The Chronic Fatigue and Burnout Recovery Podcast

Episode 147: Processing, Purpose & Stability: A Membership Conversation on Nervous System Healing

Anna Marsh — Fri, 03 Apr 2026 00:10:00 +0000

This week on the podcast we do something a little different. We share a recording from the Nurturing Resilience Membership where we focus on supporting your Nervous System as you navigate recovering from Chronic Fatigue and other Energy Limiting Illness. This is your opportunity to be a fly on the wall of one of our group calls and if you want to take part yourself, you are very welcome to join the Membership and get involved. We cover topics such as using yin yoga for emotional processing, discharging survival energy, finding purpose in life while navigating recovery and how to create stability as you navigate the inevitable ups and downs.

Join Nurturing Resilience:https://annamarsh.co.uk/nurturing-resilience/

Website:http://annamarsh.co.uk/ Instagram:https://www.instagram.com/anna_marsh_nutrition/

Episode 146 - Research Review: The PEM Puzzle

Anna Marsh — Fri, 20 Mar 2026 00:36:00 +0000

Post-exertional malaise (PEM) is more than just feeling tired after activity — it’s a delayed and often severe worsening of symptoms that affects many people with ME/CFS and other energy-limiting conditions. In this episode, Anna unpacks what PEM is, why it happens, and what current research is beginning to reveal.

Anna explains how PEM differs from everyday fatigue, explores emerging insights into energy production, inflammation, and stress responses, and discusses why “pushing through” can be harmful. She also reflects on what this research means in real life, and how it can support safer pacing, validation, and more compassionate approaches to recovery.

This episode is a helpful listen if you want to better understand PEM, feel more validated in your experience, or learn how research can guide gentler, more supportive ways of managing energy.

Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Article Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC12408823/

Episode 145 – Oxaloacetate and Chronic Fatigue: Could this compound support your energy?

Anna Marsh — Thu, 05 Mar 2026 23:44:00 +0000

Oxaloacetate is a compound that plays an important role in cellular energy production and mitochondrial function. In this episode, Anna explores the emerging interest in oxaloacetate as a potential support for people with Chronic Fatigue and other energy-limiting conditions.

Anna explains what oxaloacetate is, why it has gained attention in the chronic fatigue space, and how it may influence metabolism, inflammation, and energy production. She also discusses who may benefit, important considerations around dosing and sensitivity, and where oxaloacetate fits within a broader, foundations-first approach to recovery.

This episode is a helpful listen if you’re curious about oxaloacetate, considering supplementation, or wanting to understand how targeted interventions can support energy when used thoughtfully and in the right context.

Supplement: https://uk.iherb.com/pr/advanced-orthomolecular-research-aor-benagene-30-capsules/3308

Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 144: How to manage unsolicited advice about your chronic illness

Anna Marsh — Fri, 20 Feb 2026 03:00:00 +0000

We’ve all been there. You share some details about your chronic illness with a friend, family member or colleague and instead of empathy, you receive a prescription for yoga, meditation or a B12 injection. Although the unsolicited advice is well meaning, often it can be another load that we have to manage. Chronic illness is complex and nuanced and it is exhausting to explain the physiological complexity as well as the dramatic impact it is having on your life. This episode is here to help you waste less energy with some ideas about how you can respond in situations of unsolicited advice or when someone challenges how you are caring for your health.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 143: What I wouldn’t do if I had to recover from Chronic Fatigue all over again

Anna Marsh — Fri, 06 Feb 2026 00:08:00 +0000

Mistakes are how we learn and grow and the same is true for Chronic Fatigue Recovery. In this episode Anna shares what she wouldn’t do if she had to recover from Chronic Fatigue all over again. She shares lessons and learnings from her own experience and experience working with clients. She weaves in guidance on what she would do instead so that you can learn to build strong health foundations from the ground up.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 142: Cycle syncing when you have Chronic Fatigue

Anna Marsh — Fri, 23 Jan 2026 02:28:00 +0000

Cycle syncing is a practice whereby you align your diet, lifestyle and energy management around your menstrual cycle. In this episode Anna answers the question: can this be helpful if you have Chronic Fatigue? Anna gives an overview of the menstrual cycle and explains how imbalances at certain points in the cycle can make us feel a certain way. She shares her own experience with cyclical fluctuations in energy and how she managed them, things that have worked clients and how to manage your cycle if you have histamine intolerance or MCAS.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Additional Resources:

How to have better periods, Part 1

How to have better periods, Part 2

How to have better periods, Part 3

Perimenopause

Episode 141: How long is long enough to stick with something if you don’t feel any better?

Anna Marsh — Fri, 09 Jan 2026 01:19:00 +0000

Prompted by a question from a Nurturing Resilience Member, Anna answers the question about how long to keep going with things when you aren’t seeing progress. She talks about the importance of laying life long foundations, getting overwhelmed by healing gadgets, supplement grave yards, the importance of context, strategy and structure, testing and retesting and how giving yourself a break can be the best thing at times!

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Healing On A Budget Episode: https://annamarsh.co.uk/podcast/healing-on-a-budget/

Episode 140: How can I help? Ways to work with me

Anna Marsh — Fri, 26 Dec 2025 03:28:00 +0000

***PLEASE NOTE*** Prices quote in this episode have increased since recording. Each week I get enquiries from people who are experiencing energy limiting conditions such as CFS/ME, Long Covid, Post Viral Fatigue and Mould Illness. Your health is the most important thing and you want to make sure that whoever you work with is the right fit for your needs and your budget. Which is why I wanted to create a podcast episode where I talk about how I work and the different options - to help you decide if it could be the right thing for you. In this episode I cover my qualifications, scope of practice and break down the different ways I work with clients in my business. If you have been thinking about working with a practitioner to support your health and are considering working with me, this episode is for you.

6 Month Package: https://annamarsh.co.uk/1-1/

Road Map: https://annamarsh.co.uk/fatigue-recovery-roadmap/

Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 139: The Top 3 Things That Stop People From Recovering Energy Limiting Conditions

Anna Marsh — Fri, 12 Dec 2025 00:30:00 +0000

Prompted by a question on Instagram Anna shares 3 things that she feels stop people from recovering from Energy Limiting Conditions. She talks about how embodied safety is essential for change, some of the mistakes she made in her own journey recovering from Chronic Fatigue and insights into what can be supportive if you resonate with any of these 3 areas.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Healing On A Budget Episode: https://annamarsh.co.uk/podcast/healing-on-a-budget/

Episode 138: How I Built My Exercise Capacity with Chronic Fatigue

Anna Marsh — Fri, 28 Nov 2025 00:40:00 +0000

One of the things that people with Chronic Fatigue struggle with the most is exercise. In this episode Anna shares her exercise journey and how she approached building her capacity from heart rate controlled walking to returning back to the gym and swimming 4km! She shares her step by step process, failures, strategies to mitigate PEM and the 3 most important considerations for anyone who wants to be able to exercise more as they recover their health.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Functional Patterns: https://www.rawmotionfitness.com/

Actively Autoimmune: https://www.activelyautoimmune.com/

Episode 89: Exercise Well with Autoimmunity: https://annamarsh.co.uk/podcast/episode-89-exercise-well-with-autoimmunity-and-zoe-mckenzie/

Episode 50: Functional Patterns For Chronic Pain: https://annamarsh.co.uk/podcast/episode-50-functional-patterns-for-chronic-pain-with-brendan-turner/

Episode 137: Struggling with Motivation? It could be your nervous system.

Anna Marsh — Fri, 14 Nov 2025 03:19:00 +0000

If you find yourself struggling to do things you know you should be doing to support your health, this episode of the Chronic Fatigue and Burnout Recovery Podcast is for you. Anna does a brief recap on the nervous system and explains how certain nervous system states may contribute to feeling stuck, frozen or general apathy when it comes to making diet and lifestyle changes and being consistent with them. She offers guidance on how we can better attune to the needs of our nervous system so that we can take small steps forward in the direction of health.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 136: Expansion and Contraction As You Build Capacity with Chronic Fatigue

Anna Marsh — Fri, 31 Oct 2025 00:21:00 +0000

In this episode Anna speaks to the natural expansion and contraction which is an essential part of life. Often in fatigue recovery there can be periods of being able to do more and expand into life as well as periods where symptoms pop up, we feel more tired and able to do less i.e. contracted. We often celebrate the expansions and resist the contractions but both are an important part of the process. This episode will hopefully help you embrace, accept and plan for the natural ebb and flow of fatigue recovery and life in general.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 135: Does being an empath increase your risk of Chronic Fatigue?

Anna Marsh — Fri, 17 Oct 2025 01:59:00 +0000

Recently someone asked me if they thought there was a connection between being an empath and Chronic Fatigue. My answer: Absolutely! In this episode we unpack why. We talk about what it means to be an empath and importantly, how many of the qualities of being an empath could actually be learned survival patterns of the nervous system. We may still be sensitive, but we can learn to regulate through our sensitivity to live a beautiful and energised life!

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 134: How To Travel Well with Chronic Fatigue

Anna Marsh — Fri, 03 Oct 2025 02:27:00 +0000

Travel can have pro’s and con’s when you have a chronic illness like Chronic Fatigue. Travel can be stressful, energy demanding and destabilising to a sensitive nervous system. However, travel can also take us out of our comfort zone in a healthy way and break stuck cycles of fear.

In this episode Anna talks about the pro’s and con’s of travel, how to titrate the experience of travel back into your life as you start to be in the world more, important things to consider when travelling, how to prepare before, recover afterwards and the bits in between.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Repowr Electrolytes: https://getrepowr.co.uk/ (Use the code ANNAMARSH)

Episode 133: Burnout Vs Chronic Fatigue: Are they different or the same thing?

Anna Marsh — Fri, 19 Sep 2025 01:46:00 +0000

Have you ever wondered what the difference is between Burnout and Chronic Fatigue? Are they different or the same thing? In this episode Anna explains burnout from a nervous system perspective and how this can relate to symptoms of Chronic Fatigue. She talks about how we can support ourselves to move forward after a burnout.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 132: How To Support Your Adrenal Glands When You Have Chronic Fatigue

Anna Marsh — Fri, 05 Sep 2025 00:30:00 +0000

There are some schools of thought that suggest poorly functioning adrenal glands could be an underlying cause in chronic fatigue. Although imbalanced adrenal function could be part of the complex web of fatigue, it is more likely to be a piece of the puzzle than the whole puzzle itself.

That being said, when it comes to recovering energy and vitality, there is seldom one magic solution. Instead, improvements happen when we support the body as a whole. Part of that support may include supporting the adrenal glands. In this latest episode of the Chronic Fatigue and Burnout Recovery Podcast Anna talks about adrenal function, how to identify dysfunction with testing and symptoms and most importantly how to support both high and low adrenal output.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Nervous System Work: https://annamarsh.co.uk/workshop/

Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/

Electrolytes: https://getrepowr.co.uk/discount/ANNAMARSH

Adrenal AM Supplement: https://trueperformance-supplements.co.uk/supplement/adrenal-am/

Adaptocrine: https://www.amritanutrition.co.uk/products/adaptocrine-xl-k-124-120-capsules (practitioner code 9C5WFV)

Episode 131: GLP-1 Receptor Agonists, MCAS and Chronic Fatigue

Anna Marsh — Fri, 22 Aug 2025 01:15:00 +0000

Glucagon-Like-Peptide-1 receptor agonists (GLP-1 RA) are a class of medications originally developed to treat type 2 diabetes, but have since gained widespread attention for their effects on weight loss and metabolic health. Emerging research suggests that GLP1-Receptor Agonists could be supportive in managing inflammatory symptoms associated with Mast Cell Activation Syndrome (MCAS). Although research is currently limited, Anna talks about what we know so far and her experience with clients taking these drugs in clinical practice.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Research Paper: https://www.sciencedirect.com/science/article/abs/pii/S0002962925011061

Take the Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Episode 130: Personal Shares and Updates

Anna Marsh — Thu, 07 Aug 2025 23:58:00 +0000

This is a chatty "behind the scenes” episode where Anna shares some personal stories regarding her own healing and some exciting business updates. She covers topics such as rest, regulation, core wounds and grief.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

New Nurturing Resilience Membership: https://annamarsh.co.uk/nurturing-resilience/

Take the Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Episode 129: What To Focus On When You Are High Functioning But Not Thriving

Anna Marsh — Fri, 25 Jul 2025 03:21:00 +0000

This is part 4 of a 4 part series on what to focus on in the different stages of Chronic Fatigue and other energy limiting illnesses. In this episode Anna talks about the most important things to focus on when you are high functioning but not thriving. Anna reflects on what she would have done differently if she could go back in time and advise her younger self. You can enjoy a diverse conversation about pacing, the nervous system, boundaries, hormetic stressors and much more!

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/

Episode 128: What To Focus On When You Are Wanting To Go Back To Work

Anna Marsh — Fri, 11 Jul 2025 00:27:00 +0000

This is part 3 of a 4 part series on what to focus on in the different stages of Chronic Fatigue and other energy limiting illnesses. In this episode Anna talks about the most important things to focus on as you navigate a transition back to work. This includes knowing when the time is right, things to consider and how you can support yourself, the importance of giving space for the transition and increasing self care.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/

Episode 127: What To Focus On When You Are Houseoubnd with Chronic Fatigue

Anna Marsh — Fri, 27 Jun 2025 00:24:00 +0000

This is part 2 of a 4 part series on what to focus on in the different stages of Chronic Fatigue and other energy limiting illnesses. In this episode Anna talks about the most important things to focus on as you navigate being housebound with Chronic Fatigue. This includes things that you may be able to introduce now that you have transitioned from being bed bound, tips on how to gently build capacity and create routine and physical supports that may be useful if accessible.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/

Episode 126: What To Focus On When You Are Bedbound with Chronic Fatigue

Anna Marsh — Fri, 13 Jun 2025 00:22:00 +0000

This is part 1 of a 4 part series on what to focus on in the different stages of Chronic Fatigue and other energy limiting illnesses. In this episode Anna talks about the most important things to focus on as you navigate being bedbound. This includes an understanding of what is happening in the nervous system, tips on how to gently build capacity and create routine and physical supports that may be useful if accessible.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/

Episode 125: Are Oxalates Lowering Your Energy?

Anna Marsh — Fri, 30 May 2025 00:50:00 +0000

Chronic fatigue syndrome (CFS) is a complex and often misunderstood condition that leaves many people struggling with persistent exhaustion, brain fog, and muscle aches.

Although there are multiple different factors that contribute to symptoms and every case is different, diet can play a significant role in symptom management.

There are many different dietary approaches and different things will work for different people depending on the mechanisms contributing to their specific case. One dietary component that has gained attention in this context is oxalates—naturally occurring compounds found in many healthy foods such as spinach, nuts, and berries. For some individuals with chronic fatigue, high oxalate consumption could potentially contribute to and worsen symptoms.

In this episode Anna explores the relationship between oxalates and chronic fatigue, possible causes of oxalate intolerance, and how adjusting oxalate intake might help alleviate some of the challenging symptoms of this condition.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Low Oxalate Blog: https://annamarsh.co.uk/https://annamarsh.co.uk/chronic-fatigue-are-oxalates-impacting-your-energy/

1-1 Support: https://annamarsh.co.uk/1-1/

Episode 124 - The Importance of Layering Interventions for Chronic Fatigue

Anna Marsh — Fri, 16 May 2025 09:33:33 +0000

Not everything we do to support our bodies will have an immediate or noticeable impact. However, often these interventions work in synergy with one another.

In this episode Anna talks about the importance of layering interventions in an intentional and consistent way to move the needle of health forward over time.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Episode 123 - How To Support Low Mood, SAD and PMDD

Anna Marsh — Fri, 02 May 2025 01:46:00 +0000

Mood disorders refer to significant changes in mood that have a negative impact on daily life. It goes without saying that when someone experiences a chronic illness such as Chronic Fatigue, they may feel low at times.

However, this is different to someone who may be experiencing an ongoing low mood that feels unrelated to their current state of health or someone who is experiencing a low mood disorder that is perhaps mechanistically entangled with some of the mechanisms of chronic fatigue.

In this episode Anna talks about different types of low-mood disorders and how we can approach them alongside the journey of improving health and energy as a whole.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Episode 122- Life at the End Stages of Fatigue Recovery

Anna Marsh — Fri, 18 Apr 2025 00:59:00 +0000

What does life look like at the end stages of recovery? In this episode Anna shares “a day in her life” and compares this to how far she has come. She reflects on lessons that she is still learning and things that still feel important. This includes a discussion around friendships and building community after recovery.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Episode 121 - Candida Overgrowth and Chronic Fatigue

Anna Marsh — Fri, 04 Apr 2025 00:07:00 +0000

Candida overgrowth can contribute to chronic fatigue through a combination of immune system suppression, toxin production, gut dysfunction, and inflammation. When Candida proliferates beyond its normal levels, it can lead to various symptoms that resemble chronic fatigue syndrome (CFS) or contribute to ongoing fatigue.

In this episode Anna talks about how Candida can be a driving factor in Chronic Fatigue, how you can assess if it is something impacting you and what you can do to address it.

She covers common mistakes that people make when addressing infections such as Candida and why taking the time to go slowly and build foundations is actually what will help you get there faster.

Useful Links

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

1-1 Support: https://annamarsh.co.uk/1-1/

Gut Health Mini Course: https://annamarsh.co.uk/courses/

Detox and Drainage Mini Course: https://annamarsh.co.uk/courses/

Episode 120 - Rest Is Not Regulation

Anna Marsh — Fri, 21 Mar 2025 00:29:00 +0000

Contrary to what many people think about Chronic Fatigue Recovery, we are not supposed to be calm all the time. Rest matters and we definitely need periods of the day and night where we feel calm, relaxed and at peace. However, Chronic Fatigue Recovery is ultimately about building capacity which means that we also have to come into contact with more challenging experiences so that we can rebuild.

In this episode Anna discusses some of the patterns and trends she is noticing with clients which is preventing them from growing their capacity and accessing better quality states of true rest.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Workshop: https://annamarsh.co.uk/workshop/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 119 - How To Have Better Mornings with Chronic Fatigue

Anna Marsh — Thu, 06 Mar 2025 23:40:00 +0000

Mornings with Chronic Fatigue can be tough. Some people experience difficulty waking, feeling flat, slow and sluggish first thing in the morning and it takes ages to get up and even feel a little bit functional for the day.

Others with Chronic Fatigue may feel very wired, hyperactivated and symptomatic first thing in the morning. This can cause a negative spiral of worrying about symptoms and how the rest of the day will unfold.

Finally, others may not be overly flat or overly activated, but just have a general experience of not feeling refreshed after their sleep, which is common in Chronic Fatigue.

In this episode Anna discusses each of these challenges, underlying causes from both a physiological and nervous system perspective and, most importantly, what you can do to support your body better so that you can get more from your mornings!

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Workshop: https://annamarsh.co.uk/workshop/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 118 - How To Supplement If You Are Supplement Sensitive

Anna Marsh — Fri, 21 Feb 2025 00:53:00 +0000

Supplement sensitivity can be common in the Chronic Illness and Chronic Fatigue community. After recently posting on instagram on the topic of supplement sensitivity, I had some comments that no one is talking about this and often those who are sensitive are made to feel like they are being difficult or overly anxious. In some cases, clients get abandoned by practitioners who feel overwhelmed by their reactions.

So I wanted to create an episode where I talk about how to supplement when you are supplement sensitive. This includes a brief overview of why you may be experiencing supplement reactions, things that can be helpful that do not include supplementation and then a short practical guide on how to take supplements if you know you are sensitive.

I hope this episode will bring you some practical guidance on how to manage your sensitivity and also some validation that what you are experiencing is actually quite common.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 117 - What Your Approach To Healing Says About Your Nervous System

Anna Marsh — Fri, 14 Feb 2025 00:19:00 +0000

In Chronic Fatigue Recovery, healing happens from a regulated place and yet our nervous system state also influences how we approach healing. This creates a chicken or egg situation where, approaching healing from a dysregulated place, can breed further dysregulation but approaching healing from a place of more regulation, enables more successful self-care.

In this episode Anna describes four different ways in which we can approach our healing and how this shows up practically.

You may recognise yourself in one or all of these states, but probably spend more time in one compared to others. Through recognition of our patterns and tendencies we can learn what support we need to offer ourselves to work towards a more regulated approach on our healing journey.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Workshop: https://annamarsh.co.uk/workshop/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 116 - Mold Illness and Chronic Fatigue - Binders, Antimicrobials and Biofilm

Anna Marsh — Fri, 07 Feb 2025 00:29:00 +0000

The final stage of supporting Mold illness and Chronic fatigue is introducing Binders, Antimicrobials and Biofilm Disruptors.

In this episode Anna talks recaps on the previous 3 episodes in this 4 part series. She then talk about introducing binders, including, what are binders and why do we take them? Possible side effects and things to watch out for. The importance of dosing slowly, especially if you are sensitive. What to do if you have a reaction and how long to take them for.

She talks about antimicrobial support for the sinuses, gut and vaginal canal, including how to approach dosing for those that are sensitive. She ends the episode with a discussion about retesting and detox maintenance.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 115 - Mold Illness and Chronic Fatigue - Supporting Detox and Drainage

Anna Marsh — Thu, 30 Jan 2025 23:31:00 +0000

Supporting Detoxification and Drainage is the second step when dealing with mold illness and chronic fatigue. This is the third episode in a series on Mold Illness and Chronic Fatigue.

In this episode Anna talks about the importance of addressing digestive health and supporting healthy bowel movements, adding in sauna or sweating, lymphatic drainage and the importance of protein for liver support!

Other Episodes of Interest

https://annamarsh.co.uk/podcast/episode-79-the-gallbladder-and-chronic-fatigue/

https://annamarsh.co.uk/podcast/episode-100-heat-stress-cold-stress-and-fatigue-recovery/

Complimentary Mini Courses

Gut Health Mini Course: https://annamarsh.co.uk/courses/

Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

Detox Mini Course: https://annamarsh.co.uk/courses/

Nurturing Resilience Subscription: https://annamarsh.co.uk/courses/

General Resources

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 114 - Mold Illness and Chronic Fatigue - Mold Avoidance

Anna Marsh — Thu, 23 Jan 2025 23:22:00 +0000

Mould avoidance is the first step when it comes to dealing with mold illness and chronic fatigue. This is the second part in a series on Mold Illness and Chronic Fatigue. In this episode Anna talks about the importance of avoidance of mold. This includes how to test your home for mold and what to do if you are living in mold and you cannot get out immediately.

Anna talks about dietary changes that can be supportive to reduce mycotoxin exposure from foods and generally increase resilience of organs such as the liver and kidneys.

Testing and Remediation

ERMI: https://www.mouldlab.co.uk/products/dust-analysis-for-mould-species-environmental-relative-mouldiness-index-ermi-including-free-hertsmi-2

Pure Maintenance:

https://www.puremaintenanceuk.com

General Resources

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 113 - Mold Illness and Chronic Fatigue - Part 1

Anna Marsh — Thu, 16 Jan 2025 23:10:00 +0000

In this episode Anna discusses mold illness and chronic fatigue. She answers questions such as: What is mold illness? How are we exposed? What are the symptoms? How do I test for mold illness? What do I do if I get a positive test result?

Mold illness or sickness is a constellation of symptoms that result from a combination of the mold spore colonisation in the body and toxic load due to the mycotoxins they produce. The mycotoxins can be particularly damaging to every body system and this is what can make mould illness difficult to identify and why it often gets missed.

Some people may be more affected by mould and mycotoxins which is why two people can live in the same home and one person has symptoms and the other person doesn’t.

If you have been wondering if mold illness is playing a part in your Chronic Fatigue and would like to learn more, this episode is a great starting point.

Testing

Mycotoxin Urine Testing (Mosaic Laboratories): https://regeneruslabs.com/products/mycotoxin-1

OAT+Mycotoxin (Mosaic Laboratories): https://regeneruslabs.com/products/oat-mycotox

Other episodes of interest:

https://annamarsh.co.uk/podcast/episode-42-mcas-histamine-intolerance-and-fatigue/

General Links

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 112- How did I get here? Understanding the development of Chronic Fatigue

Anna Marsh — Fri, 10 Jan 2025 00:33:00 +0000

In this episode Anna explains the development of Chronic Fatigue using the understanding of the Mast Cell and the Cell Danger Response as a guide. She talks about how triggers and events can build up across a lifetime until the body becomes overwhelmed by its ability to cope. This very often is the point of no return. Healing is about returning to safety and little by little creating a greater sense of safety and resourcefulness in the system.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episodes mentioned here:

https://annamarsh.co.uk/podcast/episode-42-mcas-histamine-intolerance-and-fatigue/

https://annamarsh.co.uk/podcast/episode-6-understanding-the-cell-danger-response/

Episode 111 - Surgeries and Chronic Fatigue

Anna Marsh — Fri, 03 Jan 2025 00:50:00 +0000

In this week's episode of the Chronic Fatigue podcast Anna talks about surgeries and Chronic Fatigue. Specifically looking at how surgeries can be a single health changing event, similar to a viral infection or vaccination, and what we can do if we are already unwell and need to take an elective surgery.

The episode starts with a general discussion about Chronic Fatigue from a nervous system perspective and then Anna talks about the various factors that can impact the nervous system when someone has a surgery.

Anna then talks about surgery preparation from a practical point of view, post surgical nutritional and supplement support and when additional therapy and support can be helpful.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 110 - How To Rest Better

Anna Marsh — Fri, 29 Nov 2024 00:51:00 +0000

This episode covers the topic of rest and chronic fatigue, specifically, how to rest better! A while back Anna surveyed her instagram followers and 80-90% of them said they found rest hard. In this episode Anna talks about the importance of accessing “restful rest” with some tips on how to set up your day for better rest and recovery.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 109 - Pacing Matters

Anna Marsh — Fri, 22 Nov 2024 00:52:00 +0000

In this episode Anna covers the topic of pacing and Chronic Fatigue including why it is an essential part of the chronic fatigue recovery toolbox. Anna shares some of the problems that they see with their clients when it comes to pacing and things that have helped their clients get better results from their pacing. She shares some useful apps and resources that you can refer to if pacing is an ongoing challenge for you.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Mentioned here:

https://annamarsh.co.uk/podcast/episode-103-how-to-overcome-patterns-of-boom-and-bust/

https://annamarsh.co.uk/podcast/episode-86-activity-tracking-for-long-covid-me-cfs-with-harry-leeming-from-visible/

https://annamarsh.co.uk/podcast/episode-85-using-hrv-to-manage-chronic-fatigue-recovery/

https://annamarsh.co.uk/podcast/episode-55-thriving-as-a-spoonie-with-emily-fraser/

Episode 108 - If you’ve had a viral infection and never felt the same since…

Anna Marsh — Fri, 15 Nov 2024 00:53:00 +0000

If you’ve had a viral infection and never felt the same since, relapsed in your healing journey after an acute infection or if you’ve had a vaccine injury, this episode is for you. In this episode Anna explains in simple terms what has likely happened in the case of post-viral fatigue and most importantly, 5 important factors to take into consideration to start to feel better again.

In a nutshell, when we become acutely unwell due to a viral infection, the immune system creates drastic physiological changes and a large amount of inflammation and oxidative stress to save your life! This can cause damage in systems of the body that were already under stress and strain and ultimately it is the straw that breaks the camel’s back.

To restore health, function and capacity we want to help the immune system turn off fully. Although the exact framework varies from person to person, there are 5 important steps when it comes to recovering from post-viral fatigue.

Listen to the full episode for all the details.

Useful Links:

Use the code ANNAMARSH for 15% off your first order with BodyBio:

Balance Oil

GLA

See the recipe for Anna’s Raspberry Fat Bomb Here: https://www.instagram.com/reel/DAc_3Sps7Fm/

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 107 - The difference between PEM, Crashes, Flares, Setbacks and just life!

Anna Marsh — Fri, 08 Nov 2024 00:54:00 +0000

In this episode Anna talks about the difference between Post-Exertional Malaise, Crashes, Flares, Setbacks and the natural change in our output and capacity that comes when you are a human being.

She gives a high level overview of what is happening in the body in each of these experiences, how we can learn from the patterns that we have and the support that is likely needed as a consequence.

She highlights the understanding that if we can identify our tendencies, it reveals information that will help to direct and guide us on our healing journey.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Mentioned here:

https://annamarsh.co.uk/podcast/episode-15-how-to-manage-crashes-flares-and-set-backs/

https://annamarsh.co.uk/podcast/episode-16-post-exertional-malaise/

https://annamarsh.co.uk/podcast/episode-68-tracking-progress-in-fatigue-recovery/

https://annamarsh.co.uk/podcast/episode-87-3-tips-for-reducing-flares-and-crashes-around-your-menstrual-cycle/

https://annamarsh.co.uk/podcast/episode-97-words-of-wisdom-for-crashes-and-flares/

Episode 106 - Life After Chronic Fatigue: Mindset For Moving On and Not Getting Stuck

Anna Marsh — Fri, 01 Nov 2024 00:19:00 +0000

In this episode Anna answers a Chronic Fatigue listener question about Life After Disease: How to cultivate the mindset to move on and not get stuck. Although the title suggests that this is for those further along in their journey, there are still some wisdom bombs for those at any stage of their journey, especially those who are feeling stuck.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 105 -Understanding the Journey of Chronic Fatigue Recovery

Anna Marsh — Fri, 25 Oct 2024 00:17:00 +0000

In this episode Anna shares the four stages of Chronic Fatigue Recovery as she experiences them working with her clients in clinical practice. She discusses each of the stages, how we may experience them and what is important at each stage and how you can support yourself through each stage.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 104 - Two Tests We Use Most Often for Chronic Fatigue

Anna Marsh — Fri, 18 Oct 2024 00:11:00 +0000

In this episode Anna shares some behind the scenes information and talks about two of the tests they end up using most often in the practice, what they typically find, how this is useful to clients and possible results.

If you’ve been feeling like you’ve hit a plateau in your journey and have a budget to explore some additional options, this episode could help you understand a bit more about Functional Testing and how it could be helpful.

Test Links:

GI Effects Stool Test

NutrEval

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 103 - How to Overcome Patterns of Boom and Bust

Anna Marsh — Fri, 11 Oct 2024 00:57:00 +0000

If you’ve been having a chronic fatigue or chronic illness experience for any length of time, you are probably all too familiar with the cycle of boom and bust. We all do too much and crash from time to time, but when this happens again and again, we want to consider how we are contributing to it.

It isn’t always as simple as; just do less. Sometimes the “overdoing” is a reflection of maladaptive coping mechanisms that we have been relying on for years, decades even. Being able to unlearn old strategies and create new ones takes time, patience and compassion.

In this episode Anna unpacks some of the patterns to watch out for and where we can begin to create healthier coping mechanisms in life.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 102 - Holistic Dentistry, Chronic Fatigue and Chronic Illness with Dr Kayleigh Short

Anna Marsh — Fri, 04 Oct 2024 02:12:00 +0000

Anna interviews holistic dentist, Dr Kayleigh Short where they discuss why dental health is so important generally for healthy humans and for people with chronic illness and chronic fatigue symptoms more specifically.

Often when faced with a chronic illness, like chronic fatigue, we can get caught up in supporting all of the body's systems that we forget to look inside the mouth. For stubborn cases that aren't improving, Dr Short suggests having a thorough work up with a holistic dentist who knows how to apply holistic dentistry and chronic fatigue syndrome.

They discuss common root (excuse the pun) causes of poor health that can originate in the mouth and how a comprehensive intake and examination process can help to reveal issues that may often be overlooked in the traditional dental model.

They cover heavy metals, root canals, TMJ and general day to day preventative care. If you feel curious about whether your dental health could be impacting some chronic symptoms, this episode is a must to listen to!

Find Kayleigh on Instagram: https://www.instagram.com/wholisticdentalcare

Wholistic Dental Website: https://wholisticdental.com/

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 101 - Healing Words of Wisdom #1

Anna Marsh — Fri, 27 Sep 2024 02:06:00 +0000

Sometimes in our Chronic Fatigue Journey we can be in a low place and it can be helpful to have some words of support and encouragement or even gentle insights which can help us reflect on why we might be feeling stuck.

That is what this episode is for...

There are times in your healing journey when you need to take action and times in your healing journey where you need to allow, give space and integrate. Spending too much time in one versus the other is not a recipe for success.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 100 - Heat Stress, Cold Stress and Fatigue Recovery

Anna Marsh — Fri, 20 Sep 2024 00:47:00 +0000

The use of heat and cold can be supportive for health, but where do they factor in when it comes to fatigue recovery? How do we know when we are ready to add heat or cold stress to our healing routines? How can we do this safely to avoid energy crashes or post-exertional malaise?

All these questions and more are answered in the latest episode of the Chronic Fatigue and Burnout Recovery Podcast.

Hot and cold are two of several stressors known as "hormetic stressors". Hormetic stressors are stressors that, when applied in the appropriate dosage, can cause a positive adaptation in the body. Using heat and/or cold in the right dosage, can therefore, create positive changes that may be supportive for fatigue recovery. However, when applied in dosages that are not appropriate for the individual, there can be a negative adaptation, often experienced as an energy crash or symptom flare.

Therefore, knowing how and when the apply heat and cold stress appropriately, is what we cover in this episode. Unfortunately, there are no set protocols for heat and cold stress, so this episode will teach you how to work with your body to create a protocol for yourself!

Additional Resources:

Deliberate Heat Exposure Protocols From Huberman Lab

Use of Cold Exposure in Health and Performance

How To Create Stability in Chronic Fatigue

Episode 99 - Energetically Expensive Personality Traits & Chronic Fatigue

Anna Marsh — Thu, 12 Sep 2024 23:36:00 +0000

Energetically expensive personality traits are ways of being that cost us energy. Firstly the energy that we expend from being driven to operate outside of our capacity and secondly the energy from the hidden stress of denying our own authenticity.

In this episode Anna highlights some of the most important traits to be aware of and how they may show up in fatigue recovery. She talks about why these traits develop and why it is important to have a compassionate approach towards ourselves as we change them. She finishes with some suggestions around reprogramming these traits and some reflective journaling prompts that you can use to support you.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 98 - Eating Enough Protein in Chronic Fatigue Recovery

Anna Marsh — Fri, 23 Aug 2024 00:39:00 +0000

Eating enough protein is a conversation we end up having with almost all of our clients. Eating enough protein is a conversation we end up having with almost all of our clients. Protein is important for our blood sugar, immune system, antioxidant systems, detoxification systems and much much more! But how much is optimal and how do we know that we can digest and absorb it all? In this episode Anna talks about why we should be conscious of our protein intake, considerations for optimising digestion and absorption of protein, how much protein we need exactly and how she goes about getting enough in her day!

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

Episode 97 - Words of Wisdom for Chronic Fatigue Crashes and Flares

Anna Marsh — Fri, 16 Aug 2024 00:27:00 +0000

A short episode with some words of wisdom to help you through the next crash or flare.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 96 - 20 Considerations For Chronic Fatigue Recovery

Anna Marsh — Fri, 09 Aug 2024 00:42:00 +0000

There is never just ONE thing you need to do on your Chronic Fatigue Recovery journey. Instead it is the collective practise of multiple different things that slowly move the needle forward.

In this episode Anna talks through a list of 20 things to consider on your Chronic Fatigue Recovery Journey. This episode might be helpful if you are just getting started and looking for some things to focus on. It could also be useful as a personal check in, to help you acknowledge what you are doing well, what you could be doing better or what you haven’t considered yet.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Take the Nurturing Resilience Nervous System Self Paced Course: https://annamarsh.co.uk/nurturing-resilience/

Episode 95 - Healing on a Budget

Anna Marsh — Fri, 02 Aug 2024 10:39:25 +0000

In this day and age, health is a privilege and recovering from a Chronic Illness can very quickly become an expensive business. In this episode Anna talks about how to heal when you have minimal or limited financial means. We talk about low cost and no costs actions that you can take to at the very least improve stability and increase quality of life. We talk about belief systems around what is possible and how the goal is to keep moving forward, one step at a time.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Take the Chronic Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Take a Mini Course: https://annamarsh.co.uk/courses/

Episode 94 - Living Life Alongside Chronic Fatigue Recovery

Anna Marsh — Fri, 26 Jul 2024 00:36:00 +0000

How do we manage our Chronic Fatigue Recovery and also make space for life itself? When you live with a chronic illness you always have less options and less choices than someone who is typically "healthy". Even more so, when you have a low energy health condition, where do you find the energy to shoulder the extra workload of healing alongside living!?

In this episode we talk about many of the challenges that people face when focussing on Chronic Fatigue Recovery (i.e. their health), responsibilities and also living! We discuss the importance of connecting with your life force energy, even when it is just a trickle! The importance of accepting and knowing what matters to you so that you can prioritise your time and energy into your view of a “normal life”. We discuss relating to others and managing their expectations and building confidence to do more as your body allows without going back to the old patterns that were unhelpful. This episode will help you to reflect on where you are in your journey, perhaps some things you are doing well and perhaps there are blindspots that could use your attention.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Join Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 93- What is your definition of “fully recovered” from Chronic Fatigue?

Anna Marsh — Fri, 19 Jul 2024 00:32:00 +0000

Is full recovery from Chronic Fatigue Possible? What does that mean? What does the journey look like and what does it entail? In episode 83 of the Chronic Fatigue and Burnout Recovery Podcast, Anna shares her thoughts on the idea of recovery.

This is a general discussion about the importance of recovery stories and believing in the potential of recovery. She talks about factors that impact the healing timeline and her own experience of recovery to date. She highlights the importance of acceptance and giving space to grief and why focussing on improving quality of life may be more supportive for the nervous system. This episode may help you to reflect on some of your attitudes and beliefs about your own recovery and offer some words of wisdom as you navigate your own journey.

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 92 - All The Ways You Can Regulate Your Nervous System

Anna Marsh — Fri, 12 Jul 2024 00:32:00 +0000

Nervous system regulation is an important part of managing a Chronic Illness. No doubt, if you are having a chronic illness experience you have probably heard by now that you need to support your nervous system. But how do you do that? There seem to be so many different options available and it is hard to know what will work for you.

The reality is, when it comes to supporting the nervous system, there isn't a one size fits all approach. We want to find the ways that work best for our system and do more of what works! In this episode Anna talks about all the different options for nervous system regulation.

She shares some of her personal experiences with different modalities, what worked, what didn’t work and things that have helped her clients. She discusses pro’s and con’s of certain therapies and holds space for the fact that everyone heals a little differently and it is up to us to find what resonates best with our system.

If you know that nervous system regulation is a missing piece of your healing puzzle and you've felt confused about where to start or what therapies could be helpful for you, this episode will help you with some ideas to get the ball rolling.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience Program: https://annamarsh.co.uk/nurturing-resilience/

The Nurturing Resilience Program is a self-study program which will teach you tools for nervous system regulation in a slow and manageable way. It is ideal for those who are experiencing chronic health conditions such as CFS/ME, Long Covid, POTS, Autoimmunity or other complex chronic illness.

Episode 91 - Chronic Fatigue Recovery Stories with Raelan Agle

Anna Marsh — Fri, 05 Jul 2024 00:01:00 +0000

Chronic Fatigue Recovery Stories can help us borrow hope and inspiration when we find it lacking in ourselves. This is why, after her own journey with ME/CFS, Raelan Agle created a YouTube Channel to show case the recovery stories of others and to inspire the belief that recovery is possible!

In this episode of the Chronic Fatigue and Burnout Recovery Podcast, Anna interviews Raelan about her own journey with CFS/ME and the lessons she learned along the way, in her words: Growth Bootcamp!

Raelan Agle lived with chronic fatigue syndrome (ME/CFS) for ten years before finally fully recovering. After countless fruitless doctor’s visits and tens of thousands of dollars spent without providing much relief from her illness, she eventually realised that she would have to look within herself and listen to her body to find her path back to health. And thankfully she did finally fully recover!

Since her recovery Raelan has become passionate about supporting others on their wellness journey. She is the author of Finding Freedom: Escaping from the Prison of Chronic Fatigue Syndrome, has a popular YouTube channel sharing the recovery stories of others along with resources for health and healing, and online courses to support people on their health and happiness journey.

Useful links:

Raelan’s Website: https://raelanagle.com/

Raelan’s YouTube: https://www.youtube.com/c/raelanagle

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 90 - 8 Reasons Your Chronic Fatigue Recovery Progress Is Lacking

Anna Marsh — Fri, 28 Jun 2024 02:06:00 +0000

It is normal to experience ups and downs in your chronic fatigue recovery journey, but what do you do when you feel stuck, hit a plateau or lacking in progress. That is exactly what Anna covers in this episode. She discusses eight things you can reflect on and consider that may help you gain more traction and move the needle forward.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 89 - Exercise Well with Autoimmunity and Zoe McKenzie

Anna Marsh — Fri, 21 Jun 2024 00:15:00 +0000

This is a guest expert interview with Zoe McKenzie where we discuss her book which has recently been published. Although the book title suggests it is for Autoimmunity, the pages are filled with wisdom on how to exercise if you have chronic illness, fatigue conditions included. We have a wonderful conversation where we discuss the work that I did with Zoe as her 1-1 client, belief systems about exercise, exercising with fatigue, exercising with pain, finding your baseline, adjusting your baseline when life happens and everything in between (plus plenty of analogies!).

Zoe McKenzie is a Physiotherapist, Exercise Coach and Clinical Pilates Instructor who created, Actively Autoimmune, an online exercise platform for those with chronic conditions. After experiencing health issues herself from a young age, Zoe has specialised in supporting clients around the world to find a way to move their body that works with them. She works with clients 1:1 as well as with an on-demand virtual Pilates studio. She has also recently published her book ‘Exercise Well with Autoimmunity’.

Useful links:

Website: https://www.activelyautoimmune.com/

Instagram: https://www.instagram.com/activelyautoimmuneBuy the book: https://www.amazon.co.uk/Exercise-Well-Autoimmunity-Zoe-McKenzie/dp/139970852X/

Previous episodes on exercise:

Episode 27 - Building Exercise Tolerance and Capacity with Chronic Fatigue

Episode 26 - How to Exercise with Chronic Fatigue

Episode 88 - Managing Autoimmunity and Chronic Fatigue

Anna Marsh — Fri, 14 Jun 2024 00:05:00 +0000

Often in our practice we see autoimmunity come hand in hand with chronic fatigue. Not every case is an autoimmune case, but for those who do have autoimmunity, we want to consider how a dysregulated immune system is contributing to the picture of fatigue and how we can manage it.

In this episode Anna gives a high level view of the autoimmune management strategy that she uses in her practice which includes both simple and more complex strategies to support outcomes and improve quality of life.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Additional Resources:

Episode 87 - 3 Tips for Reducing Flares and Crashes Around Your Menstrual Cycle

Anna Marsh — Sat, 08 Jun 2024 09:14:13 +0000

Many women experience crashes, flares and setbacks around their menstrual cycle. The natural fluctuation in hormone levels can be destabilising to sensitive and unstable symptoms. Although we want to keep the whole picture of imbalance in mind, there are some tricks we can use to support the body around this unstable time. In this episode Anna covers her 3 top considerations for reducing symptoms, crashes and flares around menstruation

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 35: https://annamarsh.co.uk/podcast/episode-35-how-to-have-better-periods-with-cfs-me-part-1-what-does-a-healthy-cycle-look-like/

Episode 36: https://annamarsh.co.uk/podcast/episode-36-how-to-have-better-periods-with-cfs-me-part-2-testing-your-hormones/

Episode 37: https://annamarsh.co.uk/podcast/episode-37-how-to-have-better-periods-with-cfs-me-part-3-supporting-your-hormones-naturally/

Episode 86 - Activity Tracking For Long Covid & ME/CFS with Harry Leeming from Visible

Anna Marsh — Fri, 31 May 2024 00:01:00 +0000

This week's episode is a guest interview with Harry Leeming the founder of the Visible app, an activity tracking tool to help people with chronic illness use data to empower their recovery and pace better. Harry was a young, healthy active individual who caught a “virus” and has never been the same since. He has turned his pain into purpose, using his background in engineering to build out an activity tracking app that is more appropriate for people with chronic illness than some of the traditional fitness trackers. He is doing incredible work in the world to progress the research in this area and you can get involved by downloading and using the app. But first, listen to the episode!

