By Susan Heavey

Ads for prescription drugs need to be clear and direct and government needs to study the effects these ads have on consumer behavior, particularly among the elderly and minorities, a U.S. Food and Drug Administration panel of outside experts said recently.

“It’s about how it’s understood and how it’s used. It’s impact,” panel member Ellen Peters, a researcher from Oregon, said.

Data shows that advertisements for drugs prompt people to see their doctors, but it is not clear if consumers understand potential benefits and risks of the drugs being promoted by pharmaceutical companies.

Panelist Michael Goldstein, associate director at the nonprofit group the Institute for Healthcare Communication, told the FDA that it should find ways to tackle “the woefully inadequate evidence we have about what … direct-to-consumer advertising is actually doing.”

The FDA is seeking input from advisers as it prepares to report to Congress about how ads impact consumers, especially older people and children, blacks, Hispanics and other minorities.

Legislation that took effect in March allows the FDA to ask to review ads before the public sees them and to impose fines if an ad is misleading. It also empowered the FDA to study the effect of such advertising on the public.

Last year, 68,000 promotions including commercials and print ads, magnets and pens, were submitted to the FDA, according to Kristin Davis, deputy director for the FDA’s Division of Drug Marketing, Advertising and Communications.

“In an ideal world we’d look at everything,” she said, noting that staff levels make that impossible. Instead, the agency tries to target promotions, including ads, that are likely to have the biggest impact.

Drug companies spent nearly $29.9 billion in 2005 on advertising, free samples, and sales staff to promote brand name products, according to a study funded by the National Institutes of Health published last year.

More than $4 billion of that was spent on consumer ads compared to $429 million for ads directed at doctors.

U.S. lawmakers are investigating whether drug companies use marketing tricks to mislead consumers, especially through television commercials. Researchers have said drug companies use gimmicks such as small type, fast speech and flashy graphics to emphasize benefits and downplay risks.

Rep. Bart Stupak, the Michigan Democrat overseeing the House Energy and Commerce subcommittee investigation, wants drug companies to make commercials that are more clear or face tougher regulations and possible restrictions.

By Hilary Parker, WebMD Feature
Reviewed by Brunilda Nazario, MD

Looking for your meal ticket to health?  You might be wise to go for some omega-3 fatty acids served up with a side of antioxidants. The good news is, it can be as tasty as it is healthy — think grilled salmon and vegetables, drizzled with olive oil and accompanied by a nice glass of red wine.

“People who eat a plant-based diet are the healthiest people on the planet,” says Katherine Tallmadge, MA, RA, LD, an American Dietetic Association spokeswoman. “Eat at least five cups of fruits and vegetables every day.  Use olive oil instead of butter. Eat plenty of seafood. These are nutrition recommendations that won’t change.”

What is changing is our understanding of how nutrients like omega-3 fatty acids and antioxidants are responsible for the health-promoting properties of functional foods — and what you can do to maximize their effectiveness.

Antioxidants: Vitamins, Flavonoids, and Minerals

Plant foods like fruits and vegetables, whole grains, nuts and seeds are your best bet to obtain disease-fighting antioxidants such as vitamins A, C and E, the mineral selenium, and flavonoids.

The protective benefits of antioxidants seem to stem from their ability to protect your cells from dangerous free radicals, which you are exposed to as the result of natural processes and pollutants in the environment.

When it comes to cancer-fighting properties of the nutrients in a balanced diet, the whole may be more than the sum of its parts. Many scientists now believe that food synergy, or the way nutrients in the different foods you eat interact with one another, may be responsible for the health benefits of a diet rich in fruits and vegetables.

“An important result of research in recent years is less emphasis on any single nutrient, or even any group of a few nutrients, in preventing cancer, with more support for the way that a balanced, plant-based diet provides a bounty of nutrients and compounds that seem to work together to protect us against cancer,” says Karen Collins, MS, RD, CDN, and nutrition advisor to the American Institute for Cancer Research.

“Research shows that much of the antioxidant power of a healthy plant-based diet comes not from the traditional vitamins we focus on, but from a wide range of phytochemicals … these compounds seem to work best together, not on their own.”

The benefits you get from eating a diet rich in functional foods loaded with antioxidants go far beyond fighting cancer.

