What's fatigue, and what causes it?
"It's the number-one health complaint of my patients. It's not necessarily feeling physically tired as much as a sort of 360 degrees [of] being wiped out; emotionally, mentally, and physically just feeling as though you’re under a cloud and not at your best energy level. We look at common medical conditions that are linked with fatigue — things like anemia, or thyroid hormones dysfunction, or gastrointestinal disorders. We also look at how exercise plays a role — either too little or too much. [And, we] look closely at diet, emotional states, depression or anxiety, stress, and medication."
How big a role does sleep play?
"It’s not how many hours you spend in bed, but the quality of your sleep that affects your energy levels. One of the things I suggest is to sleep alone [to find out if your partner is affecting your sleep] — kick your partner out of bed for seven days. The reason for that is simple: If your partner’s tossing and turning or snoring or sets an alarm to wake up before you do, you’re not going to be able to complete the sleep cycles that your body needs. So, it’s really important to treat sleep as not necessarily 'downtime,' but as time we protect just like we protect the time we spend at work — and make sure it’s the best it can be."
Exercise is one of the most potent energy boosters that exists.
"Take a 10-minute walk. I know it sounds really basic, and a 10-minute walk might not seem like it’s particularly strenuous, but the idea isn’t necessarily that exercise has to always burn calories or build muscle. It is one of the most potent energy boosters that exists.
"In one study looking at mid-afternoon energy slumps, one group ate a candy bar and the other group took a 10-minute walk. Just a couple minutes later, both groups felt like they had more energy. But, the people who took a 10-minute walk had more lasting energy. So, two hours later, they still felt a little bit better than they had beforehand. Walking basically opens up your rib cage to get you breathing more deeply, increases your pulse rate, gets oxygen to your brain — there isn’t anything more invigorating than that."
The price many of us feel we have to pay is just being so exhausted that we can't enjoy the lives we've built.
"Coffee is actually a really complex beverage that’s full of antioxidants and other nutrients. But, it gives you a quick boost of energy through caffeine. If you become too reliant on it, you can experience predictable energy troughs as well, and then you’re more likely to have a second cup to boost your energy back up. It becomes a sort of endless cycle.
"So, I try to suggest that if you are feeling that mid-afternoon energy slump, do a body inventory. I set an alarm to go off every hour while I'm awake to remind [me] to take two minutes out from whatever [I'm] doing to stand up and take an inventory of tension or discomfort in my body. [Ask yourself,] 'Is my brow furrowed? Am I clenching my jaw? Are my shoulders hunched over? Am I breathing deeply?' All the way down to your toes.
"What I would find is that when the alarm would go off, I was slumped over at my desk — I mean so badly that I almost looked like the letter 'C' — barely breathing, certainly not deeply and restoratively enough to give me energy. By taking those two minutes, you’re getting rid of muscle tension that is zapping your body of much-needed energy. It actually takes energy to feel tense or uncomfortable."
How does your gut affect your energy levels?
"We’re now learning so much more about the microbiome: Basically, our bodies have thousands of bacteria, and many of them are in our intestinal tract. We’re starting to understand that beneficial bacteria in our guts helps to do things like keep our immune systems healthy, and it also prevents the overgrowth of harmful bacteria that makes us sick.
"The bacteria make important neurotransmitters like dopamine and serotonin. We usually think of those as just coming from the brain, but it turns out that our GI tract actually makes a large amount of those neurotransmitters. And, keeping the GI tract functioning also involves keeping the good bacteria in balance.
"We’ve all experienced a moment of worry, where we’re nervous about something in our minds, but we feel it in our guts. Well, we’re now starting to think that if your intestines are upset — if the balance of good bacteria and bad bacteria is off — it may have the effect where you feel it in your mind... So, it can be linked with things like depression and anxiety or other emotional responses."
It’s not how many hours you spend in bed, but the quality of your sleep that affects your energy levels.
"That it’s your fate. That’s why I wrote the book; The book is for everyone, but I really wrote it with my young, female patients in mind. I feel like we build these busy, wonderful, amazing lives for ourselves full of work, family, and friends, and everything under the sun. But, secretly, the price many of us feel we have to pay for having done that is just being so exhausted that we can't enjoy the lives we've built. It’s almost like women don’t believe that they deserve to have good energy, and I don’t think it should be that way. So, in the book I included common (but overlooked) causes of exhaustion, and things that you can actually change."