Useful links:

Get Visible: https://www.makevisible.com/

Episode 85 - Using HRV to Manage Chronic Fatigue Recovery

Anna Marsh — Fri, 24 May 2024 04:00:00 +0000

What is Heart Rate Variability (HRV)? How is it measured? Is it useful for Chronic Fatigue and can you improve it? These are all the questions that Anna answers in this week's episode where she shares her personal experience and clients’ experience with different devices and interventions.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 84 - What is happening in an energy crash?

Anna Marsh — Fri, 17 May 2024 04:00:00 +0000

If you have been experiencing a chronic illness, energy crashes and flares are familiar territory. What can make these events so distressing, especially early on in your journey, is not understanding what is happening and why. In this episode Anna explains the biochemistry of what is happening in an energy crash. She shares almost everything you need to know for fatigue recovery in a nutshell including the most important things to consider to make sure your energy crashes are few and far between.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 83 - 8 Mistakes I made recovering from CFS/ME

Anna Marsh — Fri, 10 May 2024 04:00:00 +0000

All healing journey’s have their ups and downs and we need to make mistakes so that we can learn. Here are eight mistakes, which led to eight fantastic lessons that Anna experienced in her journey recovering from Chronic Fatigue Syndrome.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience

Episode 82 - Listener Q&A: Pacing, Muscle Wastage, Keto Problem Solving, Increasing Exercise and Managing PEM

Anna Marsh — Fri, 03 May 2024 04:00:00 +0000

In this episode Anna answers questions from you, the listener! Anna covers the topic of proper pacing and how to prevent muscle wastage and if bodybuilding supplements are worth it. We do some problem-solving for those exploring the ketogenic diet and discuss the best time to work on exercise. We wrap up with a discussion about what to do to manage bad PEM.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience

Thyroid Blog: https://annamarsh.co.uk/screeing-for-underactive-thyroid-in-chronic-fatigue-and-how-to-address-it/

Ketogenic Diet Blog: https://annamarsh.co.uk/ketogenic-diet-chronic-fatigue/

Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

Revive Electrolytes: https://getrevive.co.uk/discount/ANNAMARSH

Episode 81 - The ONE Thing You Must Master In Your Fatigue Recovery

Anna Marsh — Fri, 26 Apr 2024 03:49:00 +0000

Stability is the foundation of healing. As humans we are self-organising, self-healing human beings. Yet, in chronic illness the body has become increasingly disorganised and increasingly unstable over time as a consequence of having to cope with multiple and ongoing stressors of life. In this podcast Anna talks about the disorganisation in a “syndromal system” and how we can support the body to become more stable and organised again. This podcast will help you reflect on where you are in your journey and areas of your life that you can prioritise to support greater stability in your chronic illness and/or fatigue recovery journey.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience-special/

Nervous System Workshop: https://annamarsh.co.uk/workshop/

Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

Episode 80 - Listener Q&A: Building Capacity, Dealing with New Infections & Symptoms, Waking Unrefreshed, Surgery Preparation, Medications

Anna Marsh — Fri, 19 Apr 2024 04:00:00 +0000

In this episode Anna answers questions from you, the listener! Anna covers the topic of building capacity and shares some of her own experience having a sensitive nervous system. She talks about the challenges of managing acute infections, especially when you are a long hauler. She shares things to think about if you are waking feeling unrefreshed. How to prepare for surgery and a conversation about her experience working with clients and their medications.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience-special/

Nervous System Workshop: https://annamarsh.co.uk/workshop/

Episode 79 - The Gallbladder and Chronic Fatigue

Anna Marsh — Fri, 12 Apr 2024 04:00:00 +0000

In this episode Anna discusses the connection between the Gallbladder and Chronic Fatigue. If you are someone who burps up a fishy taste when you supplement with fish oils, this is for you! But it is also worth listening to if you have ongoing digestive issues, oestrogen dominance or mould toxicity. We cover the basics of what the Gallbladder is, what it does in the body and things that can go wrong. We look at the connection between the Gallbladder and Oestrogen (Dominance) and other risk factors for Gallbladder Dysfunction. Finally, we discuss how to know if it could be an issue for you and what you can do to support your Gallbladder.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 78 - Diagnosis and Treatment of CFS, ME and Long Covid with Dr Sarah Myhill

Anna Marsh — Fri, 05 Apr 2024 04:00:00 +0000

Shownotes

Dr Sarah Myhill is a Naturopathic Physician who has been practising medicine since before I (Anna) was born. I have the honour and privilege of interviewing her to discuss her latest book: “Diagnosis and Treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long Covid”. We cover a range of topics, all of which are covered in more detail in the book, including; dietary foundations, simple, cheap and very effective supplements, upper fermenting gut, pacing, exercise, toxins, breast implant illness and so much more!

Useful links:

Buy the book: https://www.amazon.co.uk/Diagnosis-Treatment-Chronic-Syndrome-Encephalitis/dp/1781612544/

Episode 77 - SIBO and Chronic Fatigue

Anna Marsh — Thu, 28 Mar 2024 23:01:00 +0000

Shownotes

In this episode Anna discusses the connection between digestive health and Chronic Fatigue, specifically Small Intestinal Bacterial Overgrowth (SIBO). She talks about the symptoms, how to test for SIBO and most importantly what to do about it. She shares some insights from her own journey with SIBO and also factors that make individuals susceptible to relapses.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 76 - Listener Q&A: CFS Diagnosis, Giving Up Caffeine, How to Find a Baseline and Noise Sensitivity

Anna Marsh — Fri, 22 Mar 2024 12:54:11 +0000

Shownotes

In this episode Anna answers questions from you, the listener! Anna covers an understanding of getting a CFS Diagnosis, Anna shares her own diagnosis stories and the pros and cons of being diagnosed. We discuss how to give up caffeine which can be both simple and complex depending on how much you are having and the reasons why. Anna talks about the process she used to find her baseline and finished off talking about noise sensitivity, what causes it and what you can do about it.

Useful links:

Join Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience-special/

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 75 - Autoimmunity, Trauma and Healing with Dr. Lacey Chittle

Anna Marsh — Thu, 14 Mar 2024 23:01:00 +0000

Shownotes

In this episode Anna interviews Dr Lacey Chittle who was her practitioner in her own healing journey. Lacey shares some of her personal journey with autoimmunity weaved with beautiful words of wisdom for those who are navigating the space of chronic illness management and recovery. A must listen if you need to reconnect with hope and reignite inspiration and energy to continue on your journey - especially if you fall into the category of A-type over-doers that many of us are :)

Useful links:

Dr. Lacey Chittle Website: https://www.drlaceychittle.com/

Dr. Lacey Chittle Instagram: https://www.instagram.com/drlaceychittle/

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 74 - Personal Shares + Touch Based Therapies for Fatigue Recovery

Anna Marsh — Thu, 07 Mar 2024 23:01:00 +0000

Shownotes

In this episode Anna offers some updates and shares after completing her final module in a 3 year training to become a Somatic Experiencing Practitioner (SEP). She shares some of her reflections and learnings from the past 3 years and talks about her experience with touch as a modality for support in her journey.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

JOIN NURTURING RESILIENCE: https://annamarsh.co.uk/nurturing-resilience/

Episode 73 - How to Discern When It Comes To Decisions About Your Health

Anna Marsh — Thu, 29 Feb 2024 23:01:00 +0000

Shownotes

How do you know when you need to work on something physical vs how do you know when to work on something emotional or engage more with mindbody work? That is the question that Anna aims to address in this episode. It isn’t always easy to know what the next step is when it comes to healing. Sometimes the lesson is in getting comfortable with not knowing. If you are struggling to make a decision about what comes next in your healing adventure, this episode is for you.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 72 - How to Manage Anxiety

Anna Marsh — Thu, 22 Feb 2024 23:01:00 +0000

Shownotes

Anxiety and other mood disorders often go hand and hand with chronic fatigue. It is not uncommon for those experiencing chronic fatigue to also struggle with their mental health. Here we discuss the most important considerations to improve quality of life as you navigate your mood alongside other chronic illness symptoms.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 71: A Framework For Supporting Change: How To Overcome Procrastination, Self Sabotage and Going Round in Circles

Anna Marsh — Thu, 15 Feb 2024 23:01:00 +0000

Shownotes

Experiencing and recovering from Chronic Illness requires the capacity to change and adapt. We need to learn new habits around how we eat, how we sleep, the routines we keep, the boundaries we set and everything in between. Change, even for someone in good health, is never a walk in the park and many people are prone to procrastination, self sabotage, getting complacent and going round in circles. In this episode Anna helps you to understand these behaviours on a nervous system level, how they relate to the process of change and most importantly, how to overcome them.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Join Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience-special/

Episode 70 - Listener Q&A: Finances, Unexplained Pain, Work Related Stress, Flares and Saying Yes!

Anna Marsh — Thu, 08 Feb 2024 23:01:00 +0000

Shownotes

In this episode we answer questions from you, the listeners! We cover a variety of topics including tips for managing recovery when your financial resources are limited, possible causes of unexplained leg pain, how to manage work related stress and build one’s capacity and tolerance, how to manage flares and knowing when you can start saying yes!

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 69 - Samira’s Story: Breast Cancer, Mould, Parasites and Somatic Healing [Client Interview]

Anna Marsh — Thu, 01 Feb 2024 23:01:00 +0000

Shownotes

In 2016 and recently divorced, Samira was diagnosed with triple negative breast cancer, over 6 years she experienced the medical trauma of having cancer, not once, but twice. She started and ended a business, was a single parent, moved countries, had covid twice and ended up absolutely exhausted. Samira shares her experience of moving towards better health where she discovered the power of “less is more” and somatic healing.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 68 - Tracking Progress in Fatigue Recovery

Anna Marsh — Thu, 25 Jan 2024 23:01:00 +0000

Shownotes

It is probably no surprise that when it comes to chronic and complex illness, you don’t just wake up one day and feel better. Instead, progress happens in fits and starts and sometimes cannot even be noticed on a weekly or monthly basis. In this episode Anna talks about four ways we can track progress in our fatigue recovery.

Useful links:

Website: http://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 67 - Mindfulness Pilates with Beverley Densham

Anna Marsh — Thu, 18 Jan 2024 23:01:00 +0000

Shownotes

Beverley’s fatigue journey started with a bit of anaemia and glandular fever and ended with a car accident, domestic abuse, a divorce, autoimmunity, relocating and starting over. Despite a laundry list of physical, mental and emotional challenges, Beverley was able to keep following her heart to live her dream lifestyle in her “happy place” on the South Coast. She joins us on the show to share her story, lessons learned and how pilates was part of her healing journey.

Useful Links:

Mindfulness Pilates Website: www.mindfulnesspilates.com

Instagram: https://www.instagram.com/beverley_densham/

Episode 66 – Hypoglycemia and Fatigue Recovery

Anna Marsh — Fri, 12 Jan 2024 00:01:00 +0000

Shownotes

Anna revisits the topic of blood sugar, this time talking more specifically about those experiencing low blood sugar and hypoglycemic events. Whether your blood sugar is low, high or suspected to be normal, it is still worth listening to this episode for valuable insights into blood sugar in general. Additionally, Anna covers how to identify whether hypoglycemia could be a concern for you, how to address it first with diet and lifestyle interventions and when a ketogenic diet and/or fasting could be appropriate.

Useful Links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 65 – Navigating the New Year as a Spoonie + Holiday Updates

Anna Marsh — Fri, 05 Jan 2024 00:01:00 +0000

Shownotes

Anna shares some updates from her recent trip to South Africa as well as a discussion about how to approach the New Year if you are having a Chronic Illness experience. This is a chatty episode that covers a range of different topics including boundaries, travel, identity, mould and nervous system.

Useful Links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Nervous System Workshop: https://annamarsh.co.uk/workshop/

Episode 64 – Navigating the Festive Season and Seasonal Updates

Anna Marsh — Fri, 01 Dec 2023 00:01:00 +0000

Shownotes

The festive season can be a challenging time for so many reasons; more triggers, complex family dynamics, more commitments, late nights and increased food and drink. If you feel overwhelmed about the upcoming festivities this episode is for you. I cover four of the most important things to consider as you support your body through this time and navigate the festive season alongside your healing journey. I also give a little seasonal update and some personal shares.

Useful Links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1

Episode 63 – Recovering from Long Covid and MECFS with Lorrie Rivers

Anna Marsh — Fri, 24 Nov 2023 00:01:00 +0000

Shownotes

Lorrie is a Holistic Wellness Coach who was able to heal herself after ME/CFS kept her housebound and bed bound for 8 years. However, in 2020, she experienced Long Covid but was able to use all the tools from her previous experience to recover again! She created the Relief & Transformation: Managin g Long Covid and ME/CFS full 8 week online course and Membership Program. She is passionate about helping others who are struggling with their health, to overcome their healing challenges by addressing pathogens. Please enjoy this conversation with Lorrie.

Useful Links:

Living From Inspiration Website: http://www.livingfrominspiration.com/

Relief and Transformation 8 Week Online Course: https://www.livingfrominspiration.com/inspired-covid-recovery-and-support-subscription

Lorrie’s Youtube: https://www.youtube.com/channel/UCWwNXZW3bfQDwSDD5xAP69A

Lorrie’s Instagram: https://www.instagram.com/lorrierivers_/

Episode 62 – Underactive Thyroid, Hashimoto’s and Chronic Fatigue

Anna Marsh — Fri, 17 Nov 2023 00:01:00 +0000

Shownotes

Proper thyroid screening is important to rule thyroid imbalances in or out on your fatigue and health recovery journey. In this episode Anna discussed what proper screening entails and why you might have thyroid symptoms, even if your thyroid markers are normal. This opens up a deeper discussion about thyroid autoimmunity and why thyroid replacement therapy alone is not enough to support the symptoms associated. Anna offers additional diet and lifestyle suggestions for Hashimoto’s but some of the concepts can be applied to any autoimmune condition so still worth a listen.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 61 – Endotoxemia and Intestinal Permeability and Chronic Fatigue

Anna Marsh — Fri, 10 Nov 2023 00:01:00 +0000

Shownotes

Not everyone with Chronic Fatigue will have endotoxemia and intestinal permeability, but if you do, it should be top priority for intervention. In this episode Anna explains the concepts of endotoxemia and intestinal permeability, how you can test for them and what to do about them. Anna covers a variety of factors which can impact intestinal permeability and why a personalised approach is essential when restoring membrane health.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 60 – Malabsorption Syndromes and Fatigue Recovery

Anna Marsh — Fri, 03 Nov 2023 00:01:00 +0000

Shownotes

Chronic Fatigue can be the end point of a complex web of dysfunction leading to poor ATP production. Malabsorption Syndromes can be part of the web that needs to be untangled as someone works to improve their health, energy and wellbeing. In this episode Anna covers; what is a Malabsorption Syndrome and how might you identify if it is a problem for you? Causes of malabsorption syndromes and Anna’s own personal journey with overcoming chronic digestive issues and malabsorption.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

Episode 59 – How To Lose Weight and Fatigue Recovery

Anna Marsh — Fri, 27 Oct 2023 00:01:00 +0000

Shownotes

Weight gain can be a common and often unwanted side effect of chronic illness. In this episode Anna discusses how to approach weight loss when you are well enough to actively pursue it. The episode starts with a recap of concepts discussed in episode 33, reasons why we gain weight when chronically unwell, and then branches off into discussion about non-exercise activity thermogenesis (NEAT), resistance training, caloric maintenance, surplus and deficits and how to utilise these to your advantage. This episode is most appropriate for those who are at the tail end of their health journey and are able to give more attention to weight loss over and above other aspects of healing.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 58 – Your “Can’ts” Are Your Clues in Fatigue Recovery

Anna Marsh — Fri, 20 Oct 2023 00:01:00 +0000

Shownotes

In this episode Anna discusses how trigger avoidance is the first step in fatigue recovery but when we stay at this stage, we stay stuck. Instead, Anna offers a narrative where our limitations can be our superpowers. If we can understand the mechanisms that are generating our most limiting symptoms, we can create our roadmap to better health. She includes examples of common things she she’s in her 1:1 practice.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/Work with me: https://annamarsh.co.uk/work-together/

Episode 57 – Brain Health – Diet, Lifestyle, Nutraceutical and Exercise Interventions

Anna Marsh — Fri, 13 Oct 2023 00:01:00 +0000

Shownotes

This is the second part of a two part series on brain health. In this episode Anna discusses diet, lifestyle, nutraceutical and exercise interventions to dampen neuroinflammation and support the health of your brain.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Relevant Episodes

Episode 14: How To Have a Good Night’s Sleep: https://annamarsh.co.uk/podcast/episode-14-how-to-have-a-good-night-sleep/

Episode 10: Blood Sugar Balance and Fatigue

Episode 10 – Blood Sugar Balance and Fatigue

Episode 11: Oxygenation and Fatigue

Episode 11 – Oxygenation and Fatigue

Episode 24: Can a ketogenic diet help fatigue recovery?

Episode 24 – Can a ketogenic diet help my fatigue recovery?

Episode 20: Fasting and fatigue recovery

Episode 20 – Is Fasting Appropriate For Fatigue? How and when to do it

Episode 56 – Brain Injury, Brain Health and Chronic Fatigue

Anna Marsh — Fri, 06 Oct 2023 00:01:00 +0000

Shownotes

In this episode Anna digs deeper into brain injuries and neuroinflammation. If you are someone experiencing chronic fatigue, your support plan should consider the health of your brain. In this episode Anna explains the concept of glial cell priming and how it may impact brain health long term. Even if you do not have a known brain injury, this episode is worth a listen.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 31: Neuroinflammation and Fatigue

Episode 31 – Neuroinflammation and Fatigue

Episode 55 – Thriving as a Spoonie with Emily Fraser

Anna Marsh — Fri, 29 Sep 2023 00:01:00 +0000

Shownotes

Emily, also known as “The Spoonie Mentor” on instagram joins Anna on the podcast to talk about her personal journey recovering from a brain injury and post-concussion syndrome. They talk about pacing, belief systems, learning to rest and building a business as a spoonie.

Useful links:

The Spoonie Mentor Instagram: https://www.instagram.com/thespooniementor/

Emily Fraser Website: https://www.emilyfraser.ca/

The Spoonie Podcast: https://www.emilyfraser.ca/podcast

Pacing for Spoonies Workshop: https://www.emilyfraser.ca/workshop

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 54 – Restorative Yoga for Deep Rest with Charlotte Wightman

Anna Marsh — Fri, 22 Sep 2023 00:01:00 +0000

Shownotes

Charlotte was a busy Mum of 2, who’s perfectionist, helper and achiever behaviour patterns meant she pushed herself to breaking point. The flu was the final tipping point into CFS. Her recovery from CFS took 6 years and a multifaceted approach. The many tools of yoga were hugely helpful in her recovery and now she offers restorative and gentle yoga for others with energy challenges. In this episode Anna interviews Charlotte about her fatigue recovery journey and how she used gentle and restorative yoga as part of the process.

Find Charlotte: http://gentleyogawithcharlotte.com/

Instagram: https://www.instagram.com/charlotte.wightman.yoga/

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 53 – Parasites and Chronic Fatigue

Anna Marsh — Fri, 15 Sep 2023 00:01:00 +0000

Shownotes

If you have ever wondered if parasites could be impacting your health and energy, this episode is for you. This episode focuses on intra-intestinal parasites, protozoa and helminths. Anna talks about how these infections can impact the immune system and whether or not we should intervene and address them. She covers testing options and how you may want to consider supporting your body if you suspect parasites could be a problem for you.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/Work with me: https://annamarsh.co.uk/work-together/

Episode 52 – Viral Infections and Chronic Fatigue

Anna Marsh — Fri, 08 Sep 2023 12:01:21 +0000

Shownotes

If you had a viral infection and have never felt the same since, this episode is for you. Anna discussed post-viral fatigue, reactivation of latent viruses (EBV) and recurring infections. She talks about what testing can be useful if you suspect that a virus is contributing to your clinical picture and most importantly, what to do about it. The goal is to make something that can seem complicated a lot more simple and straightforward and help you avoid common mistakes when addressing viral load.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 51 – The Podcast is Having a Summer Holiday!

Anna Marsh — Fri, 04 Aug 2023 00:01:00 +0000

Shownotes

The podcast will be taking a little holiday over August. This is a quick episode where Anna shares some personal and business updates and explains the holiday and when you can expect the next episode.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 50 – Functional Patterns for Chronic Pain with Brendan Turner

Anna Marsh — Fri, 28 Jul 2023 00:01:00 +0000

Shownotes

Brendan shares his journey living with Chronic Pain until he found Functional Patterns which changed the trajectory of his life and career. He is now passionate about helping other overcome chronic pain and pain syndromes by addressing their biomechanics, fascia and movement patterns.

Useful links:

Raw Motion Fitness Instagram: https://www.instagram.com/rawmotionfitness/

Raw Motion Fitness Website: https://rawmotionfitness.com/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 49 – Somatic Tools For Chronic Pain

Anna Marsh — Fri, 21 Jul 2023 06:20:00 +0000

Shownotes

Part 2 of a series in Chronic Pain. Anna talks through 5 somatic tools that you can use to cope better with chronic pain. She shares some examples from her own healing journey and how she used these tools to cope with headaches, shoulder and neck pains that were part of her illness experience.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Getting To Know Your Nervous System Workshop: https://annamarsh.co.uk/workshop/

Episode 48 – The Triad of Fatigue, Low Mood and Chronic Pain

Anna Marsh — Fri, 14 Jul 2023 00:01:00 +0000

Shownotes

Anna discusses the link between fatigue, mood disorders and chronic pain. Although these conditions are often not well supported with traditional medicine, they can be unravelled and addressed if you have the patience and commitment to do so. The majority of the episode focuses on chronic pain and the mechanisms that contribute to heightened pain sensitivity, including how to evaluate and address them.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 47 – Why Do I Feel Even More Exhausted When I’m Doing “Everything Right”?

Anna Marsh — Fri, 07 Jul 2023 00:01:49 +0000

Shownotes

We’ve all been there. We feel like we’re doing “everything right” and yet continue to feel worse. When the whole point is to feel less fatigued and less exhausted it can be easy to resist relapses in energy. However, being able to connect with and embrace our experience can offer valuable lessons that will move the healing journey forward. Listen for a deeper discussion.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 46 – Privilege and Healing

Anna Marsh — Fri, 30 Jun 2023 00:01:00 +0000

Shownotes

Anna opens up a conversation about privilege and healing. Some people will have more privileges in their healing journey which may make their healing journey “easier” and others may have less privileges in their journey which may make it “harder” to heal. Whatever the case, moving through a chronic illness experience is painful. This episode is designed to make you think and reflect and perhaps consider where you are focussing on your own disadvantages too much, which could be a roadblock to healing.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 45 – Don’t Forget The Basics – They Matter

Anna Marsh — Fri, 23 Jun 2023 00:01:00 +0000

Shownotes

This episode is a reminder that basics matter. It is an opportunity for you to check in with yourself and make sure you have those all important basics covered. It is a recap on some of the concepts covered in previous episodes. Anna also talks about routines and finding the flexibility to dance between being a human and a human that needs to heal.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 44 – What Helped Me in My Recovery From Mold Illness and CFS

Anna Marsh — Fri, 16 Jun 2023 00:01:00 +0000

Shownotes

In this episode Anna highlights the things she felt made the biggest difference in her own recovery journey. She acknowledges that the journey isn’t linear; there are different stages of healing and not all of them look like progress. She finishes with a general share of things that are working for her clients as inspiration for things to explore.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 43 – Grief and Healing

Anna Marsh — Fri, 09 Jun 2023 00:01:00 +0000

Shownotes

Grief is an inevitable part of healing. In this episode, Anna talks about her own experience of grief in her healing journey. She shares a framework for understanding grief and somatic and mindset tools for working with grief in your day-to-day life.

Useful Links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 42 – MCAS, Histamine Intolerance and Fatigue

Anna Marsh — Fri, 02 Jun 2023 00:01:00 +0000

Shownotes

Mast cell activation syndrome (MCAS) and histamine intolerance may be part of the complex web of imbalances in Chronic Fatigue Syndrome (CFS/ME) and other chronic illnesses.

MCAS can be associated with pain, cognitive dysfunction, brain fog, sensitivity to light and sound or intolerance to chemicals and smells. Many of these symptoms, and more, go hand in hand with those who experience a chronic illness.

This doesn’t mean that everyone who experiences chronic fatigue or a chronic illness will have MCAS or histamine intolerance but it is something to consider as you work on supporting all of your body’s needs. In this episode, Anna covers the what and the how.

Useful links:

How to Follow A Low Histamine Diet Blog: https://annamarsh.co.uk/low-histamine-diet/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Useful links:

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 41 – Managing Hopelessness When it Feels Like “Nothing is working”

Anna Marsh — Fri, 26 May 2023 00:01:00 +0000

Shownotes

We’ve all been there. You feel like you are doing everything but nothing seems to be working. You’ve hit a plateau or you’ve gone backwards in your healing. In this episode, Anna offers support around the experience of hopelessness including a trauma-informed framework to move from the powerlessness that accompanies a lack of hope to a more powerful state. She wraps up the episodes by challenging the belief “Nothing is working” by offering a checklist to make sure that is really true.

Useful links:

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 40 – How to support a loved one with Chronic Fatigue – Part 2

Anna Marsh — Fri, 19 May 2023 08:39:41 +0000

Shownotes

In part 2 of this series, Anna covers communication, needs, and a framework for understanding relationship dynamics. The goal of the episode is to support communication so that both the illness experiencer and their supporters have their needs met. The relationship framework will help deepen your understanding of your relationships so that you are not left disappointed (and unsupported) when your expectations are not met.

Accompanying journaling exercise:

How am I currently being supported in a way that is meaningful to me?
Is support being offered in a way that is unhelpful or possibly counterproductive to my healing?
What support am I not currently receiving that I would like to receive?
What do I need to ask for specifically? Be as specific as possible.

Here are some examples:

I need you to cook dinner by 7pm on Tuesday and Thursdays evenings.
I need you to read this blog by next week Friday so we can talk about it together on Saturday morning when the kids are at tennis.
I would like it if you could ask me more questions about my healing journey. Perhaps once a week we can have a hot drink and chat about how I feel things are going.
When I tell you I am having a bad day, I don’t need you to do anything for me except sit with me for a bit and listen.

Useful links:

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 39 – How to Support a Loved One with Chronic Fatigue – Part 1

Anna Marsh — Fri, 12 May 2023 00:00:09 +0000

Shownotes

This is part 1 of a 2-part series for those experiencing a chronic illness (like CFS/ME) and their supporters. In this episode, Anna discusses relationship dynamics and how they influence the ability of loved one’s to offer support and the ability of those with a chronic illness to ask for and receive support. Anna discusses the survey results from the research on this topic and offers solutions so that supporters feel better equipped to support and illness experiencers feel better equipped to receive support.

Useful links:

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 38 – Somatic Experiencing, Brain Retraining and Healing Updates

Anna Marsh — Fri, 05 May 2023 00:01:00 +0000

In this episode Anna explains the differences in Brain Retraining and Somatic Experiencing in theory and practise. She talks about her own experience with these different modalities and shares some updates on her own healing journey working somatically with medical trauma and anaesthesia. She finished with a discussion about where Functional Medicine and Mind-Body Work intersects.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Join the next cohort of Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Episode 37 – How to have better periods with CFS/ME: Part 3 – Supporting Your Hormones Naturally

Anna Marsh — Fri, 28 Apr 2023 00:01:00 +0000

Shownotes

This is part 3 in a 3 part series on how to have better periods with CFS/ME. Anna wraps up the three part series by discussing how we can support the body generally and how to manage oestrogen dominance – a common underlying cause of hormone imbalance – more specifically.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 36 – How to Have Better Periods with CFS/ME: Part 2 – Testing Your Hormones

Anna Marsh — Fri, 21 Apr 2023 00:01:00 +0000

Shownotes

This episode is a short and sweet menu of different testing options for your sex hormones. Anna covers blood and urine testing options as well as home monitoring devices. Learn how to make sure you test at the right time in your cycle and possible genetic tests that can be useful.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Testing Resources:

Mira Device

Dutch Complete Hormones + CAR

Oestradiol

Day 21 Progesterone

Testosterone

Advanced Female Hormones for Oestrogen, Testosterone, Prolactin, LH. FSH

You can refer back to the following blog for examples of different testing options.

Episode 35 – How to have better periods with CFS/ME: Part 1 – What does a healthy cycle look like?

Anna Marsh — Fri, 14 Apr 2023 00:01:00 +0000

Shownotes

It is a common experience for women with fatigue, chronic illness and other inflammatory conditions to experience hormone imbalances alongside and on top of their primary illness experience. Sex hormones can act like the volume control of the body. As they naturally fluctuate across a month they can turn the volume up and down on symptoms. This is part 1 of a 3 part series where we look at how your sex hormones fluctuate across the different phases of the cycle, what can go wrong and why you might feel better or worse at different stages. Part 2 and Part 3 will focus on testing for female hormone imbalances and things we can do to further support the body respectively.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 34 – Mindset and Fatigue Recovery

Anna Marsh — Fri, 07 Apr 2023 00:01:00 +0000

Shownotes:

In this episode, Anna offers a framework and a toolbox to support fatigue recovery from a “mindset perspective”. Although it is hard to separate mind and body, we can influence our physiology from the top down using language, cognition, reasoning, and voluntary movement. Anna touches on how you can use the power of these tools to help you get “unstuck” in your chronic illness experience.

Useful links:

Website: https://annamarsh.co.uk/

Nurturing Resilience: https://annamarsh.co.uk/nurturing-resilience/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 33 – Weight Gain, Body Image and Fatigue Recovery

Anna Marsh — Fri, 31 Mar 2023 00:01:00 +0000

Shownotes

Navigating a fatigue recovery experience can also come hand in hand with navigating changes in body, shape, and size. For some, this is just part of the process and for others, it can be an uncomfortable experience. In this episode, Anna explains why we might gain weight in fatigue recovery and where weight loss fits in the context of fatigue recovery. She shares guidance for managing food and exercise in support of healthy body weight and minimising weight gain. She ends with a short discussion about where the nervous system may intersect with our attitudes toward weight, exercise, and food.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Road Map: https://annamarsh.co.uk/fatigue-recovery-roadmap/

Nurturing Resilience Program: https://annamarsh.co.uk/nurturing-resilience/

1:1 Fatigue Recovery: https://annamarsh.co.uk/1-1/

Episode 32 – Neurotransmitters

Anna Marsh — Fri, 24 Mar 2023 00:01:00 +0000

Shownotes

Anna shares her perspective on addressing the imbalance of neurotransmitters in fatigue recovery. She zooms out and offers an understanding about how taking a big-picture view can be much more successful and beneficial in the long term.

Products Mentioned (you can use the code AMARSH10 for 10% off)*

Sleep Supplement for Gaba Support:

https://naturaldispensary.co.uk/products/Sleep_150g-10005169-0.html

L-theanine and Lemon Balm:

https://naturaldispensary.co.uk/products/L_Theanine_and_Lemon_Balm_90_s-13318-0.html

*supplements taken at own risk

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 31 – Neuroinflammation and Fatigue

Anna Marsh — Fri, 17 Mar 2023 00:01:00 +0000

Shownotes

Anna shares a framework for understanding neuroinflammation from her training in Psychoneuroimmunology with Leo Priumbroom. This is based on the understanding that you cannot have chronic disease without neuroinflammation and that neuroinflammation is the universal mechanism behind disease. She takes her time to explain the mechanism of neuroinflammation in both acute and chronic illness and offers insight into how we support the body to find health again.

List of Polyphenol Foods

Black elderberry, black chokeberry, blackcurrant, highbush blueberry, globe artichoke heads, filter coffee, lowbush blueberry, sweet cherry, strawberry, blackberry, plum, red raspberry, flaxseed meal, dark chocolate, chestnut, black tea, green tea, pure apple juice, whole grain rye bread, hazelnut, red wine, soy yoghurt, cacao powder, pure pomegranate juice, soy flour, black grape, black olive, pure grapefruit juice, pure blood orange juice, milk chocolate, spinach, pecan nut, prune, red currant, soy tempeh, peach, soy tofu, green olive, black bean, red onion, green grape, white bean, chocolate beverage with milk, roasted soy bean, potato, shallot, soy milk, red chicory, broccoli.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 30 – My Fatigue Recovery Journey Update

Anna Marsh — Fri, 10 Mar 2023 14:49:53 +0000

Shownotes

Anna shares an update about where she is in her own healing journey. She enters into a discussion about identity and the importance of how we choose to identify with our illness experience. She finishes up sharing some strategies she is using to support her body right now.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Episode 29 – Managing Fatigue vs Deeper Healing

Anna Marsh — Fri, 03 Mar 2023 00:01:00 +0000

Shownotes

Are you just managing your fatigue recovery or are you experiencing the deeper healing that is required to fully recover? In this episode Anna talks about the difference between Fatigue Management and true healing, how she distinguishes between the two and how to know which stage you may be in at the moment.

Useful links:

Nurturing Resilience April 2023: https://annamarsh.co.uk/nurturing-resilience/

Episode 28 – Diet Changes To Increase Your Energy

Anna Marsh — Fri, 24 Feb 2023 00:01:00 +0000

Shownotes

Knowing what to eat can be really confusing. There are so many mixed messages it’s hard to know if you should be vegan, low carb, carnivore or keto!? In this episode Anna breaks down a step by step framework that you can follow to optimise your diet for energy in a way that hopefully shouldn’t feel too overwhelming and restrictive.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Digestive Health Mini Course: https://members.annamarsh.co.uk/offers/72f35762-a7b6-431d-8cba-1c144299cc74

Episode 27 – Building Exercise Tolerance and Capacity with Chronic Fatigue

Anna Marsh — Fri, 17 Feb 2023 00:01:00 +0000

Shownotes

There comes a point in one’s fatigue recovery journey where you are doing okay but you want more. In this episode Anna talks about how she progressed her daily exercise from walking to getting back into the gym and lifting heavy weights. She talks about important considerations as you take the next step and how you can minimise PEM and support recovery.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 26- How to Exercise with Chronic Fatigue

Anna Marsh — Fri, 10 Feb 2023 00:01:00 +0000

Shownotes

If you are an exercise lover, one of the biggest frustrations with chronic illness is how it impacts your ability to exercise. Unfortunately, we can only start where we are and work with what we have got, but, you can rebuild your health and exercise capacity. This episode covers some basic principles to get you started when it comes to building a baseline of physical activity. The next episode will focus on how to progress.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 25 – Perimenopause and Fatigue Recovery with Francesca Liparoti

Anna Marsh — Fri, 03 Feb 2023 00:01:00 +0000

Shownotes

Having a chronic fatigue or burnout experience and going through perimenopause at the same time, adds another level of complexity to fatigue recovery. Anna invites registered Nutritional Therapist Francesca Liparoti to talk about how we can support perimenopause alongside fatigue recovery. This episode is not just for women over 40, it is also for women in their 20’s and 30’s because the habits we create now, will hold us in a better balanced place as we move through the natural transitions of life.

Useful links:

Francesca’s Instagram:@francescaliparoti_nt (/www.instagram.com/francescaliparoti_nt/)

Francesca’s website: http://www.francescaliparoti.com/

Think Dirty App: https://thinkdirtyapp.com/

Cycles Period Tracking App: https://cycles.app/

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 24 – Can a ketogenic diet help my fatigue recovery?

Anna Marsh — Fri, 27 Jan 2023 00:01:00 +0000

Shownotes

In this episode Anna discusses the nuance when it comes to ketogenic or low carbohydrate diets and fatigue recovery. You can expect to learn how a ketogenic could be beneficial to someone who wants to increase their energy and how you can identify if it would be appropriate for you specifically. Anna shares steps on implementing a ketogenic diet including top tips for managing side effects as you transition. She shares her own experience and how to begin to transition out of a ketogenic diet once you have maximised the therapeutic benefits.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

Episode 23 – Managing Motherhood and Fatigue Recovery with Ellen Murray

Anna Marsh — Fri, 20 Jan 2023 00:01:00 +0000

Shownotes

Anna interviews her very first guest; Mindset and Empowerment Coach, Ellen Murray. Lockdown brought her multi-six figure business to a standstill and then a viral infection swept her off her feet. She shares her journey to recovery; juggling life as a mum with 2 children under 3, learning to trust and surrender, tame her inner achiever, fall in love with yin yoga and meditation and launching her new business supporting exhausted and burnout women.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Find Ellen

Facebook page- https://www.facebook.com/ellenmurraycoaching

Instagram- https://www.instagram.com/ellenmurraycoach/

Episode 22 – Two Client Archetypes: Which one are you?

Anna Marsh — Fri, 13 Jan 2023 00:01:00 +0000

Shownotes

Anna reflects on the types of clients she works with in her practise and puts them in one of two categories. She explains the qualities of each category and how she prioritises support for the client depending on where they fall. You will probably see yourself in one of the two categories and this episode may help you to understand what you could be doing more of, less of or just help you structure your recovery a little bit better.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Episode 21 – Personal Reflections for 2022

Anna Marsh — Fri, 06 Jan 2023 00:01:51 +0000

Shownotes

This episode is a little different. Anna offers up 10 journaling questions to help you reflect on the past 12 months. She talks through her own answers to the 10 questions with some vulnerable shares and insights into her health and business journey.

Journal Questions:

1. What did you love in the last 12 months

2. What were some of the magical / extra-ordinary moments?

3. What did you accomplish?

4. What would you duplicate?

5. What did you hate?

6. What was challenging?

7. What do you NOT want to happen again?

8. What did you learn?

9. What decisions did you make that were empowering?

10. What decisions will you make or what intentions will you set for 2023?

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Road Map: https://annamarsh.co.uk/fatigue-recovery-roadmap/

Nurturing Resilience Program: https://annamarsh.co.uk/nurturing-resilience/

1:1 Fatigue Recovery: https://annamarsh.co.uk/1-1/

Episode 20 – Is Fasting Appropriate For Fatigue? How and when to do it

Anna Marsh — Fri, 23 Dec 2022 00:01:00 +0000

Shownotes

Fasting is a practice that can be controversial in the healthcare space. Some people love it, others feel that it can do more harm than good. In this episode Anna breaks down the benefits of fasting, who it’s for, who it might not be for and how you can slowly introduce it into your routine if it is something you want to explore, including timing around your menstrual cycle.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Electrolytes: https://www.amazon.co.uk/Keto-Pro-Electrolytes-Electrolyte-Astaxanthin-Supporting/dp/B09CDTCYJQ/

Episode 20 – Is Fasting Appropriate For Fatigue? How and when to do it

Anna Marsh — Fri, 23 Dec 2022 00:01:00 +0000

Shownotes

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Electrolytes: https://www.amazon.co.uk/Keto-Pro-Electrolytes-Electrolyte-Astaxanthin-Supporting/dp/B09CDTCYJQ/

Episode 19 – Are Burnout, Adrenal Fatigue and CFS/ME the same thing?

Anna Marsh — Fri, 16 Dec 2022 00:01:00 +0000

Shownotes

This episode piggybacks off the previous episode on adrenal fatigue. Here Anna discusses the difference between burnout, adrenal fatigue or exhaustion and the syndrome of Chronic Fatigue. You can expect to learn a little bit about the differences and similarities and how we support each of these fatigue experiences.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Episode 18 – Adrenal Fatigue or Adrenal Intelligence?

Anna Marsh — Fri, 09 Dec 2022 00:01:00 +0000

Shownotes

It can be common practice amongst many Functional Medicine Practitioners and Nutritional Therapists to use adrenal testing to inform clinical decisions. This often comes in the form of addressing “dysfunction” with adrenal herbal adaptogens and glandulars to either “boost” adrenal function or “calm it”. In this episode Anna offers an alternative perspective which considers adrenal dysfunction to be intelligence from which we can learn more about what the body really needs.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Episode 17 – Navigating the Festive Season with Fatigue

Anna Marsh — Fri, 02 Dec 2022 00:01:00 +0000

Shownotes

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Work with me: https://annamarsh.co.uk/work-together/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

How to Navigate the Festive Season While Managing Chronic Fatigue and Burnout

The festive season is a time that many people look forward to, but for others, it can be a time of added stress and overwhelm. Many factors can make this time of year challenging, from the physical triggers of different foods and drinks to the emotional triggers of complex family dynamics and social obligations.

It’s common to feel out of control during this time, whether with your food choices or schedule. It can be challenging if you’re dealing with a chronic illness or other health condition that impacts your daily life. But there are ways to navigate the festive season more efficiently and support your body through this time.

There are four key areas to consider as you prepare for the holiday season. These areas include practical strategies for setting intentions, nervous system care, managing your food and drink intake and setting healthy boundaries.

1. Set Intentions

Setting intentions that act as a guide or reference point to navigate this time effectively is essential. Intention setting involves asking yourself what’s important to you during the next four to six weeks and focusing on it. For example, it could be a time to slow down, focus on health, rest, or prioritize connecting with friends and family. It’s crucial to make clear boundaries and manage outcomes to achieve these intentions.

It’s also important to remember that everything we do is for a feeling. As human beings, we tend to move away from pain and towards pleasure. Therefore, it’s essential to consider what you want to feel during this time and how you want the experience to unfold. You can think, sit quietly, and journal your thoughts or answers to this question.

It’s possible to have both, meaning you can prioritize your health while maintaining supportive relationships with friends and family. Having a clear framework or north star helps to stay connected to what matters during this season, and intention setting provides a guide to navigate through it effectively. By being intentional about how you use your time, what you say yes or no to, and staying connected to what matters, you can manage outcomes and make the most of this winter season.

2. Nervous System Care

It is essential to prioritize our self-care, particularly regarding the health of our nervous system. Dr. Rosanne Austin explains that having tools and strategies to self-regulate is crucial to managing triggers and setting healthy boundaries during this time. Regardless of whether one has a chronic fatigue condition, the entire world needs these tools to self-regulate. It is vital to maintain these tools during this time and to continue using them.

The nervous system plays a significant role in our ability to self-regulate, and keeping it well-regulated to set healthy boundaries is essential. When the nervous system is dysregulated, we may find that our boundaries are too loose or too rigid, leading to disconnection and exacerbating feelings of loneliness during the festive season. Therefore, it is vital to prioritize the health of our nervous system as the foundation for setting healthy boundaries.

It is also essential to use nervous system self-care to curb anxiety around food, alcohol, and staying up late. Suppose our symptoms are exacerbated because of a change in routine or diet. In that case, it is essential not to spiral into worry and anxiety, as this will worsen the symptoms further. So, having ways to self-regulate during this time is crucial to avoid becoming overly anxious about things that feel out of control.

A toolbox of self-care strategies is essential, particularly during the festive season. Free resources are available on the blog and podcast, including a nervous system mini-course for supporting individuals in finding ways to self-regulate and prioritize their nervous system health. Therefore, it is crucial to consider the next step for keeping our nervous system and not neglecting self-care during this time.

3. Manage Your Food and Drink

The holiday season can also be a time of excess, derailing your health goals. Here are some tips for maintaining health during the festive season and enjoying yourself.

Hydration is essential for healthy cells and supporting the kidneys in detoxification. It is best to drink enough water so that urine is pale yellow. Additionally, if you consume dehydrating beverages, such as alcohol or caffeine, adding electrolytes could be beneficial in keeping hydration levels up.

