Tag Archives: fatigue

Chronic Fatigue and The Paleo Diet | The Paleo Diet

Myalgic encephalomyelitis, commonly called chronic fatigue syndrome (ME/CFS), is an incapacitating condition marked by disabling fatigue of at least six months, accompanied by numerous rheumatological, infectious, and neuropsychiatric symptoms.1 However, in our modern day nearly 4 million people 2 struggle with these symptoms that impact their ability to fully engage in daily activities.  Exercise can help fight common fatigue, while even minor efforts at physical activity lead to a significant worsening of symptoms for ME/CFS patients. This often encourages ME/CFS patients to cope with their illness by completely avoiding physical activity.3,4

Western medicine has offered little support for effective treatments options, which have included self-managed exercise programs and psychotherapy, and many practitioners fail to recognize ME/CFS as having a physical cause, believing the condition is only psychosomatic.5 Fortunately, researchers have just discovered that there are actual plasma biological markers in individuals with early ME/CFS symptoms. Specifically, the data shows a significant activation of both pro-and anti-inflammatory cytokines, the cells aiding in communication of immune responses triggered by inflammation, infection and trauma.6 This data stands to offer both new diagnostic tools, as well as treatment options to reduce the severity of ME/CFS.7


Nutritional deficiencies can contribute to the clinical manifestations of ME/CFS, and also can impact the healing processes.8 The Paleo diet is nutrient dense9 and exceeds the governmental requirements for over 13 nutrients lacking most in the Standard American Diet (SAD).10 Follow the prescriptions in The Paleo Diet, while focusing on the following recommendations to target healing.


Antioxidants have therapeutic potential to reduce oxidative damage, which is often shown to be high in those with ME/CFS.11 Elevated concentrations of inflammatory cytokines might indirectly cause diminished antioxidant capacity by inhibiting albumin transcription in the liver.12 Therefore, it is important to replenish the body with dietary sources of glutathione-rich foods, as glutathione is required to properly utilize other antioxidants such as vitamins C, E, and selenium and carotenoids.13,14


Magnesium is necessary for over 300 biochemical reactions in the body. Stress hormones tend to deplete magnesium levels,15 which have also been shown to be decreased in ME/CFS patients, despite adequate dietary intake of magnesium.16 Magnesium supplementation from naturally rich sources, such as avocados, dark leafy greens, and nuts,17 has been shown to improve energy levels, emotional wellbeing, and reduce pain in ME/CFS patients.18


Low levels of essential fatty acids (EFAs), which are often linked to immune, endocrine, and sympathetic nervous system dysfunctions,19, 20 appear to be common in individuals with ME/CFS.21 The Paleo Diet mimics our hunter gatherer ancestor’s dietary intake of omega-6 to omega-3, with a ratio of 2:1 or 3:1, as opposed to the modern diet, which has been estimated at 10:1 or 25:1.22 Pastured meats and wild fish, as recommended on the Paleo Diet are naturally higher in omega-3 fatty acids and support anti-inflammatory actions within the body.


Stress contributes to the pathology and clinical symptoms of ME/CFS.23 The greater number of stressful life events predicts a worse functional and fatigue symptom profile24 and those who recover from ME/CFS for over one year report lower levels of life stress than those who did not recover.25 The lifestyle choices of hunter-gatherers differ from those of modern man in that there was adequate rest and recovery from both physical endeavors and mental feats. In addition to getting a solid night’s sleep, spend time outdoors each day, turn off technology early and practice mediation or other stress reducing activities to support your Paleo Diet lifestyle.


[1] Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994; 121:953-959

[2] Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Arch Intern Med 1999;159:2129- 2137. 2. Komarof

[3] Vercoulen JH, Hommes OR, Swanink CM, Jongen PJ, Fennis JF, Galama JM, van der Meer JW, Bleijenberg G: The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with patients with chronic fatigue syndrome and healthy subjects. Arch Neurol 1996; 53:642-649

[4] Vercoulen JHMM, Swanink CMA, Fennis JFM, Galama JM, van der Meer JW, Bleijenberg G: Prognosis in chronic fatigue syndrome: a prospective study of the natural course. J Neurol Neurosurg Psychiatry 1996; 60:489-494

[5] Ware, Norma C. “Suffering and the social construction of illness: The delegitimation of illness experience in chronic fatigue syndrome.” Medical Anthropology Quarterly 6.4 (1992): 347-361.

[6] Zhang, Jun-Ming, and Jianxiong An. “Cytokines, inflammation and pain.”International anesthesiology clinics 45.2 (2007): 27.

[7] Hornig, Mady, et al. “Distinct plasma immune signatures in ME/CFS are present early in the course of illness.” Science Advances 1.1 (2015): e1400121.

[8] Werbach, Melvyn R. “Nutritional strategies for treating chronic fatigue syndrome.” Alternative Medicine Review 5.2 (2000): 93-108.