Tallmadge says that people who eat foods rich in antioxidants have many health advantages, including:

• less cancer
• lower inflammation levels
• lower heart disease risk
• less Alzheimer’s and dementia 

For the most protection, you should try to eat a wide variety of colorful fruits and vegetables, including garlic and onion, tomatoes, watermelon, leafy greens, broccoli, cauliflower, blueberries, carrots, and bell peppers.

Beverages like tea, coffee, and red wine also contain antioxidants that may offer protection against many diseases, including diabetes, Alzheimer’s, and heart disease.

Omega-3 Fats: Fish Oil for Heart Health

Omega-3 fatty acids are some of the promising functional foods when it comes to your heart health.  A landmark 2006 study of the effects of fish on human health demonstrated that a modest intake of fish reduces the risk of dying from a heart attack by a whopping 36%.

“There is certainly enough evidence now to indicate that eating fish once or twice per week, choosing from a variety of fish, confers a benefit as strong or stronger than any other food for cardiovascular health,” says the study’s co-author Dariush Mozaffarian, co-director of the Program in Cardiovascular Epidemiology at Harvard Medical School and the Harvard School of Public Health.

The heart-health benefits seem to be greatest with the consumption of two particular omega-3 fatty acids that are found mainly in oily fish — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).  Choose oily, cold-water fish species like salmon, trout, and herring to get the most omega-3s.

What about the mercury in fish?  For most people, it’s more dangerous to avoid eating omega-3 fats than to consume the amount of mercury in most commonly eaten fish species.  The EPA and FDA suggests a limit of 12 ounces (2 average meals) of fish a week for special populations, including women who are or may become pregnant, nursing mothers, and young children. Those groups should avoid fish highest in mercury, such as shark, swordfish, and tilefish. 

Fish isn’t the only source of health-boosting omega-3s. You can also find the healthy fats in walnuts, canola oil, and flaxseed.  The omega-3s from plant-based sources, which contain alpha linolenic acid (ALA), may also have cardiovascular benefits, but the evidence is not as strong.

Regardless, all functional foods containing omega-3 fatty acids are thought to boost your health in a variety of ways by lessening inflammation levels in your body.  In the last few years, consuming diets rich in omega-3 fats have been touted for reducing the risk of Type-1 diabetes and, they may even improve your mood.

Getting the Most from Functional Foods

Researchers are now looking into the bioavailability of nutrients to learn how much of the antioxidants and omega-3 fats we eat are available for our bodies to use.

For now, here are a few tips for you to get the most out of the functional foods you eat:

• Try to buy produce that has been picked at full ripeness and maximum color, an indication of the presence of flavonoids.
• Cook your vegetables in as little water as possible to minimize the amount of nutrients lost in the cooking process.
• Aim to eat fish one to two times each week, and choose from a variety of species, emphasizing cold-water fish.
• Make sure you eat fat-soluble antioxidants like lycopene and vitamins A and E, with a little fat, such as olive oil, to help your body absorb the valuable nutrients.

by Dr. Chad Larson

All too often, by the time a person goes on vacation they are too wiped-out to enjoy it. Sometimes they even get sick. When the body gets depleted, the adrenal glands get overworked and the immune system goes down. When the immune system goes down we become a susceptible host to the local pathogen du jour. The body can get depleted in many ways, but let’s review three of the most common:

• Psychological Stress
• Pain and Inflammation
• Blood Sugar Imbalances

Psychological Stress

This is the type of stress that we are most familiar with. When we feel “stressed out” we are usually referring to something (or many things) that has mentally and emotionally drained us. This type of stress activates the sympathetic branch of the autonomic nervous system and produces the fight-or-flight response. This important response is not meant to continue indefinitely, so if this type of stress continues unchecked, the system falls short on its ability to keep up with the demand and fatigue ensues. 

Pain and Inflammation

Most people think of muscle pain and joint inflammation. When these imbalances are in a chronic state they can be especially draining on the system. But there are other sources of pain and inflammation which may be less familiar but in some cases are more severe to the body. Oxidative stress is a process by which free radicals attack DNA. Free radical are generated by smoking, excess sugar intake, excess physical and emotional stress, heavy metal toxins (mercury, lead, iron, etc.), radiation (x-rays, UV, etc.), trans fats (hydrogenated oils), certain drugs, chronic infection (gut pathogens, gingivitis, etc.). Free radicals are believed to play a role in more than sixty different health conditions, including the aging process, cancer, and heart disease.