Apart from that, managing sugar, alcohol, and higher carbohydrate foods are crucial during the festive season. These foods can cause dysregulation in blood sugar levels, increasing inflammation and histamine production. Furthermore, it can impact sleep, which affects recovery. Prioritize these types of food for lunchtime instead of in the evening so you can use the rest of the day to rebalance blood sugar, which may be better for sleep and recovery. It is also essential to focus on protein and vegetables while keeping portions of sugary or higher carbohydrate foods to a minimum.

When choosing alcohol, it is best to have it with a meal and not on an empty stomach. Certain drinks, such as clean drinks like spirits, may work better than others. In contrast, fermented beverages like wine may be more challenging, especially if mold is toxic. Trial and error are recommended to determine what works best for one’s system. Offering to bring a high-protein or high-vegetable dish to a party can also help stabilize and balance blood sugar levels.

Our body responds differently to various foods and drinks. Knowing our body and what works well for it can help us make choices that align with our health goals and intentions for the festive season. As long as our intentions align with our preferences, we should come out of the festive season feeling content with our decisions rather than disappointed in ourselves for going backward in our health journey.

4. Setting Healthy Boundaries

Establishing boundaries around rest, food and drink, connection, and conversations is essential. Boundaries are necessary for protecting our needs, and it is crucial to connect with our intentions to determine the rules we need to follow to honor them. Think about which people we should spend our energy on and avoid.

Setting boundaries takes work, especially for those who tend to please people. However, it is easier to set verbal boundaries if we approach conversations from a regulated space. Understanding that setting boundaries do not mean creating a wall is crucial. Instead, it is about communicating our needs to have healthy relationships with others. If verbal boundaries are not honored, we may need to take a specific action, such as removing ourselves from situations or declining certain events.

Maintaining healthy habits such as eating well, sleeping well, staying hydrated, and limiting coffee and alcohol intake can help regulate our nervous system. The importance of being in a regulated state is that we can be more aware of what we need, which is essential in setting boundaries.

By focusing on these four areas, we can build a robust support system for ourselves and create a holiday season that is both joyful and nourishing.

Whether you’re dealing with chronic fatigue, burnout, or other health challenges, these strategies will help you take care of yourself and stay grounded during an overwhelming time.

So if you’re feeling anxious about the upcoming festivities, tune in to this episode and discover how you can navigate the holiday season with greater ease and grace.

LET’S RECAP!

The holiday season can be an overwhelming time for many people, but it doesn’t have to be a time of added stress and anxiety. With the right strategies, you can navigate this time with ease and grace.

Firstly, set intentions for the holiday season. By asking yourself what’s important to you during the next few weeks and focusing on it, you can have a clear framework to stay connected to what matters. Secondly, prioritize nervous system care. Tools and strategies to self-regulate are crucial to managing triggers and setting healthy boundaries during this time. Maintaining these tools is essential for everyone, regardless of whether one has a chronic fatigue condition.

Next, manage your food and drink intake. It’s easy to fall into a trap of excess during the holiday season, derailing your health goals. But with a few tips like prioritizing hydration, focusing on protein and vegetables, and choosing clean drinks, you can maintain your health goals and still enjoy yourself.

Lastly, setting healthy boundaries is essential. Establishing boundaries around rest, food and drink, connection, and conversations are necessary for protecting our needs. It’s crucial to connect with our intentions to determine the rules we need to follow to honor them. By focusing on these four areas, you can create a holiday season that is both joyful and nourishing, regardless of your health challenges.

So, if you’re feeling anxious about the upcoming festivities, don’t fret. These strategies will help you take care of yourself and stay grounded during this overwhelming time. You deserve to have a holiday season that is both meaningful and enjoyable, so take the time to prioritize your health and well-being.

Resources & Tools Mentioned in the Podcast:

Episode 9 – The Nervous System And Chronic Fatigue

Nurturing Resilience Program

Nervous System Mini Course

Episode 16 – Post-Exertional Malaise

Anna Marsh — Fri, 25 Nov 2022 00:01:00 +0000

Shownotes

Post-exertional malaise is probably one of the biggest bugbears when it comes to fatigue recovery. Anna shares a general framework for tackling post-exertional malaise as well as her own experience and things that made the biggest difference for her personally.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Post-Exertional Malaise

Welcome back to the chronic fatigue and burnout recovery Podcast. Today I’m going to be talking about post-exertional malaise. If you are anything like me or anything like I posted, exertional malaise was one of the biggest bugbears in my fatigue recovery.

It was probably one of the first symptoms to creep in, although I didn’t realize that’s what was happening initially. It was one of those last things I needed to deal with to move forward and gain momentum in my fatigue recovery. I know the frustrations of post-exertional malaise very well, and I’m going to share today some things that you may want to be thinking about if you are as frustrated as I was.

And things that work for me, things that work for clients, and things to play around with my work in general. But before I share all of that with you, I guess the first thing to say is, what is post-exertional malaise? Post-exertional malaise is an increase in symptoms that occurs after exertion, which could sometimes be mental exertion.

For the most part, it is physical exertion or exercise. Usually, it happens between straight off to exercise to 24, even 48 hours after some demand on the body system. I found in my own fatigue recovery that there was definitely a pattern that I would notice.

So if I was going to get any post-exertional malaise after exercise, I might have an hour after I exercise where I would feel on top of the world running on all the fantastic endorphins and then by about almost four hours on the dot after I finished exercising, that’s when it would hit, and I would tend to feel the symptoms increase. For me, a lot of it was experiencing a lot of brain fog, fatigue and maybe some aches and pains. Although it can be different for each person, there will be a bigger cycle.

That was the small four-hour cycle, but the bigger cycle might be like a build-up cycle. If I had been doing a lot of things over, like maybe several days, I knew I could wake up one morning and just need a rest day. That, to a certain extent, was easier to manage because it was a bigger, less intense cycle.

But if I were going to get the sort of crash for hours after exercise, that would probably be the more intense cycle. I tried so many different things and many different approaches to exercise. I was constantly trying and crashing, trying and crashing, trying and crashing.

I wouldn’t recommend it. But eventually, I did get to where I needed to go. Hopefully, what I can share today in this episode can shortcut that process for you so you don’t have to go through those repeated cycles of trying and crashing, trying and crashing.

Exercise was such a big part of my life pre-CFS. I had been exercising, running, swimming, training in gyms, aerobics, spin, yoga, and CrossFit for more for about 20 years when I finally became unwell. It was such a big thing to let go of this ability to have a great workout, and it was always the thing that I wanted to get back the most, and it was the thing that took the longest to get back.

I hope this podcast today will help you get that ability to exercise back sooner rather than later because if you’re anything like me, it’s probably something you are really craving. The first thing to understand about post-exertional malaise is it is kind of like a mini-crash or a crash. You could listen to the previous episode that I did on how to manage crashes, flares and setbacks because it is like a mini crash and mini flare, a mini setback every time you get post-exertional malaise.

It’s important here to understand that inflammatory changes have happened in the body. There are nervous system changes that have happened in the body, which are self-protective intelligence because the body perceives that there is a threat. It might just be the threat is that you’ve produced too much inflammation, too much toxicity, doing whatever physical activity that you just did.

Or it could be that there’s an energy crisis, there’s not enough energy to cope with the activity that’s sending the system into distress. So here, if there’s mitochondrial dysfunction that could be impacting this post-exertional malaise, or it could be that your nervous system is just really not feeling safe enough to exercise yet. Therefore your body is responding with the post-exertional malaise as a self-protective shut down so that you don’t do more than what it can handle right now.

One of the things we want to think about is fatigue recovery, and we need to exercise. Exercise is good across so many levels and beneficial to the recovery process. But we needed to be at the right dose. Suppose you are experiencing post-exertional malaise and you’re trying to exercise. In that case, the first thing is to strip back whatever you’re doing so that you are doing an amount which is tolerable to the body, even if it’s not what you want to be doing.

I think a lot of people focus on walking when they first started to build up their activity and when I first started to build up my walking, I was doing heart rate-controlled walking, keeping my heart rate in a safe zone, and that was enough. But then, over time, I could maybe add in a little bit of swimming, and I worked out if I did a teeny tiny bit of swimming. Then I bobbed in the water for a bit, did a teeny tiny bit of swimming, and then bobbed in the water for a bit.

I could do quite a bit across about 20 minutes or so, but it was very slow going. The frustration is that if you love to exercise, and you’re used to being able to do loads of exercise, to do very, very small amounts is disheartening. But you need to remember that what you’re doing is you’re conditioning your body to get used to exercising so that the exercise is less threatening to your system.

You’re producing less inflammation as a consequence of doing the exercise because your body is used to it. So you want to find the minimum tolerable dose and then build up from there. The other thing you can do is buffer your exercise practices with restorative practices.

What that might mean is if you go out for a walk, and then you come back from your walk, maybe that’s when you do a little bit of nervous system self-care of, visualization and meditation. Sometimes I would just come home and put my legs up the wall to slow down my heart rate to get blood flow back to the brain, and I would do 15 or 20 minutes with my legs up the wall. When I was doing my walking, I would walk along the beach to a certain point, and then I would sit on a rock, I would do some breathing exercises, a little bit of visualization and a little bit of nervous system work, and then I would walk back and then would do the same when I got home.

When I eventually started doing weight and resistance training again, I would finish my resistance training with about 15 or 20 minutes of yin yoga to really calm my body down. Even still, once I finish a workout, now I’m exercising how I used to, I’ll still take a little bit of time at the end of the workout to do some stretching to bring my heart rate down to recenter my nervous system, so that’s an ongoing practice for me. The next thing you can start to think about is supporting inflammation in the body.

To a certain extent, this is what you’re probably doing as part of your healing journey anyway. In the broader context, should I say it’s making sure that your diet is optimized, you’re consuming lots of anti-inflammatory foods, you’ve got very stable blood sugar, and maybe you’re doing some fasting? Then on top of that, we can think about adding in some anti-inflammatory support around exercise.

The type of support I like specifically from a supplement perspective is glutathione. Glutathione is one of the master antioxidants in the body. So if I’ve done even now if I do a workout, which is quite strenuous, I might have some glutathione in the evening before I go to bed to support my recovery overnight.

The other thing that I like to do is add curcumin. I liked the Nutri advanced curcumin and I take 1000 milligrams, as soon as I finish a workout, so that’s two tablets after the workout, to bring down the inflammatory load from the workout. There is also research to suggest in long COVID that having 1.5 grams, so 1500 milligrams of L-citrulline and 500 milligrams of vitamin C daily can help with post-exertional malaise and exercise tolerance.

And generally speaking, I also like to add some sports nutrition to my workout. I’ll usually take creatine, branched-chain amino acids and electrolytes if I go for a long hike or even a long walk, or if I am doing something a little more vigorous, like a bit of swimming or weights workout, I would take those supplements. You don’t necessarily have to wait until you’re exercising like an athlete to support your body as an athlete would.

I always say that recovering from chronic fatigue syndrome is like being a professional athlete. Because athletes have to, you know, challenge their body, they do their training for the day, and then the rest of the day is about supporting recovery. It’s the same for chronic fatigue, we spend some of our days challenging the body so that we expand the capacity of the nervous system and the different body systems, and then we spend the rest of the day doing as much as possible so that we can restore, repair, and grow stronger over time.

A big thing you may also want to think about is what is going on in your gut. I’ve done a whole podcast on digestive health, so I won’t go into gut health in detail here in this podcast today but remember that inflammation in the gut can commonly be associated with inflammation in the rest of the body. If there’s an overgrowth of bacteria that produce toxins in your gut when you exercise, your gut barriers become a little bit leakier.

Then those toxins will pass through into the bloodstream, which will contribute to the body’s toxic load, in addition to toxic byproducts that may be getting stirred up from exercise. And remember that if any inflammation is generated through exercising, your lymphatic system and your detoxification pathways will have to process those inflammatory molecules as well. It’s a lot.

If the gut isn’t working very well, it’s an extra load that can contribute to this post-exertional malaise. If you want to do more exercise and you have digestive symptoms, remember that you don’t always have to have digestive symptoms. Still, if you do, you may want to consider addressing your digestive health before you think about expanding your exercise capacity.

A big one I wanted to mention was mould. This was possibly one of the biggest blind spots in my own chronic fatigue recovery journey. Mould had never really crossed my mind until I had been unwell for about three years, which is a long time.

I was getting so frustrated because of the post-exertional malaise I was experiencing. I would make a little progress and exercise capacity and then feel like I’d go back to square one again. I was so desperate to exercise.

I was at the point where I could hike, and I could walk, you know, provided it wasn’t too strenuous or terrain. I could walk for three hours, but the moment I tried to do anything more intensive than walking or anything resistance-based, I would go into this post-exertional malaise inflammatory state. I could not tolerate it.

Eventually, I decided to test myself for mould. The test came back positive. I started a detoxification and drainage support plan, and within a month of starting that, I could build up my resistance training.

And then, as I continued to detox more and support my body more, I was able to do more and more and more and more, and it was the final kind of nail in the coffin of three years and the making that enabled me to get my exercise back to where I wanted it to be. It was really important to me that I could resistance train because there are so many health benefits to having adequate muscle mass. Adequate muscle mass is important for metabolic health and is anti-inflammatory.

The more muscle mass you have, you’re likely to have better the quality and quantity of mitochondria, which means you have a more resilient nervous system. It supports just posture, and it’s anti-ageing. Resistance training is really important for women for their bone health.

There are so many reasons why I wanted to resistance train and it wasn’t until I addressed the mould that I was able to do that. I looked into it a little bit more at the time and one of the mechanisms is that mould increases something called vascular endothelial growth factor or VEGF. Essentially, this blocks the capillaries in the body, which ultimately prevents good blood flow and oxygenation of your cells.

There’s a link here with the increase in VEGF in long COVID. That’s worth noting. This is how mould can impact exercise capacity and cause post-exertional malaise. Still, there are a few other mechanisms if you have a lot of mycotoxins in your body. You’re exercising, that’s potentially moving them around the body, mobilizing them, and adding to the toxic load that may be coming in from tissue breakdown when you’re exercising.

We’ve got the poor oxygenation and poor circulation, we’ve got the toxins in the body, which are getting mobilized, we’ve got the toxins from exercise, and we’ve also got the inflammation that has been produced by tissue breakdown. Your body has to deal with all of that. Suppose you can’t deal with all that will cause foggy brain, fatigue, and inflammation until everything can settle down and find homeostasis again.

I don’t think it matters to eliminate the toxins, whether it’s mould, mycotoxins or other mycotoxins, but supporting the liver, detoxification, and reducing the body’s toxic load as a whole, is another thing that you can do to support post-exertional malaise. This is where in some cases, a sauna can be really helpful. The sauna is always a bit delicate because some people may or may not be able to tolerate the sauna.

I have some clients who can’t even tolerate a hot bath so the idea of going into a hot sauna is it’s just a no-go. But if you can tolerate a sauna, whether five minutes, 10 minutes, 15 or 30 minutes, it can be beneficial post workout for muscle growth and hypertrophy gains. But I found it was great for muscle recovery.

If I was feeling a little bit foggy-brained after a workout, I could have a sauna, which will nip in the bed. So really, great for detoxification. You can support your body around the sauna with antioxidants, glutathione, and binders, but that’s another story for another day.

But sauna can be complementary to reduce post-exertional malaise if tolerated. I probably was in the worst state with mould illness, and I didn’t know I had mould illness. I remember just trying to sauna would make me have post-exertional malaise.

We need to tread cautiously, but if you can tolerate it, it’s a great thing to add in. Then another thing to consider is histamine. This is where there is a little bit of overlap with mould as well. Exercise can increase histamine production.

If you are already somebody who has mast cell activation syndrome MCAS. Suppose you suspect that you are quite a histamine intolerant. In that case, exercise could push the histamine levels in your body over the edge, which could be responsible for some of your symptoms.

Mould is something that can be a histamine trigger. Still, there can be other things too, like parasites, for example, dysbiosis in the gut, other infections, and foods can send histamine levels up, so we want to consider here in this case, if you do think that maybe there’s a histamine load on the body, which is getting pushed over the threshold with exercise, we need to circle back and deal with the histamine issue, which means that we want to remove any possible histamine triggers, and then support the body as much as possible to process histamine. That could be looking at molybdenum deficiency or using things like quercetin, cumin, and antioxidants to reduce the histamine to improve the breakdown.

Again, I don’t want to go into histamine’s full ins and outs in this podcast because it’s potentially a full podcast. Still, if there are any female hormone imbalances, particularly high estrogen levels, that can influence histamine production, which might mean exercise tolerance varies at different parts of the menstrual cycle. You could plan maybe your exercise around your menstrual cycle, but that’s more of a band-aid approach.

We want to stabilize the hormone and histamine so you can train them across any part of your cycle. Then just a couple of other things. Oxygenation of the body is really important. I explained how in mould, we get that increase in the VEGF, and that decreases oxygenation and causes the post-exertional malaise. Still, anything that decreases oxygenation could be contributing to post-exertional malaise.

Here, we want to be nasal breathing with exercise. You never want to be mouth breathing if you have a chronic illness. Athletes pushing themselves to very high intensity may, on occasion, mouth-breathe.

Still, for the most part, if you’re a regular human exercising at moderate intensity, it’s nasal breathing. Then we also want to think about supporting the circulatory system and supporting the vascular system. Here we have a compound which is called nitric oxide, which is a vessel dilator.

It dilates the blood vessels, which means we get more blood flow and better oxygen transport. Here things like beetroot, for example, is a vessel dilator. The L-citrulline I mentioned previously, shown to be beneficial in long COVID can also be a vessel dilator.

Dark chocolate, berries, garlic, green tea, herbal supplements like ginkgo Biloba, or go-to cola can also be beneficial in supporting oxygenation. You can go back and listen to the oxygenation episode of this podcast, where I talk a little bit more about creating healthy red blood cells, how to test for that, and the nutrients involved. The final one is just herbal adaptogens.

These are often given to the adrenal glands, but they may also have benefits in supporting the immune system. Remember that the inflammatory load created by the immune system could be responsible for the post-exertional malaise. If we can take herbs that modulate the immune system, reduce inflammation, support oxygenation, or many other processes in the body, this could be helpful.

Things like quadriceps, Rhodiola, Siberian Ginseng, or Schisandra, any of those could potentially be beneficial. In my fatigue recovery, I would do quadriceps sometimes, usually put it in my coffee to make like a little mushroom coffee or decaf coffee that I will buy from my mushrooms, which I’ll put a link for into the show notes for you. That’s a lot to think about regarding the post-exertional malaise.

I’ll recap on everything discussed so far. We want to make sure we’re starting to find that optimal workload. How much can we tolerate, however big or small, buffering that workload with restorative practices, so the nervous system is winding down and being restabilized after exercise?

Then we add anti-inflammatory support, if appropriate. We want those baseline anti-inflammatory practices in there. So diet, blood sugar, gut health, and anti-inflammatory supplements post workout if required.

If there are any digestive issues, we want to address that; if there are any lingering immune triggers, like mould or maybe some other type of infection, that’s a priority to be addressed before we consider expanding exercise capacity. If there are histamine issues, we want to address that. We want to think about how to oxygenate the body as best as possible.

We can use a sauna for recovery or detoxification and, finally, maybe consider some herbal adaptogens as the cherry on top. That brings me to the end of today’s episode. If you have enjoyed the episode, please make sure you’ve subscribed and shared it with anybody you think it would be beneficial. And please leave a five-star review on iTunes, as those reviews help other people find the information too. I will see you in the next episode.

Episode 15 – How to Manage Crashes, Flares and Set Backs

Anna Marsh — Fri, 18 Nov 2022 00:01:00 +0000

Shownotes

However frustrating they may be, crashes, flares and setbacks are part of the fatigue recovery process. In this episode Anna explains what is happening in the body during a crash or flare and how you can support your body the move through them as quickly as possible.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

How to Manage Crashes, Flares and Set Backs

Welcome back to the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh, and today we’re going to talk about a very popular topic: how to manage crashes and flares. So if you are somebody who is recovering from chronic fatigue syndrome, long COVID, if you’ve got pods, fibromyalgia, burnout or some other complex, chronic condition, which affects your energy and perhaps leads to energy crashes from time to time, I’m sure you will know the absolute frustration or hopelessness, anger, and everything else in between comes hand in hand with a setback, a crash or a flare.

I’d like to pre-frame this episode by saying that crashes, flares, and setbacks are an inevitable part of the process. We would love for progress to be linear, but you and I both know that that is seldom the case, maybe never really ever the case in any aspect of life. Whatever goal you’re looking to achieve, whether that is healing and recovering your health, or maybe achieving something in your business or achieving something on a personal level, there are always going to be ups and downs, and those ups and downs are part of the journey.

They are necessary but don’t always feel good steps, which help us learn what we need to learn so that we can eventually realise our goal, whatever that goal is. Although crashes, players and setbacks are frustrating, the attitude I’d love for you to come away from this episode with is that they are your greatest teachers, they will bring to you the best lessons and these lessons will shape you and help you to become the person you need to be to achieve your goals. One of my favourite sayings is, “Achieve something you’ve never achieved before.

You must become someone you’ve never been.” This implies that there is an identity shift, and I would also probably say that not only is there an identity shift, but there is a shift on the systemic level of your nervous system. Your entire nervous system must shift so you can be the person you need to be to realise your goal.

Through the lessons we learn from our crashes off layers and setbacks, we can start to become aware of our blind spots and learn our edges, which is too much for the body at this stage. And if we embrace these lessons or the learning opportunities offered, we can take the actions required to reshape our thinking, the nervous system, and how we approach and practice self-care and healing. If you’re in a crash right now, and you’re listening to this, and you’re feeling all of the emotions, I know, I’ve been there too, and I don’t want to invalidate any of that emotional experience.

But I want to encourage you to know that this is not permanent and that there will be good things that come from the learning if you can take the opportunity to learn from this experience you’re having right now. As I’ve said already, as we experienced crashes, what we’re doing is we’re learning our edges. I remember when I first became fully unwell and began what I call, I guess, my healing adventure or my chronic fatigue experience, I had no awareness of what I was doing.

I was probably on a weekly basis experiencing the typical boom and crash cycles. Feeling a little bit better, then going on to do too much, then having a bit of a crash, maybe needing to spend a day or two in bed and then feeling a little bit better, and then going on to repeat the whole cycle all over again. Honestly, it took me a long time to see what was happening.

I was constantly going through these cycles because I was still in a denial stage in my healing journey, where I thought I could heal faster than I actually could. I would first say that I was doing it mindlessly while repeating these boom and crash cycles. I was all consumed by frustration.

And my inner achiever was completely hijacking and project managing the process, and all she wanted to see was progress, progress, progress, progress. It wasn’t until I started to slow down a bit and connect more to my body and understand what was going on that I began to see the cycle that I was in, and then I started to refine the process. Part of that process was learning what is too much and what I need to do to support my body.

And making a few adjustments, seeing a little progress, then having another setback, another crash and then having to reevaluate maybe or learn a new lesson, implement that, and then continue forward little bits at a time. When I speak with my clients in this chronic fatigue recovery journey, they say, “Oh, no, I’m feeling so awful. I’m so close with myself, I had another crash, or I don’t know why this has happened.”

The first question I always ask is, “Is it as bad as crashes that you’ve had before? And do you feel that you’re recovering from this crash setback or flare faster than you did before? The progress or what we’re looking for is the milestone to assess progress.

Should I say we don’t necessarily need to eliminate crashes and setbacks? But we want to see that they are starting to reduce in their frequency and they’re starting to reduce in their intensity. For example, at the beginning of my journey, I would have a big crash once a week, where I would feel a bit bound.

Of course, I could have gotten up to do things or left the house if I had used a lot of push energy. But there was no real desire or motivation to do any of those things. Maybe once a week, I entered that cycle where I would feel awful and want to lay in bed all day.

But then, as time went on, maybe I would still experience a weekly sort of cycle of doing too much but the crash days, shall we call them, meant that I felt a bit rubbish. But I could still work, I could still maybe go for like a little short walk. There were manageable, more manageable within the context of my life and then, as time went on, I could have weeks where I genuinely felt pretty good.

Then the setbacks or crashes were more cyclical with my menstrual cycle. So typically feel a little bit lower, but still functional, around my period, the first couple weeks of my cycle, pretty good, and the second half of my cycle. As time went on, those cycles became less intense.

The highs and lows were not as high and not as low, and then things just gradually started to even out. So understand that it’s not a case of being on it or feeling good all the time. Even healthy people have cycles of doing too much and needing to step back.

Life is about yin and yang. It’s about the balance between pushing ourselves and then resting and recovering. I think if you have a very strong inner achiever, I know I do, sometimes we can see, or we can perceive these setbacks or crashes like we’re failing.

We’re not failing; what we’re doing is learning, and we can move forward from this information. I gave an example of how there was a pattern in the way that my body responded to my menstrual cycles. I could use that information and say, “Hmm, something is happening here.

There’s a cyclical pattern here that’s associated with my hormones. What can I do here to even this out a little bit more?” And then I started adding in fighter estrogens, it Emami beans, sesame, and flaxseed, around about the time and my cycle when I would usually experience that crash.

Then I noticed I don’t get as many headaches now, and my energy is much more stable. So there are little things that we can do from these learning experiences, which are then constantly refining our self-care routines. We want to think about this kind of anti-hustle culture.

We’ve got this sort of toxic capitalism mindset that’s probably embedded in all of us where we need to be hustling, we need to be always on, we need to be achieving, and it’s very, very tempting to apply that to our healing. But healing must come with a softer, gentler, more compassionate attitude. We want to bring that to healing in general, and we want to bring that when we are in the midst of a crash or a flare because it’s very easy to be judgmental about why we’re experiencing what we’re experiencing.

That can stop how quickly we overcome the crash or the flare. There are many reasons why crashes or flares happen. Mostly, it’s because we’ve done too much or the body is experiencing too much.

That could be just too much physically; you tried to exercise, and then you were building it up, and then it was just too much for your body, and your body shut down. Or maybe there are some intense emotional experiences you’re having right now due to life’s complexities, and that’s just too much for your nervous system. Or it could be that you’re trying to heal too fast.

For example, you’re on a gut protocol, doing a detox, doing some deep emotional work, and your body is like, “Whoa, lady, you need to slow down a little bit.” So maybe we’re just again learning that the inner achiever hijacks our healing journey a little bit too much. There can be many reasons why we crash.

I also mentioned that I would notice trends in my hormonal cycle. But sometimes, there will also be no apparent reason. That’s sometimes the hardest to accept because often, the mind likes to have the answers; the mind likes to cling to certainty.

Often, if we can pinpoint something, “Oh, it’s because of this.” You already feel better because we have a rationale and an explanation. And the mind likes that. It’s hard to accept when we don’t know why it happened. We’ve just got to make our way through it and hope to feel better again.

I appreciate that there will also be times when there’s just no rhyme or reason to why you feel the way that you do, and to a certain extent, this is part of life, just accepting. Sometimes we don’t always get what we want, which is an answer in this case. But I’d love to go along and talk a little bit about what is happening in the body and how we support the body in this time.

When you’ve reached this point of a crash, flare, or setback, and I sort of have already said the words shut down as you’ve done too much. Your body is overwhelmed, and it’s just gone into a shutdown; there will be immune activation, and the body will go into more of an inflammatory state. That means that energy is being prioritised towards the immune system, away from the brain and the metabolic system, and that’s why you can feel the way you do.

And hand in hand, because the immune system and the nervous system are so closely linked, there will be nervous system activation. I guess the very act of experiencing a crash, probably for many people, feels like more of a freeze. So freeze, immobility, shutdown, dissociation, but remember that there is sympathetic activation underneath the freeze.

The freeze contains that fight-or-flight energy. Sometimes we have no energy, we feel very wiped out, we feel like we need to rest, but then when we go down and rest, it feels like our heart is pounding in our chest, and there’s just loads of energy in the body, but at the same time, we feel exhausted. Understand that these changes, although they feel terrible at the time, are protective.

Your body is not against you. Your body is doing its best to protect and keep you safe. You’re experiencing the exact experience you’re having because your body truly believes that this is the best possible option for you right now because there is either a real threat or a perceived threat.

That real threat could be something like an infection, or it could be that you’re in a toxic environment, or maybe you’ve had a mould reexposure. Maybe there is something very real, major stress in your life. Maybe you’re about to lose your job, or you’re in financial distress, or your partner will leave you.

Those are real threats. But there can be perceived threats as well. The judgment we’re putting on ourselves is the pressure we’re putting on ourselves. Sometimes the enormity of having a chronic illness and what that means in terms of all the aspects of your life and how you think about things can feel threatening to the body. Usually, it’s not one thing, it can be one thing, but usually, it’s a collection of things, it’s that you’re doing that gut protocol, but she maybe also did too much physical activity.

At the same time, there’s some financial and some work stress, and it’s all just too much, and the body’s like, “Okay, we need to slow things down. Let’s put you into a self-protective shut down until we can resolve the issue.” Essentially, what’s happened is that we’ve just exceeded our capacity to cope.

So if you think about the idea of the nervous system, there was a previous podcast on this. I talked about the window of tolerance, and you’re outside of your window of tolerance. Your body is shutting things down so that you can rebalance, can re-stabilise.

If you listen to the cell danger response episode, this is essentially a CDR one, the first stage of the cell danger response. Here, physiological and biochemical changes occur in your body so that your body can eventually rebalance and reach homeostasis. Most of these changes are going to be completely out of your control.

To a certain extent, there’s not a lot you can do to hurry the process along. You can do some things, which I will touch on next. But guzzling down a whole bunch of supplements or eating certain foods is not necessarily going to make a big difference at this stage.

I remember in my fatigue journey, whenever I had one of these crashes, I would start to search for a solution. I would go online, and I would be Googling, and I will be researching and reading, and then I would think, “Oh, if I just ordered myself some ribose, that will probably help me. Or if I just ordered myself this really expensive supplement, I know it’s 100 pounds, but it’s got to be worth it.”

And I would spend so much money on just buying things online that I thought would be the magic cure when I was in this state. If this is you, this is me lovingly saying to you, don’t make expensive purchases when you are in a crash or flare. The best thing you can do when you’re a crash, or if there are the things I’m going to tell you to do next but to wait it out, come to a more stable state when you’re more feeling like yourself, and then from that state and more regulated state, then you can make decisions about what you want to invest in to support your body because there are some worthwhile investments.

One of the consequences of the cell danger response is that it changes your mood. Again, this is self-protective. Because if you had an infection, and the infection made, you want to go out and socialise and be all happy, you would spread that infection to the people you’re with.

But instead, what happens is we feel very low in mood, don’t want to socialise, don’t want to see anyone, don’t want to go out, or don’t want to do anything. And then that protects that’s protected from a social perspective, so we’re not infecting other people. If you have chronic fatigue syndrome or some other chronic illness, you will not infect people with that illness.

However, physiology and biochemistry are still the same: the cell danger response kicks in your mood drops as a consequence. That’s annoying because we already feel frustrated, but it contributes to the frustration, the hopelessness, beating ourselves up, shaming ourselves and low mood. If you are in a crash or flare or having a setback and you’re in that kind of emotional state, like “Why me?”

Feeling sorry for yourself, feeling hopeless, feeling lonely. I can describe all these things because I know exactly how it feels, then understands that that is the crash talking. That is the flare talking. That is not you at your truest, most beautiful essence. When you are more regulated, some of the stories you’re telling yourself right now will feel irrelevant.

That’s just a little reminder. Then the biggest and probably most important question is what can you do to support your body when you’re in a crash, a flare or a setback? The most important thing you can do is support your nervous system.

How do we do that? Firstly, and did a whole episode on the nervous system, which you may want to go back and listen to if you haven’t listened to it already or if you want a recap. But ultimately, what we want to do is create a relative sense of safety for the body.

Remember that the body has entered the state of self-protective shutdown because of a real or perceived threat. We do want to deal with anything threatening to our environment, but we ultimately want to cultivate a relative sense of safety in the body. I say relative because it’s not that we have to feel 100% completely safe.

It will still have a chronic illness, there may still be financial issues, there may still be some relationship dynamics, which are a bit awful, and the pressures or deadlines, that life will never be perfectly organised in support of optimal nervous system regulation. But we want to find a relative sense of safety. Here, I’d like to distinguish between safety outside and inside of the body.

Because some people, when they connect to their bodies because there is pain, there’s inflammation, there are all these symptoms of their chronic illness, and it can feel very, very unsafe to go into the body and connect with it. If that’s you, if you feel more stressed, more activated, more anxious, more agitated when you start to connect with your body, that’s a sign this is too much. That’s not going to help you in this case.

Therefore, you want to find your resourcefulness outside of your body. How you can do that is co-regulation. Co-regulation is when you use another nervous system to help regulate your own. That means you could cuddle with a partner, friend, or family member. If you’ve got pets, pets are fantastic co-regulators you can have a little snuggle with.

You can also spend time co-regulating with nature. Depending on your physical capacity at this time, getting out into a garden, if you can take a short little walk or visit a green space, for me, if I could physically get there, I would go down to the beach and float in the sea. Anything you can do to connect with nature somehow could regulate your system.

Beautiful music. That was one of my favourites. It has a lot of playlists already created from teaching yin yoga. So lovely, soft, gentle piano music, just really beautiful music that had already been curated into playlists. I would lie down and listen to some beautiful music. Or it could be music that makes you feel happy.

It doesn’t have to be relaxing music. Finally, you can also connect with positive visualisation. This is really what we call resourcing and so resourcing the body. This could be just visualising how it felt when you were in this beautiful space with lovely people, and it was just a magical moment in your life, whatever that might be. There are a couple that I usually draw on as an example.

So there was a time when I was in Sri Lanka in Ella in the mountains, and Ben and I were walking back from the town centre to our little homestead accommodation, where we stayed for the night. We were walking on this dirt road, and there were no streetlights or anything. It was just completely dark.

I think we were using the torch on our mobile phones to find the way, but there was a thunderstorm. The whole valley was just getting lit up by the lightning. There were these big clouds and very dramatic drops of rain beginning to fall, but it was warm and just the most beautiful moment, and we were walking in the dark with the thunder and lightning, a little bit of rain, and it was just very, very special.

I can take myself back there in my mind; when I do that, my nervous system remembers and finds, and it can change the sensations in the body. Another one I use is just imagining myself swimming in the sea on a beautiful day and just how the water feels, how the sunshine feels on my face, and how it feels to have the sand in between my toes. You can get very, very granular on the details and spend some time sitting and visualising.

This is ultimately how the DNRS works. The brain retraining program with Annie Hopper is it’s just visualisation. Part of the trick is to feel the visualisation in your body. But if you’re not ready to go into your body, you can do the visualisation techniques at the very least. You can do those things to support your nervous system when you’re in a crash or flare that doesn’t involve you going into the body.

I will say here as well, for me, I find cold water very beneficial. This is just a personal thing for me. Having a cold shower or cool shower could help, or if I were well enough, just a cold plunge in the ocean would also be very beneficial.

Not necessarily for everyone, but good for me. If you can go into your body and have enough capacity in your nervous system to be with the maybe not-so-nice sensations as a consequence of the crash or the flare, then you can do things like breathing techniques to calm down the nervous system. Essentially a longer exhale and inhale.

You could do something like yin yoga, restorative yoga, gentle movement, or stretching. These are also great for supporting the nervous system. Somatic practices depend on where you are on your journey.

When you’re listening to this, you may not have even explored Somatics yet, but I do this with my one-on-one clients, and I teach in my programs that somatic practices can help us move or integrate activation of the nervous system in the body. Here we can also think about things like humming, yawning, and those practices which can help support the body, such as orienting resourcing grounding practices. There are lots of different tools you can use and work with the body on the inside, and those you can learn through me through my offerings or another course.

Most importantly, you approach this from a place of gentleness, kindness, and ease. Instead of the negative or unhelpful dialogue, you could have, like, “Why is this happening to me? Will I ever get better? This is all my fault.” A classic one that I always used to go into, it’s kind of like shaming myself and thinking of, like, all the times in the past, it didn’t treat my body perfectly, and that’s why this was happening.

There was a lot of shame, at least in the early days, about surrounding my illness and why I became unwell. None of that is helpful at all. The alternative dialogue you can have with yourself involves gentleness, kindness, and ease, instead of like the why questions like why is this happening to me?

You can use what and how more empowering questions. And that could be like, “What does my body need right now? What would feel most nourishing? How could I move through this day with more kindness and ease?” I would say to myself, how do I create the greatest amount of ease today?

That could be just something as simple as walking a little bit more slowly, taking my time, and not rushing, and this is how I would approach it when I have a day I need to do so, working and different tasks and task chores and things like that. How can I bring more ease and gentleness to the things that I have to do? But even if you’re just lying in bed, processing this crash, how can you do that from a place of kindness, gentleness and ease?

When you give yourself a break, you are moving through something huge and something horrific. You’re moving through something which is also very lonely to move through at times. You want to be the kindest, gentlest person to yourself as you move through this whole experience.

I wanted to touch on diet a little bit. Although I said, you know, there are no specific foods you can eat that will make the crash end faster. I think it’s always good to have a baseline to be eating in a way which is anti-inflammatory, which is where you’re regulating your blood sugar.

Sometimes doing a little bit of fasting can help if that’s already a practice that you engage in. If you’re in a crash or a flare, it’s not just suddenly the time to develop a fasting practice. You want to cultivate a fasting practice, if it’s appropriate for you, as just part of your healing, and then you could draw on that in a crash or a flare.

I was maybe doing like a 24-hour fast because autophagy can help manage and move on the inflammation. Although there are no superfoods you can take during this time, I think a foundation of eating well, which is essentially what you want to be doing anyway, as part of your recovery should be reinforced. I know when you don’t feel well, you want to have chocolate or cake, or at least I know I do.

But I also know I feel even worse afterwards as soon as I have those foods. So it’s not worth it. Finally, I think just to reflect, maybe again, when you’re starting to come out of the crash, and you’re feeling a little bit more resilient in your headspace, you can just reflect and think, “What did I learn from this?

And what would I do differently next time?” So there’s always learning or a lesson from the crash. I’ll just share some things that worked well for me. Yin yoga was something I was practising anyway. If my body needed more support, I would do a morning yoga practice, which would usually work.

I mentioned the music, so I just sometimes lie in bed and listen to beautiful music, and then go into the body. Again, this is only appropriate for those of you who are comfortable going into the body, but often we want to go into the body and then we’re like, “Oh, there’s a clear there’s a pain there, there’s a headache there.” We want to avoid those feelings for me, which won’t be the case for everyone.

I found going into my body, maybe while lying in bed and listening to some beautiful music. And then fully feeling all the sensations was very settling for my nervous system. I would feel the headache, and I would feel the pain in my jaw, I would feel the pain in my neck and shoulders and feel the heaviness behind my eyes.

If there was any emotion that wanted to come out, if I needed to have a little cry, whatever was there, I let it be there and held space for it to be there. That would take maybe not even that long, like 10 minutes, 20 minutes of just feeling at all; that would help to calm my body down and get a little bit more energy back into the system and a little bit more clarity. Again, as I said, not everyone will be able to do that.

Remember that I’ve got a couple of years of somatics training under my belt. These are practices I’m working with daily, and I’m studying to a very high level. But it’s an option; if you feel confident, that’s something you could do as well.

Just then, to recap on the episode. We first want to remember that those crash-flare setbacks are part of the process. They are the learning curve so that you can become who you need to be to achieve the goal that you want to achieve.

We want to understand that these self-protective processes happen so the body can regain homeostasis. Therefore, we want to appreciate the body’s intelligence when we’re in a crash or a flare and honour it. There’s not a lot we can do, but the best thing we can do is surrender to the process and support the nervous system.

They gave you some tools for supporting the outside and inside of the body, and then the final piece is taking the time just to reflect and learn so that we can grow from the experience. So hope you have enjoyed this episode today. As always, please ensure you’re subscribing to the podcast to get all the episodes as soon as they come out.

If you found it interesting, helpful, or useful, please share it with anybody else who may also benefit from this information. If you haven’t already, you can leave a review on iTunes, and I will be very grateful. I will see you in the next episode. Have a fantastic fatigue recovery day.

Episode 14 – How to Have a Good Night Sleep

Anna Marsh — Fri, 11 Nov 2022 00:01:00 +0000

Shownotes

Getting enough sleep is important and additionally, there is an increasing body of research which supports that circadian rhythms play an important role in regulating human physiology. In this episode Anna talks through how circadian rhythms impact the immune system and lifestyle practises that you can cultivate to modulate your immune system and sleep better.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Join the High Achiever Revival Program (HARP): https://annamarsh.co.uk/harp-2/

Work with me intimately in my 1:1 Fatigue Recovery: https://annamarsh.co.uk/1-1/

Mini Courses: https://annamarsh.co.uk/courses/

How to Have a Good Night Sleep

Welcome back to the chronic fatigue and burnout podcast. I am your host Anna Marsh, and today, I’m going to be talking about all things sleep, specifically what you want to be thinking of and how you can support your body to get a good and restful night’s sleep. We all know that we feel so much better, and life feels much more manageable when we have had a good sleep.

Unfortunately, many of us, whether we have a chronic health condition or not, can still really struggle with sleep. So the purpose of this podcast today or this episode today, shall I say, is to give you an overview of how the body’s sleep rhythms work. And then talk a little about things you could think of as you work to support your body to optimize those rhythms.

I’ll also be throwing in some Chinese medicine philosophy because it’s interesting. We will be talking about sleep practices or some supplements that could be supportive, the use of light exposure, whether you should be napping in the afternoon, and a little bit about the immune system and how that can impact sleep. Where I would like to begin is helping you first and foremost to understand the importance of healthy biorhythms.

For your cells to function properly, they need the right materials in the right place at the right time. Healthy functioning cells are likely to produce energy in the form of ATP much better than unhealthy cells. There are 1000s of genes which have to be switched on and off in a specific order, and proteins, enzymes, fats, carbohydrates, hormones and other compounds have to be absorbed but broken down, metabolized and produced in a specific rhythm.

Energy must be obtained and then distributed appropriately to allow for growth, reproduction, metabolism, locomotion, and cellular repair. When this network of systems is disrupted, your biology becomes compromised. This is what is experienced as poor health.

So disruption to the workings of our inner biology, our inner biochemistry, is created when our circadian rhythms are disrupted through our light and dark exposure in our sleep and wake cycles. It is the disruption of our natural circadian rhythm that can impact sleep. Still, it can also have a knock-on effect on impacting blood sugar regulation, the immune system and, therefore, inflammatory responses, neurology, the health of our brain and how fast we age.

Two main hormones govern these internal biorhythms. The first one is cortisol, which is the stress hormone. You may already be familiar with cortisol. The second is melatonin. A healthy person will naturally experience what is known as a cortisol awakening response, also abbreviated as a CAR.

This is saying that this cortisol awakening response is a surge, or shall we say, a peak in cortisol, which should occur 30 to 60 minutes after waking. So if you’re doing testing, for example, you can do a cortisol saliva test. You can measure your cortisol first thing as soon as you wake up and open your eyes 30 minutes later and 60 minutes later, and then you can understand whether you produce this CAR, this cortisol awakening response.

This is included in some adrenal saliva stress testing. It’s also included in the Dutch comprehensive hormone testing, with CAR’s cortisol awakening response. So if this is something that you want to test, that’s how you can test it.

Cortisol is a mobilizing energy hormone, so it’s your get up and goes to start the day. It can mobilize stored energy in your muscles and your liver; doing so will give you the energy to get up and get going. If you’re a morning person like myself, you probably feel your best in the morning and you have this strong get up and go and motivation and energy to start the day.

Cortisol should peak 30 to 60 minutes after waking, reaching its lowest point at about 2 AM. Then on the other side of the spectrum, we have melatonin, the body’s sleep hormone. Melatonin rises in response to the onset of darkness, and adequate production supports good sleep.

