Always tired? How inflammation might be to blame…and five ways to get energized.

Always tired? As a mom of two and entrepreneur in her thirties, I can relate.

If you aren’t sleeping and burning the candle at both ends, you’re going to be tired. But what if you ARE sleeping and taking pretty good care of yourself and you just can’t get your energy levels back?

Something that I’ve noticed – in myself and my clients – is that with each passing year, you have to do a better job of self-care in order to continue to feel as good. So if you are living at 35 like you did at 25 and not feeling like your old self, it’s time to step up your self-care game.

However, there could also be another surprising culprit afoot: inflammation. If you’ve got chronic conditions such as depression, type two diabetes or irritable bowel syndrome, low grade inflammation could be causing you to feel tired and low energy, even after a good night’s sleep.

Does inflammation cause fatigue?

You might be surprised to learn that chronic inflammation may be contributing to fatigue, but it’s well explored in the scientific literature. Many of these studies are looking at those with chronic disease, such as autoimmunity and type two diabetes, where it has been found that many inflammatory markers known as cytokines are associated with increased fatigue^1-3.

Fatigue is admittedly complex; it is likely that your fatigue is not attached to just one root cause. So before we talk about how inflammation contributes to feeling tired all of the time, let’s clear up some of the most common energy zappers that could leave you feeling tired all of the time.

What causes low energy and tiredness?

Not sleeping at least 6-8 hours a night

If you’re not sleeping, you’re going to be tired, full stop. Prioritize sleep by going to bed early enough each night that 6-8 hours of sleep is possible. Try to shut down screen time at least one hour before bed and make sure that you sleep in a dark, distraction-free room.

Drinking adequate water

Your body is a fluid medium, if you aren’t well hydrated, you’re probably going to feel sluggish and low energy. Start your day by drinking 1-2 glasses of water first thing in the morning – go for hot water with lemon if the idea of drinking cold water isn’t appealing. Then, drink enough water throughout the day to keep your urine pale in colour. Keep a large water bottle with you as you will likely drink more than if you have to refill a small glass multiple times a day.

Eating a nutrient-poor diet

If your diet consists of mostly hyper-processed foods from food outlets or boxed and bagged convenience items, you’re going to feel awful after a while. Start prioritizing healthy meals with plenty of fruits and vegetables and snack on whole foods like nuts instead of snack bars. Consider a whole food way of eating the baseline for good health.

Not exercising

Ironically, the more sedentary you are, the less energy you’re going to feel – this is particularly true the older you get. You don’t have to become a marathoner…but you do have to move your body. So make a commitment to yourself to go for a 20 minute walk most days and see how it improves your energy  levels.

Low Iron

Low iron and iron deficiency anemia are classic energy zappers. If you have been low energy for some time, always start with a checkup at the doctor to make sure anemia isn’t the culprit. It’s also worth noting that inflammation can cause anemia, independent of diet, in those with chronic disease⁴.

How inflammation causes low energy and fatigue

When you know you’ve got a fairly healthy self-care baseline, now it’s time to consider whether inflammation is contributing to your fatigue.

It isn’t known exactly how chronic inflammation contributes to fatigue; however, inflammation is a complex immune process that can affect the body in many ways:

• It is thought that low-grade inflammatory immune pathways can brain chemistry and neuro-inflammation, in addition to altering the activity of important enzymes required for neurotransmitter production^1-3.
• In one review, it was hypothesized that low-grade, or chronic, inflammation increases the energy needs of immune cells, causing them to use less efficient but quick pathways for generating energy. These pathways may be robbing the rest of your body of the nutrients needed to produce energy⁵.
• Mitochondria are the energy powerhouses of the cell – they produce a molecule called ATP that drives cellular functions. Chronic inflammation can increase the production of reactive oxygen species (ROS) that can damage mitochondrial function, affecting ATP production^2,5. This inflammation/mitochondria connection has been established in diseases such as Sjogren’s Syndrome^2,5. These reactive oxygen species (ROS) can incite damage responses that can alter cellular function and create a vicious feedback loop that causes more damage and more inflammation².
• To make things worse, chronic inflammation can also promote insulin resistance, which makes it more difficult for your cells to take up the glucose it uses to produce ATP for energy⁵.
• Finally, it is thought that inflammation may cause sickness behaviour, driven by your brain^5,6. Think about the last time you had a cold: the fatigue you feel encourages rest^5,6. It is thought that the body does this to help conserve energy to fight the infection, in addition to decreasing risk of further infection through social reactions⁵. Inflammation can also impact quality of sleep, which is a challenge because lack of sleep foster further inflammation⁵.

Gut Health, Inflammation and Fatigue

Your gut is an important site of immune function: roughly 80% of your immune activity occurs within and along the gut to patrol what is a delicate and critical barrier between you and the outside world. Chronic inflammation can alter the barrier function of the gut, allowing gut bacteria to enter into circulation (translocate), which causes further immune activation to try and clear the bacteria from where they aren’t supposed to be².

This has been observed in depression, where fatigue persists despite treatment². Depression has largely been considered a serotonin issue; however, inflammation is now considered by some to be a hallmark of the disease, as is gut barrier dysfunction and bacterial translocation².

It is also newly being considered in chronic fatigue syndrome, where dysbiosis, gut barrier dysfunction and bacterial translocation have been observed⁷. One recent review found that in 7 studies all reported differences in gut microbiota; however, not all reached significance and therefore, more research is needed before we can say with certainty³.