Blood Sugar Imbalances

Insulin causes fat storage. Insulin causes fat storage. Insulin causes fat storage. When excess insulin is secreted in response to excess sugar consumption, the blood sugar (glucose) is stored in fat cells. Normally, the glucose is used by the cells of the body and mostly stored in the muscles and the liver. But when there is more than the body can use, insulin forces fat cells to take in blood lipids called triglycerides and fat cells grow. Our daily energy is very dependent upon our blood sugar balance. If our blood sugar is too low we can become mentally and physically fatigued. Low blood sugar can come from either skipping meals or making unhealthy food choices like sweets, pastries, or any refined and processed flour product (such as breads, pastas, cookies, chips, and crackers that are not 100% whole grain).

So now that we have discussed some of the common causes of a lack of energy, let’s talk about ways to get healthy healthy energy levels that will truly keep you going all day long with no jittery feelings or the inevitable crash?

Adaptogens

Borrowing from long traditional uses and strong clinical science, certain herbal adaptogens and other traditional herbs have been shown to decrease symptoms of fatigue, stress, anxiety, neuralgia, depression, and sore muscles. Adaptogens are also known to increase stamina and enhance physical performance.

What is an adaptogen? In 1947, Dr. Nikolai Lazaren defined an adaptogen, “as an agent that allows the body to counter adverse physical, chemical, or biological stressors by raising nonspecific resistance toward such stress, thus allowing the organism to ‘adapt’ to the stressful circumstance.” This definition still holds true for today, but now also includes an ability to balance endocrine hormones and the immune system. Here is a list of the most effective adrenal adaptogens:

Maca
For around 2000 years Maca has been an important traditional food and medicinal plant in its native growing region. It is regarded as a highly nutritious food and as a medicine that enhances strength and endurance and also may act as an aphrodisiac. During Spanish colonization maca was used as currency.

Eleutherococcus senticosus
Eleuthero use dates back 2,000 years, according to Chinese medicine records. Referred to as ci wu jia in Chinese medicine, it was used to prevent respiratory tract infections, colds and flu. It was also believed to provide energy and vitality. Eleuthero has been shown to enhance mental acuity and physical endurance without the letdown that comes with caffeinated products. Research has shown that eleuthero improves the use of oxygen by the exercising muscle. This means that a person is able to maintain aerobic exercise longer and recover from workouts more quickly. It is also useful when the adrenal glands are depleted as it may help alleviate symptoms of fatigue and stress.

Cordyceps
In ancient China, cordyceps was used in the Emperor’s palace and was considered to have ginseng-like properties. A number of studies indicate that cordyceps may have an immuno-enhancing and antioxidant effects. It was also reported that cordyceps has demonstrated an ability to increase energy and endurance as well as reduce the onset of exercise-related fatigue. Some athletes who participate in endurance exercise events, such as distance running, swimming, cycling, adventure racing, etc., rather than sprinting, weight-lifting, etc. notice an improvement in exercise capacity and tolerance from supplementing with cordyceps.

Turmeric
The active constituent of turmeric is known as curcumin. Curcumin has been used for thousands of years as a safe anti-inflammatory in a variety of ailments as part of traditional Indian medicine. It has been shown to have a wide range of therapeutic actions. First, it protects against free radical damage because it is a strong antioxidant. Second, it reduces inflammation by lowering histamine levels and possibly by increasing production of natural cortisone by the adrenal glands. Third, it protects the liver from a number of toxic compounds. Fourth, it has been shown to reduce platelets from clumping together, which in turn improves circulation and may help protect against atherosclerosis. The U.S. National Institutes of Health has four clinical trials underway to study curcumin treatment for pancreatic cancer, multiple myeloma, Alzheimer’s, and colorectal cancer.

Ginseng
Panax (Asian) ginseng roots are taken orally as adaptogens, aphrodisiacs, nourishing stimulants, and in the treatment of type II diabetes, including sexual dysfunction in men.

