- Maybe you are that late night sleeper that has to wake up at those early hours for work or school eventually causing you to drag your feet along all day.
- Maybe you are the sugar and caffeine junkie that craves the rush and constantly need that rush in order to get your boost because without it you are pooped!
- Maybe you experienced stress after stress, event after another, and now you have diseases and symptoms that you never had before.
- Maybe you are a vegan and didn’t realize that the diet you are currently on is low in iron.
- Or maybe you were struck with a flu/cold and never have been well since…
Fatigue manifests from a myriad of different variables. To just say you have fatigue without understanding the cause of where it came from will not allow for proper treatment of your condition. From the examples above, you can come to understand that fatigue is multi-factorial. As health care providers, we need to differentiate from your history the possible causes of why you are lacking energy. This can be attributed to anything from autoimmune disease to simple things like not enough sleep or maybe even side effects from current medications. Fatigue is such an expansive topic, so I will elaborate on one of many causes.
Chapter 1.
Fatigue from Viruses
I start with viruses since this is probably one of the more exotic causes and harder to differentiate. Viruses is probably one of the oldest and most genetically-diverse, biological forms created before mankind. Its origins probably come close to the beginnings of the Earth when life first evolved. In order for viruses to have existed, they needed living biological hosts (animals, humans, or plants). Their basic purpose is to create genetic variety by infecting hosts with its genetic material. This is known as horizontal genetic transfer, in other words keeping updated with the current pace of evolution. They stimulate and challenge the innate processes of the host’s immune system. Without it, our immune systems would not develop, thereby becoming more susceptible for infection and death. This goes back to Darwin’s Theory – Survival of the Fittest.
For infection to occur, three survival mediums need to be present for viruses to take affect: the origin, the vector (or carrier), and the host. The environment of the medium is clearly a survival tool for the virus to live and potentially infect other organisms and its survival time varies.1 Each virus, depending on the medium of how its transmitted, will survive anywhere from a few hours to even a year.2 Factors affecting the survival times of viruses can be influenced by temperature3, humidity4 , and pH5.
So how do viruses apply to fatigue? Simply stated – you get sick, you get tired and sometimes tired for a longer time than normal. Some of the most well-known viruses to cause this symptom are Epstein Barr Virus, Cytomegalovirus, and Herpes Virus. But one must remember that there are millions of strains of different viruses and even the same virus can shift strains rapidly and spontaneously. They tend to keep updated and 5 steps further than current vaccination research. Which is why giving someone a vaccine, one variation of a virus, may not be so fruitful for the “flu pandemic” because you are only vaccinated for that one strain. Take for example, a baby who gets infected with the rhinovirus, a common virus passed in daycare centers. The baby will pass the virus onto the house dog. The virus can mutate and shift within the house dog, this can potentially infect the baby again. We get sick because our body sees these viruses as foreign substances. Each time a shift occurs for the virus in genetic material or marker, our body doesn’t recognize it. So, our body attacks it again.
It’s important to realize that studies published on chronic fatigue take a group of people labeled as chronic fatigue patients and test them for one virus. In fact, we know that viruses do cause fatigue, we cannot say chronic fatigue is caused by “such” and “such” virus. Fatigue is a symptom of many viruses and that is why many studies fail to prove the cause of chronic fatigue. It is in the doctor’s and your best interest to evaluate your health history and exposure to ascertain what may be causing your fatigue. Long term reactivation of past exposures to viruses are also difficult to distinguish whether it is a cause to your fatigue. Documenting past exposures to viruses/colds/flus will help in elucidating this fact.
Viruses are well known to cause fatigue as well as some cancers. The mechanism by which this works is the reaction of the immune system and the natural defenses your body puts up to fight off the foreign invader. Your body goes into a febrile state trying to get rid of the bug (remember: temp being one factor that influences survival rate of viruses). Other common symptoms include cough, sore throat, runny noses, body aches, and headaches. All of these symptoms are manifestations of the immunological reactions that occurs in the body as a result of fighting off the infection. The point of it is to expunge toxins from the body. If it’s not being expunged it’s stuck somewhere, like your throat, chest, head, etc. The infection and toxic build up causes free radical stress and oxidative damage which will eventually “wear and tear” the cells in your body. This overtime will decrease your body’s ability to have normal functioning cells and genes. Therefore, diseases that are subsequent from primary infection may result in cancer, chronic fatigue, and other disorders because of “bad programming” left behind from the virus. Additionally, the free radical stress from all the toxic build-up will disrupt muscle force, which causes the fatigue. Researchers and scientists have found that muscle force performs optimally in a balanced oxidative/anti-oxidative balance. Too much of one or the other will result in decreased muscle force. Studies already prove that providing amino acids like N-Aceylcysteine, an antioxidant, combats tumor necrosis factor (TNF), the most damaging of free radicals in muscle function.6
The key to overcoming this obstacle is a 3 step process: 1. Increase your immune system (i.e. by increasing your white blood cells to fight off the infection) 2. Help your body in the elimination of the toxic build-up from the infection (i.e. helping your body to drain the lymphatic organs, boost up detoxification processes in the liver, etc.). 3. Increasing fluids to maintain water balance and helping the body to release these toxins through various means will help speed up the process (i.e. this includes sweating, urinating, and defecating). For more information, see my future blog for the treatment of fatigue…
1. Thomas Y, Vogel G, Wunderli W, Suter P, Witschi M, Koch D, Tapparel C, Kaiser
L. Survival of influenza virus on banknotes. Appl Environ Microbiol. 2008
May;74(10):3002-7. Epub 2008 Mar 21. PubMed PMID: 18359825; PubMed Central PMCID:
PMC2394922.
2. David A. Graiver, Christina L. Topliff, Clayton L. Kelling and Shannon L. Bartelt-Hunt. Survival of the Avian Influenza Virus (H6N2) After Land Disposal. Environ. Sci. Technol., 2009, 43 (11), pp 4063–4067.
3. Anice C Lowen, Samira Mubareka, John Steel, and Peter Palese. Influenza Virus Transmission is Dependent on Relative Humidity and Temperature. PLoS Pathog. 2007 October; 3(10): e151.
4. http://www.news-medical.net/news/2009/02/09/45716.aspx
5. Edwards, Steven. Survival and Inactivation of classical swine fever virus. Veterinary Microbiology. 2000 April; 73(10), pp 175-181.
6. Matuszczak, Y. Farid, M. Jones, J. Lansdowne, S. Smith, M. A. Taylor, A. A. Reid, M. B. Effects of N-Acetylcysteine on Glutathione Oxidation and Fatigue during Handgrip Exercise. MUSCLE AND NERVE. 2005, VOL 32; NUMB 5, pages 633-638.
Dr. Brian H. Leung 