If you live in the UK, like me, come December, when it starts getting dark at four o’clock in the afternoon, there is this tendency may be to feel more sleepy and want to go to bed a bit early, and that’s likely because of the influence of the light on our melatonin levels. It’s noteworthy that there is a relationship between cortisol, melatonin and the immune system. Cortisol is anti-inflammatory, so if you’ve ever had a cortisone injection, or you know someone who’s had a cortisone injection, you would usually have that when there’s a joint which may be inflamed, and sometimes someone will have a cortisone injection to reduce inflammation in the joint because cortisone is the inactive metabolite of cortisol.

We can convert cortisone into cortisol, and then it can have anti-inflammatory activity. On the flip side, melatonin can be pro-inflammatory or anti-inflammatory, depending on the context. Generally speaking, the immune system is more active at nighttime, and if you’ve ever had a virus or cold or flu, you probably know that you feel the worst.

You might feel okay during the day. Then you start to feel a bit rougher at nighttime or towards the evening. Then maybe when cortisol kicks in, in the morning, you feel a little bit brighter, a little bit better and then, you know, as the day draws to a close, you may feel a little bit worse again.

That’s been my experience as I’ve moved through my chronic fatigue journey is, sometimes I would wake in the early hours of the morning, and my body would just feel so sore and achy, that feeling you might have if you have the flu, and I would just think, “Oh my gosh, do I have the flu or something wrong with me?” Or I would think, “Oh, today’s going to be a bad day. I can already feel this inflammation in my body.”

But then actually, come morning, I would get up and start my day and maybe move around a bit, or go down to the beach and get some cold water exposure, or things that would naturally increase my cortisol levels, the light exposure, being outside the movement, the cold water. And then I think, “Oh, I don’t feel that bad; today’s not going to be as bad as what I thought it was.” And that was just a clear example of the role of cortisol as an anti-inflammatory hormone, how it fluctuated depending on the time of the day, and how that was also impacting how I was feeling due to how it impacted my immune system.

I know we’re talking about sleep today but it’s also really interesting to understand the importance of these biorhythms in the context of sleep. So a healthy biorhythm should have this peak in cortisol 30 to 60 minutes after waking, cortisol should drop off in the evening, and then we should produce melatonin. That melatonin response should help us then fall asleep.

That’s in a perfect scenario, but what can often go wrong is that many of us, not necessarily all of us, but many of us aren’t getting or don’t have lifestyle habits which support that morning peak in cortisol. We may also expose ourselves to blue light or lights in the evening, influencing melatonin production. We’re probably also doing things that are keeping our cortisol levels elevated into the evening.

It may or may not seem obvious, but to get a good night’s sleep, we want to support the cortisol peak in the morning. We want to support the natural rise in melatonin in the evening. That is where I’m going to start when I talk about optimizing sleep or creating a good night’s sleep.

Often people aren’t thinking about what they’re doing in the morning and how that’s influencing their sleeping in the evening. But you want to start in the morning when it comes to optimizing your sleep routine. Here we want to think about doing things to encourage that cortisol peak.

The first thing you want to consider is your morning light exposure. This isn’t the lights in your home, nor the lights from your computer screen. It isn’t light streaming through a bedroom window or in the car. If you’re driving somewhere, this is daylight from outside. Essentially, you get in your body, your head, or your face outside within 60 minutes of waking, ideally as soon as you wake up, but some people take a little time to get going.

So within 30 to 60 minutes of waking, you don’t need a lot, but you do need some. If you wake up and it is a beautiful, bright, clear morning, you only need about five minutes of light exposure. If it’s kind of light cloud cover a bit cloudy, then maybe you need about 10 minutes.

And if you have like dense cloud cover, even if it’s raining, you still want to get outside, but unfortunately, for a little bit longer in the rain, 20 to 30 minutes. If you have a balcony, if you have a garden, if you have some green space near your home, if you can get outside and get that morning light exposure, if you can get more if you can spend more time outside during the day, just naturally experiencing daylight, that will also be great. But the minimum would be five minutes on a clear, bright sunny morning and then 20 to 30 minutes on a cloudy, rainy day.

That’s the very first thing, and the reason is that the light and the quality of the light falling on your eyes will be stimulating for that cortisol peak. If you wake up in the darkness, you can turn on lights in your home or use other artificial bright lights. For example, you can buy a 10,000 lux light box on Amazon or something like that.

But then, as soon as the sun does come up and you can get outside, you also want to use that opportunity. If you miss a day for whatever reason, you were sick or busy, or just for some reason, you couldn’t get outside, do a little extra the next day. So that’s the first thing if you want morning light exposure.

Here I have a lot of clients who struggle to get going in the morning; they’re dragging their feet. Especially if there is pain and fatigue, it is harder. You are the people who, although it’s harder, really need to do this because this is helping to turn on those anti-inflammatory signals, which will help you feel better.

That’s the first thing; then, we can also do other things to stimulate cortisol first thing in the morning. The second thing you could think about is movement. Again, always tricky with fatigue because different people have limited capacity.

But even if you’re able to do a short walk within your capacity, if you’re able to do more than a short walk or long walk or run or some other exercises outside, even better. If there is a way for you to do some movement first thing in the morning, that’s also going to help to raise the morning cortisol. You can also think about cold exposure.

Now, this doesn’t have to be outside, but you could do something, and I could get a cold shower for just two or three minutes under the cold tap. If you are blessed like me to live near the ocean, and you can walk down to the ocean in the sunlight and get your cold water exposure all in one go, that’s ideal. I’m very fortunate that that is my morning routine but I know that that’s not always available to everyone so just do what you can.

The final thing you could consider would have a caffeinated beverage. Again coffee has different levels of sensitivity for different people. In some of the worst parts of my chronic fatigue journey, I couldn’t tolerate coffee may be too jittery to activate my nervous system far too much, so it wasn’t an option for me.

But as I said I had morning light exposure walking and the sea to jump in even in winter so I felt I didn’t need the caffeine. But a little bit of caffeine in the morning, I would say it, probably wouldn’t be my first choice. I will probably try and do the exercise and the cold exposure before I start drinking coffee but it is an extra little tool in your toolbox that you can use.

All these things in the morning can set you up for the day to support that cortisol release, which is anti-inflammatory. It’s helping to modulate your immune system. It helps to switch things on and off and organize your chemistry and physiology for the day.

Even though we’re talking about sleep, we start a good night’s sleep in the morning with what we do after we wake up. Then, as the day continues, what else do we want to be thinking about? Again you probably want to know how to have a good night’s sleep, and I’m talking about what to do throughout the day.

The next thing I would start to be thinking about is your blood sugar. Blood sugar highs and lows throughout the day create a pattern of dysregulation, and this is stressful for the body and can strain the nervous system, but what we’re eating earlier in the day can also then have a knock-on effect in terms of how we respond to meals later in the day. Very often people don’t sleep well at night because their blood sugar drops, creating stress on the body and the nervous system.

And cortisol and adrenaline kick in to support the drop in blood sugar to increase it to mobilize sugar from the liver, for example, to re-stabilize blood sugar, but that then wakes you up. We want to be thinking about good blood sugar control during the day, which means nice, stable blood sugar, no major peaks and troughs for the entire day. There are blood sugar episodes; you can look back and check that out.

I also have my blood sugar mini-course on my website, it’s only 49 pounds, but it will teach you pretty much everything you need to know if blood sugar stability is one of your goals. Something I often get my clients to do is to use a continuous glucose monitor CGM. Here in the UK, the brand is Freestyle Libra.

That lasts for two weeks, and it’s just a little pouch that you put on your arm, connects to an app on your phone, and will continuously record your blood sugar for two weeks. Now, you can see how your blood sugar is rising and falling throughout the day and if it’s doing so within a narrow range, but you can also see what’s happening to your blood sugar at night. If you know you’re always waking up at 3 AM, or you’re always waking up at 2 AM, or you wake up repeatedly during the night, you can then correlate that with any blood sugar peaks and troughs.

Then it’s a case of making some trial and error and working out. Do you need to work on stabilizing your blood sugar throughout the day? Or play around with what are you putting in your evening meal? Do you need more carbs? or fewer carbs?

Or more proteins? Or more fats? Or more fibre? Or do you need a pre-bedtime snack? Or do you need to eat earlier or later?

There are lots of variables that you can play around with when you have the data. Then see what your body likes, how you respond to those changes, and hopefully, how you’re asleep. Next, as you go about your day, you want to ask yourself, do you need to nap?

I believe that there’s no right or wrong here. It’s not that you should nap or you shouldn’t nap. I’m a napper. In my fatigue recovery journey, I would find that even a ten or 20-minute little power nap in the afternoon could recharge my brain energy and contribute to feeling like having that sort of second wind to keep going for the end of the day. We want to be careful of naps, which are too long or too late in the day, and then reduce sleep pressure for the evening.

If you know your body, if you nap during the day, it disrupts your sleep, and then you have to decide not to nap. But if you know you can have a short little nap during the day, and it doesn’t seem to impact your sleep either way then, and that’s working for you just generally with your routine, and how you’re feeling day to day, then, you know a nap could be a good thing. I’ve also found that when I’ve been very tired, so maybe I’ve just had disturbed sleep or a few nights of not getting enough sleep, sometimes a nap helps reset my nervous system.

Because I’ve napped and felt a little more restored and less activated in my nervous system, it’s easier for me to sleep at night. I know it sounds a little bit counterintuitive, but this was something that I realized when I used to travel a lot, especially to the US, when I would typically be quite a jetlag. If I had a short nap on the plane, then when I finally got to my hotel, I would find it easier to sleep because I was less wired because my body was a little bit more rested.

Anyway, that’s a little tangent, but I just thought I’d share that in case it resonates with anyone. So we’ve talked about morning light exposure, and we’ve talked about the different strategies you can use to increase morning cortisol. We’ve discussed the importance of keeping blood sugar stable throughout the day and at night.

Now we’re starting to approach the evening. This is where most people usually start when they start to think about better sleep, they think about sleep routine. Sleep routine is important, and we want to ensure that we’re limiting bright light exposure several hours before we want to fall asleep.

Ideally, it’s quite nice, depending on where you live. What time of day does it get dark? But it’s quite nice to align this with the natural light and dark cycles of the world that you live in. So avoiding once the sun goes down, we don’t want bright overhead lights. If it’s necessary because you have work to do, maybe you’re working on a computer, you can use blue light blocking glasses, but ideally, just kind of having low-level light candles, if it’s safe to do so and avoiding, you know, too much screen time before bed.

I watch TV in the evening before bed, I probably have the least disciplined sleep routine, but I found that because I think I have such a strong morning routine, I don’t struggle too much with falling asleep. Sometimes I can, but I can watch an hour of TV and then get into bed, and I’ll usually listen to a podcast and then fall asleep listening to a podcast, and that’s my sleep routine. But I also spend quite a few hours in the evening unwinding.

I like to finish work at like four or five o’clock if I can, and then I’m an early sleeper. I’ll go to bed at 8:30. That gives me a good four hours, shall we say, where I am just unwinding my body and having some food.

I’m relaxing. I’m not doing anything too stressful, I don’t have kids that I need to put to sleep, and I’m not running around the house doing a million chores in the evening. So there is a natural unwind that’s happening. But if you are finishing work late, putting the kids to bed, wrapping up and doing chores, your nervous system needs a little more time to switch itself off.

If you can give yourself an hour, if not two hours, of studying to wind your body down, then that is if you listen to the nervous system, podcasts that I’ve already done, it’s just feeling in your body that your body is unwinding. Whatever you need to do to achieve that. It might be a bath or a shower, reading a book, listening to a podcast or doing some sort of yoga Nidra or sleep meditation.

The opportunities are endless and might just be like curling up with a partner or your pet and watching something on TV with your blue light-blocking glasses and just allowing your nervous system to feel safe and ready for bed. You don’t want to be checking emails or something to engage with stressful material before bed, and you want to give your body space, which is very obvious. I think it’s not that people don’t know that they shouldn’t be doing this before bed.

It’s the discipline to do it. And if your nervous system tends more towards hypervigilance, it can be hard to slow down and switch off. So you may need to learn some techniques and practices and then have the discipline to practice them to achieve that state of unwinding in the evening.

Then just the little things you want to have a cool bedroom, our body temperature should naturally drop at nighttime, so if the bedroom is too hot, if the body is too hot, then that can have an impact on sleep. You may want to use some blackout blinds to have a nice dark sleep environment. If possible mobile devices out of the room, turn the Wi-Fi box off, make sure there are no little LED lights or anything still on in the bedroom, no TV in the bedroom, those types of things.

Maybe a blackout mask if needed. Just have a nice sleeping environment that allows you to feel comfortable and safe. If you do struggle to get to sleep, this is where you could use a sleep story, or you could do a yoga Nidra or little sleep meditation.

There are loads available, and Insight Timer is a really good resource. If you’ve got something like an aura ring, there are some sleep stories on the aura ring app. So there are a lot of different things that you can use.

I just listen to a podcast. I usually just put the minute timer on the podcast, start listening and inevitably, I’ve fallen asleep before the 30 minutes. The next question which may be on your mind is supplements.

Are there supplements that can help with sleep? The answer is yes; some supplements can help with sleep. But remember that supplements are supplementary to your other lifestyle practices.

When we’re thinking about supplements, we want to add supplements when we can check the following boxes. Have we got a good morning routine that stimulates that cortisol peak 30 to 60 minutes after waking? Is blood sugar balanced and stabilized throughout the day?

Are we creating a good unwind routine? Are we looking and paying attention to light exposure in the evening? Are we also taking our time during the day to reduce the windup of stress? I perhaps should have mentioned this earlier, I’ll mention it quickly now I talk about this a lot, and when I talk about nervous system regulation, it’s in the nervous system mini course. But many people are getting to the end of the day and thinking, “Oh, I need to unwind and feel less stressed.”

We really want to be checking in on ourselves at regular intervals throughout the day and discharging stress to reduce the buildup. Even if you’re taking a mid-morning break, lunchtime break, and afternoon break to discharge some of the buildup of stress and nervous system activation from the day, there’s going to be less unwinding that needs to happen at the end of the day. You want to ensure your blood sugar is stable and your nervous system is regulated throughout the day.

You’ve got that good evening to unwind routine, and then you can think, “Alright, maybe I can add some supplements here.” Different sleep supplements from experience work differently for different people. But I’ll share some of the ones I encourage my clients to try.

It’s very much a case of trying this one. “How does it work? A little bit, but not great. Okay, maybe we can add this one in as well. Oh, those two together work well. Or maybe none of these work. Let’s try this one instead.”

So there can be a little bit of playing around. It can be a little bit of trial and error. But some of my favourites are magnesium. Magnesium glycinate or magnesium threonate can be great; you can take it just 30 minutes before bed in powder or capsule form, usually about 150 or 200 milligrams. Please consult your healthcare practitioner, and ensure it’s safe for you.

One of my favourites is L-Theanine with lemon balm, and the specific product is by the brand Veridian. I usually take two of those, which works out to about 400 milligrams of L-Theanine. Just as I’m getting ready for bed, about 30 minutes before I fall asleep.

That works well for me. I’ve gone through phases of taking it on a daily basis, or sometimes I just take it if I’m working late and need a little bit of help to unwind my nervous system. Or for example, I teach a couple of yoga classes on a Thursday evening, and I get home late, and then I want to help my body drop into relaxation pretty quickly.

I’ll use the L-Theanine and lemon balm. If blood sugar regulates just regulation, shall I say during the night is an issue for you and could be impacting your sleep? Something like (inaudible) could be beneficial.

Maybe 900 milligrams 30-60 minutes before bed. You probably may hear a lot about 5HTP and 5-Hydroxytryptophan to help with sleep, and this can be a little bit hit and miss. The reason being is sometimes tryptophan can go down an inflammatory pathway.

I’ll try and explain this very briefly. But tryptophan can be used to make serotonin and melatonin, which is why it can be beneficial for sleep. These can also get diverted down another pathway, which can be associated with more sort of pain and inflammation and immune activation.

It’s usually if there’s a need for B3, a new need for vitamin B6, or just inflammation, in general, that can send tryptophan down the more inflammatory side of the pathway. So we do want to be careful; if you’re supplementing with tryptophan, and it’s not making you feel any better, or it’s making you feel worse, then that could be an issue for you and then it’s better rather stick to some of the other products that I’ve mentioned. I have also dabbled a little bit personally in melatonin.

Technically, as a nutritional therapist in this country, I am not allowed to recommend melatonin. It’s not something I could necessarily recommend on this podcast, but I can share my personal experience. In that, I would say I don’t have as much trouble falling asleep, but I would have issues waking at regular intervals during the night just for a little bit, not often for a long time.

I think melatonin did tend to help the overall quality of my sleep, having better quality sleep across the night. But it is something you kind of wants to be careful of. Eventually, I stopped taking it and switched to the L-Theanine and lemon balm.

I’ve not noticed much of a difference. Since I’ve done that, I feel that the L-Theanine lemon balm is equally good for me. Speaking of waking in the night, the thing I wanted to touch on is nervous system activation and immune activation.

The nervous system and the immune system are so closely linked that when the immune system is active, the nervous system is also going to be more activated because there’s a sense of threat. We can do all the unwinding, meditation, yoga Nidra, and somatic practices throughout the day to support the nervous system regulation. But if there’s a threat inside our body, like some infection, mould or a dysbiotic gut, we need to deal with that.

We can’t meditate on our way to better sleep when those things happen. This is when we want to consider whether there could be a gut issue. If your sleep gets worse around the full moon, when parasites tend to be more active, that could be a clue that maybe there’s a parasite, which is activating your immune system.

That’s impacting your sleep, and there can be imbalances in the microbiome that can impact sleep. I had a client who was struggling with her sleep. All she did was take a probiotic, and she said she was sleeping so much better just from taking a probiotic.

It’s not as easy in all cases, and she was fortunate to have such an easy, quick fix. But it highlights the role of gut bacteria and sleeps, so you can listen to the gut health podcast if there are any digestive issues. I’ve also got my gut health mini-course you can take.

That could be something that could positively impact your sleep. If there’s a mould, spore mycotoxin issue that can also stimulate histamine production, which can impact sleep, anything that’s sort of increasing histamine production, or mast cell activation syndrome, which I won’t talk in detail about today. All of this can impact sleep.

Anything that impacts the immune system and the body’s inflammatory environment will need to be addressed. We can modulate the immune system by working on that morning peak cortisol curve. But if there’s a threat or an infection, we need to remove it, all the other things are supportive, but we need to get to the root of the issue.

Where I’d like to finish today is to talk about the Chinese medicine clock. I am not trained as a Chinese medicine practitioner. I’ve only briefly touched on Chinese medicine through my yin yoga training because yoga is steeped in Chinese medicine.

But according to Chinese medicine, there are different times of the day associated with other organs and emotions. The idea being is that if sleep is a problem for you, say at nine o’clock at night, or one o’clock in the morning, or three o’clock in the morning, you can look and see which organ or which emotion is associated with the time that you’re always waking up or struggling to fall asleep. That could give some clues and insight into what may need help and support as you work towards better sleep.

Again, as I said, I’m not a Chinese medicine practitioner; I wouldn’t make put all my clinical decision-making on the Chinese medicine clock. But suppose a client is doing all the other things I’ve already spoken about in this podcast today. In that case, I might go, if you say it’s always 3 AM, well, 3 AM can be associated with the lungs, grief and sadness, or have you lost someone recently, and obviously, chronic illness is riddled with feelings of grief.

So there’s going to be a lot of grief for someone who’s chronically unwell. Maybe there’s some emotional support that’s needed there. Or maybe there’s some work we need to do around the lungs or breathing. I’ll go through the talk with you more for your interest in anything else just in case it rings any alarm bells and gives you some insight into how you can support your body.

The adrenal glands and the thyroid glands are the hours between 9 PM and 11 PM. This is associated with fear. Again, for me, fear says fight or flight, nervous system activation, we know that if someone’s stressed, if they’re worried if they’re afraid, that’s going to be activated for the adrenal glands, that’s going to make it maybe difficult for them to fall asleep.

That one makes a lot of sense, logically. The next is 11 PM to 1 AM, which is associated with the gallbladder. The gallbladder is really important for bile production, which we need for fat digestion; many of my clients have poor fat digestion.

It’s also involved in discernment and decision-making. Maybe if someone was always waking up between 11 PM and 1 AM, I might ask or check how their fat digestion is working. But maybe also ask if there are any big decisions I need to make.

1 AM and 3 PM are the liver associated with anger and frustration. Here, we might be thinking detoxification issues, or sort of any anger, sort of fight response stuck in the body, then 3 AM to 5 AM, is the lungs. The lungs are associated with grief and sadness just over the heart.

Again, here, we might think about how we support the lungs, is the person waking up at three to five coughing? Or is there something else going on? Is there a loss? Is there grief? Is there unprocessed sadness, and do we need to work somatically with that?

Finally, 5 AM to 7 AM is a large intestine. This is involved letting go. Maybe there are some digestive issues if the person wakes up at 5 AM, and that’s earlier than they would like; maybe we need to think about the gut. Or maybe we need to think about something more emotional, something they’re struggling to let go of, something they’re holding on to.

That is a nice way to finish up the episode today about the Chinese medicine clock. Hopefully, from listening to all the other guidelines today, you’ve got some things that you could work on, whether that’s your morning routine, your blood sugar during the day or at night time thinking about your unwind routine, and that sleeping environment, maybe playing around with some supplements starting to think if there’s maybe some inflammation or an immune response that needs to be addressed. Also, think about the Chinese medicine clock and if any of those hours and the organs and emotions resonate with what you’re going through right now.

As always, I hope you have enjoyed the episode. Please leave me a five-star review on iTunes; it will help other people to find the podcast who will benefit from this information, and please share it on your social media. You can always tag me anna_marsh_nutrition; let me know your biggest takeaways from the episode. Let me know if the episodes are helping you. And I’m very much looking forward to sharing with you in the next episode.

Episode 13 – How To Support The Mitochondria

Anna Marsh — Fri, 04 Nov 2022 00:01:00 +0000

Shownotes

The Mitochondria are often referred to as the energy powerhouses of the cell. Healthy, abundant and well functioning mitochondria are important for health and abundant production of Adenosine Triphosphate (ATP), the energy currency of the cell. In this episode Anna explains the factors that influence mitochondria health and function and the dietary and lifestyle practises that can support better energy production.

Useful links:

Website: https://annamarsh.co.uk/

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Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

How To Support The Mitochondria

Hello, and welcome another episode of the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh, and today we’re going to be talking about all things mitochondria. Before we dive into that, I’ll pre-frame this episode by saying, if you’ve listened to some of the other episodes in the past, I talk about fatigue or low energy as something impacting the body’s ability to make ATP, the body’s energy currency.

And of course, there are multiple mechanisms or combinations of mechanisms, which can result in poor ATP or low energy production. One of those mechanisms is poor mitochondrial health or some metabolic roadblock in the body’s process of making energy via the mitochondria. So we do want healthy and well-functioning mitochondria for energy production.

What you’ll probably start to realise, as I talk a little bit more about mitochondria today, is that a lot of the practices that we would use to support the mitochondria or the health of the mitochondria are also practices that we would use when considering other aspects of energy and biochemistry, some of which I’ve already talked about in previous episodes, like blood sugar, or oxygenation or digestive health. This is where we want to see the body, not in a reductionist approach, so reducing systems down to isolated processes, but rather seeing the body as a network of interlinking symptoms. That’s why when we work on one aspect of our health, it can start to improve other aspects that we didn’t think we were directly targeting, that it can have that knock-on benefit.

When we are talking about the mitochondria today, there may be a little overlap in terms of some of the other things I’ve discussed in previous episodes. That means I might not go into those specific details because you can go back and listen to a podcast on blood sugar; for example, I might make small references to what you can do in this episode. So as we dive in, I guess the first thing to cover is what the mitochondria are.

I appreciate that I’ve thrown this word around a few times, and we’re only a few minutes into the podcast episode, but it might be helpful to understand what it is. Our human bodies are made up of cells, and all cells have mitochondria within the cell. The mitochondria are often referred to as the cells, energy-producing powerhouses or energy-producing factories because it is through a series of biochemical transactions or biochemical processes that happen within the mitochondria that the body produces a well should I say, can produce ATP.

We can make a little bit of energy not using the mitochondria, which I’ll talk about in a moment about how that happens. Still, we make most of our energy using the processes inside the mitochondria and the mitochondrial membrane. This means that if we want to make more energy or be effective at making energy, we want to have mitochondria.

We want to have lots of them. We want them to be dense within the cell, and we want them to have everything that they need to function optimally. That’s what this episode is all about. But before we talk about mitochondria specifically, let’s talk a little bit about the steps that come before because this is where you’ll start to see that there is an overlap between mitochondrial health and some of the other things that I’ve already talked about on this podcast. If we’re thinking about energy production in the form of ATP, a whole series of steps must occur before we can produce energy.

The first step is we need food. We make energy from proteins, fats, and carbohydrates in the diet. Without carbohydrates, we can also make ketones, which can be used for energy, which relies on eating. We need to eat enough calories to eat food and fuel our bodies appropriately.

That food needs to become digested, which I talked about in the gut health episode; we need to be able to adequately chew and break down and digest our food and absorb it. So absorption is an active process, meaning we need healthy gut membranes to absorb the food. Then once we’ve absorbed the food, it needs to be transported, and we also need to be able to transport oxygen because the mitochondria use the fuel from our food in the presence of oxygen to make energy.

So we need to be able to transport food into the cells, which requires healthy functioning insulin. We also need to be able to transport oxygen into the cells, which requires healthy red blood cells, and I talked about this in the oxygenation episode. There are certain nutrients which are important for that to happen.

So then we get to the cell, and if we use glucose as an example, we will transport glucose via insulin into the cell and start burning that glucose. This doesn’t happen in the mitochondria. This happens in the cytosol of the cell.

Your proteins, fats, and carbohydrates are broken down into a molecule called Acetyl-CoA, and then we can use Acetyl-CoA in the mitochondria to begin the processes which help us make ATP. We make a very small amount of energy in the cell’s cytosol when we’re undergoing, or these nutrients undergo, the process of glycolysis. So sugar burning, we can do that without oxygen, and we can do that very quickly.

What it means is when we need energy instantly, like we might need it instantly, if we were responding to a big threat or big stress, and we had to run away or fight and fight or flee. When the nervous system is very activated, the body will tend towards glycolysis because it’s quick, fast, and easily available, we don’t have to rely on oxygen, but the yield is low. We can only produce two molecules of ATP in the cell’s cytosol.

But then, if we have the time, we can start burning fats in the mitochondria in the presence of oxygen, which can further yield another 36 ATP. The only challenge is that it takes a little bit longer. So it’s not an instantaneous energy source; it takes a little bit longer, but the yield is very high.

We need oxygen and various other nutrients for the mitochondrial to function properly. Now understand all of this, you can probably begin to understand a little bit more about the factors that can influence energy production through the mitochondria. If you’ve listened to previous episodes, for example, the cell danger response episode.

One of the things you may have heard me talk about in that episode is that the mitochondria are not only energy-producing organelles but also our defence organelles. They are sensory organelles that scan the body and respond to threats. The first thing we need to know then you can always go back and listen to the cell danger response episode.

If you want all the details on this is that when the body is under threat, that could be if there’s a toxic overload. For example, it could be that there is emotional and mental stress, or the nervous system is in a state of fight or flight. Or it could be something like a viral infection, bacterial infection, yeast infection, or mould infection.

When the body is experiencing a state of threat and understands that it needs to put in its defences and operate from a place of defence, no changes are naturally created in the mitochondria to shut down energy production. Therefore, the first thing we want to consider when considering how we support the mitochondria is we need to ask if the body is currently in a state of threat.

Because if the body is being threatened, the first thing to do is to help the body reach a place of relative safety. That means you don’t necessarily have to be 100% safe, grounded, calm, and chilled out. Still, the body needs to feel safe enough for the mitochondria to lower defences and begin functioning more optimally.

That’s the first thing we want to do is consider the cell danger response, consider if there’s an active threat, and then do what we need to do to support the body to find a relative sense of safety so that we can ease up on these changes in the mitochondria and then the mitochondria processes can happen more smoothly, in favour of producing energy for the brain and the muscles and for the organs to function as they should. For this episode, let’s assume that there’s no threat, no danger because that’s covered in previous episodes. Let’s look at what we need to know and how we support the body’s healthy mitochondrial function.

I believe we can start with this if it’s just starting from the ground building healthy foundations through our diet and lifestyle practices. Every time we eat a meal, we have the opportunity to eat in a way that’s going to offer the mitochondria nourishing foods, which is going to offer the mitochondria nutrients that it might need, and which is going to send signals perhaps of inflammation so that could be inflammation signals may be threatening, or anti-inflammatory signals. Signals send safety messages to the mitochondria, which will all, over time, collectively influence the health of the mitochondria.

Let’s consider, for example, that the mitochondria are part of the cell. You know healthy cells will work well; healthy cells with healthy cell membranes and mitochondria will work effectively. How do we build cells?

We build cells from the nutrients we’re receiving in our diets. Specifically, if we consider cell membranes, cell membranes are made up of fat. The balance of fat in our diets can then have a positive or negative impact on cell membranes, which affects the health of the cell, and then they can also impact the health of the mitochondria.

Here, we want to consider a diet with good amounts of healthy fat. So thinking here about things like oily fish, avocado, olive oil, olives, and coconut products, the MCT is the medium chain triglycerides, and coconut products can benefit the mitochondria. So we want a diet which has lots of good fat.

Typically where this can go wrong is people who are dieting excessively and cutting fat out of their diet, so their overall fat intake is quite low, or if there are digestive issues, a lot of my clients on their stool tests, they’re not digesting and absorbing fat very well, so that needs supporting and this is where we circled to gut health and liver and gallbladder health as well. Or maybe someone is eating fats in their diet, they’re not dieting, but the choice of fats is poor. There’s a lot of processed fats in, you know, the takeaway is processed foods, ready meals, it’s okay to have a little bit of saturated fat, for example, from grass-fed meat.

It’s okay to have cholesterol that you naturally get in eggs, which can benefit the body. But when there’s a lot of packaged or processed food, poor quality cuts of meat, processed meats, like sausages or burgers or things which may have no extra sort of fats or lipids added to them, that’s not necessarily going to be conducive to creating an anti-inflammatory environment in the body, or in nice healthy cell membranes which are flexible and able to do the job of your transporting the nutrients that we want into the cell but also releasing the waste products that we produce as well just through our natural metabolic processes. So good quality fats in the diet are a must.

We also know that plant-based foods are very beneficial. The main ones I’ll drop here will be things like berries, cherries, and your polyphenols, so deep, red or deep purple foods tend to be very beneficial for the mitochondria. Still, things like broccoli, green tea, seaweed, and almonds can also have therapeutic benefits.

There are so many different plant-based foods that have a variety of benefits for health. Of course, it will be great to see people having a couple of cups of green tea or get a day, some blueberries, maybe having some broccoli with the meals, some oily fish, those types of foods. Still, just having a good variety of plants in the diet, having an abundance of plants with your meals, so aiming to fill, for example, half a plate of your meal each evening or each breakfast, lunch and dinner with plant-based foods, that’s a really good goal to have in terms of plants.

I am not overanalysing here, and going well. Should I choose broccoli or asparagus because it will be based on mitochondria? I encourage people not to overthink but aim for colour, variety, and trust; every food will give them some nutritional benefit.

So we’ve talked about plants and fats, and we want good quality protein. Protein is such an important nutrient. We don’t only need it for energy, but we need it for muscle building for our lean body mass.

If you have more lean body mass, you have more mitochondria. We want to ensure that we get enough protein in our diet. I ask clients to aim for about 1.5 grams per kilo of body weight. Sometimes we may go much lower in the short term for various reasons if they’re on a ketogenic diet or the protein digestion isn’t great. We’re just trying to take that off while we work on some digestive health, but I think 1.5 grams per kilo body weight may be a little bit more if you want to lose weight.

If you’re struggling with blood sugar control, doing a lot of exercises can be beneficial. But I feel like 1.5 grams per kilo body weight is achievable. Then make sure that’s incoming from things like your oily fish eggs, which I mentioned grass-fed meat, you get some protein from nuts and seeds, and you can also have legumes.

So a variety of different proteins. If someone is vegan, that’s fine; they’ve just got to make sure they’re getting enough protein from the vegan foods they are eating and be prepared to work quite hard at it. You can use protein powders and things to supplement your diet, but they are a supplement.

They shouldn’t be the sort of front and centre of your diet, just having protein shakes or powders to get your protein intake in. You want to focus on real foods as much as possible, especially if blood sugar is an issue. That brings me to the next point: we want healthy blood sugar.

When the body is burning sugar as fuel, you may have heard the saying that if you don’t use it, you lose it. The same goes for how we use these different metabolic pathways: sugar burning versus fat burning. If we eat a diet, which is very high in carbohydrates, and we’re having quite high carb meals or dominant carbohydrate meals, there’s a lot of frequent eating going on.

There are no big gaps between meals, but someone’s eating every two or three hours, snacking a lot, and is dependent on carbohydrates. They find it quite hard to go without a meal. Some of the things we may be talking about in the blood sugar episode, then what the body is learning from that behaviour, is always sugar available. I can rely on my glycolytic system.

It’s cheap, and it’s easy to run. Yeah, it doesn’t produce that much energy, but there’s always substrate available for this. So when we eat a high carbohydrate diet, or we eat in a way that doesn’t support healthy blood sugar control, the body learns to use glycolysis to make energy and the mitochondrial pathways weaken and remember that those mitochondrial pathways, although they maybe take a little bit more work, they have a good energy yield.

They’re producing so much more energy in the glycolytic pathways. One of the ways we can train the body to use those mitochondrial pathways, and if you think of strengthening a muscle in a gym, you go in, and you have to train it, which means you have to use it or you lose it. The same goes for these mitochondrial pathways; we must use them or lose them.

For us to use them, we have to make sure that blood sugar is balanced throughout the day, and you can refer back to the blood sugar episode for more detail on that. Also, we can potentially consider practices like fasting. And fasting isn’t something I’ve talked about in much detail yet.

I might do just a separate episode on fasting because I do get a lot of questions about how to approach it, and just genuinely very quickly is on say if you aren’t going to use practices like fasting, you want to kind of ramp yourself up towards it build up towards it, instead of just diving straight in, but that might look like reducing how often you eat in a day so if you’re someone who’s a snacker, starting to train your body to have three meals a day, and no snacks, and then you can look at reducing the window in which you eat your food. If you normally eat breakfast at 8 am and dinner at 8 pm, you’ve got a 12-hour window overnight. Still, you’re not eating; what if you could push breakfast out a little bit later or bring your evening meal in earlier, then maybe have a 14-hour window?

In doing so, you can play around with that and maybe do a day where you don’t have any meals, so you have one meal at the very end of the day, so you’ve done a 24-hour fast. Maybe that’s not something that you do daily, some people do, but for the most part, it’s not practical for many people or enjoyable, especially if you like your food. But that’s a way that we can bring more flexibility to our metabolic system because we’re not putting loads of carbohydrates into the system and are constantly feeding the glycolytic system.

That mitochondrial fat-burning energy system has an opportunity to go, “Oh yeah, we need to do some work here.” And in doing so, keeps it strong and healthy. That’s kind of where we can begin with food and ultimately, just really focusing on single ingredient foods, unprocessed foods, foods in their natural state, and making sure that we’ve got good amounts of those colourful fruits and veg, we’ve got good amounts of high-quality protein and high-quality fats.

Then carbohydrate consumption is tailored towards blood sugar control, which will differ for each person. We all have different carbohydrate tolerances. Mine is rubbish, and I can only eat very few carbohydrates daily.

If I eat something, that’s probably what a normal person would consider being like a standard portion of brown rice, thinking that that’s healthy, which could potentially send my blood sugar very high. So it’s worthwhile thinking about your unique blood sugar tolerance and how you stay within the limits of that tolerance because that will be important for your mitochondria’s health. If you want to dive deeper into that, there’s the blood sugar episode.

I also have the blood sugar mini-course on my website. Now that we’ve covered the food bits and bobs, the next thing to consider is just nutrients. This is where I could teach you all the biochemical pathways but don’t worry, and I will not do that.

But I’m just going to highlight a few nutrients that could be important. I’ll start with oxygenation. You can always go back and listen to the oxygenation episode, where I talk about the important nutrients for red blood cell health.

But remember that the mitochondria operate in the presence of oxygen. We need adequate oxygenation of the body for healthy mitochondrial function, and part of that will be the transport of oxygen via the red blood cells, which rely on vitamin B6, vitamin B12, folate and iron. We want to ensure that we are digesting, absorbing and assimilating those nutrients appropriately because that will contribute to mitochondrial function.

Then once we get into the cell, we have certain nutrients, L carnitine and magnesium. The next thing we want to consider is we’ve got fats, we’ve got carbohydrates, and we’ve got proteins, which are broken down into various acids, like suberic acid and diprotic acid, and pyruvic acid; you don’t need to worry about the names. They are then shuttled into the mitochondria, where they then form Acetyl-CoA.

Specific nutrients are important to get these acids into the mitochondria. These nutrients or the nutrients involved are carnitine and magnesium. So magnesium is an important nutrient involved in over 300 reactions.

It can often be low in people with fatigue. So it’s always a can be, should I say, not always. It can be a quick win. For some people, when they start taking magnesium, it can help with their energy. Carnitine may also benefit from some carnitine, especially if you’re vegan or vegetarian and don’t eat much red meat.

Once we’ve got Acetyl-CoA formed in the mitochondria, we go through what is known as the citric acid cycle. So the citric acid cycle is a biochemical process that helps to produce NADH and FADH. These are then transported to the mitochondrial membrane, and it’s by-transporting electrons along the mitochondrial membrane that the body cannot make ATP.

I appreciate a very quick biochemistry lesson, but you want to know that for us to produce this NADH and FADH-2, we need to go through a series of biochemical steps. These biochemical steps require nutrients or vitamins and minerals as cofactors. In other words, if we want these steps to operate well to operate effectively, and therefore energy production to operate well and operate effectively, we need to have adequate levels of these nutrients, which means we need to be able to digest, absorb and assimilate them from our food.

These nutrients include things like iron, such as vitamin B3, magnesium, manganese, vitamin B1, and vitamin B2, so without adequate levels of these nutrients, these processes don’t happen as effectively. If they’re not happening as effectively, we don’t necessarily make energy as effectively as we’d like to. Then when we get to the mitochondrial membrane, CO Q 10, Coenzyme Q 10, is, again, another really important nutrient that’s important to help shuttle electrons along the mitochondrial membrane, which is how we make energy.

Not all of my clients, but my clients benefit from taking the vitamin supplements or want to make sure that iron levels are good, magnesium levels are good, and maybe it can be beneficial to take some CO Q 10. Do you have clients who respond well to it and some who don’t respond just because it’s not their main issue? It’s not what they need.

Typically, if we’re considering testing, how do we know what someone needs or doesn’t need? This is where I like the neutrophil, which will give us an idea of how these different biochemical processes work. But it can also give us an idea of your CO Q 10 levels.

Like, what are your magnesium levels like? What are your manganese levels like? So we can also see if there are low levels of these nutrients contributing to the function of these processes in the mitochondria.

Finally, worth mentioning here is that in addition to needing nutrients to help these pathways work well, heavy metals can inhibit these pathways, so if someone has high mercury or fluoride or arsenic or aluminium exposure, for whatever reason, that could be something that’s inhibiting the health of these cycles. We know that toxins like heavy metals are already activating the cell danger response. Still, they can also affect the body by putting it into this threat mode and inhibiting these energy pathways in the body.

Again, the neutrophil, one of the tests I like, can measure blood and heavy metals. Heavy Metal testing is a bit controversial, but if something’s coming up high in one of these tests, we want to consider how it impacts these energy pathways. Consider the client’s health history where possible exposures could be and safely support detoxification because heavy metals can be tricky to work with.

That’s just an understanding of the nutrients that are involved. The other thing that’s also really important for healthy mitochondria is managing oxidative stress. Oxidative stress is the balance of oxidative species produced, which can be produced naturally due to metabolism happening in the body.

But they can also be produced when the cell feels threatened and in danger, which can be self-protective in the short term. Assuming the cell is okay, we’ve already set it for this episode. It’s not in danger. Therefore, we want to ensure that the oxidative stress of the cell is well managed.

The cells have three antioxidant enzymes, which are important for managing oxidative stress. These are catalase, glutathione, and superoxide dismutase. These are enzymes. So they’re made from proteins, which is why we need to have good protein and amino acid consumption, which means we must also be able to digest and absorb proteins. But in addition to this, we might also need the nutrients which support these enzymes.

So adequate levels of iron, copper, zinc, selenium, and manganese will all be important for these oxidative or show the antioxidant enzymes that manage the cell’s oxidative balance. We’ve talked about the importance of food, and we’ve talked about the importance of cell membrane health and getting good fats in your diet. We’ve talked about the importance of oxygenation.

We’ve talked about managing blood sugar, we’ve talked about specific nutrients that can be involved, and we’ve touched on digestion. I’ve said that digestion is important because we need to digest, absorb and assimilate the nutrients from our food that will be part of these mitochondrial biochemical processes. But we also need good digestive health because if digestive health is imbalanced, for whatever reason, that can be something that can then have an impact on mitochondrial function.

After all, it’s potentially threatening to the cell. There are certain toxic gases, for example, hydrogen sulfide gas, which can be produced if someone has an excess of sulfur-producing bacteria in the gut, which can directly be toxic to the mitochondria and impact their function. Digestive health is another essential part of the process.

Again, I did a whole episode on digestive health, so if you want to touch on that, you can listen back to that episode. The final couple of things I just wanted to mention here are the hormetic stressors. So hormetic stressors are stressors, which in the right dose can be beneficial to the body and obviously in an excessive dose, or if there’s not enough of a dose, then it can either obviously be ineffective if it’s too small a dose or if there’s an excessive dose, that can create a lot of damage and threat to the body into the cell and impact energy production.

These hormetic stressors include fasting, which I’ve already touched on. Fasting is great for blood sugar control, but it can also be good for autophagy which is the cell’s natural waste clearing process. It’s helping the body or helping the cells to clean up the debris and eliminate waste.

It’s facilitating natural detoxification on a cellular level. For blood sugar control, detoxification, and in the right dosage, fasting can encourage the increase of size and number of mitochondria exercises. Another classic one already mentioned if you have more muscle mass, you have more mitochondria.

Still, exercise can stimulate mitochondrial biogenesis, the process by which the body makes mitochondria. Also, it’s, especially if we’re doing exercise at a lower intensity, encouraging the workings of these mitochondria machinery, which will be beneficial. Exercise is always tricky for people with fatigue because, depending on their capacity, they may not be able to exercise at all or as much as they would like.

This must be considered in the context of what’s going on for you. Maybe exercise is something that you build up towards, but as soon as someone can exercise, encourage them to do as much movement as much exercise as they physically can within their capacity because it’s going to be great for blood sugar control, great for blood flow, and great for building up one’s mitochondrial foundations. Then the other thing that we can do is our heat stress. For example, if you tolerate using a sauna, 10 minutes three times a week can be good for the mitochondria.

Hot yoga, again, if you can tolerate another good one for the mitochondria and cold exposure. Cold exposure is great for the mitochondria. I do believe doing something like 11 minutes per week is sort of the sweet spot for a lot of people. Again, I’ll do a whole episode on these hormetic stressors where we can dive into them in more detail.

But 11 minutes a week is like three to four cold showers. Or if you’ve got access to the ocean as I do, you can always do cold water depths. Be mindful of being safe with a friend because cold water shock can be anything.

Those are the hormetic stresses; another thing also to consider is a ketogenic diet. A ketogenic diet can mimic fasting. So even if you’re not eating, or if you are eating, but you’re eating foods which are very, very low carbohydrates, that could be a stepping stone towards fasting.

Then the final thing here to consider would be thyroid function. Thyroid hormones or adequate amounts of thyroid hormones do have a positive impact on mitochondrial biogenesis. This means we want to do some basic thyroid screening, just check the thyroid hormones are where we want them to be, and if they’re not, then we need to start looking for why they might be low.