Rhodiola rosea
The Vikings used rhodiola to enhance physical strength and endurance, and it was commonly used by many Northern peoples to treat fatigue, poor physical endurance, nervous system disorders, and infections, and to enhance fertility. Rhodiola rosea is effective for improving mood and alleviating depression. Russian research shows that it improves both physical and mental performance, reduces fatigue, and prevents high-altitude sickness. Rhodiola rosea’s effects are attributed to its ability to optimize serotonin and dopamine levels, due to monoamine oxidase inhibition and to its influence on opioid peptides such as beta-endorphins.

Ashwagandha
Ashwagandha stimulates the activation of immune system cells, such as lymphocytes. It has also been shown to inhibit inflammation and improve memory. These actions may support the traditional reputation of ashwagandha as a tonic or adaptogen - counteracting the effects of stress and generally promoting wellness.

Coenzyme Q10

I would also highly recommend Coenzyme Q10 to boost your energy. Coenzyme Q10 (CoQ10) is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs. For various reasons, the supply of CoQ10 can become depleted in the body affecting the production of ATP. CoQ10 is also a powerful antioxidant that protects the body from free radicals. The key features of CoQ10 are:

• Support for the heart and entire cardiovascular system
• Antioxidant and immune enhancement
• Production of ATP, the metabolic energy on which the body runs

Evaluate Your Adrenal Hormone Supply
 
Additionally, we recommend you have an evaluation of your adrenal hormones. If you have an imbalance of your main adrenal hormones - cortisol or DHEA - your energy and sense of wellness can be affected. Depending on the results of the Adrenal Hormone Test, a therapeutic protocol can be determined that is specific to your individual needs.

Please do your part and make healthy dietary and lifestyle choices in addition to the above recommendations. Please avoid excess amounts of sugar, including sweets and any refined processed grain product, like breads, pasta, crackers, chips, cookies, etc. Choose only the 100% whole grain variety. Also, regular cardiovascular exercise has been shown to increase physical energy and improve sleep.

To no surprise to many of us, as more and more consumers are embracing integrative medicine, so are practitioners.  According to a recent survey by Jackson & Coker, a significant number of healthcare providers are using some form of integrative medicine to enhance their own health and well-being, or they have introduced certain facets of alternative medicine into their patient care.

The survey, entitled “Healthcare Providers’ Use of Complementary and Alternative Medicine,” was sent during June to thousands of physicians and other health professionals throughout the United States, with nearly 300 individuals responding.

The survey queried respondents as to what heath measures they personally hope to achieve in using some form of CAM. The results were as follows:

• Stress relief 19.0%
• Improve general health 15.6%
• Pain management 13.3%
• Improve mental alertness 11.4%
• Weight reduction / control 9.3%
• Reduce hypertension 8.2%
• Overcome insomnia 7.8%
• Lower cholesterol 5.9%
• Control diabetes 3.5%

The survey pointed out, interestingly, that only a small number of doctors (15%) believe that as complementary and alternative medicine becomes more acceptable within the healthcare field, more insurers will provide approved reimbursement. Sixty-two percent felt it was either “not too likely” or “probably unlikely” that insurance coverage will substantially increase in the foreseeable future.

Most interestingly, the survey showed one of the areas that needs more focus – the education of integrative medicine by practitioners.  The health practitioners surveyed learned about complementary and alternative medicine through various means: formal medical training (13%), seminars on holistic medicine (21%), and self-teaching or interaction with colleagues (25%). The types of alternative modalities, therapies, and treatments with which health providers were most familiar included: herbal medicine, massage therapy and reflexology, yoga and meditation, chiropractic treatment, biofeedback, and acupuncture. Other approaches with which they were less familiar included: hypnotherapy, aromatherapy, Tai Chi, and Ayurvetic medicine. 

These findings are just one of the reasons why respected organizations that educate physicians and other health care professionals on the latest findings and emerging procedures in integrative medicine practitioners are so important.  In fact, efforts like the Integrative Medical Consortium are a collaborative alliance of CAM associations is committed to advancing integrative medicine for the well-being of patients worldwide and includes American College for Advancement in Medicine, American Academy of Environmental Medicine, American Association of Naturopathic Physicians, American Holistic Medical Association, and International College of Integrative Medicine. AMARC Enterprises is excited to be working with many of those organizations through conferences and membership communication to not only keep people informed and up-to-date but also to keep ourselves aware of news and information that is disseminated so that we can pass the knowledge on to you, our readers.

