6 Tips to Manage Endo Fatigue
By Meredith East-Powell
Feeling constantly tired is a common symptom of endometriosis. This isn’t your normal kind of tired that happens after a busy day; this sort of tired never seems to get better, even after rest.
It’s not fully understood what the causes endometriosis related fatigue, but fatigue is a common symptom of inflammatory conditions such as endometriosis (1).
Here are a few possible underlying causes of chronic fatigue:
Less efficient energy production: inflammation changes the way the body generates energy which is less-efficient and leads to reduced nutrient availability (1).
Free radicals and oxidative stress: inflammation also causes an increase in free radicals which can cause cellular damage. Normally, antioxidants help protect cells against free radicals (also known as reactive oxygen species or ROS), however if there’s an imbalance and too many free radicals, it can cause damage to cells which is known as oxidative stress (1). When this happens, mitochondria can become damaged and less efficient at producing energy (1).
Chronic stress: ongoing stress and diet can both contribute to inflammation (2). In addition, high levels of stress can lead to depression and/or anxiety which are also linked to fatigue.
Sleep: inflammation and stress can also affect sleep, reducing sleep quality and altering the circadian rhythm which can cause fatigue (1).
6 ways to help manage endometriosis fatigue:
Eat an anti-inflammatory diet that is rich in antioxidants, fibre and healthy fats; a Mediterranean diet is a great example (3). The Mediterranean diet is rich in wholefoods; vegetables, fruit, wholegrains, legumes, nuts, seeds, spices and olive oil are consumed daily. Fish is eaten about 4 times per week. Poultry and eggs are eaten in moderation, red meat is limited to no more than once a week and processed foods are avoided. Be sure to drink plenty of water as even mild dehydration can cause fatigue.
Women experiencing food sensitivities will need a more tailored diet by removing foods that are triggering their symptoms and contributing to inflammation. Common problem foods for women with endometriosis can include cow’s dairy, gluten and eggs. Digestive symptoms can be a result of other issues such as poor absorption of high FODMAP foods or chemical sensitivities such as histamine. In this case see a nutritionist for tailored advice.
Mindfulness meditation is known to offer a range of benefits including improved pain tolerance and sleep quality (4, 5). Mindfulness is simply observing the present moment without judgement or attaching to your thoughts. Start with just 5 minutes of mindfulness a day and gradually increase. Mindfulness doesn’t need to be practised sitting cross-legged on the floor, you can simply sit in a comfy chair and enjoy your favourite drink, or you can try slow deep belly breathing. Apps such as Insight Timer or Calm are also helpful and offer a huge range of guided meditations.
Try supplementing: CoQ10 is an antioxidant but this nutrient is also involved in energy production and may help alleviate fatigue (1). Other supplements which are helpful for inflammation, oxidative stress and energy metabolism are magnesium, B6, zinc, fish oil, vitamin E, vitamin C, curcumin and N-acetyl cysteine.
Exercise can also be helpful in managing fatigue but can be difficult to incorporate initially; start off slowly and find a type of movement that you enjoy. Yoga, qi gong or walking are gentle forms of exercise. Another option is to work with an exercise physiologist, who can create an exercise program tailored to your needs.
Implement a sleep hygiene routine. A good night’s sleep is crucial to your health. Plan ahead and decide what time you want to go to sleep, then at least 30 minutes prior turn down the lights, turn off all electronic devices and do something relaxing such as yin yoga or meditation. Avoid alcohol, eating a large meal just before bed and avoid caffeine after midday. If possible, go to bed at the same time every day and wake at the same time every day.
It should also be noted that chronic fatigue can be associated with a range of other health conditions. If you’re struggling with fatigue and it’s interfering with your life, see your GP.
Meredith East-Powell is a nutritionist, yoga teacher and the Wellness Coordinator for Qendo. To read more articles from Meredith or connect with her head to thehealingyogi.com
References:
(1) Lacourt, T. E., Vichaya, E. G., Chiu, G. S., Dantzer, R., & Heijnen, C. J. (2018). 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 neuroscience, 12, 78. doi:10.3389/fnbeh.2018.00078
(2) Nasef, N. A., Mehta, S., & Ferguson, L. R. (2017). Susceptibility to chronic inflammation: an update. Archives of Toxicology, 91(3), 1131–1141. doi:10.1007/s00204-016-1914-5
(3) Bonaccio, M., Pounis, G., Cerletti, C., Donati, M. B., Iacoviello, L., de Gaetano, G., & MOLI-SANI Study Investigators (2017). Mediterranean diet, dietary polyphenols and low-grade inflammation: results from the MOLI-SANI study. British journal of clinical pharmacology, 83(1), 107–113. doi:10.1111/bcp.12924
(4) Rusch, H. L., Rosario, M., Levison, L. M., Olivera, A., Livingston, W. S., Wu, T., & Gill, J. M. (2018). The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Annals of the New York Academy of Sciences. doi:10.1111/nyas.13996
(5) Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 51(2), 199–213. doi:10.1007/s12160-016-9844-2
The materials available on or through the websiteqendo.org.au [‘QENDO’] are an information source only. Information provided by QENDO does not constitute medical advice and should not be relied upon to diagnose or treat any medical condition.To the maximum extent permitted by law, all contributors of QENDO make no statement, representation, or warranty about the quality, accuracy, context, completeness, availability or suitability for any purpose of, and you should not rely on, any materials available on or through the website qendo.org.au. QENDO disclaims, to the maximum extent permitted by law, all responsibility and all liability (including without limitation, liability in negligence) for all expenses, losses, damages and costs you or any other person might incur for any reason including as a result of the materials available on or through this website being in any way inaccurate, out of context, incomplete, unavailable, not up to date or unsuitable for any purpose.