I’m sure there is so much more about mitochondria, but this is probably a great understanding of where to start. I’ll finish with a little bit of a wrap-up, and the first thing we want to consider is just the basics of a healthy diet. So whole foods, proteins, a good balance of fats in your diet, colourful plants, and optimised blood sugar.

Once you’ve got those foundations of blood sugar stability, there’s an opportunity to play around with some fasting, and then maybe layering on things like exercise stress, heat stress, cold stress, as appropriate for you. We want to ensure that we include some therapeutic foods. I had mentioned things like oily fish, berries, cherries, almonds, broccoli, green tea, and seaweed, in any kind of polyphenols would be great.

But again, just colour and variety, I think, keep it simple. We want to think about good digestive health. If there are any kind of obvious gut niggles, there are things we want to address. Testing can be helpful sometimes to reveal if there are any specific nutrients we’re lacking, which can be beneficial because there are so many different pathways in the functioning of the mitochondria to produce energy. It’s really difficult to guess, so this is where testing can help us understand which nutrients you might need specifically, and then we can top up with extra nutrients there.

But keeping things simple, just a really good B complex, maybe a multi-mineral, checking our levels, and playing around with a bit of CO Q 10 could all be beneficial. Then we want to ensure that we’re oxygenating well and managing inflammation through our diets and lifestyle practices. The final one here is just sleeping, ensuring that we’re optimising our sleep or getting sunlight in the morning.

We’re watching out for bright lights and blue light at night. We’re doing all the things we need for sleep hygiene to sleep well. That is probably a good place to wrap up things you can do to support your mitochondria.

Hopefully, that’s given you some big rocks to work on some big chunks and pieces of the puzzle. If you would like more help and support with your fatigue recovery journey, you’re more than welcome to reach out and discuss your options for working with me. If you’ve enjoyed the podcast today, please leave a review.

Maybe share it on your social media, tag me, and let me know what your big takeaways were. Sharing this information helps others who also need to find it so you can share the love—wishing you a wonderful fatigue recovery day. I will see you in the next episode.

Episode 12 – Gut Health and Your Energy

Anna Marsh — Fri, 28 Oct 2022 00:01:00 +0000

Shownotes

If you want to know if your gut health could be impacting your energy, the short answer is; YES! However, in this episode Anna breaks things down into more detail. She talks about the 4 main ways digestive health can leave you feeling fatigued and foggy and the “5R” approach for better digestion, health and energy.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Gut Health and Your Energy

Hello, and welcome another episode of the chronic fatigue and burnout recovery podcast. In today’s episode, I will discuss all things gut health. But before I dive into the content for today, I want to bring your attention to some of the things I’ve been talking about in the previous episodes.

So for the past couple of episodes, I’ve talked about blood sugar and oxygenation. Prior to that, I do believe I talked about the nervous system, and these are all that I would call low-hanging fruit. These are things that I’m always working with my clients on either to check.

Is this thing imbalanced? Is it not imbalanced? And if it’s not imbalanced, we need to address it. Because these are easy, accessible, and affordable things that we can focus on as we work to recover our energy. For this reason, these are also available as mini-courses on my website.

You can buy a blood sugar mini-course, a nervous system mini-course, and an oxygenation mini-course. Today, on the topic of gut health, you can buy the gut health mini-course as well. But if you feel that you don’t just want a mini course, and you don’t just want to work it all out yourself, these topics that I’m talking about today are also modules in the High Achiever Revival Program, which is my group program for high achieving women who want to recover from burnout and chronic fatigue.

The difference between doing the mini-course and joining the High Achiever Revival Program, also known as HARP, is that I combined the information you receive on the modules as you would receive on this podcast, but in a lot more detail with the group environment. Monthly group calls where you can feel supported on a monthly basis and have conversations about your recovery with someone for one personalized consultation. What this means is that when you join the program, you’ll have several one-ones with me, where we can go through all of this together, and I can highlight to you exactly where you want to be spending your time and your energy and your attention as you work through the program.

I just wanted to bring that to your attention as we dive into the next episode. Because if you have been enjoying the content on the podcast and find the information helpful, but you feel like you need a little bit more support and input in implementation, those would be fantastic opportunities for you. The alternative option is to work with me one-on-one in my fatigue recovery intensive, six months of working with me on a much more intimate level.

But anyway, that’s enough of a little bit of advertising slash marketing for you today. Let’s talk about all things gut health. Suppose you have been listening to the previous episodes. In that case, one of the things I’ve said previously is that we experience fatigue when the body isn’t able to make energy and when the body isn’t able to make what is known as ATP. Many different mechanisms can result in the same endpoint, the endpoint being poor ATP production.

And as we’re working on recovering energy, health, and well-being, we’re trying to identify this specific individual’s mechanisms inhibiting ATP production. If you’ve listened to some of the previous episodes, we’ve talked about the root cause or possible root causes and how these causes keep the nervous system and the immune system in an activated state, which is inherently draining on ATP production. But then, of course, in the past few episodes, when we’ve looked at blood sugar and oxygenation, we’ve looked at how specific mechanisms can impact energy production.

And digestive health is just the same. However, I would say here that it kind of straddles the low-hanging fruit and the possible root cause category because in some of my clients, there can be digestive imbalance which is, for the most part, one of their root causes. Clients who have a history of parasitic infections, for example, or clients with a small intestinal bacterial overgrowth – SIBO can be affected by fatigue, and also typically, in a lot of my client’s health histories, they can often be a very high antibiotic use either in childhood or across a lifetime.

This can all impact the gut, so I do see digestive health as being a factor in inhibiting ATP production, or it can be one of those root cause things that we need to go in and deal with. For today, I’m going to overview the digestive system and how it works and then talk about what can go wrong. Then I’ll also introduce you to what we can start to think about as we work on rebalancing the gut. If you have listened to this episode, you feel that you would still need some more help and support in addressing any digestive dysfunction because some people do need that personalized input so that they may need some more advanced testing.

They need some more specific help in terms of rebalancing their guts. There’s always the option; obviously, you can always work with another practitioner or take things the next step further with me and think about joining HARP on my one-to-one fatigue recovery. Recently, on my social media, somebody asked a question if gut health could be something that is impacting energy levels.

The short answer is yes, and it definitely can be. But the more complex answer is that there may be many different ways in which digestive health could be impacting your energy levels, specifically. The key to establishing well-being is working out what’s going on for you and meeting your unique needs.

So let’s start with a brief lesson in terms of how digestion works. The way that I like to approach this is from the top down or north to south. If you’ve heard me talk about the nervous system, you’ll often hear me say, oh, you know, we want this sort of bottom-up approach, where we’re working with the body to influence the brain then.

With digestion, we do it the other way around, working from the top down, from north to south, from the brain down to the colon. Therefore, the first part of your digestion is not your gut per se, or what people would think about as their gut, but it’s the brain and the nervous system. The brain will sense food availability, even before a meal begins.

Anybody who’s ever felt hungry will probably know that as soon as you start to feel hungry, even just imagining food can bring saliva into your mouth can get your stomach rumbling. As we begin to choose the foods we want to eat, as we begin to chop and prepare and cook food, as we smell the food as it’s cooking, this is all being received by the nervous system. Our senses are smelling and tasting and feeling and seeing the food.

That information is then communicated to the body, and the body is then preparing your digestive tract. It prepares the release of digestive juices so you can digest your meal. On the flip side here, if we’re very stressed, and we’re eating at our desk, and we’re not even connecting with the food on our plate or eating on the go, we’re not going to be digesting very well.

Chronic stress, as we know already, can impact the tone of the vagus nerve and affect the signals sent to the digestive system because it’s probably not going to feel very safe to digest your food when you are in a perceived state of danger. So the body needs to feel safe to digest food, and if there’s stress or chronic stress, that can impact digestive function. In addition, this inflammation in the brain can impact these downward signals to the digestive tract.

Suppose there’s an injury or brain injury, for example, a concussion, which has caused inflammation in the brain. In that case, that can affect digestion, but also understand that sometimes we can get a certain amount of inflammation in the brain when there is an infection in the body. For example, if you have a viral infection, you may lose your appetite, and if that becomes chronic or somebody has a stomach bug, they can also lose their appetite.

We first want a healthy brain and a healthy nervous system for good digestion. Some of those things are also reliant on a healthy gut. Still, we know that there’s a lot we can do to support our nervous system through Somatic Experiencing, brain retraining, breath work, yoga, and a lot we can do to support our brain in terms of eating nourishing foods.

Provided that the brain and nervous system are working well, the next point in the digestive process is the mouth. The mouth is where food enters the body, and it’s in the mouth that we chew our food. As we chew our food, we further stimulate digestion, producing some enzymes in the mouth to break down the food and stimulate the lower parts of the gut.

This is why proper chewing is important. So if you’ve been busy, rainy, or stressed, you rush out, grab a sandwich, and eat it super, super fast because you’re in a stressful state where everything is urgent, and you’re in a rush. Your sympathetic nervous system is activated; that’s going to be much worse for your digestion than taking the time to think about your food and make a nice plate of food and prepare it and smell it and then take the time to sit and be present with the food, eat it and chew mindfully.

Then we go to the next point in the process: the stomach. We chew the food adequately in our mouth, and that food goes into the stomach. It’s in the stomach that the food we eat combines with stomach acid, and this will further degrade the food before it moves into the small intestine.

Still, if we have any issues with stomach acidity, acid, which is too high, or acid, which is too low, this can be problematic. Actually, for the most part, a lot of people have stomach acid, which is too low, which means they’re not digesting their food appropriately. When that bolus of food hits the small intestine, ideally, the acidic bolus of food should be a trigger for the release of things like pancreatic enzymes, which are going to further degrade the food or the release of bile from the gallbladder.

But if we have insufficient acid, we’re not sending those signals to release the bile and the pancreatic enzymes. Then again, we’re not getting or liberating the nutrients we need from our food. It’s also here in the small intestine that we release bile, which is important for healthy fat digestion, and fat-soluble nutrients, which have multiple different roles in the body.

And for that to happen, we need a healthy liver and a healthy gallbladder. So this is where digestive health overlaps with detoxification. If there’s any toxic load, perhaps there’s a mould illness or mycotoxins in the body; there are heavy metals in the body.

Suppose there are a lot of environmental chemicals. In that case, that’s all potentially going to have a challenge or be a challenge on the liver and the gallbladder, which will affect fat digestion. It’s also in the small intestine, where many macronutrients like fats, amino acids, and carbohydrates are absorbed.

So proteins have an important role in the body, and fats have an important role in the body, as do micronutrients like B vitamins, minerals like iron, zinc, chromium, the fat-soluble nutrients, which I’ve already mentioned. If there’s any stagnation or inability to break down and digest these nutrients and absorb them, that’s going to have an impact on our overall health. The final part of the process is the colon.

If you’ve heard of the microbiome, the microbiome is the colony of bacteria, viruses, and fungi that live in the guts, and they make up the gut environment. And in the colon, we have trillions of bacteria that absorb water in the colon, electrolytes, vitamin K, biotin, and short-chain fatty acids. All of these different things are happening in the colon.

But the role of the gut microbiota that lives in the colon is to regulate immune signalling. They can influence mitochondrial metabolism, and they’re also involved in maintaining the gut barrier that essentially is a barrier between the outside world and the inside world because we think of our digestive tract as being inside of us.

But it’s outside us, and I liken it to a doughnut. If you think of a doughnut with a little hole in the middle, you wouldn’t think of the hole in the middle as part of the doughnut. It’s just a hole. The same is true for our digestive tract. One big hole or one big column runs mouth to anus. On the surface of that, just if you think about a sugary doughnut with sugar sprinkled on it on the surface of our digestive tract, we have all these bacteria, maybe some years, some parasites, all sorts of different cells and they’re all making up or informing the health of the digestive tract, but they’re not in the body.

They’re just creating a barrier between the world around us and what’s happening inside the body. That’s a really helpful way to think about it. We may experience changes in the bacteria that live on the sugary bits on the doughnut that can impact the quality of that healthy layer.

I’ve touched on this briefly, but the next thing to consider is what can go wrong. Here, I should say four main things that could potentially be problematic for your fatigue recovery journey. I’ll name these all now, and then we’ll go into each of them in a little more detail.

The first is meal digestion, not being able to digest and break things down. The second is malabsorption. Even if we can digest and break things down, can we absorb them and get them inside the body from the outside?

Then there’s inflammation, immune system activation, and microbiome changes. Because the microbiome does have this role in influencing the immune system, mitochondrial function, and the gut membrane’s health. If there are any changes in the microbiome, this potentially impacts the body along those several different mechanisms.

The first is maldigestion. If you listened to the previous episode, where I discussed oxygenation, you probably already know that nutrients have very important roles in the body. For example, vitamin B12, folate, vitamin B6 and iron make red blood cells, which we use to transport oxygen around the body.

If we don’t have enough of these nutrients, and we don’t have healthy red blood cells, we don’t transport oxygen effectively, and that’s going to be a roadblock in terms of our ATP and energy production. But that’s just one very small example of how nutrients impact the body. There are so many ways we need to get good amounts of amino acids because amino acids make up our main tissue or muscle mass or organ mass, bones, tendons, or joints.

We also use vitamins and minerals as cofactors in various reactions that are important in the body, we have got 1000s of reactions happening every single moment of every single day, and we need vitamins and minerals so that these reactions can happen. The effects of mild digestion mean that the body is undernourished from a macronutrient perspective. We don’t have enough proteins, fats, and carbohydrates, some of which will be burned to make energy.

We also don’t have enough mittens and minerals, so these different biochemical and enzymatic processes essential to our health happen effectively. We can’t make hormones; we can’t make neurotransmitters; we can’t detoxify properly, so we rely on our nutrition. If you eat and you get bloated, if you have bowel urgency or heartburn after a meal, if you have difficulty tolerating proteins or fats and you avoid these foods, or if you experience fatigue after eating, or you have a problem digesting and absorbing your food, these can all be signs that there may be some mild digestion going on.

This means you want to consider how you can support your digestion in the context of your fatigue recovery. In some cases, it can be just as simple as taking a supplement to help you, perhaps while you work on some of the upstream factors, such as chewing, the nervous system, the brain, and the health piece. I had a client experiencing a lot of fatigue after eating, and just some basic enzyme support helped her in terms of her energy pressures, especially in the afternoon.

That would be the first thing to consider is, is there any maldigestion going on? In my journey, I had a lot of maldigestion. About six months into becoming unwell, I started to develop chronic diarrhoea, which was bowel urgency after eating.

And I suspect I don’t know for sure, but when I did a stool test, I had some fat mouth digestion. There were very high faecal fats in my stools, and I suspect there was a liver gallbladder link, possibly due to mycotoxins toxic overload. And I had chronic diarrhoea for almost two years.

On and off, sometimes it was a little bit better, sometimes a little bit worse. I tried so many different things to support my body, and in the end, the thing that helped me the most was working on my nervous system alongside a sensible diet and supplementation. I had been doing various dietary and supplemental things, but bringing in the nervous system piece in conjunction with that began to shift things for me.

But then, at the time, when I had all of these digestive issues going on, I did an organic acids test and just basically needed like every single B vitamin, every single fat-soluble vitamin; I think the only thing that was okay was my mineral levels, but it was evident in my nutrient status, that there was a lot of mild digestion going on. You can probably safely assume that if you’ve a lot of digestive issues, there may be some mild digestion and some nutrient deficiencies. Then you want to address the gut first and then work on addressing the nutrient deficiencies. The next thing I said I would touch on would be malabsorption.

Once food has been digested, it needs to be absorbed. So just digesting well is not the only piece of the puzzle; we also need to get that food across the gut lining and into the bloodstream, where it can be taken up and used as appropriate. If the gut lining is damaged, if it’s inflamed, or leaky, as what is often colloquially referred to, nutrient absorption will be poor.

This depends on the integrity of the gut membrane, and the integrity of the gut membrane can be compromised when there are infections. A yeast infection, mould, parasites, excessive bacteria, dysbiosis, small intestinal bacterial overgrowth, other parasitic infections, or bacterial infections will affect the gut lining. Stress and nervous system dysregulation can affect the gut lining; poor diet, so eating too often, eating too many carbohydrates, and eating too many fats, can be an issue.

Then even things like eating too much salt or gluten, if you’re sensitive to gluten emulsifiers in processed foods, food glue, nanometric particles, or even chemicals from food packaging, specifical things like BPA, can disrupt the gut lining. First and foremost, if we’re thinking about this north-to-south model, we must address what’s going on upstream. Nervous systems support brain care, chewing, creating a safe environment to eat, connecting with the food, supporting any mild digestion, and then thinking about what could affect the gut barrier.

Have you got a good, well-balanced diet? Are you taking adequate rest breaks between eating? Are there any infections that need to be removed? This is where testing can be helpful, and this is where working with a practitioner doesn’t have to be me. Still, it could be someone similarly qualified to get to the bottom of what you need to do because there can be many different things impacting the gut that will start to help with this malabsorption piece.

The next thing is to consider inflammation and immune activation. To a certain extent, if there is mild digestion and malabsorption, there’s likely also probably going to be some inflammation and immune activation, and 80% of our immune system is located in and around the gut membrane. When the gut is inflamed, that can then be a spillover inflammation that can become systemic.

That means that it’s affecting other areas of the body. The analogy I like to use here, possibly already used in another podcast episode, is that we all know how it feels to have an acute illness or a bout of flu. For example, we can feel fatigued, achy, foggy brain, low in motivation, and even small tasks feel exhausting.

Walking up a flight of stairs would make you feel tired and achy. These symptoms are not the virus per se or the infection per se, but rather they are the consequence of energy in the body being prioritized away from the brain, hence the foggy brain and fatigue, and low motivation, and prioritized away from the metabolic system hence the aching muscles and the fatigue and exhaustion on physical exertion and energy aren’t being prioritized to the immune system so the immune system can do its job, which is to resolve the threat of the invading pathogen, the invading virus. When we feel this way, we feel rubbish.

Nobody likes to feel this way. But it’s also intelligence in the body, how we feel as a consequence of this energy being prioritized away from the brain and the metabolic system and towards the immune system. Now back to the gut, if inflammation in the digestive system sends inflammatory signals to the immune system, it might not be to the extent of an invading virus.

Still, it might be on a lower level. We may not feel as absolutely unwell as we would if we had a viral illness, but we feel similar symptoms on a lower grade. We still feel that fatigue, we still feel that achiness, we still feel that brain fog and low motivation, and exhaustion from physical activity.

It’s just a little bit watered down. In this case, possible triggers could be a gut pathogen, but it also could be that there’s been some chronic stress and the gut membrane has become more permeable. Then there’s maldigestion, and because the food we’re eating hasn’t been broken down properly, bigger protein particles cross the barrier into the bloodstream, activating the immune system. Or we can get endotoxins, toxins produced as a consequence of gut bacteria that then travel into the bloodstream.

That’s going to be activating the immune system, but it’s also going to add to the toxic load, which is going to impact maybe the liver and the gallbladder. Then we can’t produce enough bile, and one of the roles of bile is to carry toxins out of the gut, so that’s compromised such a toxic load increases further. But we also can’t get our fat-soluble nutrients, which are going to be important antioxidants when we can’t digest our fats properly, and that’s going to be important for managing inflammation or creating healthy cell membranes, which then impact mitochondrial function.

We can see that the effects of these imbalances in the gut are far-reaching, which is why we want to ensure that all these different steps in the digestive processes are fully optimized so that the body is getting what it needs. We’re also not creating extra stress and immune activation through our digestion. The final thing I want to discuss is the microbiome.

Here we’re talking about the balance and the colonization of the gut by different viruses, bacteria, and fungi. There are many bacterial species in the gut, and different species impact the body differently. The research in this area is still very new; we probably only know a drop in the ocean of everything we need to know about the bacteria in our gut, but here are some examples.

Some bacteria may affect the conversion of thyroid hormone T-4 to the active thyroid hormone T-3. If there’s an imbalance with these bacteria, then maybe we’re not making enough of this active thyroid hormone that could impact energy, or some bacteria may play a role in blood sugar stability, which means somebody with a bacterial imbalance may struggle to keep their blood sugar stable, and that could impact energy. We also might have certain bacteria; for example, the Desulfovibrio bacteria produce hydrogen sulfide gas, which has been known for years as toxic gas and an environmental hazard.

It can inhibit mitochondrial function and diminish ATP production. This was something that, when I did my stool test, I tested very high for. I got a lot of benefits from going on a low-sulfur diet.

I did a low-sulfur diet with some supplementation and nervous system brain retraining, and combining those few things finally got me out of that pattern of chronic diarrhoea. But ultimately, what we want is that we want the microbiome to be diverse. It’s not about having lots of certain types of bacteria and then very few or none of the other types.

But it’s really about having this diverse range of species that all work synergistically together. One of the things we can do to encourage that diversity is to have a diverse diet. One thing that discourages diversity is having a very limited diet and antibiotic use.

The more courses of antibiotics someone has had across a lifetime can impact the diversity of their gut bacteria. A little challenge that I like to set my clients is to aim to eat 20 to 30 different plant-based foods per day. Different research says different things, some say 20 to 30 per week, and I say if they can hit a minimum of 20 per day, that’s great.

That means that if you make a salad, and you put three different types of lettuce in that salad, say you put red leaf lettuce, romaine lettuce, and radicchio lettuce, that’s three different types of plants. Then you add some avocado, and then you add some tomato, cucumber, and celery. That’s another four different types of plants; then you’ve got seven types of plants.

Then say maybe you make a curry for dinner and add ginger, onion, garlic, some cumin and coriander, and some chilli. That’s six different plant species that you’re eating in your curry. As your day goes by, you’ll count up these different plants, and the goal is to have 20 different plants each day.

So that’s something you can give a little go and see if it works for you. The other final thing is that exercise can positively impact the microbiome. One of the things we experience a lot in fatigue is people stop moving their bodies, either because they just physically can’t, or they build up a fear of movement.

I encourage people to move as much as possible within their physical limitations. As they experience more and more wellness to continue to increase their physical activity, obviously, within healthy limits, over-exercising can be detrimental to well-being. That hopefully gives you an overview of different mechanisms by which digestive health can impact energy.

If you know your gut doesn’t feel right and want to know what to do about it, I guide my clients through the five R process, which is universal for functional medicine. When you do functional medicine training, you learn the five R processes. The five R process stands for remove, replace, reinoculate, repair, and rebalance.

I’ll briefly go into each of these. Remove means removing things that shouldn’t be there. It might be removing foods that someone is reacting to, pathogens like parasites or yeast overgrowth, or maybe if there are too many bacteria, there’s a bacterial overgrowth of dysbiosis.

Those bacteria may need to be pruned back. In some cases, I’ll refer clients to a doctor who will recommend antibiotics for parasitic infections, which can help in energy. In other cases, we may use antimicrobial herbs for this removal phase.

The next thing we want to do is replace. This means replacing the missing things, and you just heard me talk about the importance of the diversity of fibers in the diet. Here, we may want to add these plant-based fibers to replace those, and we may need to give some digestive support to support acid production, enzyme production, or fat digestion.

We’re replacing what should be there but isn’t there. Then we get to reinoculate. That is putting in the good stuff, the good bacteria, whether through fermented foods or a probiotic. Then we have the repair. Repair refers to repairing the gut lining.

Remember that I mentioned that lining is important because the outside or inside of the doughnut interface is the barrier between the inside and outside worlds. It’s the first port of call that our immune system has to react to things to protect us and keep us safe. When we repair the gut lining, we want to focus on nutrients.

For example, bone broth is rich in certain amino acids, which can be helpful for the gut lining. We can also have vitamins A and D, omega-three fatty acids, vitamin K, and zinc; these are all important gut-lining nutrients. Finally, to rebalance.

Rebalance refers to the lifestyle we need and how that supports our digestive health. In this case, it’s about looking after our brain and our nervous system, making time to slow down and use all five senses when we eat our meals, really chew properly, and having that ongoing lifestyle that supports our digestive health. That’s a very brief introduction to how you can support your digestive health.

As I said at the beginning of the episode, if you feel like you need more support in this area, there are a few things that you can do. I have my gut health mini-course, which you can take, which includes my Beat the Bloat Guide, which goes into these five R’s in a lot more detail, and there are recipes and meal plans so that you could do a five R process yourself.

The other option is to work with me in the High Achiever Revival Program, which is a combination of one on one and group work, where you have year support from myself, where you’re going through modules, jumping on group calls, and having a certain amount of one on one calls where we go through things together and can hone in and personalize and target a plan to you. Or you can work with me one-on-one, and in the one-on-one and group work, there’s the option to do testing as well. I hope that has been useful for you today.

I hope you now understand how digestive health could impact your energy levels and where you can, at the very least, begin to address your digestion. If you have enjoyed today’s episode, please feel free to share it on social media, share it with your friends, or leave a review so that other people can find this episode and get the help they need; I will see you in the next episode.

Episode 11 – Oxygenation and Fatigue

Anna Marsh — Fri, 21 Oct 2022 00:01:00 +0000

Shownotes

We make energy in the presence of oxygen and this means that the body must be able to optimally take oxygen in through the breath, transport it around the body and then into the cells. Any breakdown in this supply chain can be a roadblock to the production of the body’s energy currency ATP and this can be experienced as fatigue. In this episode Anna discusses red flags and what tests, foods, supplements and general lifestyle practises may be helpful to optimise your body’s oxygenation and energy production.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Oxygenation and Fatigue

Hello, and welcome back to the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh, and we will focus on all things oxygenation in this podcast today. So what is oxygenation? Why is it important for your fatigue recovery journey? If you listen to the previous episode on blood sugar, you probably heard me say that fatigue at the end of the day is the end point of poor ATP production.

ATP is the body’s energy currency. How the body makes ATP or how the body makes energy is dependent on many, many different factors, some of which I covered in a previous episode where I talked about the causes of fatigue. All those causes, which I discussed, result in the endpoint of poor ATP production.

Poor oxygenation could be a contributing factor, from poor ATP to poor energy production. So what I want to cover in this episode today is what we want to be thinking about when we consider that our body may or may not be oxygenating well. When I look at these kinds of concepts like blood sugar and oxygenation, these are what I would call the low-hanging fruit.

I call them the low-hanging fruit because they’re accessible and easy to test for. They’re easy to identify, that I wouldn’t say, easy to address, necessarily, but fairly easy to address, fairly straightforward to address, and inexpensive to address. When I’m working with a client, either one on one in one of my one-on-one packages, or even if I’m doing a one-on-one consultation as part of my group program, then what I’m doing is I’m asking these basic questions, how is this person’s blood sugar?

Is this person oxygenating well? These are very easy and accessible things we can address as we work towards the entire big picture of ATP and energy production. Health and well-being are created when the body has the energy for all the systems to function well.

When we think about oxygenation, what do we want to think about? What do you need to know? Well, one of the first things I like to lead is that we make the most energy in the presence of oxygen. Energy is made in the cell’s mitochondria; we make the most energy and ATP when we burn fat for fuel, and we burn fat for fuel in the presence of oxygen. So we need oxygen to get through our nose, mouth, lungs, and bloodstream.

It needs to be transported through the bloodstream, infiltrate into the cells, get into the cell’s mitochondria, and then combine with the fat in the cell’s mitochondria to then be used to create energy. There’s a series of steps involved, and any breakdown in those steps will impact how much energy or ATP you can make. We think about it in the context of how you breathe, how you will initially get oxygen out of the air and into the body through the lungs, which requires good breathing practices.

It also requires healthy lung tissue, and your lungs are one of the body’s barriers; we need to transport the oxygen. So we need to know that our transporting molecules or red blood cells are healthy and can do a good job. Then once oxygen is transported through the red blood cells, we also need to make sure we’re moving the body, so the blood is circulating.

We need good circulatory health and oxygen to infiltrate the cells, which means we want healthy cells and healthy cell membranes to support that infiltration process. It’s an entire supply chain, and a breakdown in the supply chain will potentially create a breakdown in energy production, which could contribute to fatigue. So let’s dive into these supply chain steps in more detail.

The first step to consider is how you are breathing. The primary thing that I’m asking what I’m looking for when I speak with my clients is, “Do you breathe through your nose? Or do you breathe through your mouth?” People who breathe through their mouth tend not to oxygenate as well as people who breathe through their nose.

This is where people may lack awareness, not even realize that their mouth is breathing during the day, or perhaps they aren’t conscious of how they breathe during the day, but they’re breathing through their mouth at night. Remember, nighttime is when the body does a lot of its little cleanup jobs, it’s a very important time for rest and recovery and repair, and oxygen is going to be a really important part of that rest, recovery, and repair process. If we’re breathing badly at nighttime, when we’re asleep, the body will not be at an advantage during those restful night hours.

We want to consider nasal breathing. If you are somebody affected by fatigue, nasal breathing should be done 100% of the time. For example, people who exercise at high intensity may need to start using their mouths at some point to breathe.

But that may only be very, very high intensities for a very short time. Most people should be breathing through their nose the entire time, especially if fatigue recovery is a goal, because you shouldn’t be exercising, at least at this point, at an intensity that would encourage you to breathe through your mouth anyway. That can also be a nice way to put a little handbrake on yourself.

If you are a little bit gung ho when it comes to exercise, you can only do it through your nose if you limit yourself to exercise. That’s like applying the brakes a little bit on your exercise intensity. Another thing we may want to consider is breathing very shallowly.

Notice that you very seldom breathe through your belly, and you tend to breathe more into the chest and upper chest, and your breath is very shallow. That’s potentially going to be something that impacts the oxygenation of the body. We tend to do that more so when we’re stressed.

This is where we can see an overlap between oxygenation and the nervous system because when someone’s nervous system is more activated, their breathing may be more rapid, it may be more in the upper chest, versus somebody who is much more centred and grounded and well regulated, they may tend to breathe more into the belly. Here if you’re very stressed, if you’re sitting a lot, if you’re quite hunched over, working at a desk, maybe you want to take some breaks throughout your day where you open up the chest, open up the ribcage, do some nice breathing exercises to encourage good breathing and flow of breath throughout the day. You might also be told that you snore a lot, and maybe a partner complains about your snoring.

If you’re snoring at night, you probably breathe through your mouth. Saying or often yawning throughout the day can also indicate poor oxygenation. Sometimes sighing and yawning can also be a discharge from the nervous system.

So just understanding the difference between the two may be something for another day if you can hear your breathing. Oxygenation is probably not great if it’s very kind of like laboured and raspy. If you experience any nasal congestion, people with it may default to breathing through their mouth.

So if nasal congestion is an issue for you, that’s something you may want to address in your journey towards better oxygenation. What do you do if you identify that your breathing is probably something you could be working on as part of your fatigue recovery journey? If you want to train nasal breathing, that might mean actively working on nasal breathing.

First, when you’re at rest, even just lying down, to begin with. If you find it quite challenging, you could practice nasal breathing by sitting up, then you can practice nasal breathing on a little walk, and then maybe you can integrate it into more intense exercise if that’s something you can do. Because not everybody who’s recovering from fatigue can even walk very much at all, let alone do more intense exercise.

You could use mouth taping at night, get some micropore tape from the chemist, and pop it over to keep your mouth closed at night so you can focus on breathing through your nose. Suppose that feels quite distressing initially and activating for your nervous system. In that case, you could practice mouth taping in the evenings while watching TV, for example, and then build up to the competence to wear some mouth tape at nighttime.

You want to address any underlying nasal issues, very common when there are mould spores in the nose, when there are digestive issues, when there are inflammation issues, maybe if there are food sensitivities, histamine issues, all of that can impact the nasal passages, that is another podcast for another day. But we want to ensure that we’re addressing as much as possible so that you can breathe adequately through your nose. Once we’re breathing, we also want to ensure that the air we breathe is circulated around the body.

That means movement and movement is always a tricky one for people with fatigue because if I think about the spectrum of my clients, I have some clients who may only just be walking to the bathroom and back or the kitchen and back each day, to other clients who are building up their exercise tolerance and getting back into exercising, like a normal human being. So on that spectrum, it’s very broad, and different people have different levels of movement capacity. The guidance I usually give is just little and often within your capacity.

Even if you’re only able to walk to the bathroom and back or the kitchen and back, there might be little movements or stretches that you can do seated or even in your bed to get things moving. You can challenge yourself to do those little walks hourly. For someone who has a greater capacity, it’s not just going to the gym and doing your hour-long workout but taking the stairs, parking your car further away at the supermarket, and building up those 10k steps, not just in one go. But in little intervals throughout the day, you are constantly just working on moving the body.

It’s great, obviously, for blood flow and oxygenation, but also your lymphatic system, getting toxins out of the body. Once we are breathing well and circulating oxygen around the body with our movement practices, we also need to ensure that we’ve got healthy blood cells that will transport the oxygen where it needs to go. That is specifically looking at the red blood cells and the red blood cells being made by the nutrients vitamin B12, folate, iron, and vitamin B6.

There are deficiencies in these nutrients, whether due to poor consumption or you’re consuming enough. Still, you’re unable to digest and absorb these nutrients because of digestive issues, or maybe you’re burning through a lot of these nutrients, and you’re using up a lot because of other imbalances in the body. For example, I won’t talk about imbalances in the biochemical process of methylation today but to give lip service.

If you’re methylating a lot or there are problems with your methylation cycles, you may need these nutrients more. We’ve got various reasons why you may need more of these nutrients. We can begin to identify if there are any issues with the red blood cells and if you perhaps need more of these nutrients for whatever reason by using testing, which your doctor will be able to do for you, which is to look at a full blood count, sometimes also called a complete blood count, it just depends who you’re talking to.

This full blood count will be able to measure your red blood cells, your haemoglobin levels, and your hematocrit levels. Suppose you have low red blood cells, haemoglobin, and hematocrit. In that case, that’s a sign that there can be anaemia in some cases, poor oxygenation, or an inability to oxygenate the body adequately.

But then we need to dig maybe a little bit deeper and work out what the problem is specifically. In this case, we’ll look at some other markers. So the Mean Corpuscular Volume – MCV, the Mean Corpuscular Hemoglobin – MCH, the MCHC, the Mean Corpuscular Hemoglobin Concentration, and the RDW, The Red Cell Distribution Width. If there are changes in these markers, that can start to suggest this is an iron problem versus a B vitamin problem.

Sometimes we can have both, so we need to double-check these things, which I’ll talk about in a moment. But if you have an elevation in these markers, and your MCD, your MCH, or your MCHC, that can indicate there may be a need for B12, folate, or vitamin B6. If these markers are low, that can then suggest that maybe there’s an iron issue.

The only thing is what happens if you need B vitamins and iron, we can’t always tell exactly from these markers, which is why we then want to look at a few other markers as well. If you’ve tested your full blood count, you can also test your ferritin levels, so ferritin is your body’s iron stores. Now the tricky thing about ferritin is that the reference range is huge.

Therefore, sometimes I have a lot of clients who are within range but right at the bottom of the reference range. What you want to know about ferritin, especially if you are experiencing fatigue, is that the ideal amount is about 50 micrograms per litre. The reference range is 10 to 122 micrograms per litre.

Because it’s so broad, it’s really important to know what you’re aiming for. Of course, if yours is maybe 40, or 55, it’s probably not such a big deal. But sometimes, I have clients with a ferritin level of 12, and the bottom of the reference range is 10.

Then we know we want to bump their ferritin levels up closer to the middle of the reference range. That’s what we want to know about ferritin. If ferritin is very high, that can sometimes indicate inflammation in the body.

If I see a very high ferritin count, I’ll usually also want to see one of the other iron markers. We can have the total iron binding capacity, which are other markers your doctor can run for you. Or you can always use a private testing company like Medichecks, for example.

Sometimes those markers can also start to indicate if there’s elevation and iron, which can sometimes indicate inflammation. So with Veriton, even though the reference range is so broad, we don’t want to be too high up on the reference range. We don’t want to be too low down on the reference range, and about 50 is a good place.

But you may have also just heard me say that if we have an increase in our MCV, MCH MCHC, that can be due to the need for B12, folate, or vitamin B6. But how do we know which one? Is it all of them? Is it just one? Is it two of them, but not the other one?

This is where I like to dig deeper with clients and recommend organic acids testing. Organic acids testing will tell us about the functional need for these nutrients. Sometimes your doctor will run maybe a serum B12 or serum folate.

These levels often come up normal with clients just because it’s a snapshot of how much B12 or folate is circulating in the bloodstream at that point in time. But it’s not telling us how much it’s getting into the cell and doing the job it’s supposed to do. This is where organic acids can give us that information.

I’ll often see clients with normal serum folate or normal serum B12, and then we’ll do the organic acids, and they might need more folate, or they might need more B12, or they might need more B6. In case it’s relevant, these specific markers are the mevalonic acid best indicator of the need for B12. Figlu, F-I-G-L-U, is the best indicator of the need for folate, and then sensorynic acid is the best indicator of the need for vitamin B6. We’d be looking for those in an organic acids panel to see if all of them.

Is it one of them? Is it two of them? And then we can offer those dosages respectively, as required. If we start to identify a need for these nutrients, we must think about why. Why would this be love for this person?

In this case, we think they are just not eating enough of these foods, which can be common for vegans or vegetarians who maybe aren’t getting a lot of iron or aren’t getting a lot of B12 in their diets. If that’s the case, there’s no way around it, and these people will have to supplement with iron and B12. But if someone isn’t vegan or vegetarian, we could encourage them to consume more of these food sources, and they can consume iron-rich food sources; liver, and red meat, for example, would be great for B12 and iron.

We might also consider that maybe there’s an issue in the gut. Maybe this person is not digesting and absorbing these nutrients, and that’s the issue, their dietary intake is adequate, but for whatever reason, they’re unable to digest and absorb adequate amounts. Or, as I’ve discussed, some nutrients might be lost.

For example, women with heavy periods can use a lot of iron. Or has this person just been in an accident? Have they lost a lot of blood? Or circling back to digestive health, could they be a parasite feeding on the iron and then starving the human host of getting the iron they need?

We do want to consider what else may be going on that may be increasing the demand for these nutrients. Then we want to address any digestive issues, ensure the diet has good amounts, and that we can digest and absorb them well. Add in supplements if necessary, and then monitor.

The full blood count takes four months for these cells to turn over. We will want to do the digestive work, dietary work, and supplementation, and then once you’ve done all of that four months later, we can retest. We want to check if these things have improved, if they’re getting better, or if we need to dig deeper and consider other reasons for the increasing demand for these nutrients in this person’s body.

So I touched on the good sources of iron but also to say other good sources of B12, which could be things like liver, sardines, venison, shrimp or scallops, beef, lamb, eggs, cheese, especially cottage cheese, milk, yoghurts, and turkey are all good sources of B12, and fo folate, romaine lettuce, spinach, asparagus, so a lot of leafy greens, liver again, parsley, kelp, spring greens, broccoli, cauliflower, celery, lentils, brussel sprouts, would all be good sources of folate. The final thing I wanted to address regarding oxygenation is blood pressure. Our blood pressure is essentially what regulates the flow of blood around the body.

With low blood pressure or anyone who has experienced low blood pressure before, you’ll know you get very lightheaded and dizzy because there’s not enough blood going up to your brain. If enough blood goes up to your brain, brain tissue is not getting the energy it needs to produce oxygen. Often hand in hand with things like chronic fatigue syndrome, we also get many people who experience Pots.

So Postural Orthostatic Tachycardia Syndrome, where someone may experience dizziness, an increase in heart rate, or even blackouts, especially when moving from sitting to standing or lying down to standing. The autonomic nervous system regulates our blood pressure. So if someone is experiencing low blood pressure or Pots-type symptoms, this is again where that nervous system work comes in.

But if our blood volume is low, that’s going to put extra strain on the heart to maintain blood flow, and it’s also going to put a strain on blood pressure. This is where, you know, we often hear about people with high blood pressure being a problem. And, of course, if your blood pressure is high, this part of the podcast may not be specifically for you.

But if your blood pressure is low, or you tend to have these Potsie-type symptoms, we want to think about how we can support it. One of the best things you can do is to increase dietary salt, so salt or sodium in your diet, possibly supplementing with electrolytes, those with high sodium content.

Very often, when people become unwell, they change their diet, and they change their diet to be healthier. But in doing so, they may cut out a lot of processed foods, and they may, in some cases, even avoid salting their food because they’ve heard that salt is supposed to be bad for them. As a consequence, they have a very low sodium diet which can put a strain on the adrenal glands, and it can put a strain on our blood pressure.

In many cases, I recommend that clients salt their food, supplement it with electrolytes, or actively seek to eat salty foods that will still be healthy. For example, pickled foods, olives, and cured meats, provided that they are cured healthily with not a lot of other additives and preservatives, can all be fantastic sources of salt. We can also experience blood pressure issues due to stress, poor sleep, or even exercise.

But increasing your electrolytes and salt intake can be a quick win in this case. That does bring me to the end of the oxygenation episode for this podcast. I hope you’ve made some notes, you’ve got some things that you can think about, you’ve got some things that you can begin to work on. Always a reminder, if you found this episode useful, please leave a five-star review. Please share this information with your friends or anybody you think would benefit.

When you leave a review and share the podcast, it helps other people find this information, and in doing so, we can all recover and be healthy together. So wishing you a wonderful day, and I will see you in the next episode.

Episode 10 – Blood Sugar Balance and Fatigue

Anna Marsh — Fri, 14 Oct 2022 00:01:00 +0000

Shownotes

In this episode Anna explains why blood sugar regulation is essential for anyone who is experiencing and looking to recover from fatigue. She discusses the importance of blood sugar control for nervous system regulation. She highlights discerning signs that blood sugar imbalances could be a problem for you and how to use glucose monitoring and dietary changes to bring blood sugar into better balance.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Blood Sugar Balance and Fatigue

Welcome back to another episode of the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh, functional medicine and trauma-informed nutritional therapist and chronic fatigue syndrome, recoverer or survivor; not quite sure, which is the best one to say survivor sounds very dramatic, and recoverer doesn’t sound quite slick. So, either way, I have recovered from chronic fatigue syndrome, and I’m here today with you to talk about blood sugar and fatigue.

In today’s episode, I’d like to cover what blood sugar got to do with chronic fatigue. Why is it so important? Here’s a bit of a spoiler alert; it is very important. Then I also want to cover signs of imbalanced blood sugar, how to begin to balance your blood sugar, and factors that will influence your blood sugar control. So let’s dive straight in.

We can talk about what blood sugar has to do with chronic fatigue. Ultimately, fatigue results from the inability to produce enough ATP or energy to meet the body’s needs. As the body’s energy currency, there are various mechanisms by which our ATP production can be influenced.

Blood sugar dysregulation is one of them. So if you are experiencing changes in your blood sugar, if you think that blood sugar could be a problem for you, I always check with all of my clients, even if I think their blood sugar is absolutely fine. Let’s check because it’s low-hanging fruit. It’s something really practical and actionable that you can address.

If it’s a problem for you, we want to nip it in the bud because it is something that will impact your body’s ability to produce energy. The reason is that food is fuel, and we get food or fuel from the proteins, fats, and carbohydrates in our diet. The brain needs glucose. A lot of fatigue is brain fatigue. The brain feels tired, and this has low brain energy.

Yes, sometimes the muscles or the metabolic system can feel tired and lacking in energy, but I know when I was experiencing chronic fatigue syndrome, there were days when my muscles and my body felt like they were okay; they could do stuff. But my brain just felt tired and didn’t want to do anything. Of course, there were also days when I just had heavy, tired muscles and a heavy brain and didn’t want to do anything. But brain energy and good and healthy brain function are important for our fatigue recovery.

Therefore, when we eat food and our diet, that food needs to be converted into glucose. For example, we can use amino acids from proteins to make glucose, which could supply the brain with energy. Or we can make ketones if we follow a ketogenic diet, which can supply the brain with energy.

But at the end of the day, the brain’s preferred fuel source is glucose. That doesn’t mean the more sugar or glucose we eat, the better. But we need to get that glucose across the blood-brain barrier and into the brain and the brain cells so that the brain can use it as energy.

