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Natural Medicine Q&A
Ask Dr. P
by Kasra Pournadeali, ND
Natural Medicine Specialist

Wouldn't it be nice to have more energy? Have you ever been unable to do what you wanted because you were too tired? If so, you're not alone. It is called fatigue, and it's one of the most common complaints today. It comprises an estimated 55% of visits to doctors, and almost everyone has, at some point, suffered from it.

Fatigue can have many and sometimes multiple causes, some more serious than others. Anemia, hypothyroidism, drug side effects, overexertion, chronic infections, allergies, emotional problems, Addison's disease, diabetes, stress, emphysema, malignancies, nutritional deficiencies, autoimmune diseases, excessive use of alcohol or caffeine, and numerous other things can cause fatigue.

With even more treatments than causes of fatigue, it's critical that a licensed ND, MD, or DO properly investigate the reasons behind your fatigue. This prevents serious medical conditions from going untreated, and allows the treatment (whether conventional or naturopathic) to be specific for you.

Q: What is the alternative approach for fatigue?

A: Each person's situation is very unique. Simply put, it's the least invasive method to help you achieve long-term improvement in energy, while also promoting your optimal total health.

After identifying the causes of your fatigue, interventions might include promoting blood sugar/ metabolic balance and normal endocrine function through dietary change, orthomolecular medicine, and use of plant medicines or natural hormones. Other methods such as supporting normal sleep, treating chronic viral infection, and relieving musculoskeletal stress can improve energy. Let's not forget psychological stressors and dietary stressors like excess caffeine, alcohol, refined carbohydrates or food intolerances as contributing factors to fatigue. Again, identification of the causes of your fatigue is critical so treatment can be individually designed.

Q: I want to boost my energy and think ginseng tea might help, is this enough or are there other things I can use?

Ginseng has been used for centuries for just that purpose. Several studies suggest it can improve physical performance, reduce physical and mental fatigue, improve work capacity, and tolerance to stress. However, there many forms of ginseng with actions that can vary. Examples include Panax ginseng (Chinese or Korean Ginseng,) Panax quiquefolium (American ginseng,) Panax japonicum (Japanese ginseng,) Panax pseudoginseng (Himalayan ginseng,) and Eletherococcus senticosus (Siberian ginseng).

Availability of so many different kinds of ginseng with different effects can lead to confusion, and is why you should take ginseng and other plant medicines under professional supervision.

Teas, although a preferred delivery form for many conditions, are not my method of choice for treating fatigue. This is because teas are highly variable in active constituents (or what gives teas their medicinal effects). With such variability, the effectiveness of a tea cannot always be guaranteed. And my patients typically aren't pleased when I tell them their herbal medicine may or may not work!

The efficacy (or effectiveness) of teas also depends on making them properly. It would seem simple, but even how long the herbs steep adds variability to the dosage of active constituents and therefore variability of the achieved effects.

In defense of teas however, they are typically well tolerated by most individuals not taking drugs, and since they are often less concentrated than encapsulated herbs, they have fewer potential side effects. Also the calming nature of tea as a medicine should also not to be underestimated, as it can be profound in the overall healing process.

Ginseng is not safe for everyone, and toxicity although rare, can include anxiety, irritability, nervousness, insomnia, hypertension, breast pain, and menstrual changes. Other "energy boosting" stimulant herbs can have similar effects and like any form of medicine should be used under professional guidance.

Other naturopathic interventions potentially helpful for combating your fatigue might include bitters such as Gentiana lutea, digestive enzyme supplementation, thymus extracts, Licorice or Glycyrrhiza glabra, and amino acids like tyrosine, or 5-Hydroxytryptophan. Studies show that even nutrients like magnesium, potassium, and vitamin B12 can improve energy. Without knowing more about the causes of your fatigue, it's difficult to know if ginseng tea would be enough or even appropriate for you. I recommend you see your naturopathic doctor for a diagnosis and treatment approach specific for you.

Q: I've heard that Carnitine has been shown to increase energy. Is this true?

A: Carnitine is an amino acid necessary for conversion of fat into energy. It is found primarily in animal meats and dairy, although most carnitine in the body is synthesized from lysine, aided by methionine, Vitamin C, niacin and B6. Carnitine, in different forms, has been used in Alzheimer's disease, senile dementia, kidney disease, cardiovascular disease, intermittent claudication, and chronic lung disease with varying degrees of efficacy.

I'm aware of only one study suggesting supplementation with L- Carnitine improved muscle energy metabolism and possibly exercise performance. Many double blind studies however, have shown Carnitine to improve heart muscle function. It is possible that this effect can lead to an improvement in energy level, but not necessarily in persons without carnitine deficiency or heart failure. I typically recommend carnitine for persons with heart failure, cardiomyopathy, or chronic lung disease, as the studies seem to better support this. I don't recommend it for fatigue unrelated to these conditions or for otherwise healthy persons. See your naturopathic doctor for dosing specific to your needs.

For more information or to schedule an appointment, please contact the Northwest Center for Optimal Health at (360) 651-9355.




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