Episode 8 – Possible Root Causes of Chronic Fatigue

Shownotes

Although knowing your root cause may not be essential to moving forward on your journey, it can make all the difference when it comes to a full recovery. In this episode Anna discusses possible root causes that you may want to have on your radar. She also shares her own personal journey and how, when she discovered this root cause, it was the final nail in her CFS coffin. 

Useful links:

Website: https://annamarsh.co.uk/

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Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Possible Root Causes of Chronic Fatigue

Hello, and welcome back to the chronic fatigue and burnout recovery podcast. In this podcast, I’m going to be talking about the possible root causes of chronic fatigue. Suppose you have tuned into some of the recent previous episodes, specifically the cell danger response episode and the episode I released last week on the big picture of fatigue recovery. In that case, you may already have a sense of what the possible root causes could be. Feel free to go back and listen to those episodes if you haven’t already, but in this episode. I will touch on them a little bit more, not in huge detail, but just enough to give you a sense of what could be happening for you. 

So when I first became unwell with chronic fatigue, I guess there were certain biochemical imbalances that I was addressing in my body. For example, when I started working with a practitioner, I already had many self-care practices. I was meditating, I was practising yoga, I was spending time in nature, I was journaling, and there were a lot of things that I was already doing to look after my body. 

Therefore we jumped straight ahead, and we jumped into rebalancing some of those secondary biochemical imbalances. I worked a lot on my blood sugar in the beginning, I worked on my digestive health, I worked on oxygenation, a lot of those pieces of the puzzle that I mentioned in the previous episode, and then when I spoke with other people about what was going on in my body, a lot of the chronic fatigue, literature or resources or people posting things online, it’s all very much nervous system focused. There’s this assumption almost that chronic fatigue is just burnout. It’s just a dysfunction of the nervous system. 

I would say yes; we need to factor the nervous system, nourishment, or nervous system care into a chronic fatigue and burnout recovery plan. But sometimes, other things are going on. Ultimately, chronic fatigue develops when something has worn down the system over time. 

And yes, that could be chronic stress or big traumas which have happened in the past, changing the window of tolerance. Therefore, everyday stress is very stressful to an individual. But where I went so incredibly wrong in my journey was stopping there, thinking that I just needed some supplements for my mitochondria and needed to work on my blood sugar balance and support my nervous system, and that would be enough, and that was when I was doing all of those things. I didn’t feel like I was making the progress I wanted. I started to look deeper into what was going on with the progress I should have been making for all the time, energy, and money I was investing in my health and self-care. I just felt like something had been missed. Then, I discovered that mould mycotoxins began to do a mould detox protocol. 

Then as a consequence of that, I started to feel a lot better. I pre-frame this episode with this little story to understand that many people you may see online and the posts you may read on Instagram may say you need to brain retrain or regulate your nervous system. Then you will be well, which can be very gaslighting for the people doing those things and still not getting better, in some cases even getting worse. This is an opportunity to think a little bit bigger and think about other things that could be happening. 

I do not want to say that brain retraining or nervous system work isn’t helpful because it’s incredibly helpful. For people who are only experiencing burnout or only feeling unwell because of the nervous system, it can be great, and it can take them the whole way. But many people need other support to work through that cell danger response to get the body out of threats and to help it feel relatively safer. 

So the things I’m going to discuss today will be mould, mycotoxins or moulds, and illness. I’m going to talk a little bit about viral infections. I’ll talk a little bit about trauma and the nervous system, and I’ll talk about toxicity and the gut. 

The first one on that list is mould and mycotoxins, and obviously, this is an area that I feel very passionate about because this was my personal experience. However, I work with some clients where mould isn’t an issue. A paper in 2013 tested 112 patients with chronic fatigue syndrome for mould and mycotoxins, and 104 of those 112 patients, so 93% tested positive for at least one mould mycotoxin, with 30% of cases testing positive for more than one of those mycotoxins. 

90% of these cases had a current or historical history of exposure to a water-damaged building. When the exposure was current environmental testing was performed in the water-damaged building, and potentially mycotoxin-producing mould species were identified as mycotoxins. Where the exposure was, current environmental testing was performed in the water-damaged building, and potentially mycotoxin-producing mould species were identified. 

They also had healthy controls in the study who had no prior or current exposure to water-damaged buildings. These healthy controls didn’t test positive for mould or mycotoxins, so here we can see that there can be a relationship between chronic fatigue and mould and mycotoxins. Typically if someone has had mould exposure through a water-damaged building, they can inhale mould spores which can produce mycotoxins, potentially colonize the body and continue to produce toxins. These toxins can cause damage by increasing oxidative stress, which is the balance between damaging reactive oxygen species and protective antioxidants. 

This damage can specifically target and damage cells in the nervous system. In hindsight, I noticed a change in my nervous system after my mould exposure. I had junk caffeine the whole way through my fatigue recovery. 