And part of that process requires good blood sugar control because if blood sugar is too high, we get poor brain glucose penetration, which means that we’ve got a lot of glucose in our bloodstream. Still, we cannot penetrate the blood-brain barrier and get that glucose into the brain cells, where it’s required to make energy and ATP. So more is not better but what we want to do is we want to control glucose within a narrow range.

I’ll tell you about that range. Specifically, I advise my clients that it is between 4 and 6.3 millimoles per litre. If you’re using a different set of units, you’ll need to do the conversion for those units. That means the blood sugar may increase after we eat a meal. We digest the carbohydrate in that meal, it travels from the gut into the bloodstream, and we’ll experience an increase in blood sugar after we eat.

But two hours later, two hours after we’ve eaten, we want that blood sugar to maybe have peaked at about 45 minutes, one hour after eating, and that peak should not exceed 6.1, 6.3 millimoles per litre. And we should have it back down to baseline by about two hours after a meal, and the baseline would be whatever it was before you ate. So if your blood sugar was 4.5 before you ate, maybe it will be good to be around 4.5 after two hours after you’ve eaten your meal, so that’s the narrow range we’re looking for. If blood sugar is going too high, there are going to be a lot of consequences.

If blood sugar goes higher than seven, that would be defined as hyperglycemia, and that’s when we typically start to see poor brain penetration, although arguably, it could happen at lower levels. We’re also starting to see an increase in the need for insulin, which can lead to type two diabetes over time. Still, it can also increase inflammation in the body, which will not support fatigue recovery and good energy levels.

But on the other side is what happens if blood sugar goes too low. If your blood sugar drops too low, maybe you’re not eating enough, maybe you’re exercising too much. This will probably be for those still physically active but very tired.

So under-eating or over-exercising for how much you’re eating, or just eating erratically, skipping meals, or eating the wrong types of food, can sometimes cause blood sugar to go very high and maybe crash very low. When blood sugar crashes too low, the body panics and the body can become stressed. We can get increases in stress hormones like adrenaline and cortisol, and that is dysregulating the nervous system.

You can do all the breathing exercises and somatic practices that you like. Still, suppose your blood sugar is on a roller coaster ride. In that case, it’s going to feel very, very challenging, probably almost impossible, dare I say, for you to experience a very calm and settled and regulated nervous system because your window of tolerance is going to be very narrow if your blood sugar is crashing.

So the goal here is that we want to have stability. Yes, we will experience high blood sugar and lows as we eat throughout the day, but we want to minimize the impact of those highs and lows because we want to minimize poor brain glucose penetration. We want to ensure we’re not producing too much insulin to have good insulin sensitivity of the cells to take up the glucose and get it into the muscle tissue where we can use it.

We also want to ensure we’re not riding that roller coaster ride of highs and lows and then producing a lot of stress hormones because that can also be just regulating our sex hormones, thyroid hormones, and sleep for inflammation in the body. All of these things would be potentially influenced by these blood sugar highs and lows. Hopefully, I understand why blood sugar regulation is crucial for fatigue recovery.

Now I’d like to talk about the signs that you may have some imbalanced blood sugar. Generally speaking, there are two patterns that I typically tend to see with my clients. The first pattern, which I’ll refer to as pattern A, is the low blood sugar type.

This is often created when there is erratic eating, when somebody has a lot of stress, or just eating an imbalanced diet. There may be difficulty waking up in the morning, and maybe no appetite often because stress levels are very high. They may experience dips in energy during the day.

Often they’ll lose function before meals, so for example, they may experience poor mental function, fatigue, difficulty focusing and concentrating, maybe feeling a little bit hangry, and then they’ll eat something and feel much better. They may feel energized after meals but crash a little later, about three or four in the afternoon, have those typical afternoon munchies and afternoon cravings, and may be irritable and, at times, lightheaded. They may have a lot of cravings for sweet things.

They may find it difficult to sleep through the night because possibly low blood sugar increases their stress hormones, waking them up. That would be the first kind of pattern. Maybe there’s an opportunity for you to think, “Do I experience any of these things?” The next pattern, which we’ll call, pattern B, would be the high insulin type.

This is often created when somebody has just been eating a diet which is too high in carbohydrates for too long. Perhaps they’ve been under stress for a long time and are quite depleted, maybe from an adrenal gland perspective. This type of person may wake up feeling refreshed, and they may wake up craving sugar.

They need the sugar to have the energy to get going. But then the caveat is they can’t get it into their cells and use it to get stored as excess body fat. They may experience fatigue after meals, so they may eat, then their blood sugar goes high, or they produce very large amounts of insulin.

That means that even though they’re putting all this fuel into their body, it can go where it needs to. Therefore they’re not energized by their food. They may need stimulants; for example, they always crave something sweet after a meal, or they always need to have some coffee, maybe in the afternoon. They may find it difficult to fall asleep, whereas the previous type may fall asleep okay and then wake up at night; this person may find it difficult to fall asleep.

Often when I teach this to my clients, they may also resonate with a little bit of A and a little bit of B, which is also okay. It’s okay to be both types. But essentially, if you resonate more with type A, which sort of goes up and down highs and lows, whose goal is to achieve stability in your blood sugar, we want to stabilize blood sugar.

If you resonate more with this pattern B type, the goal is to become more flexible. So we’re looking for flexibility. What this means is the ability to go without a meal. I’m not saying miss a meal, but have a good chunk of time between meals and not be so reliant on carbohydrates and not so reliant on food all the time so that we become metabolically flexible, which means we have the flexibility to use different fields. For example, with the fat that’s already stored in our bodies, instead of needing to eat all the time to supply energy, we have metabolic flexibility.

How do you know if blood glucose control is a problem for you? You may know intuitively because you feel it, and you feel the dysregulation in your body, and you know your blood glucose or blood sugar isn’t right. But the other thing you can also do, which is what I get my clients to do, monitors their blood sugar to check.

You can buy a diabetic glucometer, one of those little finger prick devices where you have a little monitor, and you have your test strips, and then you prick your finger and put the blood onto the test strip, and the monitor will tell you what your blood glucose is. When I first started measuring my blood sugar, that’s what I used all the time. Since then, technology has come a long way.

We also have the option of a continuous glucose monitor or a CGM and a continuous glucose monitor and monitor or a little patch that you stick onto the back of your arm. It connects to an app on your phone, and that means at any moment in time, you can tap the app on your phone through the patch on the back of your arm, and you’ll get a reading on your phone, which will tell you what your glucose levels are. When I’ve done the CGM, I’ve done the finger prick monitoring.

I do find finger prick monitoring a little bit more reliable. But I think the CGM is a great place to start. Suppose you are time-poor and don’t want to be faffing around picking your finger. I guess carrying a monitor and strips around with you throughout the day if you’re busy or have a busy job, or you have a lot of meetings or things like that, so there’s a convenient element to having the CGM. Also, it’s nice because you get a nighttime reading, you’re not going to wake up in the night and prick your finger, but the CGM will measure your blood glucose across the night.

You can see if you’re getting any highs and lows, which could impact your sleep. And it’s also nice because you can see that if you’ve got a steady, stable curve like an undulation of blood sugar throughout the day, you get a very nice visual of what’s happening. Or you can see if your blood sugar is like peaks and troughs, so the graph aspect you get from the CGM is also nice.

I think the fingerprick is more sustainable for people who need to measure their blood sugar longer because the CGM is about 60 pounds, 50-60 pounds, and lasts only a couple of weeks. So if this is something you want to be doing, I have been measuring my blood sugar on and off for about three years; it would cost me a fortune if I were using CGM all the time. So it comes down to personal preference, but that’s a nice way to see what’s happening.

From there, you can make adjustments to your diet and make adjustments to your routines so that you can bring your blood glucose into a more regulated state. That brings me on to well, how do we do that? How do we create better blood glucose control?

Several things will impact your blood glucose diet because we’re eating three, four, or five; who knows, six times a day will impact blood glucose significantly. But our activity levels can have an impact on blood glucose, our stress levels, how well we’ve slept, how much muscle mass we have, any nutritional deficiencies, inflammation in the body, digestive health, toxins, and our hormonal cycles, if you’re a woman, they’re all going to have an impact on blood glucose. Now, it goes beyond the scope of this episode today to go into detail about all these areas.

I’m going to keep this conversation primarily focused on food, and the question is, what do we need to think about when it comes to our diet and blood sugar control? The first thing is that carbohydrates in the diet will greatly influence our blood sugar. But when we combine dietary carbohydrates like grains, root vegetables, fruits, proteins, fats, and low carb, fibrous vegetables, that can help to smooth out the glycemic impact of those higher carbohydrate foods.

You may notice already that I haven’t mentioned pasta or bread or cakes or sticky buns or doughnuts, and I haven’t mentioned they processed carbohydrates because it’s probably very unlikely that a diet high in processed carbohydrates will be good for blood sugar regulation. But some people will be able to tolerate certain amounts of unprocessed carbohydrates. I like to advise people to think about their diet by starting with protein first.

Meals should be protein-centric; we should be designing our meals around the protein source because we need to get adequate protein in our diet. It’s really important for our muscle mass, neurotransmitters, repair, enzymes, and so many important things that we need protein for, and we need to ensure that we’re getting adequate amounts. We want to think about the protein source and our diet.

You can choose if you want to be vegan or vegetarian, eat animal protein, be pescatarian, or eat eggs. I don’t mind, but your diet wants to be centred around where you’re getting your protein from. Then we want to add in some good fats.

That could be fats from oily fish, nuts and seeds, avocado, olives, olive oil, cold pressed seed oils, or coconut products like coconut oil, coconut yoghurt, or coconut milk. Those will ideally make up the fats in our diet. We want to ensure we’ve got a decent amount of low-carbohydrate vegetables on our plate.

Any vegetable that doesn’t grow below the ground, vegetables that grow below ground, like beetroot, carrot, potatoes, and butternut squash, are all going to tend to be higher in carbohydrates and more likely to spike your blood sugar. So vegetables that grow above the ground will be your fibrous carbohydrates. Now you’ve got your plate of protein, fat, and fibre.

You want to think about using your blood sugar monitoring and, “How much carbohydrate can I tolerate? If I want to add a sweet potato to that meal, what happens to my blood sugar an hour or two hours later? Or if I want to add some rice to that meal, what happens an hour, two hours later?”

We can start personalizing our diets based on our glycemic responses. When I did this three years ago, now, when I was in my initial stages of recovery, I couldn’t tolerate any carbohydrates. I could have the protein, fat, and vegetables, but when I put some rice, sweet potatoes, and white potatoes on my plate, my blood sugar levels went far too high.

That meant I, for a period of time, had to follow a very low carbohydrate diet until I was well enough to do more exercise to build more muscle mass so that I had bigger storage units for my glucose, my muscle mass being my storage units. And I started introducing and tolerating more carbohydrates in my diet because I was using more carbohydrates through physical activity, and I had bigger storage units for when I didn’t need to use that carbohydrate immediately. But because I had to go on a very low carbohydrate ketogenic diet, that doesn’t mean every person with fatigue does.

The beauty of glucose monitoring is that you work out exactly what your body needs. Some people don’t like to know because it means they have to give up potatoes or rice, or they can’t have sweets, cakes, chocolates, or ice creams. Unfortunately, that’s just the reality of the situation.

You can choose to continue to eat those foods and feel bad and damage your health, or you can spend some time focusing on restoring your health so that you can enjoy those foods and modern ration in the longer term. That’s what I’ve done, and I can now have some sweet treats and enjoy them from time to time. I don’t overindulge too often.

Then finally, I’ll say as well that if you’re using a CGM, there’s no escape; you’ll see your glucose and everything that’s going on with your blood sugar for a two-week timeframe. But when clients use finger prick devices, they only measure when they eat well. And they don’t measure their blood sugar when they go out, or they have a treat or do something that’s not making a healthy choice.

But they do not realize that they’re avoiding or not measuring or eating in a way that makes them not want to measure several times a week. That several days of the week where they’re experiencing regulation, or should I say just regulation. So you want to make sure that you’re disciplined with yourself, to gather your data consistently, to be very organized about how you are collecting that data so that you’re not kidding yourself, that you’ve got this under control when the reality is, when you eat well, you’ve got it under control.

But when you don’t eat well, you don’t have it under control, and you’re not eating well half the week. That’s something to keep in mind. Another little thing that you may want to think about when you’re looking at blood sugar control is sleep.

So if you have a poor night’s sleep, sometimes even the foods you could tolerate before, you may not tolerate so well on a day after a bad night’s sleep. That doesn’t mean you throw the baby out with the bathwater, do the best you can and then work on addressing your sleep. The two can go hand in hand, so when our blood sugar is regulated, we don’t sleep so well, and our blood sugar is regulated; something must break that cycle.

Additionally, our physical activity can influence how much we’re able to burn up sugar that we’re eating but also, we are more insulin sensitive when we move more. When you move your body, you don’t need insulin to take sugar out of the bloodstream into your muscles. It happens more passively when you exercise.

Exercise is tough for people with fatigue, but if you can do as much movement as you are safely able to, that’s a really good place to start. That could be a little 10-minute walk before a meal or after a meal. You generally keep your body moving as much as possible throughout the day.

Stress levels will be another thing that will impact blood glucose, and if you didn’t listen to the previous episode on nervous system regulation, you can go back and listen to that. That should give you some pointers regarding managing stress throughout the day because stress is part of life. It all comes down to how we manage ourselves and manage our environments and manage the challenges that we experience day to day.

There are other more complex issues like nutrition deficiencies, which can impact blood sugar, digestive imbalances, inflammation in the body, or toxic overload. All these things can impact blood sugar control, but they are best explored with a practitioner; if you need to do more testing or dig deeper. For this episode, know that if you’re having some gut issues affecting your blood sugar, and maybe once you address those gut issues, your blood sugar balance gets a little bit better.

If your body is overloaded with toxins, maybe you have some mould and mycotoxins that could impact blood sugar. If you’re in a state of inflammation, your body is naturally a little bit more insulin resistant because it wants to prioritize fuel towards the immune system. Suppose you have any nutrient deficiencies that can also cause blood sugar imbalances, specific things like

Chromium, magnesium, or vitamin B6. That brings me to the end of this episode today on blood sugar. Hopefully, you are all rushing out to get your CGM or fingerprick monitors and start monitoring how you respond to your food. You can use this podcast and the feedback you’re getting from that monitoring to play around with your diet and approach it from a place of curiosity so that you can begin to optimize your blood sugar over time. I’ll also say here that it does take time. It took me about a good year before I could get my blood sugar to a healthy place two hours after a meal consistently because of all the different things that were going on in my body.

It will be a bit hit and miss, especially with my evening meals tending to be much better earlier in the day. Once it was in that better place consistently, I also broadened and added more carbohydrates back into my diet. So it takes time and commitment, but is it worth doing? Definitely yes. I hope you will find benefit from it and enjoy the process.

Episode 9 – The Nervous System and Chronic Fatigue

Anna Marsh — Fri, 07 Oct 2022 00:01:00 +0000

Shownotes

In this episode Anna explains how the nervous system works and how nervous system dysregulation can contribute to chronic fatigue and other health conditions. She offers an overview of how to begin to find more regulation day to day.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

The Nervous System and Chronic Fatigue

Welcome back to the chronic fatigue and burnout recovery podcast. I will discuss the nervous system and chronic fatigue in this episode today. This is a really popular topic, and I think I always get asked on my Instagram stories on my Instagram account, how do I regulate the nervous system? I get lots of questions about the nervous system.

Over the past few years, as I’ve been recovering, more and more nervous system programs have popped up specifically for people with chronic fatigue and illness. So this episode today is to give you a little bit of an overview of the nervous system and why it is so important in chronic fatigue and fatigue recovery. Finally, I’ll just be talking about some things you can do to support your nervous system as you work on your fatigue recovery journey.

I’d like first to give an overview of how the nervous system is mapped out. This is something that I would normally teach my clients when we start working together when we’re doing nervous system-specific work because I think having the understanding and the awareness is helpful for people to understand what’s happening in their bodies. Usually, when people have chronic fatigue or chronic illness, especially where they feel a little bit abandoned, let down, or maybe even gaslighted by the medical system, there is this real need and want to understand, “What’s going on? What’s happening to me? What’s going on inside of my body?”

So I would like to do more of the, shall we call, head-based explanations. I want to talk a little bit about the important cognitive aspects that need and desire to understand. But I will also say that much of the nervous system’s work is not based on understanding. You don’t have to understand the ins and outs of how the nervous system works to have a resourceful nervous system. A lot of the magic of the nervous system work comes in practice and the self-regulating exercises, which I’ll touch on towards the end of the episode.

Starting with the nervous system breakdown, I was listening to a podcast the other day, and the person I won’t mention was the one whose podcast I was listening to keep on talking about the central nervous system. “This is your central nervous system going into a freed state.” It’s important to start and distinguish that we have the central nervous system, the brain, and the spinal column.

Then we have the peripheral nervous system, the branches that go out into the body. In that peripheral nervous system, we have more branches: the autonomic and somatic nervous systems. In today’s episode, I will discuss the peripheral nervous system, specifically the autonomic nervous system.

As we talk about this concept of nervous system regulation, we’re talking about the autonomic nervous system. Many people will be familiar with some of the initial stuff I’ll share, but some of you won’t, so it’s important to break it down and keep it simple. So the autonomic nervous system has two further branches.

We have this sympathetic nervous system, which is responsible for fight or flight, and I’m sure those terms will be quite familiar to most people. And then, we have the parasympathetic nervous system, which has two branches. We have the ventral vagal branch, which I call the soft break.

This is the segment of the parasympathetic system that is involved in self-regulation and co-regulation with other people and social engagement. When we’re looking at nervous system regulation, this is the part that we often want to strengthen and retrain. The parasympathetic nervous system also has the dorsal vagal complex, where the DVC.

The DVC is usually associated a little bit more with the sort of freeze response, the shutdown response, or the immobility response, that we can sometimes access if we become overstimulated with activation. Our sympathetic nervous system, the branch responsible for fight or flight, is often called the big spender. We use a lot of energy to activate our sympathetic nervous system, our fight-or-flight responses. I have been taught that the sympathetic nervous system is like a rocket ship.

It takes off fast and very quickly, and it activates everything all at once. This is when we’ll experience that increase in heart rate, that sudden constriction in our chest, maybe you’ll feel gripping in your stomach, the heart beating fast, breathing frequency increasing. There can be this flooding of intensity, very overwhelming intensity, when the sympathetic nervous system is very activated.

That second, the rocket ship shooting off into space requires a lot of energy to shoot off into space. But also, if we stay in that fight or flight response that’s very energetically demanding on the body, then we’ve got the parasympathetic nervous system, and the role of the parasympathetic nervous system is to counterbalance the sympathetic nervous system. In a well-regulated system that can use that ventral vagal complex, the soft break, we can tone down the parasympathetic responses and come into regulation.

But when somebody has lost what we call vagal tone, or that vagal brake isn’t finely tuned enough or strong enough because it just hasn’t been exercised or used enough, then we may rely more on the dorsal vagal complex, which is the heartbreak or the handbrake. How this has been taught to me is that the dorsal vagal complex is like a parachute coming over that rocket ship. If you can imagine a rocket ship shooting up into space, and then a parachute was coming over the nose of the rocket ship and then dragging the rocket ship back down to earth, yes, it’s counterbalancing the activation of the sympathetic nervous system.

But it takes a lot of energy to do that. We often think of the frozen state, immobility state, or shutdown state associated with this over-activation of the dorsal vagal complex as a very low energy state because we feel perhaps very fatigued or exhausted, or numb when we’re in a freeze. But a lot of energy is bound up in that free state.

One of the reasons people can stay stuck in freeze is that to come out of a frozen state would almost be like lifting that parachute. If we were to lift that parachute even a little bit, all the energy of the rocket ship could come rushing out. That could be very overwhelming for the body to experience all that sympathetic activation as the freeze state lifts.

Some people might stay stuck in trees because they haven’t built their capacity to tolerate the activation of the sympathetic nervous system. As the freeze starts to thaw, so here I’m going down a complete rabbit hole. But there’s so much nuance and complexity when working with the nervous system.

I want to keep this episode today as a basic general overview. But when working one-on-one with clients or in my group programs, we’ll get much more into the nuance and what’s going on with each individual’s specific nervous system and what they need. I wanted you to get from that rocket ship analogy that it takes a lot of energy to be in a fight or flight.

It also takes a lot of energy to be frozen because freeze holds on to all that sympathetic activation from fight or flight. When our energy is being prioritised to these survival responses for whatever reason, we don’t have energy that is just going towards prioritising the day-to-day function and maintenance of the body. And that’s the maintenance of your cells and your digestive tract and the maintenance of balanced hormones and balance, blood sugar, and all the different things we need to do.

There can be nutrient deficiencies daily because many nutrients affect our stress responses. Then we’re not absorbing nutrients very well from our food because digestion isn’t being prioritised. After all, we’re in a state of threat. So the result is this chronic wear and tear on the body.

If you’ve listened to some of my previous episodes, I talk a lot about this chronic wear and tear on the body, the cell danger response, and the consequences of being in this constant state of threat. Ultimately, these are adaptations that are life-saving in the short term. But when we get stuck in these survival adaptations for too long, they become destructive and dysfunctional.

This is where the nervous system starts to intersect with our ability to recover from these complex fatigue conditions and other chronic illnesses. So what I would say is that we often think of these survival states as being a bad thing, and there can sometimes be this message that we need to be very well regulated and very calm. There’s a lot of emphasis on calming the body down.

But actually, what we want to be able to do is to have the capacity each day to move through varied states. So to have flexibility between our ability to respond to something a little bit stressful and settle and return to baseline when things are safe. In a normal, healthy person, throughout the day, they’re probably moving through different states of activation. They’re probably quite relaxed, perhaps when they wake up in the morning.

But then, as the day continues, and there are emails, commuting, childcare, and all the different things that may come into one’s life throughout the day, one may feel more activated or very activated. But then they may take a lunch break or walk in the park for 30 minutes, maybe have a really lovely conversation with a friend, and that activation level comes down. In a healthy person, we should be moving through different states of activation throughout the day.

But when we get stuck in a state of activation, problems arise. Many people will become increasingly active throughout the day and then go a million miles an hour. They may be experiencing shallow breathing, and their heart is racing in their chest. They have a lot of muscle tension.

But they’re so busy and focused on the jobs they have to do all the things that need to get done. They’re not necessarily aware of their body and what’s going on. Therefore they don’t even notice how activated they are. Then it gets to the end of the day, and they wonder why they can’t get to sleep at night, wake up in the middle of the night, or their neck hurts. Why isn’t their digestion working so well?

Why do they feel so exhausted all the time? Why are they waking feeling unrefreshed? It’s because they’ve just been operating in this very, very high state of stress the whole day. Then the other thing that can happen is if the stress goes on too much for too long, or if anything happens that becomes too overwhelming for the body to cope with when we move through into fight or flight. But then we can also freeze.

The freeze usually happens when the activation level becomes so high that the body’s only way to cope or what the body perceives as the safest way to cope is to go into this freeze disassociation, shutdown, exhaustion, and immobility. It’s important to understand in this case that this is self-protective. The body isn’t, you know, trying to make your life difficult, or it’s not bad luck, or it’s not unfair.

Your body is always doing its very best to protect you and keep you safe, even when it’s not convenient to experience the consequences of that. We can sometimes move through fight or flight and get stuck in this very high sympathetic activation. Or we can get stuck in a free state so we can get stuck on, which is sympathetic activation, or we can get stuck off, which is that very extreme dorsal vagal activation.

What determines if we get it stuck on or off is the nervous system’s capacity. So we have what is known as the window of tolerance, which, as the name suggests, is the window in which a person’s nervous system tends to thrive. If the stresses we experience daily fall within our capacity within our window of tolerance, easy days, we can keep on flowing throughout the day.

But things like childhood trauma, big traumas that happened later in life, or lots of little traumas that happen across a lifetime, can all impact the window of tolerance. Even, you know, day to day, we can have changes in the window of tolerance. When we are at different places in our hormonal cycle, we may feel that our window of tolerance is narrower.

If you have a chronic fatigue condition, if you’re in a crash or flare, your tolerance window will be narrower. If you haven’t had a good night’s sleep, your tolerance window will be narrower. If you haven’t eaten very well, if your blood sugar has gone too low or too high, perhaps you will have a narrow tolerance window.

We can have big things that happen in life which are out of our control, which impact the window of tolerance. Then we can also have things in our day-to-day life that are within our control to a certain degree that impact the window of tolerance. But either way, if we had lots of childhood trauma, if we had lots of chronic stress throughout our life, if we had some big, you know, things happen like a divorce or operations or an accident or some financial issues, or we made redundant from a job, you know, various things can happen, we may experience a narrowing of the window of tolerance over time.

What this means is that we tolerate less, quite literally, but the small things become big things. And it’s easier and easier for the body to become overwhelmed, and we spend more time in that fight or flight energy system, we spend more time perhaps even going into freeze, and then it’s easier to get stuck.

Because there’s a loss of regulation, there’s a loss of capacity to cope. So circling back to that ventral vagus nerve, when we are constantly in this high state of activation, we lose vagal tone because we’re not spending enough time using that part of our nervous system. That’s also what results in a narrowing of the window of tolerance.

One way we expand our tolerance window is by increasing vagal tone, which means using that ventral vagal branch of the nervous system more intentionally daily. I like working out in the gym, and I’ve been a fitness person for almost all my life. I used to love going to the gym before becoming unwell.

And now that I am well enough to do so, I’m enjoying going back to the gym and lifting weights. When someone lifts weights, we know that they have to exercise the muscle to get stronger and more effective and grow. The same goes for your ventral vagal complex; we must exercise that part of our nervous system.

Because if we don’t use it, we lose it. So when we let the day take control, get up in the morning, and just go 100 miles per hour, and there’s no settling that happens naturally throughout the day, we’re not using the ventral vagal complex. One of the first things I say to my clients is just starting to take little breaks, where you maybe do something for a couple of hours, and then you take a little pause, you allow your system to settle, and then you go again.

I had a client, a super busy client, and she was working for the NHS. She had fibromyalgia. She was so busy, with loads of meetings, always too much to do, and not enough resources in the day. But she said I can commit to doing one minute of breathing every hour. All she did was slow down her breath every hour.

She just set a little alarm, a little reminder on her phone, and she did so across an eight-hour workday of eight minutes of breathing spread out across the day. And the difference that it made was phenomenal. She just felt so much more balanced.

So much more grounded and less exhausted by the end of the day because she was doing eight exercises for her ventral vagal complex across the day. If you want a little tip, that’s a little hack that you can do. There’s so much I could say here, but what I’m going to transition into, what we can do or what else we can do to begin to achieve more regulation in the system.

Here, I’ll say, especially if you go online, a lot of people are saying, “Do this exercise, this will be good for your vagus nerve, or do that exercise, and this will be good for your vagus nerve.” I don’t doubt that those exercises are helpful. But I have a slightly different process that I’d like to introduce to you too.

Those exercises might be part of the process. But I want you to understand the bigger picture. How do we achieve more or better self-regulation? The very first step is to slow down the pace of your life. I explained to my client with fibromyalgia how she felt like she couldn’t slow down the pace of her life.

But she could take those single minutes, once every hour, to create a little bit of slowness, making a difference. But one of the first stages of change is awareness. To become aware of anything, we have to have a little space, and we have to create a little space for that awareness.

And actually, one of the things I love about working with fatigue clients is that by the time they come and see me, most of them have got that spaciousness because their body has given it to them. They aren’t able to have a very busy life because their body just won’t let them. So fatigue recovery is an excellent opportunity to have this space to slow down. Still, even I remember, in the early days of my fatigue recovery, I was so uncomfortable with slowing down that even though I was maybe lying down “resting.”

I was busy, and I was on social media, I was listening to podcasts, I was reading books, and I was filling my brain with more information and more information. That was just completely overloading my system even more. We want to slow down and start to become aware. That’s the first step. What’s going on?

The second step is awareness and attunement. Once we have that space, whether it’s that one minute in between meetings, or if it’s, you know, just putting away the social media, putting away the books, putting away the podcasts, and just allowing yourself to be with your body a little bit, then you can start to become aware of “What is here with me now? What’s happening in my body?

This is what I refer to as attunement. So attunement is to harmonise, and it’s really to connect with the body, the sensations that are present, and to give the body what it needs. This is where one of the techniques I teach my clients is just tracking, tracking the sensations in the body.

It’s very common in chronic illness for the body to be a very uncomfortable place to be. Therefore we tend not to want to feel the body, and if you’re having problems feeling and experiencing your body because it feels very unsafe to do so, there are other techniques you can use. That’s maybe a different episode for another day. But we tend to also focus on what doesn’t feel good because we have this dangerous bias.

We’re constantly scanning for danger and threats in our environments. We’re going to notice all “My head feels achy, and my shoulders feel achy, and this much tiredness behind my eyes.” But I would also invite you to begin to look for what feels okay.

Does it feel neutral, at least if it doesn’t feel good? Even if it’s just your baby toe, ear lobes, or cheeks? Start to look for the places in your body that might have some positive sensations, but if not, maybe just some neutral sensations and start to become aware of what’s happening. Because once we start to become aware of what’s going on in the body, we can then start to become aware of what we need, and so many people with chronic illness and fatigue have pushed past the needs of their body time and time and time again.

Part of healing is coming back into attunement with the body’s needs. This brings me to my next step, step three, which is giving the body what it needs, or what I also like to refer to as resourcing. We want to create resourcefulness in your system. And resourcefulness is a counter force to the dysregulation of the nervous system to the dysregulation created by trauma that hasn’t yet been integrated into the body. We want to build up resources, and not just exercises that you do, but we want you to build a resourceful life.

Here, I like to frame this as your nervous system interacting with the food you eat, the environment that you’re in, the people that you spend time with, the animals that you spend time with what you’re doing, you know, your social media work, reading books, or cooking or gardening, whatever it might be, your nervous system is interacting with everything, every single moment of every single day. You want to take that time now that you’ve slowed down and you’ve attuned to ask yourself, “Is the way I’m spending my day today resourcing my nervous system? Or is it depleting my nervous system?” This doesn’t mean that absolutely everything we do needs to be resourced – not at all.

But maybe while you are healing, there need to be more things that are resourcing and fewer things that are depleting. Then you start to create a life and an environment that supports the resourcefulness of your nervous system. Because it’s all very well knowing that for six breathing, for example, breathing in for four out of six, helps to calm down the nervous system.

But if you do you for six, breathing for 10 minutes, and you walk back into a job that you hate, into a relationship that you hate, or you’re spending time with people that make you feel bad, or you’re eating terrible food. You’re not getting outside, and you’re not doing anything that you love. You’re not going to get the impact you want in changing the nervous system, so we want to build resourcefulness. The other reason we want to build resourcefulness is that resourcefulness supports the capacity of the nervous system. It widens the window of tolerance. And when the nervous system is more grounded, more supported, more resourceful, then we can start to go into some of the other stuff we may want to look at if you feel that there’s past trauma that you want to look at or investigate, or you maybe need to do some brain retraining or things like that, you’ve already built some capacity within your nervous system.

That takes me to the next thing we may want to consider. So brain retraining is popular. If you’ve done any research around fatigue recovery, you’ve probably already heard of it. I guess different people will have different takes on the brain retraining, but it’s using your thoughts and your mind to change the signals sent to the body.

So brain retraining is like a top-down approach. That means that we are maybe looking at certain ways of thinking or certain belief systems that are causing stress to our bodies because we think about things in a stressful way, or we believe something about the world which makes the world a stressful place to live in. Part of brain retraining is becoming aware of and then reconditioning these thought or belief patterns, which influence our behaviour.

In doing so, we know we can change the body’s response to our thoughts internally, but maybe also change external behaviours that keep us stuck in our fatigue. The thing to remember about brain retraining is it is top-down. Most communication happening in the nervous system is from the body to the brain, so it’s from the bottom up.

So I trained in NLP – Neuro Linguistic Programming, a huge foundation of brain retraining, about 14 years ago, and I’ve done my coaching qualifications. I’ve done neuro strategy qualifications. I’ve worked a lot with what I would call this “mindset work” in the past with my clients.

Since diving more into the somatic world, which I’ll talk about in a second, I find that the best way to use brain retraining is if we can integrate it with the body’s somatically because there is a saying that our state defines our stories, or stories follow state, which means that our state, the state of our nervous system, how activated the nervous system is, will determine how we then think, how we then believe, therefore what we do or what behaviours we create as a consequence. So if we use affirmations, for example, if you feel unsafe in your body, and then you use an affirmation, “I am safe, I am safe, I am safe.” But your body is sending you a very different signal.

Sometimes that can heighten the activation within the body because the body doesn’t feel like it’s being attuned. We want to use some mindset tools. But we want to integrate that with a body receptive to receiving those tools.

Again, you know, that’s a whole thing that I teach in my high achiever revival program and with my one-on-one clients, so it’s way beyond the scope of today’s episode to go into that in much more detail. But just to say that brain retraining is best combined with somatic work so that we can get to land in the body. The next thing that you may want to do to support your nervous system is maybe some somatic work.

Here, it might be important to distinguish between Cymatics and somatic experiencing. Cymatics is any kind of mind and body-based practice where we use interception. Interception is our ability to sense within the body and to be able to sense what’s going on inside the body.

Interception and somatic practices work because we bring our mind or cognitive attention to the body. Doing that has a very settling effect on the nervous system and helps the nervous system to settle. That’s one of the ways that we can strengthen the vagal brake.

There are various somatic practices out there, some of them may involve sounds or movements, and there’s a wide variety of things that you can do somatically to support your nervous system. Then we have somatic experiencing, a very specific practice requiring a lot of training. The purpose of somatic experiencing is to safely release and integrate shock and trauma and survival energies that are stuck in the body due to traumas that have been experienced, either big traumas or little traumas, and chronic stress.

It can be helpful to have individuals process the survival energy relating to specific events. It can also help the individual tolerate stress and widen the tolerance window. There’s a lot of similarity and overlap between the two.

But I would say the difference between Cymatics and somatic experiencing is that somatic experiencing is much more specific to the needs of the individual. For example, some somatic practices may be to discharge the energy of anger, which might encourage someone to push against a wall, hit the pillow, scream into a pillow, or make a sound. But Somatic experiencing would work with the person’s nervous system and understand how that person’s nervous system wants to integrate that survival energy.

For example, when someone senses something in their body, they bring up a specific event or something they may feel angry about. They may not want to push or punch or scream. Maybe there’s another movement or sound that the body wants to make. For this reason, a much higher level of integration and resolution can be achieved through somatic experiences.

And somatic practices, when inappropriately attuned, can raise the system’s survival energy. Suppose someone hasn’t built the capacity to tolerate anger and is invited to discharge by pushing a wall or screaming into a pillow. In that case, that can raise that level of fight energy in the body, which may be too much for them to handle. This is why we always want to start from the ground up by slowing down awareness and attunement, building resourcefulness, and then going into some of these more sophisticated practices.

The final thing on my list regarding nervous system regulation is hormetic stressors. Hormetic stressors create a small inflammatory effect in the brain, which then causes an anti-inflammatory impact on the rest of the body. This can be very beneficial for the nervous system.

This is where we can use heat stress, cold stress, fasting, exercise, hypoxia, and low oxygen states to stress the body and challenge the nervous system to build its capacity to handle stress. This usually comes much later in someone’s journey for reasons already discussed. We want to have a good level of attunement, and we want to have a good level of resourcefulness and resilience in the body.

First and foremost, before we start adding these big external stressors, it’s very easy to do too much, especially when someone’s not well attuned to their body and their capacity and tolerance. These hormetic stressors are dose-dependent. So that means that how much is appropriate for one person may be different for another.

Again, it’s beyond the scope of this episode to go into detail about the ins and outs of all these hormetic stressors. That’s something I’ll do in another episode in the future. But for now, just understanding that these are something that can positively influence the nervous system when used in the appropriate dosage and at the right point in someone’s fatigue recovery journey, you wouldn’t be adding in hormetic stressors when somebody is still very dysregulated, or still in a state of cell danger response one, for example, when there’s a lot of threat already still going on in the body.

These things will come later as we expand the person’s capacity. I didn’t have this on my list, but it’s worth mentioning that we also achieve nervous system regulation by supporting the body’s physiological processes. Blood sugar, which I will talk about in the next episode, is important for nervous system regulation, good digestive health, eating an anti-inflammatory diet, and having adequate nutrients. These are all going to be really important things for the nervous system.

Because if we have dysregulated blood sugar and dysbiosis in the gut, if we lack nutrients, that’s stressful for the body. Some are messaging you may come across as you go through your fatigue recovery journey, as all we need is nervous system regulation to become well. I beg to differ.

I believe nervous system regulation is a really important part of the puzzle. But we have to think about the big picture and how we are supporting the body from all angles because these physiological and biochemical imbalances can just regulate the nervous system. I want to make sure that we are seeing and addressing those.

That brings me to the end of this episode today. There was so much I feel I could have said here. I felt like I missed out so much, and I hope I have done the episode some justice, at least. If there are any other questions or things you feel you’d like to know more about, please feel free to reach out to me through social media or my website, and then I can pick up on those things in a future episode. Until then, may you have a wonderful fatigue recovery day.

Episode 8 – Possible Root Causes of Chronic Fatigue

Anna Marsh — Fri, 30 Sep 2022 00:01:00 +0000

Shownotes

Although knowing your root cause may not be essential to moving forward on your journey, it can make all the difference when it comes to a full recovery. In this episode Anna discusses possible root causes that you may want to have on your radar. She also shares her own personal journey and how, when she discovered this root cause, it was the final nail in her CFS coffin.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Possible Root Causes of Chronic Fatigue

Hello, and welcome back to the chronic fatigue and burnout recovery podcast. In this podcast, I’m going to be talking about the possible root causes of chronic fatigue. Suppose you have tuned into some of the recent previous episodes, specifically the cell danger response episode and the episode I released last week on the big picture of fatigue recovery. In that case, you may already have a sense of what the possible root causes could be. Feel free to go back and listen to those episodes if you haven’t already, but in this episode. I will touch on them a little bit more, not in huge detail, but just enough to give you a sense of what could be happening for you.

So when I first became unwell with chronic fatigue, I guess there were certain biochemical imbalances that I was addressing in my body. For example, when I started working with a practitioner, I already had many self-care practices. I was meditating, I was practising yoga, I was spending time in nature, I was journaling, and there were a lot of things that I was already doing to look after my body.

Therefore we jumped straight ahead, and we jumped into rebalancing some of those secondary biochemical imbalances. I worked a lot on my blood sugar in the beginning, I worked on my digestive health, I worked on oxygenation, a lot of those pieces of the puzzle that I mentioned in the previous episode, and then when I spoke with other people about what was going on in my body, a lot of the chronic fatigue, literature or resources or people posting things online, it’s all very much nervous system focused. There’s this assumption almost that chronic fatigue is just burnout. It’s just a dysfunction of the nervous system.

I would say yes; we need to factor the nervous system, nourishment, or nervous system care into a chronic fatigue and burnout recovery plan. But sometimes, other things are going on. Ultimately, chronic fatigue develops when something has worn down the system over time.

And yes, that could be chronic stress or big traumas which have happened in the past, changing the window of tolerance. Therefore, everyday stress is very stressful to an individual. But where I went so incredibly wrong in my journey was stopping there, thinking that I just needed some supplements for my mitochondria and needed to work on my blood sugar balance and support my nervous system, and that would be enough, and that was when I was doing all of those things. I didn’t feel like I was making the progress I wanted. I started to look deeper into what was going on with the progress I should have been making for all the time, energy, and money I was investing in my health and self-care. I just felt like something had been missed. Then, I discovered that mould mycotoxins began to do a mould detox protocol.

Then as a consequence of that, I started to feel a lot better. I pre-frame this episode with this little story to understand that many people you may see online and the posts you may read on Instagram may say you need to brain retrain or regulate your nervous system. Then you will be well, which can be very gaslighting for the people doing those things and still not getting better, in some cases even getting worse. This is an opportunity to think a little bit bigger and think about other things that could be happening.

I do not want to say that brain retraining or nervous system work isn’t helpful because it’s incredibly helpful. For people who are only experiencing burnout or only feeling unwell because of the nervous system, it can be great, and it can take them the whole way. But many people need other support to work through that cell danger response to get the body out of threats and to help it feel relatively safer.

So the things I’m going to discuss today will be mould, mycotoxins or moulds, and illness. I’m going to talk a little bit about viral infections. I’ll talk a little bit about trauma and the nervous system, and I’ll talk about toxicity and the gut.

The first one on that list is mould and mycotoxins, and obviously, this is an area that I feel very passionate about because this was my personal experience. However, I work with some clients where mould isn’t an issue. A paper in 2013 tested 112 patients with chronic fatigue syndrome for mould and mycotoxins, and 104 of those 112 patients, so 93% tested positive for at least one mould mycotoxin, with 30% of cases testing positive for more than one of those mycotoxins.

90% of these cases had a current or historical history of exposure to a water-damaged building. When the exposure was current environmental testing was performed in the water-damaged building, and potentially mycotoxin-producing mould species were identified as mycotoxins. Where the exposure was, current environmental testing was performed in the water-damaged building, and potentially mycotoxin-producing mould species were identified.

They also had healthy controls in the study who had no prior or current exposure to water-damaged buildings. These healthy controls didn’t test positive for mould or mycotoxins, so here we can see that there can be a relationship between chronic fatigue and mould and mycotoxins. Typically if someone has had mould exposure through a water-damaged building, they can inhale mould spores which can produce mycotoxins, potentially colonize the body and continue to produce toxins. These toxins can cause damage by increasing oxidative stress, which is the balance between damaging reactive oxygen species and protective antioxidants.

This damage can specifically target and damage cells in the nervous system. In hindsight, I noticed a change in my nervous system after my mould exposure. I had junk caffeine the whole way through my fatigue recovery.

Then, after the mould exposure, I noticed a change in my tolerance to caffeine and a huge increase in anxiety. We can also get specific types of mycotoxins that can induce mitochondrial dysfunction in the brain and impact brain energy and cognitive function. Mycotoxins can also interact with the neuroimmune axis, triggering inflammation and inflammation of the brain leading to cognitive dysfunction.

This is why we see very low brain energy and brain fog in cases of mould toxicity. Mycotoxins can also impair neuroplasticity, contributing to cognitive dysfunction, depression, anxiety, and other mental health issues. Mycotoxins can also compromise the blood-brain barrier, which means they can cross into the brain and have a neurotoxic effect on neurons.

The other helpful thing is that mould mycotoxins and spores are associated with a histamine response. They can trigger mast cell activation syndrome. Therefore, we often see that people with mould toxicity also may have a lot of those high histamine symptoms, which can manifest in various ways. Still, it might look like shortness of breath, feeling a little more asthmatic, or maybe reactions on the skin itching, to name a few. So it goes beyond the scope of this specific podcast to talk about the ins and outs of what you do if you have a mould problem.

But the first thing I would say at this point is that if you suspect you’ve had mould exposure because you know, you’ve lived in a water-damaged building or you resonate with some of the symptoms of mould toxicity. Then it is worth testing to make sure that this is a problem for you or to see if this is a problem for you or not. When I work with clients, we will make a case history, and I might ask questions about living in a mouldy home or a water-damaged building and combine that with the symptoms they’re presenting worth, especially if they’ve got a lot of high histamine symptoms. Then I might suggest testing, and the test you can do for this is the mycotoxin test by Great Plains laboratory.

Regenerus is the provider here in the UK, and you would need to work with a practitioner like myself to get tested. But once you are tested, the test interpretation is easy. It’s pretty much black or white, you’ve got it, or you don’t, but creating a strategic support and recovery plan can be quite involved. The next possible root cause is fatigue, and I would like to discuss trauma and chronic stress.