[9] Cordain, Loren, et al. “Origins and evolution of the Western diet: health implications for the 21st century.” The American journal of clinical nutrition 81.2 (2005): 341-354.

[10] Cordain, Loren. “The nutritional characteristics of a contemporary diet based upon Paleolithic food groups.” J Am Neutraceutical Assoc 5 (2002): 15-24.

[11] Fulle S, Mecocci P, Fano G, et al. Specific oxidative alterations in vastus lateralis muscle of patients with the diagnosis of chronic fatigue syndrome. Free Radic Biol Med 2000;29:1252-1259.

[12] Werbach, Melvyn R. “Nutritional strategies for treating chronic fatigue syndrome.” Alternative Medicine Review 5.2 (2000): 93-108.

[13] Mårtensson, J., J. C. Lai, and Alton Meister. “High-affinity transport of glutathione is part of a multicomponent system essential for mitochondrial function.” Proceedings of the National Academy of Sciences 87.18 (1990): 7185-7189.

[14] Bounous, G., and J. Molson. “Competition for glutathione precursors between the immune system and the skeletal muscle: pathogenesis of chronic fatigue syndrome.” Medical hypotheses 53.4 (1999): 347-349.

[15] Seelig M. Presentation to the 37th Annual Meeting, American College of Nutrition, October 13, 1996.

[16] Grant JE, Veldee MS, Buchwald D. Analysis of dietary intake and selected nutrient concentrations in patients with chronic fatigue syndrome. J Am Diet Assoc 1996;96:383-386.

[17] Manuel y Keenoy, Begoña, et al. “Magnesium status and parameters of the oxidant-antioxidant balance in patients with chronic fatigue: effects of supplementation with magnesium.” Journal of the American College of Nutrition19.3 (2000): 374-382.

[18] Cox, I. M., M. J. Campbell, and D. Dowson. “Red blood cell magnesium and chronic fatigue syndrome.” The Lancet 337.8744 (1991): 757-760.

[19] Gray JB, Martinovic AM. Eicosanoids and essential fatty acid modulation in chronic disease and the chronic fatigue syndrome. Med Hypotheses 1994;43:31-

[20] Behan PO, Behan WM, Horrobin D. Effect of high doses of essential fatty acids on the postviral fatigue syndrome. Acta Neurol Scand 1990;82:209-216.

[21] Howard JM, Davies S, Hunnisett A. Magnesium and chronic fatigue syndrome. Letter. Lancet 1992;340:426.

[22] Cordain, L., et al. “Original Communications-The paradoxical nature of hunter-gatherer diets: Meat-based, yet non-atherogenic.” European journal of clinical nutrition 56.1 (2002): S42.

[23] Logan, Alan C., and Cathy Wong. “Chronic fatigue syndrome: oxidative stress and dietary modifications.” Alternative medicine review: a journal of clinical therapeutic 6.5 (2001): 450-459.

[24] Buchwald DS, Rea TD, Katon WJ, Russo JE, Ashley RL. Acute infectious mononucleosis: Characteristics of patients who report failure to recover. The American Journal of Medicine.2000;109(7):531–537.

[25] Lim BR, Tan SY, Zheng YP, Lin KM, Park BC, Turk AA. Psychosocial factors in chronic fatigue syndrome among Chinese Americans: A longitudinal community-based study. Transcultural Psychiatry. 2003;40:429–441.

Fight Fatigue with Energizing Workouts | The Paleo Diet

Are you too tired to work out? You’re not alone. Finding natural ways, meaning without caffeine and sugar, to feel invigorated is important. One in five adults worldwide experience persistent fatigue, including 24% of the US.1 The last thing you might feel like doing when you’re low on energy is exercising. However, it turns out that one of the best ways to fight fatigue is with regular exercise.2  12 population-based studies conducted between 1945 and 2005 measured the relationship between physical activity and feelings of energy and fatigue. All of these studies found an association between physical activity and a reduced risk of experiencing feelings of low energy and fatigue.3

Despite how active our hunter-gather ancestors were, they did spend a significant amount of time resting and recovering.4 Our modern environment and technological advances have changed both the way we move and rest. How exercise helps fatigue isn’t exactly clear, but research suggests it directly impacts the central nervous system to increase feelings of energy and lessen feelings of fatigue.5

Lifestyle factors that lead to fatigue should always be considered first, such as getting adequate sleep (maybe even more than 8 hours),6 proper nutrition, and managing stress, as they all contribute to a restored well-being. Over-training your body without programming the correct recovery time can also lead to feeling tired or weak. Resolving the lifestyle factors can significantly improve any sluggish feelings you may be struggling with.

