Fatigue by Clinicians Technical Info

Fatigue

B vitamins are water soluble molecules that are not stored by the body. They are needed daily to support many bodily functions. Deficiencies of one or more of the B vitamins are common, especially during times of fasting or weight-loss or as a result of diets that include substantial amounts of refined and processed food, sugar or alcohol. As a group these essential nutrients are normally named the B complex vitamins as they are commonly found together in foods. They have similar coenzyme functions and several individual "Bs" are required to be present for each vitamin to work effectively. Small quantities of certain B vitamins can also be made in the body, primarily in the large intestine. Bacteria, yeast, fungi and moulds are all capable of producing B vitamins. The overuse of antibiotics may prevent this function. The B vitamins could be described as catalytic spark plugs of the body; they function as coenzymes to catalyse many biochemical reactions. B vitamins help provide energy by acting with enzymes to convert carbohydrates to glucose, and they are also important in fat and protein/amino acid metabolism. The B vitamin group is very important for the normal functioning of the nervous system and is often helpful in promoting a relaxation or energy effect for people who are stressed and/or fatigued.

The health of the skin, hair, eyes and liver is influenced by the B vitamins, as is that of the mucosal linings, especially in and around the mouth. The general muscle tone of the gastrointestinal tract is also enhanced with proper levels of B vitamins that, in turn, allows the bowel to function more efficiently. Symptoms of B vitamin deficiency include fatigue, irritability, nervousness, depression, insomnia, loss of appetite, sore (burning) mouth or tongue, and cracks at the corners of the mouth.

Magnesium is critical to many cellular functions (including energy production, protein formation and cellular replication). In its primary function as an enzyme activator, magnesium participates in more than 300 enzymatic reactions in the body. Approximately 60% of the magnesium in the body is bone. The tissues with the highest magnesium concentration are those that are the most metabolically active (brain, heart, liver and kidney). Two groups most prone to magnesium deficiency are the elderly and women (especially during the premenstrual phase). Deficiency is often secondary to factors that reduce absorption or increase secretion of magnesium, such as high calcium intake, alcohol, surgery, diuretics, liver disease, kidney disease and oral contraceptive use. Deficiency signs and symptoms include fatigue, mental confusion, irritability, weakness, heart disturbances, problems in nerve conduction and muscle contraction, muscle cramps, loss of appetite, insomnia, and a predisposition to stress. A noticeable recurring contraction of an eyelid muscle or large muscle cramping which is not caused by peripheral vascular disease, anxiety or insomnia are indications that magnesium may be deficient. Testing Magnesium Levels. Low magnesium levels may go unnoticed because serum magnesium testing often returns false negative results. Most of the body’s magnesium store lies within cells, not in the serum (the non-cellular portion of the blood). A low magnesium level in the serum reflects end-stage deficiency. A more sensitive test of magnesium status is the level of magnesium within the red blood cell (erythrocyte magnesium level).

Interactions

Magnesium, calcium, potassium and other minerals frequently interact and some minerals may reduce the absorption of magnesium. Vitamin B6 works together with magnesium in many enzyme systems and increases the intracellular accumulation of magnesium. A high calcium intake and a high intake of dairy foods fortified with Vitamin D result in decreased magnesium absorption. There are many drugs that may deplete magnesium levels in the body, particularly many diuretics, insulin and digoxin. Coenzyme Q10 (CoQ10 ), also known as a ubiquinone, is an essential component of the mitochondria - the energy producing unit of the cells in our body. CoQ10 is involved in the production of ATP, the energy currency of all body processes. CoQ10 exists in every plant and animal cell, however the amount from dietary sources is insufficient to produce the beneficial effects seen when CoQ10 is supplemented. Beneficial effects of CoQ10 revolve around its ability to improve energy production and act as an antioxidant. Some situations in which CoQ10 may be deficient include the presence of cardiovascular disease, such as angina, high blood pressure, congestive heart failure, and coronary artery bypass surgery; stroke; diabetes; periodontal disease; immune deficiency; cancer, muscular dystrophy, and the use of statin (cholesterol lowering) medication. CoQ10 is heavily involved in oxygen transport at the mitochondrial level. The antioxidant activity of CoQ10 is limited to protection against lipid peroxidation. It works with Vitamin E in preventing damage to lipid (fat) membranes and plasma (blood) lipids. CoQ10 supplementation, like other antioxidants, may offer significant protection against atherosclerosis by preventing lipid peroxide formation and oxidation of LDL (bad) cholesterol.

A recent review suggests that CoQ10 as nutrient support may become part of standard therapy for prevention and treatment of cardiovascular disease. A six-year study at the University of Texas found a 75% three-year survival rate among congestive heart failure patients who took CoQ10 while undergoing conventional therapy. This compares with a 15% survival rate for those receiving only conventional therapy alone. Conditions in which CoQ10 could be of benefit include congestive heart failure, angina, diabetes, hypertension, periodontal disease, chemotherapy-induced toxicity, breast cancer, Parkinson’s disease, muscular dystrophy, mitochondrial dysfunction and for users of statin medication. Vitamin B5 is available in many foods and is manufactured by our body's intestinal flora. It is present in all living cells and important to metabolism functioning (as part of the molecule coenzyme A that is involved in adrenal function) and in cellular metabolism of carbohydrates and fats to release energy. Correction of low Vitamin B5 levels has been shown to bring about some alleviation of symptoms of rheumatoid arthritis.

Vitamin B5 Deficiency: Signs and Symptoms. Vitamin B5 deficiency should be quite rare for at least two reasons: it is contained in large number of foods such as liver and other organ meats, milk, fish and poultry, whole grains, sweet potatoes, broccoli, cauliflower, oranges and strawberries; and our body's intestinal flora produce it. However, the standard western diet, which is high in refined and processed foods, combined with our reliance on antibiotics that are known to reduce the good bacteria produced by intestinal flora, can lead to Vitamin B5 deficiency. Teenagers are more likely to experience such a deficiency because their diets often include high amounts of "fast food" sugars and refined flours (all low in B vitamins). The problem may be compounded as acne (common to this group) is often treated with tetracycline antibiotics that reduce the intestinal bacteria and subsequently lower the production of Vitamin B5 in the colon.Decreased adrenal function caused by Vitamin B5 deficiency can lead to a variety of metabolic problems.

Fatigue is most likely but there may also be physical and mental depression, a decrease in hydrochloric acid production and other digestive symptoms, some loss of nerve function and problems in blood sugar metabolism (with symptoms of low blood sugar being most commonly seen). Vitamin B5 deficiency may also reduce immunity that includes both cellular and antibody response.