If you are a living, breathing human being, you have been impacted by trauma, which could play a role in your fatigue recovery. It’s most likely playing a role, whether that’s big or small, in your fatigue recovery. Maybe you already know a little about trauma and the nervous system, or maybe you’re thinking, what has this got to do with my energy levels? Or nothing “bad” has ever happened to me, so I don’t have to worry about trauma. Before I go into a bit more on this, I’d like to clarify a few things.

The first thing I’d like to clear up is what trauma is. And why do we all have it? And then, I’d like to answer the question, could this be a root cause of your chronic fatigue symptoms? So let’s start with what trauma is. Most people think of trauma as what is referred to as the big Ts.

These are big and significant life events like abuse, loss, being in a major accident, or experiencing a horrific incident. But trauma can also be little Ts, and it can be small accidents, divorce, financial issues, legal issues, or the loss of a loved one or even your pets. It can be a relationship breakdown, surgery or invasive procedures, and many more.

But trauma is anything that happens too fast, too soon, and goes on for too long. That is too much for the nervous system to handle. Therefore, it’s less about the actual event and more about the person’s nervous system who is experiencing the event. Chronic stress can be a trauma; it accumulates over time and wears down the nervous system.

Eventually, even small things can feel too big to handle, and the nervous system can experience overwhelm or shutdown. Chronic fatigue and chronic diseases can develop when something wears down over time, eventually too much for the body to cope with. It’s really important to understand that trauma isn’t in the brain, but it’s in the body, and traumatic events, big or small, that haven’t been given the space and support to be processed can get stuck in the body and keep the body in a heightened nervous system state.

What this means is there can be people who do experience big Ts, horrific, tragic events, but if they have the support that they need, if there’s space for them to process that traumatic energy, they can be much less affected than somebody who maybe only experiences a minor incident, but doesn’t have the support or the resourcefulness in their system at the time. What we’re specifically looking at when we consider the pathophysiology of chronic fatigue or chronic illness is that the physiology and biochemistry of the body change to maintain survival mode, but over time, this comes at a cost to our health. Here I like to describe how the nervous system can get stuck on or off.

Stuck on might look like a constantly heightened sympathetic nervous system, characterized by anxiety, hypervigilance, nervous energy, difficulty sleeping, and that tired but wired feeling. Stuck off is the nervous system in a parasympathetic dominance state, characterized by exhaustion, fatigue, disassociation, immobility, and shutdown. In case you’re wondering, yes, you can have a little bit of both because when we are in this state of freeze or shutdown, there is usually a huge amount of sympathetic energy underneath.

There can be a sense of exhaustion and anxiety or difficulty sleeping and shutting down. It doesn’t necessarily have to be one or the other. But either way, in the context of fatigue, the body’s resources are prioritized towards threats and maintaining the responses of the survival systems. They’re prioritized away from rest recovery and repair, which means that we don’t get the body’s nourishment.

It’s like trying to drive a car with your foot flat on the accelerator and the handbrake right up. You burn through huge amounts of energy, but you can still feel quite stuck, and like you’re going nowhere. There’s no test which will say to you, yes, nervous system dysregulation is the root cause of your chronic fatigue. But I think many people sense that it is because we start to slow down, tune in, and connect to the body. We notice the sensations that are present there, we can notice if there are sensations of activation, or we can notice if there are sensations of freeze or shut down, and people feel it. They feel it in their heart rate.

They feel it in how their breath moves in and out of their body and how grounded and peaceful, and calm they feel in their body. Again, that’s beyond the scope of today’s episode to go into detail on this. But what we want to do is support the body to find a sense of safety and remember that if there are other triggers, like toxins, mould, infections, or viruses, those things will also need to be removed or supported so that the body can experience that sense of safety.

But from a nervous system perspective, we only want to think of the idea that the nervous system is interfacing with your life, every single moment of every day. Therefore everything you’re doing day to day, day in and day out, is sending messages to your nervous system. This is where creating a healing routine, a way of living a way of being in the world can be supportive for your nervous system, in addition to all the other practices that you might do somatically with brain retraining and hormetic stressors to support your nervous system, our day to day lives have to feel safe.

If you are a high achiever, overworking, constantly trying to perfect and prove and please and perform to suddenly go from a very, very high activation to a state of rest and regulation can feel overwhelming for a dysregulated system. It’s okay for these changes to be slow, but we want to ensure that we’re heading in the right direction and supporting our regulation daily as much as possible. The next possible root cause of fatigue could be toxins and heavy metals.

Toxins are commonly overlooked when it comes to energy. Admittedly, I only really got into exploring toxins and detoxification when I realized that mould toxicity was one of the root contributors to my chronic fatigue. The sad fact of the matter is that toxins are everywhere. We want to consider a toxic load and fatigue recovery support plan, even if you don’t have mould exposure.

Even if you don’t have heavy metals, we still really want to be supporting the liver and the detoxification pathways. Because the immune system needs to detoxify its immune molecules, if you’re fighting off an infection, those immune molecules must go somewhere.

Therefore healthy detoxification is a really important part of immune regulation. Toxic overload can include fatigue and brain fog, feeling hungover, muscle and joint pains, skin conditions, and weight gain, especially around the middle. Toxins can come from the food we eat, the air we breathe, the water we drink, food packaging, processed foods, pesticides on our foods, home cleaning and beauty products, chemicals, biotoxins, or heavy metals.

There’s a huge range of ways that we can get exposed to toxins, and when it’s never going to be perfect. We’re never going to eliminate toxins from our environment, but we can reduce them and support how we eliminate toxins from the body. There are a few ways toxins can contribute to fatigue, and the first one is that they are one of the main triggers for the cell danger response.

If you haven’t already listened to that episode on the cell danger response, you want to do that. But the cell danger response is the cell’s ancient and universal response to threat. If the body perceives that there’s an overwhelming amount of toxicity in the environment, it’s going to shut down.

Then energy is prioritized away from the brain and away from the body towards survival, towards the immune system. But toxins can also interfere with the way that the body makes energy. Specifically, heavy metals can interfere with the Krebs cycle, the cycle inside the mitochondria by which we produce ATP.

Toxins can be endocrine disruptors that disrupt the body’s hormonal systems and influence cortisol, blood sugar, thyroid hormone, and sex hormones. These imbalances could be playing a role in fatigue. Toxins can also disrupt the microbiome, that balance of bacteria we have inside the digestive tract.

Because it’s such a close relationship between the gut and the brain, they can also impact health and energy and cause brain fog and fatigue. Toxins, specifically heavy metals, can also feed parasites, compromising immune function. It can use energy to keep the immune system active constantly. Finally, detoxification is a very energetically demanding process.

It takes a lot of energy to detoxify. Therefore, if the liver is overburdened, that’s a drain on the body’s energy and resources. But suppose your energy and resources are already low. In that case, that means that there’s even less energy to prioritize towards detoxification, which can increase the toxic burden and, therefore, the toxic load on some of these systems, impacting energy.

So how do you know if toxins are a problem for you? Here, I feel like, in this retesting something like urine mycotoxins, there are not a lot of really great tests available for toxic load. We would tend to look at the symptoms of a client. I mentioned some of the symptoms when I started talking about toxins today.

We might also look at toxin exposures, especially when we’re looking at certain professions, like hairdressers, cleaners or trades, people who are using a lot of chemicals as part of their work, somebody who has mercury amalgams, or somebody who has breast implants or gets a lot of botox and fillers, these will be sort of classic red flags to consider toxic load. But there may also be genetic abnormalities in genetic testing when we look at single nucleotide polymorphisms or snips. Some people may have certain genetic snips, which means they have compromised detoxification because their detoxification enzymes may be slightly more sluggish.

I also like doing the organic acids test, which measures the functioning of the Krebs cycle because heavy metals can potentially be roadblocks to the Krebs cycle. If we’re seeing a lot of backup in the movement through the Krebs cycle, that can sometimes be an indicator to test heavy metals. You can test heavy metals and blood, and you can test heavy metals in urine, the testing can be a bit controversial, but it might be worthwhile depending on the case history.

Then we get to Lyme disease and viral infections. This is such a big area, but I also feel it’s an area with many unknowns. We have so many viruses that don’t even have names. We cannot even test for these viruses because the tests haven’t been developed. So my approach when thinking about a viral load in someone is if we do the testing, and we’ve got the information that maybe there are some positive tests, we want to consider the terrain. So Louis Pasteur said on his deathbed that the pathogen is nothing. The terrain is everything.

We want to consider the terrain in the context of chronic or historical viral and bacterial infections that may be behind ongoing fatigue. In this case, the terrain is the body and the interconnected network of the body’s systems. Do we think about the gut, the mitochondria, the hormonal systems, the toxification, and methylation?

Many of the systems I’ve spoken about in the other episodes, and we’re starting to think about IVs functioning optimally to support the body manage this viral load. One of my favourite analogies is where the virus is the hammer, and the window pane is the body. If you throw a hammer at a window pane and the window breaks, even when you remove the hammer, which is the virus, you still have a broken window, and there’s still some cleanup work that needs to be done.

Very often, when someone becomes unwell due to a virus, when the body is protecting against infection, so a viral infection, in this case, what we experience is a huge inflammation of the immune system. The immune system creates a raging fire to protect the body from the virus. Let’s say the immune system does its job and can protect the body from the virus.

But there’s been a lot of damage that has been created in creating that fire. Even though the pathogen or the threat is gone, a lot of imbalance is created in the process that needs rebalancing. Sometimes we need antibiotics or natural antimicrobial support like herbs to remove bacteria, viruses, or parasites from the body.

But sometimes, we also need to use all the other tools in the trauma-informed functional medicine tool test to help the body recover, rebalance and restore optimal function. Here, if you think about the cell danger response I spoke about a couple of episodes ago, it’s a very similar model. We want to do what we can to remove the threat and then go on and support the body. That might look like supporting the gut, addressing the microbiome, looking at parasites or yeast, promoting good digestion and absorption of nutrients, and ensuring that the gut membranes are working well.

We might want to be looking at that low-hanging fruit, so addressing blood sugar, making dietary changes, working on sleep, reducing inflammation, improving detoxification, improving our toxic load, supporting the nervous system, supporting the mitochondria, and making sure the hormonal systems are in balance that we can lower inflammation and support the immune system as a whole. Even if there is some viral infection, it’s usually never about just going after the infection.

In some cases, that can be helpful. For example, in acute Lyme, taking antibiotics can be helpful. But in the longer term, and especially when someone has been ill for a while, it’s really about considering the whole body and what imbalances are present in the whole body, and what we need to do for that unique individual to bring things back into balance.

I would say just the final one here is looking at gut infections. I work with many clients who develop fatigue, sometimes after a viral infection but sometimes after a tummy bug or a parasitic infection. Here again, it’s the same issue, this idea of how do we support the terrain, if the infection is still present, then we maybe need to do some removal protocol to clear the body of the parasite or the bag or whatever it might be.

But we also need to support the nervous system because the nervous system is very closely related to the immune system and supports the immune system directly so that the body’s capacity to deal with this threat or challenge is bolstered. It’s strong, and it’s resilient. Very likely, if there has been an infection there for a long time, the body has created adaptations to deal with that infection. It’s created imbalances and other body parts, and we want to address those. I like a stool test when we look at gut infections as a possible root cause of fatigue. They can be helpful but don’t always pick up on everything.

Again, we want to look at the client’s symptoms, history, and another testing that could give clues to what’s happening. That brings me to the end of this episode, looking at the possible root causes of chronic fatigue. Hopefully, I’ve covered the big ones.

There may be other secondary imbalances that can also cause fatigue, for example, mitochondrial dysfunction and changes in the sex hormones. But this is just assuming that those changes are secondary to these big things which have triggered the system, and remember that we want to help the body move to a greater sense of safety so that we can create balance in these other systems too. As always, if you have enjoyed the episode, please share it if you know anyone who would benefit from hearing this and listening to this, and please make sure you leave a review because your reviews help others find these episodes and help them get the support and information that they need on their fatigue recovery journey. I will see you in the next episode.

Episode 7 – Where to Start?

Anna Marsh — Fri, 23 Sep 2022 00:01:00 +0000

Shownotes

Having a map and knowing where you are on that map can make all the difference to your fatigue recovery journey. Anna shares the framework she uses with her clients which includes the different stages of recovery and the most important tests, interventions, supplements and attitudes for each stage.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Where to Start?

Hello, and welcome back to the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh, a trauma-informed functional medicine nutritionist and chronic fatigue survivor. Today I wanted to talk about where to begin or a high-level view of fatigue recovery.

Fatigue recovery is multifaceted. You can do a lot of research and read many things, and it can become very overwhelming very quickly to know what you need to be working on and, more importantly, what order and how to approach it. Albert Einstein said the definition of genius is taking the complex and making it simple, and I’m not going to hold my hand up and call myself a genius. But I would like to simplify this fatigue recovery journey for you by giving you a framework or at least an idea of some roadmap that you can follow on your fatigue recovery journey.

What I’ll share with you today is essentially the framework that I use when I’m working with my one-on-one clients. It’s this sort of big map that I have in my head. When I’m taking a client history, when I’m conversing with my clients, I’m filtering the information that I’m gathering from them through this lens, and then from here, making decisions about where we begin, what we do, how we structure things, how we order things, what tests to take, what supplements to take, and all those other parts of fatigue recovery. I’m a big-picture thinker, that’s my strength, and I think that works well in functional medicine and working with these chronic and complex cases because I can see the big picture, and sometimes that’s much more helpful than getting zoned in on the teeny tiny little details.

I tend to work from the outside in, in the sense that I tend to deal with what I call the big rocks first, and then as we work on each rock one at a time, we can get a little bit more granular on what the specifics of those rocks are. This is a five-step process, which makes it sound super simple and super easy. But in reality, we all know that recovering from a chronic and complex health condition, chronic fatigue, fibromyalgia, or burnout, is anything but simple and easy.

But I’m just going to break it down into this five-step process to simplify it for you and make it easier to communicate. Stage one of your fatigue recovery journey revolves around removing anything that is threatening the system, anything that’s triggering the system, and creating a relative sense of safety. I use the word relatively because it’s very hard for us always to feel 100% safe today.

There’s so much complexity in everyone’s lives. But we want the body to feel relatively safer than before so that some interventions and processes can land in the body. This is where there’s both an art and a science to healing, the sciences, all the technical details, which I’m very well versed in. But then there’s the art, just knowing how much is enough for this person’s body.

How quickly can we move? Do we need to be more gentle? Does this person need more internal resourcefulness? How do we build that as we work together over time? So in terms of removing the threat and creating a relative sense of safety?

In my previous episode, I talked about the cell danger response in a lot of detail. If you haven’t already listened to that episode, it should be the one just before this one, and you can go back and listen there. In that episode, I’ll go into the cell danger response and much more detail.

But for this episode, I’m going to touch on it very briefly, which is to say that the cell danger response is the ancient intelligence of the cell. It is the body’s universal response to threat, and it’s the mitochondria which are energy-producing organelles but also danger-sensing organelles that may sense danger in the environment. They create a series of biochemical changes in the body, suppressing energy production as a self-protective mechanism against a threat. It is helpful in the short term but not beneficial if we get stuck in the long term.

In the first stage of fatigue recovery, removing the threat and creating a sense of safety is thinking about the cell danger response and whether something big is threatening or triggering the system. Mostly, that could be a toxin, mould, mycotoxins, environmental toxins, or heavy metals. For example, it could be some infection like a viral infection, a fungal infection, a bacterial infection, or a parasitic infection, which is continuously triggering the system. In a future podcast, I’ll go into a little more detail and possible things to explore or sometimes, and especially for those who are more just burnt out, it can be chronic stress or trauma which has caused a massive disturbance of the nervous system.

Therefore there is a sense of threat in the body; even though the event has been and gone, the body can still feel stuck in time. If any of these threats are present, the first step is to reduce, remove, and alleviate them so that the body feels relatively safe moving forward. Here, this is where I’ll say, you know, a lot of people not always with chronic fatigue syndrome and burnout tend to be very type personalities.

This was the case of my healing adventure, where I used my inner achiever to project manage my healing journey. Therefore, it was very easy to want to do everything all at once make all the tears, take all the supplements, do the fasting, all the different possible things that one could do, while still clinging on to my old life a little bit, and maybe not fully letting go of some of the things I should have let go of at the time. It was just too much. I wasn’t creating a healing routine, and it’s understandable because usually, people arrive in a state of poor health with a dysregulated nervous system, whether that is nervous system dysregulation from trauma or chronic stresses or just the natural dysregulation in the system that happens when we have an infection or toxin exposure.

From a place of dysregulation, it’s really hard to be grounded, have patience, slow your life down, and do all the things you need to do to ease yourself into healing. It’s just not the place we come at this from when we’re unwell, or at least very few people can come at this come at their recovery from a very grounded, centred space, at least in the beginning, part of the healing journey is actually finding that groundedness and centeredness inside of you and then building routines in your life that support that. That part of stage one is starting to think about what allows you to feel grounded and resourceful and the pace at which you need to live your life to create space for your healing.

This idea of stage one, removing the threads and creating a relative sense of safety, identifies those more technical triggers that need to be removed. But it’s also thinking about what resources, your system, gives you the space and the time to slow down and create an opportunity in your life for healing. Then at the stages, while we may want to think about supporting the nervous system, as an experiencing somatic practitioner, my favourite approach is to use Cymatics.

But there are lots of approaches people can use. You can do restorative yoga, yin yoga, meditation or breath work, or various brain retraining programs. I’ve done all those things, and I think they all help in their way.

My absolute favourites are my go-to favourites have been yoga, time in nature, and then somatic work. So once the body feels relatively safer, it’s time for some other things to land. There’s more openness in the body for us to get traction on some other areas that may need to be addressed.

This will be unique for each person. Some people need to focus more on certain areas than others. But this is where we start to address secondary imbalances and more complex biochemistry, so this is step two.

Here, we’re looking first and foremost, or at least I’m looking first and foremost, at the low-hanging fruit. The low-hanging fruit is where we’re just thinking about the easy things we can start to rebalance. Mostly, that’s blood sugar for many clients and how their diet impacts their blood sugar.

We’ll do an episode specifically on these areas. But for now, know that you know high and low blood sugar levels throughout the day will affect the nervous systems, stress hormones, sex hormones, and energy availability in the cell for energy. We want blood sugar to be nice and stable and at an appropriate level. If it’s not, that’s the low-hanging fruit we want to address; then the other thing I’m considering is digestive health. We want the gut to be functioning well.

What is required is that there can be many benefits just from cleaning up the diet to support better blood sugar control and digestion benefits. But in some cases, we may need to use stool testing and then a little bit deeper into some specific things that may need to be addressed for that person. Also, in addition to that, thinking about oxygenation. So this is where I like to take a full blood count, a ferritin count, and an iron panel and then be given an assessment over someone making healthy red blood cells and getting oxygen to their cells to produce energy.

How are they breathing? Are they mouth breathers? Or do they breathe through their nose? Are they moving their body and allowing that oxygen to get all the tissues? Those are things we would look at in oxygenation.

Those would be the basic things in addition to sleep and rest, which I haven’t mentioned specifically here because I feel that’s more part of the healing routine, making sure someone is sleeping well. If sleep is challenging, more investigations may come later, making sure someone is resting because we think we’re resting on the paper. But when we check in with the body, the body is not physically in a state of rest.

These low-hanging fruit things I’ve mentioned are blood sugar, oxygenation, digestive health, sleep and raising, and reducing inflammation. These are all in my high achiever revival programs. They form part of the membership site.

So that’s always an option available if you’re looking for more support in starting to work on the nervous system, work on some of these low-hanging fruits, and have the support while you do it. The high achiever revival program could be a good option for you. Then we get into step two, B, which addresses more complex biochemistry.

When I say more complex biochemistry, what I’m referring to here is the detox pathways, the mitochondria, your six hormones, maybe your stress hormones cortisol, for example, maybe we need also to give some support to nutrition, maybe there have been some nutritional imbalances created from high stress and poor digestive health. Perhaps the body needs more support around managing inflammation or methylation. This is where we’ve cleared the white noise.

We’ve supported the nervous system and got the body into a healing routine. We’ve removed or aren’t addressing any major threats. We’ve got blood sugar stable, we know the body is oxygenating well, digestive health is improving, and now we’re like, what else? What next?

What are the additional tweaks that we need to go in? This is where personalization is important and functional testing can be beneficial in revealing the individual’s unique weaknesses. In practice, I get to see a lot of tests from all different clients.

But you know, you can have clients with chronic fatigue syndrome, which has been diagnosed, or clients just experiencing fatigue; there are many commonalities. Then it can also be some unique individual differences. Therefore, every support plan I create for my clients can be a little different based on what they have going on in their bodies and lives. This is where we can use functional testing to dig a bit deeper under the hood, find out what’s going on, personalized diets, personalized lifestyles, personalized supplements, and then all be well.

The body’s capacity is improving. The person is feeling more energized, and they’re able to do more. They’re noticing that they have more resilience and resourcefulness in their life. That inevitably brings us to step three.

Step three is what I call the neuro reprogramming piece. I mentioned this here because when someone starts to feel better and have more energy, it can be very tempting to direct that energy and wellness toward the patterns that made them unwell in the past. Here, I’ll break this down a little bit more for you.

Very often, there are personality traits that many people with fatigue experience. Most people don’t have all of them, and some people may not have any of them. But there is usually a combination of several.

These patterns or tendencies might be a tendency towards perfectionism, towards pleasing people, maybe always needing to be in control, and maybe overgiving over helping to get a sense of self-worth through helping others or through one’s achievements. Unless we address what is happening below the surface, it’s very normal for someone; as soon as they start to feel better, they go back to doing whatever they were doing. It might only be a matter of time until they experience a relapse or a setback, and just being completely transparent with you is that I think it’s a little bit of both. We often do start to make changes in these areas.

But we also tend to do a little bit more, maybe, do a little bit too much, realize it, have a little bit of a setback, learn from the setback, and then take the next step forward. So progress is not linear; we don’t manage to reprogram all these personality traits overnight. But it’s just important to understand our tendencies and begin to work with them and address them.

Here I’ll say that many of these personality traits develop, or have developed over time, in an attempt or as coping mechanisms to create a sense of safety. People feel safe when they please others and feel safe when they feel things are in their control. People feel safe, maybe when they’re achieving or helping others.

We want to give the body other ways to feel safe. This is where the nervous system self-care, somatic work, and somatic therapy can help. Because as we change the setpoint of the nervous system and build the window of tolerance and the nervous system’s capacity to handle discomfort and stress, we can rely less and less on these personality traits.

But when we don’t have other tools, and we don’t have other coping mechanisms because we haven’t taken the time to learn them intentionally. We will inevitably default back to our old patterns and behaviours as soon as we have a little more energy. So in terms of what this looks like, this could look like more nervous system work somatic therapy, it could look like brain retraining, it could also just look like NLP and coaching. All of that is offered to my clients, and many programs also offer that.

Also, to say here that this isn’t like a linear process, I’m talking about this as step one, step two, and step three. But when I work with my clients, it’s a little bit more intuitive. We’ll add in the pieces that are needed as they’re required.

There’s overlap between these stages or steps, and we might not always do them exactly in the order I’m describing. But generally speaking, this is the order. Then we have step four, which is building capacity and challenge.

So now we’re in a state where the body feels safe. We’ve removed the major threats, addressed those secondary imbalances and the low-hanging fruit, optimized the unique biochemistry of the individual, and worked on detox and mitochondria and sex hormones, and adrenal hormones, all those things. The body is feeling well.

You’re mindful of your personality traits. You’re conscious of finding new ways to cope and new ways to do things that are more in alignment with your healing and your goals. Now it’s time to do more.

Here I’ll say that I had a conversation with one of my clients, and she said, “I thought one day I would just wake up and feel good, and then I would be able to do the things I wanted to do.” The reality is that we have small energy changes over time. This is generally speaking because it can be different for everyone.

As we experience these more changes in energy over time, we’ve gradually challenged the body to do a little bit more and do a little bit more and do a little bit more. But as we’re doing a little more and doing a little more, we’re still kind of like surfing the edge of what is too much, And what is too little.

What is overstimulating us, and what is understimulating us? People will tend to have a preference for one or the other. Some people are moreover copers and tend to do too much. Some people are copers and tend to do too little.

When we over cope and do too much, we overload the system, and there’s not enough time for rest, recovery, and repair, and therefore there’s a degeneration over time. But when we under-comp cope, we don’t necessarily experience the fullness of challenge and stimulus required to build capacity. Here it’s about finding that delicate balance between doing too much and too little.

Maybe knowing your coping style, are you someone who tends always to take things a little bit too far? I’m that person, or are you someone who always tends to be a little more constricted and protective and do too little because you fear a crash or a setback or doing too much? In the case of both of these, both over copers and under copers benefit from nervous system regulation.

Especially for over copers, when over copers are more somatically connected to their body, they’ll be able to send sooner when they are pushing too far. Sometimes we also push too far as coping mechanisms for our nervous system, just regulation. So a more regulated nervous system means less over-coping as a coping mechanism, if that makes sense.

But under, copers may need to use the nervous system to feel safe and do a little more. We need incremental challenges that feel like a stretch but are not stressful. This could be across all different aspects of life; it could be doing a little bit more exercise, doing a little bit more mental work or your job, or taking on a few more hours at work.

You could be socializing more; one of my clients even said one of her goals was “I’m just going to practice sitting up more” because she had gotten into the habit of lying down to rest. She realized, “I probably don’t need to be lying down as much as I am anymore. So I’m just going to practice resting, but I’m going to risk setting up.” And that was her capacity-building challenge for a month, and she just said, “I’m going to sit up more, and I’m going to read books. So I have the mental and postural challenges of standing up.”

So it can be something as small as that, or bigger things like getting into cold water immersion or heat stress, fasting, or hypoxia when we modulate oxygen availability. There are lots of different ways. But essentially, you want to safely build the system’s capacity because that’s how we get stronger.

Any athlete will tell you that. If you want to run a marathon, you train for it by progressively overloading the body. Suppose you want to lift really heavy weights. In that case, you train for it by progressively lifting heavier and heavier over time while supporting the body and giving it the nourishment it needs for rest and recovery.

This step is about finding that balance of how I can challenge myself in a way that still allows me to recover and make progress. Then we get to the final step, which is preparing to be well because when you have been through such a big thing, there’s such a big recovery journey; there can be so much involved here. Sometimes even well-being and being able to do what we want without limits is the ultimate goal.

That can feel scary. There can still be a lot of constriction and fear in the body from the trauma of being unwell. Maybe it can feel safe or unsafe, should I rather say, to fully embody your wellness.

This is where self-sabotage can creep in. Sometimes there are benefits to being unwell. Sometimes it’s easier to set boundaries with people because you say, “Oh, I don’t have this condition, and I can only do so much; therefore, I can’t attend this event or that event or whatever it might be.”

But sometimes, when you have full health and well-being, you may still not want to do those things. But now you have to say no because you don’t want to; you don’t have your illness to fall back on. That can be a benefit to staying unwell, and so self-sabotage is sneaky.

But ultimately, self-sabotage creeps in when we have what is known as a secondary gain. There is a gain to staying where we are and a perceived loss to fully realizing our goal, health, or well-being. This is where it can be really helpful to explore for yourself through journaling or working with a practitioner.

But what do you need to do to fully realize your wellness and even jot down what I am afraid of? If I was to be well, what would I be afraid of? What will be hard for me? Why wouldn’t I want it? Those are questions we don’t often take the time to explore but can be valuable.

It can also be really valuable to set goals and ideals for what you want your new healthy life to look like. Because it doesn’t have to look like your old life, it can look like something completely different. There may be lessons and learnings from your recovery journey that you want to carry with you into your new healthy and well life.

If we don’t set those intentions, and we don’t get clear on our boundaries and our wants and don’t want, it can be very easy to get sucked back into a life that we don’t want. So to recap, as we wrap up for today, on those five stages or five steps. Step one was to remove the threats in the body and create a relative sense of safety which involves creating a healing routine and supporting the nervous system.

We had steps two A and two B, which addressed more complex biochemistry and the low-hanging fruit, essentially the secondary imbalances created by the body being threatened for so long. Then step three is that neural reprogramming work. Step four is building capacity with health challenges. Step five is preparing to be well. So I hope you have found that insightful and useful today.

As always, if you found this episode useful or you know somebody who would enjoy listening to it, please feel free to share. Also, don’t forget to leave a review because your reviews help others find this information, and you can spread the love. I will see you in the next episode. You have a wonderful fatigue recovery day.

Episode 6 – Understanding The Cell Danger Response

Anna Marsh — Fri, 16 Sep 2022 00:01:00 +0000

Shownotes

The cell danger response (CDR) is the body’s universal and ancient response to threat. It offers a framework from which we can begin to understand what may be happening in those experiencing burnout and fatigue conditions like CFS/ME. Knowing where you are in the CDR can help you to make decisions about what to focus on and where to prioritise your resources in your fatigue recovery journey.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Understanding The Cell Danger Response

Hello, everyone, and welcome back to the chronic fatigue and burnout recovery podcast. I am your host of functional medicine and nutritional therapist Anna Marsh, and today, we will talk about the cell danger response. The cell danger response is a fantastic framework for understanding or putting your chronic fatigue symptoms into context.

So I came across the cell danger response through the work of Dr. Neil Nathan, who I absolutely love. He wrote the book toxic, which prompted me to test my urine and mycotoxins, and eventually discovered that that was a big factor in the symptoms I was experiencing. But all of that aside, the original creator of the model was Dr. Robert Navio.

I’m not the expert that Dr. Neil Nathan or Dr. Robert Navio is in this area. But this podcast is not about bringing you all the very detailed science. And it’s about helping you understand these frameworks. So you have some context for what could be happening in your body and how to approach the different recovery phases.

As I said already, I love this framework. The purpose of today is to teach it to you, and hopefully, some pennies will drop, some things will fall into place, and you’ll have a little bit more context to support you on your journey. I think one of the hardest things about experiencing a syndrome like chronic fatigue syndrome, when there are many hard things about experiencing a syndrome like chronic fatigue syndrome, is that there’s this lack of understanding because you’re not getting the support from your regular doctor, there are some incredible doctors out there.

But for the most part, many people have these very traumatic stories of not being fully supported and fully understanding what’s going on. Today’s purpose is to give you a little bit more understanding and guide you on your journey. So the cell danger response is an ancient cellular intelligence. It is the body’s or the cells’ universal response to threat. It’s how the cells respond to danger in the body, as the name suggests.

Talking about danger or a threat could be a trigger, like a chemical or toxin exposure, a physical threat, or a biological threat. It’s anything that exceeds the cell’s capacity to maintain homeostasis, which is essentially how the cells and body regulate itself, and ultimately maintain balance in the body. If we are experiencing a trigger, a threat, or a challenge, and it is so challenging that it exceeds the cell’s capacity to cope, then the body will initiate the cell danger response.

It’s important to understand here that the cell danger response is protective. It is ancient body intelligence designed to support you and keep you safe. When we get stuck in the cell danger response or one of the stages of the cell danger response, which I’ll touch on in a moment, we can start to experience a decline in health and then chronic disease.

You may have already heard of the mitochondria if you’re on your fatigue recovery journey. Mitochondria are the little organelles that are in all of our cells. They are how the body makes energy in the form of ATP. Often we refer to the mitochondria as the body’s energy factories, and it is the health, abundance, and function of these mitochondria that allow for good energy production, health, and well-being.

But mitochondria also have another role. Yes, they are energy-producing factories, and we want them to be abundant, healthy, and working well. But they also have another role, which is the role of defense. They are sensing organs and thought organelles. They sense the environment that’s going on in the cell. They sense the environment that’s going on in the body, and they respond appropriately.

So if these mitochondria sense and perceive that is a threat that is a toxin or a trauma or a microbe, then they’ll start to initiate a series of self-protection changes, which are beneficial in the short term. They’re very, very important in the short term. But what can happen in the case of chronic disease is that the body can get stuck in one of the stages of the cell danger response. Unless we can help the body to move through and complete the cell danger response and feel safe again, then we remain stuck and stuck in our illness or symptoms, or whatever our experience of health is. Chronic fatigue might mean that we are stuck in one of the stages of the cell danger response. Therefore, a model for chronic fatigue recovery is helping the cell, mitochondria, or body feel safe again and then also helping it complete the full cycle of all the different stages of the cell danger response.

So what are the stages, and what changes occur in the body at each stage? We have CDR one, cell danger response one, CDR two, and CDR three. CDR one is when the body moves from a state of health to a state of threat. I would call this the high alert stage, and in this stage, the body starts to experience changes in metabolism, the immune system, and even psychological changes or changes in how we see the world.

Here I’ll segue a little bit, and I’ll explain that previously, I’ve done a diploma in psycho neuro immunology, and one of my teachers and mentors, Leo Primbroom, always used to teach that health is about flexibility. We need to be flexible metabolically, which means that we want to be able to use carbohydrates as fuel, use fats as fuel, and be able to continue to fuel the body in the absence of fuels coming in, for example, when we’re fasting. We also need to be immunologically flexible.

That means the immune system should respond when there is an infection or when there is some threat. But the immune system should respond, resolve the threat, and go back to baseline. So there’s flexibility to move between a range of high and low immune activation.

Then finally, we also want to be psychologically flexible, which means that we’re flexible in our thinking. We don’t necessarily have rigidity in our belief systems needing to control everything and struggle when things aren’t just so. I love that the psycho neuro immunology idea of health is about flexibility because it very much overlaps with the cell danger response model. And, when we’re in cell danger response, there is a shutdown, there’s a shutdown in the flexibility of the metabolism, the immune system, and probably our psychology.

In the short term, that’s very, very helpful. But we do want the flexibility to move out of those changes in the long term as we reclaim our health. Finally, just a little note on the psychological aspect. Anyone who’s had the flu knows that their mood is low, they don’t feel good, they can be more emotional or tearful, and they may find it more difficult to think positively. That’s all a psychological response or a psychological representation of what’s going on in the body at that point in time. It can also be protective to a certain degree.

Because if you’re feeling, though, you will not want to overexert yourself if you don’t have motivation. If you feel quite withdrawn and antisocial, you’re not necessarily going to go out and spread your disease, whatever it might be, your infection to other people. So there is a beneficial positive adaptation that happens, which, yes, in the short term, we don’t want it to continue long term.

Circling back to the cell danger response one, what are the specific changes that begin to happen in the body? Well, first of all, the mitochondria can prioritize energy production, away from sort of metabolism away from the brain and cognitive function, and ATP or energy is prioritized towards dealing with the threat to dealing with survival. Or for the immune system to increase its activity to resolve a possible infection.

Again, anyone who’s ever had the flu will know how you feel when you’re sick, your energy is low, your brain is foggy, and even walking up a flight of stairs can leave you breathless, and your muscles are tired and achy. That’s a classic example of the body prioritizing energy to the immune system to thread to survival and away from the metabolism of the muscle tissue and the brain’s cognitive functioning. We’ve all experienced that, but people with chronic disease or a chronic illness or chronic fatigue might feel like that to a certain degree most days then another change that happens is an increase in oxidative stress, which is the body’s oxidative stress is the body’s ability to balance the natural production of oxidative or damaging molecules with antioxidants.

In this case, there’s an increase in oxidative stress, and very often, we’ll hear in disease that oxidative stress is quite prevalent. But it’s really important to understand that in the short term, that oxidative stress is being produced for self-protection. Taking a whole bunch of antioxidants may not be beneficial in the CDR one because the body is producing oxidative stress to help to counterbalance the threat. That’s a change that we may experience.

Then other changes that may occur are a shutdown or reduction in methylation. I’m not going to go into the ins and outs of what methylation is today because that’s probably a whole other podcast in itself. But methylation is a really important biochemical process, which is important for the health of multiple body systems. One of the things that methylation does is produces the powerful antioxidant glutathione.

Given what I’ve just mentioned about the increase in oxidative stress, which is beneficial to the body, in the cell danger response, we don’t necessarily want to purchase a lot of glutathione because that’s going to be an antioxidant. But additionally, another reason for shutting down methylation is that some infections and viruses can hijack the body’s methylation processes and use it to its advantage; hence, it’s advantageous to shut it down in the short term.

Then, the next change that happens is it can be a change in tryptophan metabolism. Tryptophan is one of the body’s amino acids that can be used to make serotonin and melatonin. And if you don’t know, serotonin is our happy hormone, it increases mood, and melatonin is our sleep hormone. So there is a mechanism by which tryptophan can either get prioritized towards serotonin and melatonin production, or it can get shifted in another direction where we make kind of Rumenic and quinolinic acid, which are associated with pain and inflammation.

Again, very beneficial in the short term but may cost our mood and sleep. If we get stuck in the CDR one in the long term, there may be changes in vitamin D metabolism. We have a huge challenge where people are not spending enough time outside, not spending enough time in the sunshine.

Most of my clients have low vitamin D. However, and this also begs the question, is this an outdoor sun exposure problem? Or is this a cell danger response problem, and we sometimes don’t know? We may experience changes in Vitamin B6 metabolism, which can impact histamine production. Histamine can then drive more inflammation, which is beneficial in the short term to help resolve the threat but not long term.

That’s why many people stuck in the cell danger response may be histamine sensitive or have a lot of histamine-like symptoms. That can also be changed in the microbiome and often in functional medicine. You’ll hear people say, you know, health starts in the gut, we work on the gut first, and yes, working on digestive health and digestive function is important.

But if we address digestive health too soon, when there’s still an active threat, this can be counterproductive to what the cell danger response is trying to achieve. Then finally, we get changes in metabolism. When it’s at rest, the immune system is a fat-dominant system. It uses fat for energy at rest.

But an active immune system uses glucose for energy. There is a shift from your fat-burning energy system towards your sugar-burning energy system glycolysis, which can then create a knock-on effect in terms of blood glucose control, and the ability to regulate blood sugar. Remember that all of these things are supposed to be beneficial in the short term.

But in the case of chronic disease or chronic conditions, sometimes this cell can be stuck in the CDR one. That can be because there’s a presence of mold, or the presence of toxins and mold, mycotoxins, maybe heavy metals, it can be because there’s an active infection, or it can be because there’s been a major trauma, or lots of little traumas adding up over time, which has really sent the nervous system into a state of distress, or very often, as I see in my clients, usually a combination of several of these different factors. So really, what we want to do if we suspect that somebody is in the cell danger response one, we have to remove the triggers, we have to be able to calm the system down so that it can feel relatively safer.

I say relatively safer because initially, it will be very difficult to feel 100% safe. But we need to help the body feel safer to continue the recovery process and move through CDR two and CDR three. So there are no tests that will say you’re in CDR one.

Okay, now you’ve moved to CDR three, okay, CDR two is complete, now you’re moving on. So it is very much about trial and error, and some clues can tell us where someone might be. For example, suppose someone is very sensitive to mitochondrial support, or they don’t respond to a lot of the support we might give to the gut or the mitochondria. In that case, we could assume maybe that they’re still in a CDR one, and we need to start thinking about what the trigger is here.

What are the triggers that we need to remove? This is where knowing your root cause comes in can be beneficial. Usually, someone is in a CDR one if interventions make them feel worse or they’re just not responsive. This is why I work the way I do in my practice, which is to offer a continuity of support across six months, given that some people may not be as complex in terms of their case history and what they’re moving through.

But many of my clients have a lot going on, and therefore if they come and see me once, I say, okay, let’s support your gut. For example, let’s try some mitochondria. Let’s try some mitochondria support, and they support the gut, so they do the mitochondria, and nothing happens, or they get worse, they’re never going to come back and see me again.

But, that information, even though it doesn’t feel like progress, it’s telling us something about where we need to go next, which is okay. Likely, there’s still an active trigger here. We need to dig deeper and then address that trigger. I say this for myself, and I say this for any practitioner that you might be working with or considering working with. It’s tough to know. In functional medicine, we build health through taking a client’s history, using testing, noting the client’s symptoms, and then how they respond to the interventions. Sometimes we just head straight out the gates, and somebody gets better straight away, and sometimes we have to mess up and make a few mistakes to get more information so we can choose the right intervention.

That takes time, and that takes being in a supportive clinical relationship. Then we move into CDR two. CDR two is all about rebuilding after CDR one has been completed, and here in this CDR two is where we can start to get a better response to mitochondrial support. We can start getting a better response to gut support, and we may have already started detoxification, opening up those detox and drainage pathways in CDR one.

But now, we can start to become a little bit more aggressive in CDR two, and we may want to think about how we can use nutrition as metabolism changes. So previously, the immune system was very active in that anaerobic sugar-burning metabolism. But now maybe metabolism is shifting and becoming more of an aerobic fat-burning metabolism.

We could start thinking about fasting or a ketogenic diet to encourage autophagy to help with the cleanup process that may be required to help clean up any damage and debris created from CDR one. Then finally, here, we may start to get a little bit more traction with supporting methylation. If we had offered methylation support and CDR one, it probably would have been non-responsive or possibly even made someone feel worse because methylation has shut down.

So now we can bring in methylation support, maybe we can add in antioxidants, and we’re starting to help the body rebuild again, then we transition into CDR three. And CDR three is when we begin rebuilding the communication lines between different body systems. What can happen is this can happen automatically in some people. As we remove the threads, give the system some nourishment, and support the nervous system, then maybe what happens is the body starts to reboot, and those systems naturally start to work a lot better.

That’s what we hope for. But for some people, especially if they’ve been ill for a long time, the body can be habituated to operating in dysfunction. So essentially, dysfunction is their new normal. Therefore, even beneficial interventions can feel like a threat to the body. This is where we want to use nervous system care and support, maybe some brain retraining, if appropriate.

We’re really helping the body feel safe as we make these changes. It might be an opportunity to dig deeper, maybe to do some functional testing. We can look at the hormonal systems, for example, or we can look at what additional nutritional support may be required or what’s going on in the gut, and we can explore and dig a little bit deeper.

This might be a good time to start building the body’s capacity, using hormetic stressors like heat stress, cold stress, fasting, and stress hypoxia, to strengthen the resilience and help the body build its capacity to handle stress as things resolve. Hopefully, from CDR three moving forward, the body can reestablish a sense of health.

This may take longer for some people, and it may take shorter and others. It’s really about knowing what your body needs and giving it that nurturing. Here, we also need to say that there’s an art and a science to healing, the sciences, all the technical stuff. It’s like, okay, what do my test results say? What’s happening here? What mechanisms are working? How do we support those, and what nutrients and dosage?

Then there are the arts, which is just that sense of what the body needs. Because there may be some people who are so desperate to be well, they’ll throw all their resources into their healing, but it’s too much, and that healing is too overwhelming for the nervous system. Again, this is why I work with my clients the way I do over a longer, extended, and supportive timeframe.

We can make those little tweaks and adjustments and continue supporting the nervous system so that it’s a gentle, grounded, and useful approach, which is also embedded in science. That is everything I have to say about the cell danger response today. If you have enjoyed this episode, please let me know. You can reach out on social media. You can share the podcast on your social media, and please remember to leave a review.

Having more reviews helps more people find this podcast, and in doing so, more people can be helped by the information I share. Wishing you a wonderful fatigue recovery day, and I’ll see you in the next episode.

Episode 5 – Do You Need To Know Your Root Cause?

Anna Marsh — Fri, 09 Sep 2022 09:00:00 +0000

Shownotes

Is it possible to recover your energy and vitality when you don’t know why you became unwell? Anna takes the time to address this question and offers a nuanced perspective that may be important for those that don’t know why they became unwell and for those that do!

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Do You Need To Know Your Root Cause

Today I wanted to create a short episode to answer the question, do you need to know the root cause of your fatigue? So the root cause is often the thing that keeps your body in threat. In previous episodes, I discussed the cell danger response, universal response to threat, which affects the body differently.

Essentially, this response keeps the body stuck in a particular state where rest, recovery, and repair are impossible until the body feels safe.