If exercise is good for us mentally and physically,7 why is it so hard to get going? There’s no one answer. Research indicates that the perception of fatigue leads individuals to believe it takes too much effort to push through their feelings of discomfort during exercise, even when their bodies have the capacity to do the work.8 As tempting as it might be to skip your whole workout when you’re tired, it is better to attempt to participate in something rather than nothing. Specifically, a shorter duration or less demanding program is more beneficial and energizing than sitting in front of the television.

Here are some ideas, based on the exercise principles of duration, frequency, and intensity,9 to get you started:

Low intensity exercise

Skip your regular trip to the gym and take a leisurely walk or bike ride in the outdoors.  Exposure to natural light can increase energy10 and improve your mood.11,12

Alternatively, you can practice yoga in the comfort of your home or at a professional studio. In addition to providing a chance to relax your mind and stretch your body, it has been shown to increase energy and improve the quality of life of those with cancer and multiple sclerosis.13,14

Body weight or weighted resistance exercises can also be performed at lower intensity and lower volume. Low-intensity strength training has been shown to have similar results on muscle strength and tissue composition compared to higher-intensity lifting.15

High intensity exercise

There is compelling evidence on the benefits of high intensity training.16 However, on the days when you’re especially tired, consider doing a very short duration workout, for 8-10 minutes, of high intensity training to maximize the effects on your energy level.17

Performing a grueling, endurance-type high intensity workout when you’re tired can lead to an increased stress response from the body,18 as well as lead to injury from failure to maintain proper form through the movements.

When you’re low on energy, choose to do something you enjoy doing for exercise, even if it’s much easier than how you normally move. You can make up the heavy strength training or long endurance rides after you’re feeling rejuvenated enough to tackle the task. Listening to your body while maintaining your active lifestyle is a key habit to maintain the life-long habit of healthy living.


[1] Chen, Martin K. “The epidemiology of self-perceived fatigue among adults.”Preventive medicine 15.1 (1986): 74-81.

[2] Puetz, Timothy W., Patrick J. O’Connor, and Rod K. Dishman. “Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis.”Psychological bulletin 132.6 (2006): 866.

[3] Puetz, Timothy W. “Physical activity and feelings of energy and fatigue.” Sports medicine 36.9 (2006): 767-780.

[4] O’Keefe, James H., et al. “Exercise like a hunter-gatherer: a prescription for organic physical fitness.” Progress in cardiovascular diseases 53.6 (2011): 471-479.

[5] Puetz, Timothy W. “Physical activity and feelings of energy and fatigue.” Sports medicine 36.9 (2006): 767-780.

[6] Czeisler, Charles A., et al. “Human sleep: its duration and organization depend on its circadian phase.” Science 210.4475 (1980): 1264-1267.

[7] Stathopoulou, Georgia, et al. “Exercise interventions for mental health: a quantitative and qualitative review.” Clinical Psychology: Science and Practice13.2 (2006): 179-193.

[8] Marcora, Samuele. “Perception of effort during exercise is independent of afferent feedback from skeletal muscles, heart, and lungs.” Journal of applied physiology 106.6 (2009): 2060-2062.

[9] Shephard, Roy J. “Intensity, duration and frequency of exercise as determinants of the response to a training regime.” Internationale Zeitschrift fuer Angewandte Physiologie Einschliesslich Arbeitsphysiologie 26.3 (1968): 272-278.

[10] Eastman, Charmane I., et al. “Light treatment for sleep disorders: Consensus report VI. Shift work.” Journal of Biological Rhythms 10.2 (1995): 157-164.

[11] Terman, Michael, and Jiuan Su Terman. “Bright light therapy: side effects and benefits across the symptom spectrum.” Journal of Clinical Psychiatry 60.11 (1999): 799-808.

[12] O’Keefe, James H., et al. “Achieving Hunter-gatherer Fitness in the 21< sup> st</sup> Century: Back to the Future.” The American journal of medicine123.12 (2010): 1082-1086.

[13] Chandwani, Kavita D., et al. “Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer.” Journal of the Society for Integrative Oncology 8.2 (2009): 43-55.

[14] Oken, B. S., et al. “Randomized controlled trial of yoga and exercise in multiple sclerosis.” Neurology 62.11 (2004): 2058-2064.

[15] Taaffe, D. R., et al. “Comparative effects of high‐and low‐intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women.” Clinical Physiology 16.4 (1996): 381-392.

[16] Laursen, Paul B., and David G. Jenkins. “The scientific basis for high-intensity interval training.” Sports Medicine 32.1 (2002): 53-73.

[17] Babraj, John A., et al. “Extremely short duration high intensity interval training substantially improves insulin action in young healthy males.” BMC Endocrine Disorders 9.1 (2009): 3.

[18] Urhausen, Axel, Holger Gabriel, and Wilfried Kindermann. “Blood hormones as markers of training stress and overtraining.” Sports medicine 20.4 (1995): 251-276.


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