Then, after the mould exposure, I noticed a change in my tolerance to caffeine and a huge increase in anxiety. We can also get specific types of mycotoxins that can induce mitochondrial dysfunction in the brain and impact brain energy and cognitive function. Mycotoxins can also interact with the neuroimmune axis, triggering inflammation and inflammation of the brain leading to cognitive dysfunction. 

This is why we see very low brain energy and brain fog in cases of mould toxicity. Mycotoxins can also impair neuroplasticity, contributing to cognitive dysfunction, depression, anxiety, and other mental health issues. Mycotoxins can also compromise the blood-brain barrier, which means they can cross into the brain and have a neurotoxic effect on neurons. 

The other helpful thing is that mould mycotoxins and spores are associated with a histamine response. They can trigger mast cell activation syndrome. Therefore, we often see that people with mould toxicity also may have a lot of those high histamine symptoms, which can manifest in various ways. Still, it might look like shortness of breath, feeling a little more asthmatic, or maybe reactions on the skin itching, to name a few. So it goes beyond the scope of this specific podcast to talk about the ins and outs of what you do if you have a mould problem. 

But the first thing I would say at this point is that if you suspect you’ve had mould exposure because you know, you’ve lived in a water-damaged building or you resonate with some of the symptoms of mould toxicity. Then it is worth testing to make sure that this is a problem for you or to see if this is a problem for you or not. When I work with clients, we will make a case history, and I might ask questions about living in a mouldy home or a water-damaged building and combine that with the symptoms they’re presenting worth, especially if they’ve got a lot of high histamine symptoms. Then I might suggest testing, and the test you can do for this is the mycotoxin test by Great Plains laboratory. 

Regenerus is the provider here in the UK, and you would need to work with a practitioner like myself to get tested. But once you are tested, the test interpretation is easy. It’s pretty much black or white, you’ve got it, or you don’t, but creating a strategic support and recovery plan can be quite involved. The next possible root cause is fatigue, and I would like to discuss trauma and chronic stress. 

If you are a living, breathing human being, you have been impacted by trauma, which could play a role in your fatigue recovery. It’s most likely playing a role, whether that’s big or small, in your fatigue recovery. Maybe you already know a little about trauma and the nervous system, or maybe you’re thinking, what has this got to do with my energy levels? Or nothing “bad” has ever happened to me, so I don’t have to worry about trauma. Before I go into a bit more on this, I’d like to clarify a few things. 

The first thing I’d like to clear up is what trauma is. And why do we all have it? And then, I’d like to answer the question, could this be a root cause of your chronic fatigue symptoms? So let’s start with what trauma is. Most people think of trauma as what is referred to as the big Ts. 

These are big and significant life events like abuse, loss, being in a major accident, or experiencing a horrific incident. But trauma can also be little Ts, and it can be small accidents, divorce, financial issues, legal issues, or the loss of a loved one or even your pets. It can be a relationship breakdown, surgery or invasive procedures, and many more. 

But trauma is anything that happens too fast, too soon, and goes on for too long. That is too much for the nervous system to handle. Therefore, it’s less about the actual event and more about the person’s nervous system who is experiencing the event. Chronic stress can be a trauma; it accumulates over time and wears down the nervous system. 

Eventually, even small things can feel too big to handle, and the nervous system can experience overwhelm or shutdown. Chronic fatigue and chronic diseases can develop when something wears down over time, eventually too much for the body to cope with. It’s really important to understand that trauma isn’t in the brain, but it’s in the body, and traumatic events, big or small, that haven’t been given the space and support to be processed can get stuck in the body and keep the body in a heightened nervous system state. 

What this means is there can be people who do experience big Ts, horrific, tragic events, but if they have the support that they need, if there’s space for them to process that traumatic energy, they can be much less affected than somebody who maybe only experiences a minor incident, but doesn’t have the support or the resourcefulness in their system at the time. What we’re specifically looking at when we consider the pathophysiology of chronic fatigue or chronic illness is that the physiology and biochemistry of the body change to maintain survival mode, but over time, this comes at a cost to our health. Here I like to describe how the nervous system can get stuck on or off. 

Stuck on might look like a constantly heightened sympathetic nervous system, characterized by anxiety, hypervigilance, nervous energy, difficulty sleeping, and that tired but wired feeling. Stuck off is the nervous system in a parasympathetic dominance state, characterized by exhaustion, fatigue, disassociation, immobility, and shutdown. In case you’re wondering, yes, you can have a little bit of both because when we are in this state of freeze or shutdown, there is usually a huge amount of sympathetic energy underneath. 

There can be a sense of exhaustion and anxiety or difficulty sleeping and shutting down. It doesn’t necessarily have to be one or the other. But either way, in the context of fatigue, the body’s resources are prioritized towards threats and maintaining the responses of the survival systems. They’re prioritized away from rest recovery and repair, which means that we don’t get the body’s nourishment. 