By Chris D. Meletis, ND

Fatigue is one of the most frequent health concerns I hear about from my patients in clinical practice. Although many turn to energy drinks, which, when rich in nutrients, are a better alternative to coffee, in reality this is only a temporary solution. It’s better to find the reason behind why a person is fatigued in the first place. By eliminating each of the possible causes, the real culprit will be found.

In this article, I will describe the most common reasons for fatigue and what steps can be taken to increase energy levels once the underlying cause of the exhaustion is pinpointed.

Overt Disease

When looking into the reasons behind why a person is so tired, it’s helpful to first determine whether he or she is suffering from a disease that could be causing the fatigue. For example, in one study, all patients with heart failure complained of daily chronic fatigue.(1)

High blood pressure also is associated with increased fatigue as are autoimmune diseases and chronic infections. Therefore, it is important to undergo a thorough checkup to eliminate a specific health condition. Once specific diseases are ruled out, then the less obvious energy drainers mentioned below can be explored.

Adrenal Dysfunction

One of the first steps is to conduct a salivary hormone test (adrenal function panel). This test monitors a person’s morning, afternoon, and evening cortisol levels as well as DHEA levels in order to determine the health of the adrenal glands.

Adrenal burnout and the associated imbalance in cortisol levels is a frequent cause of fatigue. Under conditions of stress, the adrenal glands produce cortisol and other stress-related hormones. A perfectly balanced body will learn to cope with stress and return rapidly to a resting state when the stressor is eliminated. However, the capacity to cope with stress is limited, highly individualized and worsens with age. Consequently, a person’s body may not realize that a stressful event has ended and continue to produce the high levels of cortisol triggered by the event. This over production of cortisol ultimately leads to exhausted adrenals where the glands are no longer able to produce sufficient levels of this important hormone. Adrenal dysfunction may be manifested by an excess or inadequacy of cortisol and DHEA and loss of sensitivity of the hypothalamus and pituitary to the normal, inhibiting effects of these hormones.

In a recent study of 78 working subjects, researchers used a salivary test to measure the daily variations in cortisol in both the non-exhausted subjects and the exhausted subjects. The researchers found that the exhausted subjects experienced significantly lowered morning cortisol levels. In the non-exhausted subjects, the morning cortisol levels were normal.(2)

“The results would support the notion that exhaustion is associated with hypothalamus-pituitary-adrenal (HPA) axis hypoactivity as assessed by salivary cortisol,” the study authors noted.

Morning cortisol levels also have been found to be lower in female chronic fatigue patients compared to controls.(3)

A salivary hormone test (adrenal function panel) can help determine whether disturbed cortisol levels are the reason behind an individual’s fatigue. When test results indicate low cortisol levels in the morning this generally is indicative of adrenal burnout, and supplementing with a formula that contains glycyrrhizic acid from licorice combined with adrenal powder and potassium can be very helpful. Glycyrrhizic acid mimics the effects of cortisol and helps burned out adrenals recover. Glycyrrhizic acid should be taken for several weeks at a time and then supplementation should stop for a period before resuming again. Individuals with high blood pressure should monitor their blood pressure daily when using licorice.

Individuals whose adrenal function panel indicates their cortisol levels are chronically elevated often find it helpful to consume a supplement that contains Relora®, a proprietary blend of an extract from Magnolia officinalis bark and an extract from Phellodendron amurense, and Sensoril®, a patented Ashwagandha (Withania somnifera) root and leaf extract. Each of these substances has been shown to balance cortisol levels.(4-5)

In my clinical practice I also find that SeriPhos™ is helpful in controlling elevated cortisol levels.

Mood Disorders

Fatigue and depression often present with similar symptoms. One review of the medical literature established that chronic fatigue syndrome is underdiagnosed in more than 80 percent of the people who have it and that it is often misdiagnosed as depression.(6-7)

Fatigue is often a symptom of seasonal affective disorder (SAD), a depressive disorder that occurs in individuals who are sensitive to the decreased sunlight that occurs in winter. The onset of winter may lead to more severe bouts of depression that can interfere with ones ability to function at work or in the home. This reoccurring form of depression usually begins in the fall, increases through the winter holidays, and doesn’t let up until the return of spring. Symptoms of seasonal affective disorder include extreme fatigue and lack of energy, increased need for sleep, sleeping much more than usual, carbohydrate craving and increased appetite and weight gain.

