Chalder says.
Some natural health experts think candida, a yeast infection of the intestines and bowel, may be to blame. "Candida overgrowth is a significant factor for many
people feeling exhausted and is linked to food sensitivities," says Dr John Briffa, a nutritional physician. "Partially digested food particles leak through the lining of
the gut into the bloodstream and can make you feel pretty terrible," he adds. Dr Briffa also believes many patients with chronic fatigue may have weak adrenal
function: "The adrenal glands produce the two hormones adrenalin and cortisol and are vital in regulating our responses to stress. People with chronic fatigue
often have a reversed pattern of cortisol production so they wake up with hardly any energy. Ironically, their energy levels are then boosted later at night, just
when they need to sleep."
Marcus Webb, a naturopath, agrees. "Our 'fight and flight' system, which was perfect millennia ago, when stress would consist of the occasional sighting of a
sabre-toothed tiger, is constantly on alert in today's more pressurised environment. It simply cannot cope with modern-day tigers jumping out at us every
half-hour. Our bodies never have the chance to come out of an acute stress reaction and soon end up in a state of chronic stress, which compromises the
immune system. The immune system then can't fight off infection, and the result is exhaustion," Mr Webb says.
Dr Chalder uses a combination of treatments for fatigue, including cognitive behavioural therapy and lifestyle changes. Mr Webb uses a range of herbal remedies,
from nutritional supplements such as COQ10 to ginseng and liquorice root, which have been used through the ages in the treatment of stress and emotional
disorders.
For Carolyn, salvation came in the form of a little pill called Enada, currently causing a stir in the United States and recently launched over here. American
scientists believe that people with chronic fatigue have lowered levels of ATP, a chemical energy source that powers all the cells of the body. A recent US clinical
trial on 26 patients with chronic fatigue showed that 31 per cent felt less sluggish and had fewer aches and pains after taking the supplement. Carolyn
discovered Enada on a trip to the States to visit her mother. "After six weeks my energy had increased, and within three months I went from being a total
'bedcase' to leading a near-normal life again," she says.
Experts in the field are cautious about Enada. Anthony Pinching, professor of immunology at Bart's Hospital and an authority on chronic fatigue syndrome, is
sceptical. "There are minimal and so far unconvincing scientific data on the use of Enada in chronic fatigue syndrome. It is troubling to see these kind of
supplements being marketed so heavily to a vulnerable group of patients, whose expectations will be raised and who have limited resources to spend on them,"
he says.
It is true that, at about 40 a box, Enada is expensive. Yet many chronic fatigue sufferers search the Internet for anything that may help their symptoms. "It is
bizarre that in the States, doctors' first line of treatment for chronic fatigue is often Enada, and yet over here it's almost unheard of," says Carolyn, who now buys
Enada on the Net.
Whatever the experts think, Carolyn is evangelical about Enada. Not only is she now back on track but she is planning a holiday and looking forward to the future
with confidence: "Maybe it doesn't work for everyone but it has really helped me crack the problem. Last year I could barely think about what was happening in
the next hour, let alone the next week or month. Now I can honestly see myself returning to work this year."
Dr Trudie Chalder's book "Coping with Chronic Fatigue" is published by Sheldon Press, priced 5.99
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