It’s like trying to drive a car with your foot flat on the accelerator and the handbrake right up. You burn through huge amounts of energy, but you can still feel quite stuck, and like you’re going nowhere. There’s no test which will say to you, yes, nervous system dysregulation is the root cause of your chronic fatigue. But I think many people sense that it is because we start to slow down, tune in, and connect to the body. We notice the sensations that are present there, we can notice if there are sensations of activation, or we can notice if there are sensations of freeze or shut down, and people feel it. They feel it in their heart rate. 

They feel it in how their breath moves in and out of their body and how grounded and peaceful, and calm they feel in their body. Again, that’s beyond the scope of today’s episode to go into detail on this. But what we want to do is support the body to find a sense of safety and remember that if there are other triggers, like toxins, mould, infections, or viruses, those things will also need to be removed or supported so that the body can experience that sense of safety. 

But from a nervous system perspective, we only want to think of the idea that the nervous system is interfacing with your life, every single moment of every day. Therefore everything you’re doing day to day, day in and day out, is sending messages to your nervous system. This is where creating a healing routine, a way of living a way of being in the world can be supportive for your nervous system, in addition to all the other practices that you might do somatically with brain retraining and hormetic stressors to support your nervous system, our day to day lives have to feel safe. 

If you are a high achiever, overworking, constantly trying to perfect and prove and please and perform to suddenly go from a very, very high activation to a state of rest and regulation can feel overwhelming for a dysregulated system. It’s okay for these changes to be slow, but we want to ensure that we’re heading in the right direction and supporting our regulation daily as much as possible. The next possible root cause of fatigue could be toxins and heavy metals. 

Toxins are commonly overlooked when it comes to energy. Admittedly, I only really got into exploring toxins and detoxification when I realized that mould toxicity was one of the root contributors to my chronic fatigue. The sad fact of the matter is that toxins are everywhere. We want to consider a toxic load and fatigue recovery support plan, even if you don’t have mould exposure. 

Even if you don’t have heavy metals, we still really want to be supporting the liver and the detoxification pathways. Because the immune system needs to detoxify its immune molecules, if you’re fighting off an infection, those immune molecules must go somewhere. 

Therefore healthy detoxification is a really important part of immune regulation. Toxic overload can include fatigue and brain fog, feeling hungover, muscle and joint pains, skin conditions, and weight gain, especially around the middle. Toxins can come from the food we eat, the air we breathe, the water we drink, food packaging, processed foods, pesticides on our foods, home cleaning and beauty products, chemicals, biotoxins, or heavy metals. 

There’s a huge range of ways that we can get exposed to toxins, and when it’s never going to be perfect. We’re never going to eliminate toxins from our environment, but we can reduce them and support how we eliminate toxins from the body. There are a few ways toxins can contribute to fatigue, and the first one is that they are one of the main triggers for the cell danger response.

If you haven’t already listened to that episode on the cell danger response, you want to do that. But the cell danger response is the cell’s ancient and universal response to threat. If the body perceives that there’s an overwhelming amount of toxicity in the environment, it’s going to shut down. 

Then energy is prioritized away from the brain and away from the body towards survival, towards the immune system. But toxins can also interfere with the way that the body makes energy. Specifically, heavy metals can interfere with the Krebs cycle, the cycle inside the mitochondria by which we produce ATP. 

Toxins can be endocrine disruptors that disrupt the body’s hormonal systems and influence cortisol, blood sugar, thyroid hormone, and sex hormones. These imbalances could be playing a role in fatigue. Toxins can also disrupt the microbiome, that balance of bacteria we have inside the digestive tract. 

Because it’s such a close relationship between the gut and the brain, they can also impact health and energy and cause brain fog and fatigue. Toxins, specifically heavy metals, can also feed parasites, compromising immune function. It can use energy to keep the immune system active constantly. Finally, detoxification is a very energetically demanding process. 

It takes a lot of energy to detoxify. Therefore, if the liver is overburdened, that’s a drain on the body’s energy and resources. But suppose your energy and resources are already low. In that case, that means that there’s even less energy to prioritize towards detoxification, which can increase the toxic burden and, therefore, the toxic load on some of these systems, impacting energy. 

So how do you know if toxins are a problem for you? Here, I feel like, in this retesting something like urine mycotoxins, there are not a lot of really great tests available for toxic load. We would tend to look at the symptoms of a client. I mentioned some of the symptoms when I started talking about toxins today. 