Clinically, when I note that a patient’s fatigue is worse in winter and associated with “the winter blues,” I find that the use of 5-HTP, L-theanine and vitamin D3 together with maximizing outdoor time and light therapy can help significantly.

Thyroid Health

The thyroid gland is a major controller of metabolic activity in virtually every body tissue. If fatigue is accompanied by other symptoms such as weight gain, hair thinning or loss, cold hands and feet, low body temperature, depression, slower bowels and dry skin, then hypothyroidism should be suspected and testing for levels of the thyroid hormones free T3 and free T4 as well as TSH is a good approach. In fact, one of the reasons for the strong connection between depression and fatigue mentioned above may be that individuals who present with both conditions may be suffering from underactive thyroid.

Meanwhile, in individuals who exhibit fatigue along with weight loss, rapid heartbeat, and nervousness, hyperthyroidism should not be overlooked.

In addition to a complete thyroid panel, an iodine sufficiency test can help determine whether iodine status is playing a role in thyroid health and overall energy levels. Guy Abraham, MD has found, in a number of studies, that supplementing with a special combination of iodine/iodide known as Iodoral® can improve the health of both patients with hypothyroidism and hyperthyroidism. Dr. Abraham noted that whole body sufficiency for iodine was associated with a sense of overall well being, lifting of “brain fog,” feeling warmer in cold environments, increased energy, needing less sleep, achieving more in less time, experiencing regular bowel movements and improved skin complexion.(8)

Sleep

Restorative sleep is essential to optimal energy levels. Fatigued individuals should therefore look to their sleep habits as a possible cause of low energy levels. Snoring and waking frequently during the night can be an indication of sleep apnea and this issue should be addressed.

Additionally, anyone who finds it hard to fall asleep or to stay asleep, who suffers from restless legs syndrome or who wakes up with heart palpitations may have sleep issues that are causing fatigue.

One of the major causes of age-related sleep disturbances is a reduction in the amount, and alteration in the timing, of melatonin production by the pineal. Supplementation with melatonin has often been shown to ameliorate these disturbances in the sleep-wake rhythm. In a study of elderly women, 35.7 percent of investigated subjects noted an improvement in general sleep quality and in such sleep parameters as sleep initiation, the amount of time it takes to fall asleep, number of awakenings episodes, and wake time after sleep onset.(9)

In addition to improving sleep, melatonin has been shown to act directly on reducing fatigue in patients with chronic fatigue syndrome.(10)

Allergies

Allergies—both allergic rhinitis and delayed food sensitivities—can be another fatigue-causing factor. Recently,

GeorgetownUniversityMedicalCenter researchers noted there is emerging evidence to suggest that food allergies appear to be an important triggering event in chronic fatigue syndrome and fibromyalgia.(11)

In my clinical practice, I also have noted that energy levels often increase in fatigued patients who eliminate offending foods from their diets. Consequently, I always recommend that anyone suffering from fatigue take a food allergy test for “hidden” food sensitivities. Delayed food allergies can contribute to digestive problems, body aches, headaches and symptoms typically not associated with classic allergy symptoms.

Food allergies/sensitivities also play a large role in the amount of suffering a person experiences with seasonal allergies. This is because it is the total burden on an individual’s system that ultimately determines how readily the body releases histamine and inflammatory substances that lead to many of the miserable symptoms of allergic reactions. The combined environmental and food allergen burden results in total susceptibility to succumbing to allergic symptoms.

Testing for hidden food allergies helps identify delayed IgG immunoglobulin allergens. This technology that I have used for years in my clinical practice has now been applied to home test kits, available here, that can identify reactions to 96 different foods. The results indicate low, moderate or high reactions to different foods.

Avoiding offending foods will produce dramatic results, but for times when food allergen exposure cannot be avoided, GI Cell Support, Digestive Enzymes, probiotics (Culturelle® or BioPro™) and Lectin Lock™ can help support the body’s overall health. For seasonal allergies, the combined use of bromelain, vitamin C and quercetin can provide additional support.