Five anti-inflammatory diet strategies to fight fatigue and increase energy levels

If you think that inflammation might be contributing to your fatigue, taking concrete steps to manage inflammation with your diet is a solid strategy. Good nutrition is critical for optimal metabolic function. You just can’t run your body well when it lacks for nutrients – but in inflammation, as you’ve seen, you might require even more fuel to help repair and restore good function.

Start your day with a green smoothie

Most of us start our day with a refined sugar and refined starch-laden breakfast, which can spike blood sugars and leave our body starving for vitamins and minerals. Instead, blend up some plant-based protein powder that offers 15-20 grams of protein (I love Botanica and Sunwarrior) with a big handful of baby spinach, a small banana, some blueberries and a spoonful of nut butter. You’ll increase your intake of anti-inflammatory phyto-chemicals and give yourself a nutrient-dense start that gives your cells what they need to function optimally.

Eat omega 3-rich foods daily, and consider a supplement

Omega 3 fatty acids are scarce in our food supply and are often outnumbered by potentially pro-inflammatory omega 6 fats. So, aim for 2-3 tablespoons of ground flax, chia or hemp seeds to provide all of the omega 3 ALA you need in a day.

If you have active chronic disease, I also encourage a plant-based omega 3 supplement that contains higher levels of EPA (I like NutraVege Omega 3 Plant 2x), a fatty acid associated with decreasing inflammation. In one trial of a fatigue-reducing, anti-inflammatory diet high in omega 3s, blood levels of EPA were associated with improved symptoms⁶.

Make half your plate colourful veggies at every meal

One of the most powerful dietary shifts you can make is to cover half your plate in colourful veggies at meal time. I love this rule of thumb because it doesn’t require you to change what you like to eat…just alter the ratios in which you eat. Fruits and vegetables contain antioxidants, which your mitochondria may require in higher levels in chronic inflammation⁵. If you want to see what this looks like in practice, check out my book Eat More Plants, which is packed with anti-inflammatory, vegetable-forward recipes.

Try a probiotic

Particularly if you experience any digestive symptoms such as elimination problems or bloating alongside your other symptoms, consider taking a clinically proven probiotic such as Bio-K+ or Visbiome. Probiotics can help fight off more pro-inflammatory gut bacteria that can drive inflammation and gut barrier dysfunction. I know that it can be confusing to choose a probiotic, if you need more information, this is how I choose the probiotics I use in my practice.

Snack on nuts and seeds more often

Our snack foods are often the least healthy choices we make during the day… but they don’t have to be! I love snacking on raw almonds, pistachios and pumpkin seeds because they contain healthy fats, plenty of energy-stabilizing protein and critical minerals. Try packing ¼ cup of one of these picks with 1 tablespoon of something sweet like dried cherries, raisins or occasionally, dark chocolate chips.

How do I know if inflammation is a problem for me?

Much of the research I’ve cited looks at folks with chronic disease – which quite frankly, is many of us in modern society. If you have any of the following conditions, inflammation is likely a part of your life:

• Cardiometabolic diseases such as heart disease, type two diabetes
• Digestive concerns such as irritable bowel syndrome, celiac disease or Crohn’s disease
• Skin conditions such as eczema, psoriasis or rosacea
• Autoimmunity or chronic conditions such as rheumatoid arthritis, fibromyalgia

But what about if we don’t have chronic disease? Might inflammation be playing a role here? It’s possible that a very low level of inflammation is present, especially if you haven’t been taking good care of yourself lately.

If you are worried about symptoms that are cropping up, or you aren’t feeling as well as you could, always go get a thorough checkup with your doc first. Then, you’re empowered to take charge of your health with anti-inflammatory nutrition.

There is no reason not to feel energized and ready to tackle all that life throws at you, no matter what stage of life you are in. And plant-forward, anti-inflammatory nutrition is the perfect partner to help get you there.

References

1. Lasselin, Julie, et al. “Fatigue symptoms relate to systemic inflammation in patients with type 2 diabetes.” Brain, behavior, and immunity26.8 (2012): 1211-1219.
2. Morris, Gerwyn et al. “Central pathways causing fatigue in neuro-inflammatory and autoimmune illnesses.” BMC medicinevol. 13 28. 6 Feb. 2015, doi:10.1186/s12916-014-0259-2
3. Du Preez, S et al. “A systematic review of enteric dysbiosis in chronic fatigue syndrome/myalgic encephalomyelitis.” Systematic reviewsvol. 7,1 241. 20 Dec. 2018, doi:10.1186/s13643-018-0909-0
4. Louati, Karine, and Francis Berenbaum. “Fatigue in chronic inflammation – a link to pain pathways.” Arthritis research & therapyvol. 17 254. 5 Oct. 2015, doi:10.1186/s13075-015-0784-1
5. Lacourt, Tamara E., et al. “The high costs of low-grade inflammation: persistent fatigue as a consequence of reduced cellular-energy availability and non-adaptive energy expenditure.” Frontiers in behavioral neuroscience12 (2018).
6. Komaroff, Anthony L. “Inflammation correlates with symptoms in chronic fatigue syndrome.” Proceedings of the National Academy of Sciences of the United States of Americavol. 114,34 (2017): 8914-8916. doi:10.1073/pnas.1712475114
7. Zick, Suzanna Maria et al. “Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial.” Breast cancer research and treatmentvol. 161,2 (2016): 299-310. doi:10.1007/s10549-016-4070-y