We might also look at toxin exposures, especially when we’re looking at certain professions, like hairdressers, cleaners or trades, people who are using a lot of chemicals as part of their work, somebody who has mercury amalgams, or somebody who has breast implants or gets a lot of botox and fillers, these will be sort of classic red flags to consider toxic load. But there may also be genetic abnormalities in genetic testing when we look at single nucleotide polymorphisms or snips. Some people may have certain genetic snips, which means they have compromised detoxification because their detoxification enzymes may be slightly more sluggish. 

I also like doing the organic acids test, which measures the functioning of the Krebs cycle because heavy metals can potentially be roadblocks to the Krebs cycle. If we’re seeing a lot of backup in the movement through the Krebs cycle, that can sometimes be an indicator to test heavy metals. You can test heavy metals and blood, and you can test heavy metals in urine, the testing can be a bit controversial, but it might be worthwhile depending on the case history. 

Then we get to Lyme disease and viral infections. This is such a big area, but I also feel it’s an area with many unknowns. We have so many viruses that don’t even have names. We cannot even test for these viruses because the tests haven’t been developed. So my approach when thinking about a viral load in someone is if we do the testing, and we’ve got the information that maybe there are some positive tests, we want to consider the terrain. So Louis Pasteur said on his deathbed that the pathogen is nothing. The terrain is everything. 

We want to consider the terrain in the context of chronic or historical viral and bacterial infections that may be behind ongoing fatigue. In this case, the terrain is the body and the interconnected network of the body’s systems. Do we think about the gut, the mitochondria, the hormonal systems, the toxification, and methylation? 

Many of the systems I’ve spoken about in the other episodes, and we’re starting to think about IVs functioning optimally to support the body manage this viral load. One of my favourite analogies is where the virus is the hammer, and the window pane is the body. If you throw a hammer at a window pane and the window breaks, even when you remove the hammer, which is the virus, you still have a broken window, and there’s still some cleanup work that needs to be done. 

Very often, when someone becomes unwell due to a virus, when the body is protecting against infection, so a viral infection, in this case, what we experience is a huge inflammation of the immune system. The immune system creates a raging fire to protect the body from the virus. Let’s say the immune system does its job and can protect the body from the virus. 

But there’s been a lot of damage that has been created in creating that fire. Even though the pathogen or the threat is gone, a lot of imbalance is created in the process that needs rebalancing. Sometimes we need antibiotics or natural antimicrobial support like herbs to remove bacteria, viruses, or parasites from the body. 

But sometimes, we also need to use all the other tools in the trauma-informed functional medicine tool test to help the body recover, rebalance and restore optimal function. Here, if you think about the cell danger response I spoke about a couple of episodes ago, it’s a very similar model. We want to do what we can to remove the threat and then go on and support the body. That might look like supporting the gut, addressing the microbiome, looking at parasites or yeast, promoting good digestion and absorption of nutrients, and ensuring that the gut membranes are working well. 

We might want to be looking at that low-hanging fruit, so addressing blood sugar, making dietary changes, working on sleep, reducing inflammation, improving detoxification, improving our toxic load, supporting the nervous system, supporting the mitochondria, and making sure the hormonal systems are in balance that we can lower inflammation and support the immune system as a whole. Even if there is some viral infection, it’s usually never about just going after the infection. 

In some cases, that can be helpful. For example, in acute Lyme, taking antibiotics can be helpful. But in the longer term, and especially when someone has been ill for a while, it’s really about considering the whole body and what imbalances are present in the whole body, and what we need to do for that unique individual to bring things back into balance. 

I would say just the final one here is looking at gut infections. I work with many clients who develop fatigue, sometimes after a viral infection but sometimes after a tummy bug or a parasitic infection. Here again, it’s the same issue, this idea of how do we support the terrain, if the infection is still present, then we maybe need to do some removal protocol to clear the body of the parasite or the bag or whatever it might be. 

But we also need to support the nervous system because the nervous system is very closely related to the immune system and supports the immune system directly so that the body’s capacity to deal with this threat or challenge is bolstered. It’s strong, and it’s resilient. Very likely, if there has been an infection there for a long time, the body has created adaptations to deal with that infection. It’s created imbalances and other body parts, and we want to address those. I like a stool test when we look at gut infections as a possible root cause of fatigue. They can be helpful but don’t always pick up on everything. 

Again, we want to look at the client’s symptoms, history, and another testing that could give clues to what’s happening. That brings me to the end of this episode, looking at the possible root causes of chronic fatigue. Hopefully, I’ve covered the big ones. 

There may be other secondary imbalances that can also cause fatigue, for example, mitochondrial dysfunction and changes in the sex hormones. But this is just assuming that those changes are secondary to these big things which have triggered the system, and remember that we want to help the body move to a greater sense of safety so that we can create balance in these other systems too. As always, if you have enjoyed the episode, please share it if you know anyone who would benefit from hearing this and listening to this, and please make sure you leave a review because your reviews help others find these episodes and help them get the support and information that they need on their fatigue recovery journey. I will see you in the next episode.