Nutrient Deficiencies and Environmental Toxicity

When the body is not receiving enough of a particular nutrient or is overburdened with environmental pollutants, this can take a huge toll that compromises energy levels. Therefore, in my clinical practice, I recommend all my fatigued patients take an organic acid test that also checks for environmental pollutants.

Organic acid testing, which I also routinely use to help my patients, is also available here, and is important for those seeking to fine tune or increase a supplement program’s effectiveness. The patient receives specific recommendations of vitamins, minerals, nutrients and amino acids and dosage suggestions. Depending on overall health status and medications taken, either implementation or discussion with one’s physician or nutritional supplement expert is recommended.

The clinical benefits seen when the body’s unique needs are addressed can be the difference between modest clinical results versus a significant metamorphosis. 

The organic acid test also looks for detoxification markers that provide insights into the capacity and success of the body to process and cope with an increasingly toxic environment.

Other Factors

Fatigue can be a side effect from various pharmaceuticals such as statin drugs, blood pressure medications and antidepressants so checking the cautions that accompany the prescriptions is important as are doctor-patient discussions about this topic.

Additionally, a diet overloaded with processed food, refined carbohydrates and sugar can make a person feel sluggish. Dehydration is another important factor in low energy levels. Drinking 64 ounces of water every day is essential to enhance energy levels.

Conclusion

When trying to determine the reason for fatigue, the only approach one can take is to begin eliminating potential causes. By playing detective and looking at all the factors mentioned above, the reason why a person is fatigued will likely become apparent and steps can then be taken to eliminate exhaustion.

References

1. Jasiukeviciene L, Vasiliauskas D, Kavoliūniene A, Marcinkeviciene J, Grybauskiene R, Grizas V, Tumyniene V. Evaluation of a chronic fatigue in patients with moderate-to-severe chronic heart failure. [Article in Lithuanian]. Medicina (Kaunas). 2008;44(5):366-72. 

2. Lindeberg SI, Eek F, Lindbladh E, Ostergren PO, Hansen AM, Karlson B. Exhaustion measured by the SF-36 vitality scale is associated with a flattened diurnal cortisol profile. Psychoneuroendocrinology. 2008 May;33(4):471-7.

3. Nater UM, Maloney E, Boneva RS, Gurbaxani BM, Lin JM, Jones JF, Reeves WC, Heim C. Attenuated morning salivary cortisol concentrations in a population-based study of persons with chronic fatigue syndrome and well controls. J Clin Endocrinol Metab. 2008 Mar;93(3):703-9.

4. LaValle J, Hawkins, E. Relora—The Natural Breakthrough to Losing Stress-Related Fat and Wrinkles.North Bergen NJ: Basic Health Publications; 2003: 16. 

5. Bhattacharya, S. et al. Anti-stress activity of sitoindosides VII and VIII, new acylsterylglucosides from Withania somnifera. Phytother Res. 1987;1: 32-37.

6. Griffith JP, Zarrouf FA. A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression. Prim Care Companion J Clin Psychiatry. 2008;10(2):120-8. 

 7. Arnold LM. Understanding fatigue in major depressive disorder and other medical disorders. Psychosomatics. 2008 May-Jun;49(3):185-90. 

 8. Abraham, GE. The safe and effective implementation of orthoiodosupplementation in medical practice. The Original Internist. 2004; 11:17-36.

9. Pawlikowski M, Kolomecka M, Wojtczak A, Karasek M. Effects of six months melatonin treatment on sleep quality and serum concentrations of estradiol, cortisol, dehydroepiandrosterone sulfate, and somatomedin C in elderly women. Neuro Endocrinol Lett. 2002 Apr;23 Suppl 1:17-9.

10. van Heukelom RO, Prins JB, Smits MG, Bleijenberg G. Influence of melatonin on fatigue severity in patients with chronic fatigue syndrome and late melatonin secretion. Eur J Neurol. 2006 Jan;13(1):55-60.

11. Bellanti JA, Sabra A, Castro HJ, Chavez JR, Malka-Rais J, de Inocencio JM. Are attention deficit hyperactivity disorder and chronic fatigue syndrome allergy related? What is fibromyalgia? Allergy Asthma Proc. 2005 Jan-Feb;26(1):19-28.