With that framework in mind, I often talk about how we need to know why we became unwell to address those challenges, threats, or whatever may be going on in the body and move forward. Unfortunately, addressing the root cause may confuse some people because some may not know why they’re unwell. And then, obviously, that can create a sense of panic, perhaps anxiety.

I don’t know why I’m unwell. I don’t know why I’m unwell. No one can help me. I don’t have access to the tests that I need, which that internal dialogue I appreciate is not very helpful for healing and well-being and supporting a well-regulated nervous system state. Dealing with a chronic and complex condition can be challenging for so many reasons.

We don’t always get the support that we need through the medical professionals we’re working with, and we don’t necessarily get the support that we need from our friends and family because, through no fault of their own, they don’t understand what it’s like. So I want to empower people to move forward in their health journey, feeling as supported and informed as possible, and with empowering internal dialogues because that’s really important for regulating our nervous system and our mental well-being. I don’t want to create a spin of anxiety, and almost like an obsession around, I need to know why I’m unwell and why I’m unwell because I don’t think that’s helpful.

But there is what I’ve noticed with the clients that I work with, and there is a strong desire to want to understand, to want to understand what’s happening in the body and what’s happening to them, and to help them to make sense of their symptoms. I think this desire to understand is a human desire to feel safer or more in control in a situation that feels very much out of control. And I get that.

That’s why I love the framework of the cell danger response, the framework of understanding polyvagal theory, how the nervous system works, and this idea of fight, flight, and freeze because I think those frameworks help people understand their bodies a bit better. This idea of the cell danger responses: if the cells feel under threat because there’s a trauma, an infection, a microbe, or a toxin threatening the cells, they’re going to shut down energy production.

Likewise, if the body is operating from a dysregulated nervous system state, and there’s a lot of freeze in the body, that can also look like fatigue, exhaustion, and shutdown. We already have those bigger frameworks in which we can understand what’s happening to the body. I guess where I emphasize this idea of needing to know your root cause, and I think that you can still make progress in your recovery journey when you don’t know your root cause.

So what I want to communicate today is that you don’t need to know your root cause to move forward. If you’re thinking, “Oh, I can’t move forward, I can’t make progress. I can’t move towards wellness because I don’t know what’s causing this yet.” That’s not true.

You can do a lot to support your body, and I’ll start talking about these things in more detail from the next episode onwards. I really want to empower you to understand that there are always things you can do to support your body to move forward and make progress. Do some people fully recover without ever knowing why they were unwell?

Yes, they totally do. And it’s likely because they just gave their body the nourishment that it needed, and that nourishment was appropriate for whatever was going on in their system. But then there are also some people, and this was my experience, doing a lot of things to support their bodies and not making progress.

If that’s the case, it’s likely that something got missed. That’s when knowing the root cause can be helpful. Because, for example, if someone has mold or mycotoxins, and they don’t know that, because no one’s ever taken a thorough case, history suggested it could be an issue for them, and then suggested testing, then they can just be running into a wall and feeling like they’re getting nowhere until that deeper issue is addressed.

So if someone has a gut infection, a parasite, or something going on, and that’s not necessarily being dealt with or addressed, they may make a certain amount of progress. Still, they’re never going to get to that state of fully thriving and feeling fully energized. Suppose someone has a hormone imbalance, and what they need is hormone replacement therapy, and that’s not offered.

In that case, they can continue to move through life feeling like they’re working, just slugging away and not getting that full experience of aliveness thriving that we all want. Because they didn’t know that that was what they needed, do you need to know your root cause to make progress? No, I believe that you can make progress by supporting your body generally.

But if you’re not making progress, there’s an invitation to dig deeper and see if something got missed and if there’s a root cause that needs to be addressed. Then finally, knowing the root cause in the beginning can help to shortcut the process. Suppose I had known that mold mycotoxins were an issue for me.

In that case, it could have taken a year, maybe even two years, off of my recovery if I had fully understood the ins and outs of the nervous system and polyvagal theory and what it means to support my body. From a nervous system perspective, I could have knocked so much time off my journey and saved so much money on tests that were premature to what I needed to be testing. I spent so much money taking supplements my body needed but would have probably been more effective further down the line when I dealt with the mold and the nervous system.

I hope that helps answer the question today, and I hope that wherever you are in your journey, you can identify things you can do to move the needle forward on your health. If you can’t keep listening to the podcast, there will be loads more inflammation coming up. If you feel like you need help picking this apart and starting to identify what’s going on in your body, what you need to prioritize, where to begin, what tests to run, what supplements to take, the whole minefield of all the different things you need to do to take care of yourself?

That’s my job. So you can always reach out and take a look at my website. Consider working with me one-on-one so that you can feel fully supported in your fatigue recovery journey. So have a wonderful fatigue recovery day.

Remember to leave a review and share this episode if you have enjoyed it and receive value from what I’m sharing. And I will see you in the next episode.

Episode 4 – What Testing Do You Need For Fatigue?

Anna Marsh — Fri, 02 Sep 2022 20:30:05 +0000

Shownotes

We’ve all been there – you go to the doctor, they run some tests, the results come in and you are told that everything is normal. Yet, your body, you feel anything but normal. In this episode Anna talks about the difference between functional and diagnostic reference ranges, how you can get more from your blood work than what your doctor is telling you and functional testing options that she finds most useful to support her 1:1 Fatigue Recovery Clients.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

What Testing Do You Need For Fatigue?

Welcome back to the chronic fatigue and burnout recovery podcast. If you listen to the previous episode of the podcast, I went through the causes of fatigue generally and chronic fatigue specifically. And it was a fairly substantial episode. I think I spoke for about 30 minutes, talking through all the possible things that could be contributing to fatigue.

So today, I want to answer the question you were probably asking as you were listening to that episode: How do I know if these things are a problem for me? What I’d like to talk about today is what testing you may want to explore, investigate, ask your doctor to run, or if you’re working with a functional medicine practitioner or nutritional therapist like myself, what do you want to maybe ask them about or ask them to help you with. So what I’m going to do is just kind of run through the various tests and terms of how I do this in my practice. Different practitioners may have different perspectives, and they may do things differently.

But this is just a framework for how I work. Also, if that is something you’d like to do, if you’d like to work with me, you could also understand how we would work together to explore some of these options. So, where I like to start is to get a general big picture.

Usually, by the time clients come to me, they’ve been to the doctor, they’ve had some blood work done, they’ve been told everything is normal, or there are just one or two things that are out of balance, but nothing that’s helping them to move forward. But if that hasn’t been done, if they haven’t had any recent bloodwork done, then I would like to get some updated bloodwork, just to get a set, get a sense of the lay of the land and what’s possibly going on. So I personally really like the Well Woman Panel by Medichecks.

It’s just a nice, all-inclusive panel with some elements I want to see as I’m starting to work with a client. Specifically, things like vitamin D and C reactive protein. It includes a complete blood count, which would then give me a sense of what this person’s red blood cell health is like. Are they oxygenating adequately?

Do we need to support them with nutrients for oxygenation? It also looks at elements relating to the immune system, like the white blood cell, counts the neutrophils, the lymphocytes, and the basal fill the monocytes, eosinophils. So these are all immune molecules, which can tell if the immune system is maybe a little bit active. I also want to see an iron panel including ferritin.

So some of my clients will have low iron, and some of my clients will have very high iron. So if there’s low iron, we definitely want to support that. The tricky thing with iron is the reference range is so big.

So I think it’s something from like nine to 110. And, you know, as long as someone’s in the reference range, they’re deemed healthy. But really, we want to see clients with fatigue around about the middle of the reference range, so at about 50.

But high iron can be a problem as well because high iron can be a source of oxidative stress and damage to the body. So if iron is high, we want to consider why it is high and how we support the body to get those iron levels down, which might reduce inflammation and vitamin and mineral cofactors.

So what I usually do when I get the bloodwork from my clients is there is a fantastic book called blood chemistry and CBC analysis by Weatherby in Ferguson, and they have functional reference ranges. So what this means is that when you get a blood panel done through your GP and they have their set of reference ranges, those reference ranges are there to diagnose disease. So they are looking for imbalances that have become so great that the body is now in a disease state.

But I’ll refer to a narrower set of reference ranges as functional reference ranges. Functional reference ranges are not necessarily looking for disease. They’re looking for imbalance. The idea is that if the reference ranges are narrower, we can catch an imbalance before it spills over into a disease state. So when I’m analyzing blood work for my clients and looking at it through the lens of the functional reference ranges, we often catch things that have fallen through the cracks in the traditional reference ranges.

So often, I’ll find sub-optimal oxygenation. Usually, we’ll see increased or increased white blood cell count, or maybe a low white blood cell count, elevated neutrophils, and suppressed lymphocytes, which are signs of some chronic infection. This is very common in my chronic fatigue clients, and so that’s always been a little clue to suggest, okay, what could possibly be triggering this immune system, as I spoke about in the previous episode, where I touched on the cell danger response, if the cells of the body still perceive that there is a threat or a danger, that’s going to limit optimal energy production. So if we see clues in the complete blood count that the immune system is a little bit active, we want to understand why that would be and work towards addressing it. Then that can inform the patient’s case history, where we go next in terms of other testing options.

The Well Woman Panel by Medichecks also includes your thyroid and markers. So TSH-T 43. If someone is showing up with a thyroid imbalance, I do like to test maybe reverse T3 or thyroid antibodies, and Medichecks do a panel as well.

If we’re looking at sex hormones, and then we may want to do something like a day 21 progesterone, we may want to do testosterone, sex hormone binding globulin, estrogen, FSH, LH, all of those can be done in blood, your doctor may be able to do them for you. Or you can use a company like Medichecks if we want to dig a little bit deeper into sex hormones. Then my favorite functional test is the Dutch Complete Hormones, which looks at progesterone, testosterone, and estrogen but also their metabolites. So how they’re getting broken down and detoxified in the body.

It also has an adrenal profile, which can sometimes be useful. Additionally, what I like about the Dutch Complete Hormones is I’ve got a little section at the end, which includes organic acids. So it can tell us about the need for B12, and it can tell us about the need for B6.

So when we do a complete blood count, and if there’s anything that’s showing up in the complete blood count that may suggest oxygenation is an issue, we know that good oxygenation requires adequate iron, B12, folate, and B6. So we can rule iron in or out using an iron panel. But it’s difficult then to say whether somebody needs B12, or B6 or folate or one of them, or two of them or all.

When we do the organic acids piece in the Dutch Hormones test, it helps us know, at least for B12, and B6, whether those are required or not. The only thing it doesn’t cover is folate. Then that’s a nice segue into the next piece, which is diving deeper and understanding what other nutrient deficiencies may be present and how we support the body with those. My big favorite test for nutrient deficiencies is the NutrEval, a blood and urine test offered by Genova diagnostic, and it’s quite a big test.

It’s very comprehensive. It’s also not cheap. I offer my clients at a trade price of about 500 pounds. But you could expect to pay up to about 700 pounds for a test like this. So I offer my clients the savings, which will give them a full organic acid profile.

Your organic acids test will tell you about different things happening in the body. It can give clues to what’s happening in the gut, and it can give clues to what’s happening with the mitochondria and energy production. It can look at neurotransmitters, it can look at branched-chain amino acid metabolism, and it can look at detoxification.

Why this is very useful is because what it tells us is it tells about the functional need for certain nutrients. And so if you do a Medichecks panel, for example, you’ll get serum folate, serum B12, and serum magnesium marker, but all those markers tell us how much is in the blood at that moment in time that the test was taken.

It’s not necessarily giving information about how much is getting into the cells and how it’s being used within them. We would get that information from a NutrEval, or an organic acids test. Because really, we’re probably only going to start seeing changes in serum folate, serum B12, or serum magnesium. When the body is extremely depleted, we can catch deficiencies earlier if we’re using a more advanced panel like a NutrEval or just the organic acids component, that will tell us also about methylation, it will also tell us about vitamin D, that can be helpful to determine if any poor oxygenation is due to the need for folate as well.

So I like the NutrEval. It will also give you a fatty acid profile. So this will tell you if you’ve got a good balance of Omega three or omega six in your cells. Usually, all my clients are slightly imbalanced when we run the NutrEval test.

So the next thing we want to think about is blood sugar. Blood sugar, if you’re running a basic blood test, you’ll get your HB1AC, which is an indicator of your average blood sugar across a three-month period. That can be helpful. It’s helpful when I see someone’s HB1AC is out of range.

But it doesn’t necessarily accurately reflect the optimal blood sugar balance and account for highs and lows that someone may be experiencing day in or day out. If somebody has a very high blood sugar but also has a tendency to drop to very low blood sugar, so they’re experiencing peaks and troughs in blood sugar, HB1AC is the average. So the average is something very big, and something very small is something that’s medium, which means that you may actually look like you’ve got optimal blood sugar balance on paper.

But there’s an issue with blood sugar swinging from high to low throughout the day, which isn’t captured. Additionally, if you’re fasting for blood glucose measurements, when you’re fasting, your blood glucose is always going to look the absolute best it will look all day long. But we really want to see how your blood sugar responds to the foods you’re choosing to eat, and therefore I like to get people testing their blood sugar around mealtimes.

So you can do that with a finger prick blood sugar monitor, or with a CGM, a continuous glucose monitor, or a little patch you put on your arm. It connects to an app, and then you can always tap your phone to the patch on your arm and get an indicator of what your blood sugar is doing at any moment in time. Those can be much more useful tools when your blood sugar markers look normal on paper, but we are digging a little bit deeper, and we’re starting to see what’s going on under the hood.

Then the next thing we might want to consider is a stool test to assess for gut dysfunction. I do this with most of my clients, and the stool test that I like is the GI Effects Comprehensive Stool Analysis, which is available through Genova diagnostic. I do believe that you have to work with a practitioner to run the GI effects.

There are other stool tests out there. But the GI effects is the one I use the most and I’m the most familiar with. Then, the next thing may be to consider if you suspect that mold exposure could cause your fatigue symptoms, a mycotoxin test can be another useful test.

I like the Mycotoxin Panel by Great Plains Laboratory, available here in the UK via Regenerus. Again, you need to work with the practitioner to order that test. It’s also in terms of getting accurate results maybe a week before taking the test, which is a urine test to ensure you avoid high mold foods. Foods that could be contaminated with mold spores like grains, coffee, chocolate, mushrooms, etc.

So, eat a clean diet of meat, fresh veggies, and good fats for a week before taking the test. Then there are a couple of other ones I just wanted to mention. I don’t use these as often, but just so you know the sources if it’s of interest to you.

If food sensitivities concern you, then it’s worth doing the Cyrex Panel. Cyrex is also great for anybody who’s got autoimmunity. It can test for celiac disease or non-celiac gluten sensitivity.

The cyrex tests are great for looking for antibodies to chemicals and antibodies to certain pathogens. So they offer a whole range of different tests. I must say that I don’t often use their tests. But when I’ve got a client who specifically needs to do something relating to the immune system, food sensitivities, gluten sensitivity, any autoimmune thing going on, then I will use the cyrex tests, and then my tests of choice.

Then the final thing I talked about in the previous episode was the idea of infections, which could be bacterial infections or viral infections, and I would say that usually, by the time a client comes to me, the doctor has always already screened them for Lyme disease or EBV cytomegalovirus, toxoplasma. So these infections usually have already been tested for, so it’s not typically testing that I would tend to run with clients, that maybe if you’re already just starting and embarking on this journey, then you can have a conversation with your doctor about the various viruses and bacteria that you could maybe test for together or a referral to get tested if your doctor feels that it’s appropriate. So that’s quite a lot of tests. I would always start with a blood test to address the low-hanging fruit, as I like to call it and get a sense of where you want to go next with your testing.

When I work with clients, we’ll do a full case history. Usually, it starts to become quite obvious what would benefit the client. Most often, we will do a blood test, a stool test, maybe a NutrEval, or organic acids, and then mycotoxins if appropriate for the case history and the symptoms and perhaps a Dutch test if hormone imbalances are of concern to the clients. That is everything I wanted to share with you today. I hope you have enjoyed learning a little bit more about testing. If you have any further questions, you can feel free to reach out to me on social media or look around my website, and I will see you again in the next episode.

Episode 3: Causes of Fatigue Generally and Chronic Fatigue Specifically

Anna Marsh — Fri, 02 Sep 2022 19:57:11 +0000

Show notes

Fatigue can be complex and multifaceted, with many possible combinations of contributing factors, and every case is different! In this episode, Anna talks through the framework she uses in clinical practice to narrow down the causes of fatigue for each client.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Causes of Fatigue Generally and Chronic Fatigue Specifically

Hello, and welcome back to the chronic fatigue and burnout recovery podcast. I am your host Anna Marsh. And today, we’re going to talk about the causes of fatigue generally and chronic fatigue specifically.

I wanted to talk about general causes of fatigue because very often, even if someone has a chronic fatigue syndrome diagnosis or has burnout, it’s very common for them to have underlying imbalances, which are general causes of fatigue as well. So, for example, someone with chronic fatigue syndrome or burnout may have nutrient deficiencies, they may have blood sugar imbalances, they may have what I would call oxygenation issues or poor red blood cell health. When we’re working towards helping someone increase their energy and become more well, irrespective of the complexity of their case, we always want to ensure that all areas are covered.

So these are the areas I will discuss in this podcast today. I will move through them in sequential order, starting from the most basic and obvious and then moving into the most complex. So this podcast is for you. If you have chronic fatigue syndrome or burnout, or you don’t know why you feel so tired, or maybe you’re actually quite a high functioning, but you’re just struggling with a little bit of fatigue, there will be information in this podcast that will be really, really useful to help you get to the bottom of things.

Then further down the line, there’ll be another episode on testing so that you can begin to explore these things for yourself or know where to begin to explore these things for yourself if you want to dig a little bit deeper. So let’s just go straight in. This is the sequence or the, I guess, the sequence of my thinking when I’m working with a client.

The very first thing we want to consider when we consider fatigue is the overall energy balance, which is that very simple scientific equation of energy in versus energy out. And essentially, is this person with fatigue? Or are you fatigued, doing too much, and not eating enough calories?

Very, very typical for women, very typical for busy women, especially, who are just running like a million miles an hour, maybe there are kids, maybe there’s a career, maybe they’re very involved in work, or they have other life pressures, and they’re just not eating enough. There are a lot of demands, whether that is mental demands, physical demands, or emotional demands. All of these things take energy to cope with. And if we’re not eating enough and not resting enough, we’ll feel tired.

Having previously run a successful weight loss program, sometimes this is something I asked my clients to check, do you feel that you’re eating enough? And we can use something like an app like My Fitness Pal, not forever not to become dependent on external apps. But just to say, let’s just check in and put your food into an app and see how much you’re eating daily.

Sometimes people just need to eat a little bit more and feel better. So even if someone is really unwell with a diagnosed condition, often the symptoms associated with the condition if there’s nausea or a lot of lack of appetite due to something else going on in the body. People are naturally going to begin to restrict how much they’re eating. And just eating more won’t solve the whole condition.

But it will help them feel better, it will increase their baseline within the condition. Therefore, even if you’ve been unwell for a while, it’s important to remind yourself about some of the basics because sometimes the basics are so basic that we look past them, and they become our blind spots. So the first thing we want to look at is whether we are eating enough, and knowing how much exactly someone needs to eat depends on their height and weight, muscle mass, and how much they move each day.

I can’t give you specifics about how much you, as the individual listening to this podcast, should be eating. But I would say kind of on average anything around sort of 1500 to 2000 maybe even 2500 calories for a bigger or more active person is sort of ballpark, but if people are only eating sort of 800 calories consistently, then we really want to be mindful of how that’s contributing to how they’re feeling. So then the next thing we want to look for is blood sugar imbalances.

Within that kind of energy balance, eating enough food, the quality of that food will also be really important. And I will do a specific episode on blood sugar imbalances where we can dive deeper into all the reasons why someone may have a blood sugar imbalance. But for the essence of this podcast, just to keep things surface level today, we really just want to make sure that the proportions of macronutrients, proteins, fats, and carbohydrates are appropriate for the individual.

So really, what I see with a lot of clients is, especially if they’re more unwell and therefore less active, carbohydrate tolerance tends to be lower, which means if they’re eating large amounts of carbohydrates, or too many processed carbohydrates, or sometimes not even large amounts of carbohydrates, but just too many carbohydrates for their unique situation at the time, we’re going to start to see maybe highs and lows in blood sugar. And when blood sugar goes too high. This affects energy penetration in the brain.

Obviously, we need to get energy into the brain. So we can think and operate really well, in terms of focus, concentration, mood, and all those lovely things. The other thing is that if our blood sugar drops too low, we will also feel tired.

Blood sugar stability is the name of the game. We want to have stable blood sugar throughout the day. And to achieve that, we really want to be able to know what that breakdown of proteins, fats, and carbohydrates that we need in the diet needs to be, and to be eating consistently throughout the day, not too much, not too little. As I said, we can go into this in more detail further down the line in another episode.

But blood sugar imbalances are also associated with our mitochondria health. Our mitochondria are the little organelles in the cells where we create energy. So if blood sugar is imbalanced, that’s impacting the cellular machinery, which is important for energy production.

Therefore, we really want to get blood sugar balanced as we work towards more energy and better health. So we’ve got the energy balance dialed in, we’re stabilizing blood sugar throughout the day. What comes next? The next big thing that I start to think of when working with my clients is oxygen delivery. In the presence of oxygen, we make energy in the mitochondria, which means that we need to get oxygen from the air that we breathe into the body via the lungs, the bloodstream, and our cells.

That is a multi-step production line where multiple things can go wrong that would affect oxygen delivery in the cell and, therefore, the ability to produce energy. So here, the main thing we’re looking at is how we’re breathing. If someone’s mouth breathes, has sleep apnea, or has any breathing issues, then we’re not necessarily going to be getting oxygen into the body.

Once oxygen is in the body, we need to transport it. And the red blood cells are our oxygen transporters. If there are any issues with our red blood cell health, that’s going to affect oxygen delivery. Here we rely on specific nutrients like B12, folate, iron, B6, to make healthy red blood cells. Nutrient deficiencies, which then have a knock-on impact on blood cell health, will impact our energy levels and fatigue.

This is part of what I would call the low-hanging fruit. These are the things that are really important to test and address. First and foremost, they’re almost like the initial screening that I do with all clients how are your red blood cells? Do you have an oxygenation issue? What do we need to address here?

Because this can be a quick win for people if we have low red blood cell health or poor red blood cell health, and we can just take a few supplements and address that quite quickly and feel a little bit better, then we know that we can that’s done and dusted, and we can move on to other things with more energy to tackle those things. So talking about oxygenation segues kind of nicely into nutrient deficiencies. I’ve already mentioned B12, folate, iron, and B6.

But there are multiple different nutrient deficiencies that can be associated with fatigue. So for the purposes of today, I’m not going to talk about every single one. But I would like to think about this idea of nutrient deficiencies happening because something has gone wrong in that production line. We’re either not eating adequate amounts of certain nutrients, which can be common in restrictive diets.

Sometimes people will restrict their diets because they feel unwell when they eat certain foods. If there’s poor digestive health, and the nutrients aren’t necessarily getting digested, and then absorbed and transported appropriately to wherever they need to go in the body, then that’s going to be an issue for the functioning of the body, and the end result is fatigue. So there are many reasons why someone would potentially have nutrient deficiencies.

We could also have nutrient deficiencies if there’s a high need for specific nutrients, and therefore the body is burning through a lot of that nutrient and using it up, and so we have a high demand for more. For example, iron, which we know is really important for mitochondrial function and energy production, which we know it’s really important for oxygen, oxygenation, and the transport of oxygen around the body can also be used in our antioxidant enzymes, for example, catalase. So we need iron to make catalase.

But then if we’re, if we have a lot of damage, we have a lot of oxidation in the body, we’re going to need to make lots of catalase, and therefore our demands for iron can be higher. Then obviously, another classic one for iron is women with hormonal imbalances and heavy bleeding. So talking about nutrient deficiencies is also then a nice segue into gut dysfunction.

There are many reasons why gut dysfunction can cause low energy. One of those reasons is that if the gut is dysfunctional, we can have poor nutrient digestion and absorption. Then we have nutrient deficiencies, which can contribute to fatigue.

But because the gut is so closely linked with the immune system, infections in the gut or imbalances in the gut, like dysbiosis, and imbalance of the bacteria in the microbiome, can all have an impact on the immune system. This is essentially one of the things that can keep the body in a sense of threat or a sense of danger.

We know that the mitochondria, which are really important for producing energy, are not only energy-producing machinery, they are also defense machinery. The mitochondria are sensing the body and sensing what’s going on. Then make decisions about whether I should make lots of energy because it feels safe and well to do so.

Or are we under threat? Do we need to maybe shut down energy production or prioritize energy production in the immune system but shut down energy production in the brain and the muscles until this threat has been resolved? So if there are imbalances going on in the gut, or if there’s a gut infection, then that can potentially be a sort of signal to the mitochondria to say, there’s a threat here, we don’t want to prioritize energy production to the brain or to the muscles, we need to prioritize energy production to the immune system.

If you’ve ever had a cold or flu, which I’m sure that you’ve had what it feels like when energy is prioritized to your immune system, you feel tired, you feel foggy, you maybe have a headache, you feel socially withdrawn, you have flu-like symptoms. So those sickness symptoms that we get when our immune system is active are a consequence of this change in energy distribution, energy prioritize to the immune system, energy prioritize away from the brain and the muscle tissue. So this is just one of the mechanisms by which gut dysfunction can affect our energy.

There are many others, and in the future, I will do another podcast where I talk about all of these in more detail. But for now, just know if you have any GI symptoms, those symptoms could be a clue that you have imbalances in your gut, and you may want to look at the gut function and how it relates to your fatigue. Here that could be bloating, constipation, diarrhea, acid reflux, or cramping.

There are lots of different GI experiences people can have. And really, you want to be able to eat your foods, digest your food, no bloating, no smelly gas, or no excessive gas, a little tiny bit is okay, and have regular bowel movements without any issues. And so if that’s not happening, then it could be a sign that you need to look at your gut.

But sometimes I have clients who say, “Oh, my gut is fine, it works absolutely perfectly.” But they still have gut issues that are manifesting systemically. That means it’s manifesting in challenges with this skin, or maybe they have challenges with their joints, or maybe they have hormonal imbalances.

Other things are going on outside the gut, but the root cause is gut dysfunction. So I’ve introduced you a little bit as I’ve been talking about gut dysfunction as the cell danger response. So the cell danger response is a universal response to threat.

It’s really a change that happens in the body when the cells perceive that there’s a danger or threat. So as I’ve already explained, the mitochondria are not only energy-producing machinery, they’re also defense machinery. They’re sensing the body’s environment for infections, toxins, or stress in general, and then making decisions about energy production, should we make more energy, or should we prioritize energy towards the immune system at this time, we’ll shut down energy production altogether.

The cell danger response is a really helpful model for understanding fatigue. Because once the cell danger response has been activated, a series of biochemical changes happen in the body. These changes can be associated with dysfunction and imbalance, leading to chronic disease and, in this case, chronic fatigue.

So I won’t talk again in extreme detail about the cell danger response; that’s for another day. But it’s important then to understand that toxins can trigger the cell danger response, infections can trigger the cell danger response, and trauma, micro-traumas, multiple micro-traumas, like chronic stress, can trigger the cell danger response, but so can b traumas, and just general nervous system dysregulation. So these are the other factors that can possibly cause fatigue.

Usually, when someone has a chronic fatigue condition, and they’re addressing the nutrient deficiencies and balancing their blood sugar, they’re working on oxygenation, and their energy balances well. But they’re still kind of stuck in this very low-energy place. The stuckness is usually a clue that the body is almost stuck in the cell danger response because the body feels like it is still under threat. There is still something that is causing the body to feel threatened, hence the sustained low energy.

This is where we want to start to dig deeper. This is where I’ll talk a little bit about the root cause. What is keeping the system under threat? And how do we address that? So in some cases, as I’ve mentioned, it could be toxins. If someone has had mold exposure, they have mold spores in their body, and those mold spores are producing mycotoxins, that’s going to be something that keeps the cell under threat.

But there will probably also be multiple changes in the body’s biochemistry due to the damage created by those toxins. And again, I won’t talk about it in great detail today because I can talk about that in its own episode. But mold is a common cause of chronic fatigue syndrome.

But there can be other toxins that can also cause fatigue. We live in a toxic world we have multiple toxin exposures every day. Sometimes if we have one big exposure, for example, to mold and more and mold producing mycotoxins.

It weakens the body system. So the body struggles to cope with other toxins. Then there’s a load that builds up. And I have had a client who had breast implant illness, she had breast implants removed. But then she had multiple toxins in her body, heavy metals, plastics, and mold, because the system was overwhelmed and couldn’t cope with the toxicity.

In this case, we really want to sort of remove and avoid toxins where possible and support the body to detoxify so that that cell danger response can move through its full cycle, and the body and the cells no longer feel under threat. The next thing would be possibly infections. So we talked about gut infections, which could be parasites and just be a general imbalance of the gut microbiome or no other infections.

Sometimes people will get a virus, and then they end up with post-viral fatigue, or someone may be infected with Lyme disease and its co-infections. It’s a lot of people who have glandular fever, EBV, mononucleosis, whatever terminology you’d like to use, and then that can be a cause of their ongoing fatigue. So, again, that’s something I can talk about more in another episode.

But here, I like to think of this analogy of the window pane and the hammer. If the window pane is your body, and the hammer is the virus or the infection, if I throw the hammer at it, it shatters that window. If I go over to the shattered window and the hammer, and I pick up the hammer, and I take it out of the room, I’ve removed the infection, I’ve removed the virus, but there’s all this broken glass that still needs to be cleaned up. That’s usually the approach that we would take is that sometimes what happens is there’s been a big threat, and that big threat has created a lot of damage.

But even once we remove the threat, the damage itself that was created can also be a perceived threat. So even though the virus is long gone, there’s still much cleanup work. As we clean up those body systems that have become damaged and disrupted from the massive immune response needed to deal with that threat, the body becomes better again.

That’s essentially the approach I take when working with my clients who’ve had a major infection that’s been a trigger for their chronic fatigue. So the next thing on this list is trauma and nervous system dysregulation. Again, you’ve probably heard me say this so many times today, but I’ll go into this specifically in its own episode.

This is just a broad overview today. But chronic stress just regulates the nervous system. And we know that nervous system dysregulation keeps the body in a threat state. When the nervous system is stuck in what we would call sympathetic activation, so fight or flight, or even not necessarily stuck in fight or flight. But if there’s too much activation, it goes into a nervous system freeze and gets stuck there.

That can typically be associated with many symptoms that we see in chronic fatigue and burnout. But also takes a huge amount of energy to maintain a system that is constantly trying to survive. That’s what Steven Porges calls the cost of doing business.

The cost of keeping the body in this very heightened nervous system state is very draining on the body’s resources, nothing is being prioritized for the general sort of day-to-day housekeeping that we all need for rest, recovery, and repair that keeps the body systems healthy, isn’t happening. And nutrients are getting depleted, and we’re burning through our energy stores.

There are a lot of changes that happen biochemically in the body to sustain our survival responses. We need tools to help the body get out of that stuck survival response. Especially if someone has had big traumas.

Or especially if someone has a lot of adverse childhood experiences referred to as ACEs. This can make their body more sensitive. So sometimes, the actual event which triggers the fatigue or the burnout is a small event.

But it’s actually a big event relative to the body’s ability to tolerate because there has been so much that has happened before, even from childhood, that has worn the system down over time. Then something small needs to happen. That tips the scales over into imbalance.

These imbalances in the nervous system that are created across a lifetime can make someone’s immune system more susceptible to infections and more susceptible to toxins, and therefore, the immune system is weaker and then eventually loses its ability to cope. So there are just a couple more things that I wanted to touch on here. And the next thing is mitochondrial dysfunction.

Mitochondrial dysfunction is, as I’ve already explained, your mitochondria are your little energy-producing factories in the cell. And healthier and stronger mitochondria are associated with body resilience and our ability to make energy. What a lot of people might think that you need to do is just give nutrients that support the mitochondria.

But hopefully, now from listening to all of this, you can maybe understand that the mitochondria function has possibly become dysfunctional because of active cell danger response. So part of restoring mitochondria health is helping the body to feel safe again. Then yes, we want to do other things that support the mitochondria, like give them the nutrients they need, support cell membrane health, and support blood sugar.

But all of those interventions can sometimes be wasted, or possibly even make someone feel worse if we haven’t dealt with the root cause or that big threat. Then the other thing we want to think about, which I’ve touched on when we talked about toxins is toxic load. When the body is overwhelmed with toxins, we are overwhelming the cells and entering into a cell danger response.

We want to consider detoxification, supporting the liver and the kidneys, and the drainage pathways like the gut and the skin and our ability to sweat and how we breathe and supporting all of those pathways to reduce the overall toxic load. Then lastly, kind of all the way there on its own is hormones. So hormones can be, to a certain extent, a root cause of fatigue, which might be as if someone has very low levels of certain hormones.

For example, women entering perimenopause, who have low levels of progesterone, or perhaps athletes who are overtraining, undereating, and may have low levels of estrogen, specifically. So sex hormones can be a fatigue factor. But I find that sex hormone balance is usually a byproduct of everything else going on.

When the body is in a cell danger response, it’s not really prioritizing reproduction. It’s just not the most important thing at that point in time. So we want to work on the overall health of the body systems, get the cell out of threat support, just general and healthy adrenal functions so that the body is coping with stress day to day, we’re keeping blood sugar balance, the body has all the nutrients that it needs, the gut health is working well. When we do all of those things, sex hormones usually get better.

So that would usually be my approach: let’s deal with all those foundations first, and then either test sex hormones are circled back in test sex hormones and then decide if we need to intervene. And in some cases, we do, and in some cases, body identical hormone replacement therapy can be really helpful. So that’s what we might consider when we’re looking at sex hormones.

But I think that there can be an attitude where people say, “Oh, it’s just my hormones.” And they either just want to take hormone replacement therapy, but they’re not addressing all the other things that are going on or do not understand the connection between hormones and everything else going on in the body. Then the last thing would be thyroid hormones.

Yes, under active thyroid can be a cause of fatigue. So that’s something that I would usually test for do an initial screen, rule it in, rule it out. If we see that underactive thyroid is an issue, we want to consider how we would deal with that.

Does this person need medication? Do they need to speak to their doctor about that medication? Is it more borderline? Do we want to support the cell danger response again because that can impact thyroid hormone? Do we want to give important nutrients for manufacturing those thyroid hormones?

Again, considering where the thyroid is in the picture of everything else going on, and if there’s thyroid autoimmunity, like caching motors, we also need to consider how we support the immune system’s tolerance. So you might be wondering, the one thing I probably haven’t mentioned so far is adrenal dysfunction and what is colloquially called adrenal fatigue or tired adrenal glands. I haven’t given too much attention to this because I often don’t find that it’s that relevant in practice.

I get asked this question very often on social media. Now, what’s the relationship between chronic fatigue, adrenal fatigue, and burnout? I want just to say if I’m clinical practice is I have clients with chronic fatigue, fatigue or burnout with normal adrenal function, high adrenal function, low adrenal function, and have tried to work on adrenal function specifically, and then not really seeing adrenal profiles change.

Where I’ve kind of arrived personally, in my practice, is, let’s support the whole body and the nervous system. If we do all of those things, and someone feels well, great, and what this looks like in terms of an adrenal profile test is maybe not as important as how they feel. If they feel like they’re making progress and having success and their fatigue recovery, they’re feeling good.

I will also probably do another episode in the future where we talk about the adrenal glands specifically. So that is everything for today in terms of the causes of fatigue, general and chronic fatigue syndrome specifically, are there other things that could be causing fatigue? Yes, maybe, but these are the major players in the game, what I would call the big rocks.

This is where you can look as you start exploring what could be at the root of your chronic fatigue or burnout. I’ll see you in the next episode. And once again, if you have enjoyed today and are experiencing value from the information I’m sharing, please leave a five-star review on iTunes. When you leave a review on iTunes, that helps other people who might need or benefit from this information find the information in the first place.

It would be really much appreciated by me. And of course, if you’ve loved the episode if you know somebody who may benefit from hearing it, share it with them, and share the love. So again, I’ll see you in the next episode and have a wonderful fatigue recovery day.

Episode 2 – My Fatigue Recovery Story

Anna Marsh — Fri, 02 Sep 2022 19:46:28 +0000

Show Notes

Who doesn’t love a recovery story? In this episode, Anna talks from the heart and shares her journey recovering from Chronic Fatigue Syndrome and Mold Illness. She shares both her personal and professional learnings that have shaped the framework she uses in her practice to help others make their own recoveries.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

MY FATIGUE RECOVERY STORY

Hello, and welcome back to the fatigue and burnout recovery podcast. I am your host, Anna Marsh. In this episode, I’m going to share my fatigue recovery story. And just full disclosure, I haven’t planned anything; I will talk freely and hopefully share from the heart.

Before I go into everything, I guess I wanted to say that often, for me personally, and maybe for many people as well, it can feel really self-indulgent, having this platform just to talk about yourself. So in some ways, I feel it can be quite cathartic to share one story. At the same time, there’s a lot of self-judgment thinking; or who would be interested in this, and is this just a self-indulgent way to express myself? So I’m just going to go for it, I think. And what I would say is that every single person’s story is different.

I know in my own recovery, I would read stories, maybe from other people, and listen to other recovery stories. I would think maybe there are certain stories that really resonated with me. And then there are parts of stories that maybe resonated with me.

Then there are other stories where I used to think, well, that person is 10 years younger than me, or that person had post-viral fatigue, and I didn’t have post-viral fatigue, so it’s not relevant to me.

I would encourage you if you’re listening to this and you’re committed to listening to the rest of this episode, to notice how you respond to the content and take what serves you, discard what doesn’t, and come in with an element of curiosity, because there may be some lessons and insights which will help you reflect on your own story.

And there could be something in here today that helps you move the needle forward with your own fatigue recovery journey. So from my heart to yours, I just want to say that I really hope there is something here today that can be of value to you. And if not, hopefully, there will be more value in future episodes.

So the first thing that I guess I wanted to say and express was that I had my first fatigue experience quite young when I was nine years old. I had been doing my homework at the dining room table on a Sunday night. And then I lay down on the floor, and I just said, It’s too much, I can’t, I’m too tired.

It wasn’t that I was trying to get out of doing my homework like most nine-year-olds probably would be on a Sunday night. But there was just a feeling of lethargy and exhaustion in my body, which I suspect at the time was emotional. To a certain extent, obviously, at the time, I didn’t know that there was a lot of family stress going on. My parents were separated and getting divorced.

There were some other dynamics going on in the home, which made life a little bit stressful. There was just a lot going on for a nine-year-old girl who maybe didn’t know how to manage the emotional enormity of the situation. And nobody knew what was wrong with me. I took a month off school and went to various different doctors. I was eventually diagnosed, rightly or wrongly, I’ll never know, with nephritis, which is inflammation of the kidneys.

I think I was put on a lot of antibiotics and medications, I had to take time out of school and rest. Eventually, I was building up my school hours. So I would go for the morning. Then I would go until lunchtime and eventually stay for the full school day. And I wasn’t allowed to do any sports or anything like that.

So I did sort of recover over the course of six months, I had a relapse a few months later and just went through the same process again of resting and then building myself back up. And then all was well for a really long time. I was a very normal, maybe not even normal, probably very high achieving child, very a type personality, academic, high achieving in school, got good grades, all of that.

I was never really good at sports, but I enjoyed exercise, swimming and running, and aerobics classes. That’s what fueled my interest in my first degree, Human Kinetics and Ergonomics. I had always had an interest in nutrition, because when I was diagnosed with nephritis, I was given some really bad advice, which was to eat lots of carbohydrates to increase my energy levels.

As you can imagine, the increase in carbohydrates ended up being donuts and ice cream, and packets of crisps. It wasn’t very good for me. I probably gained about two stones over the course of a few months and went straight into puberty at nine years old. So there was also a lot of body image stuff, shall we say, thrown in the mix there. My body changed very quickly, it felt very out of control at a time in my life, where there was a lot of emotional change happening in the household.

I think I just wanted to lose weight and be a normal child. And because of that, I developed an interest in nutrition. So the plan was always from a young age to study nutrition. But that wasn’t available in the hometown where I lived. My parents worked for the local university, and education was essentially free, which was a huge privilege. Therefore, it made sense for me to go to the local university and study Human Kinetics and Ergonomics, Sports Science, and Biochemistry, so that I can set up with the foundations.

So should I later want to do further nutrition studies? So that’s what I did, had a very typical university lifestyle, lots of partying, lots of late night drinking, and not eating very well, but still very much interested in sport and still doing very well academically. But by the time those university years came to an end, I knew that nutrition was still my passion.

And the opportunities available in South Africa at the time were limited. I was off, I was busy completing my honors project. I was struck down with appendicitis. And I was bed bound in recovery after having my appendix removed. And so lying in bed, unable to do anything, or go anywhere.

I began thinking about the future and what I wanted to do next. I got on Google, and I started researching. I started to research nutrition courses in the UK. And I found the course that I really wanted to do, I just read the prospectus. I was like, this is everything that I’ve wanted to study my whole entire life. And little did I know at the time, it was based on functional medicine, or the functional medicine model.

So I’m very fortunate. My mum is English, my dad is South African, and I have a British passport. So the idea of moving to England to study wasn’t as daunting as it would maybe be for someone else. So I had a call with the university. I made plans to start the course online distance learning from home for a year in South Africa. And then the year after that moved to the UK to complete the practical elements, the elements that couldn’t be done via distance learning.

This was before zoom, and all the fantastic technology we have today. So this was 2007. I began that degree, quite a while ago now. I had to travel to the UK to do certain aspects. They used to post me DVDs of the content all the way to South Africa, because there was no online learning platform at that point in time.

Anyway, slight digression. So I moved to the UK in 2008. When you’re young, you just make decisions, and you do things because you don’t think so much about the consequences. I think that maybe in some ways, that’s a good thing. Because you think more about what can go right as opposed to what can go wrong, and therefore you take risks and you take leaps of faith.

And that was definitely what I had done. But when I landed in the UK, there was also the reality of just finding somewhere to live or finding a job. The plan was that I would work as a personal trainer in a gym so that I had the flexibility to work and earn a living to support myself but then the flexible time.

If I needed to take a day off to attend a training or do coursework and I could study, in between and the hours when I wasn’t working with clients, but it was a very full-on job because you work first thing in the morning sometimes until the last thing at night. So some days, I would leave the house at 5:30 in the morning, and I would get back at half past 9:10. And just sort of fall asleep, wake up and do it all over again.

So that was a huge strain that was starting to take its toll on my body. In addition to that, it’s just stressful. I think living in a foreign country, which is culturally different, you don’t have the support network or connections you might have in your own country.

Then the financial pressures of running your own business in a country where you don’t have the support network, and you don’t have the connections, and you’re trying to study, all on top of that. So there was a lot going on. And the signs definitely started to show in my body, and had a lot of IBS-type symptoms.

I think given all the antibiotics I took due to the supposed nephritis diagnosis as a child, my gut has always probably been a bit of a weak point. And there are a lot of IBS symptoms, brain fog, hormonal imbalances, my skin, which has never, I’ve never had bad skin, but my skin was just starting to break out a little bit more, and just extreme fatigue. It wasn’t enough, I think, to be called chronic fatigue syndrome at that point in time.

But I was tired. I was very, very tired. Life was hard. And it was a slog. But fortunately, I was studying health, I was studying nutrition, and I was learning about functional medicine, even though I didn’t know it at the time.

I was able to start to do things to support my body, I was able to balance my blood sugar, I was able to take supplements to support my digestion, and I used herbs to support my adrenal glands. I worked on lifestyle components. So I found a place to live where I felt that I could be more settled and more rested. And as time went on, I built those important support connections that we all as human beings need.

And it did take some time. It took a good, I’m just thinking it was sort of 2009, 2008, 2009 through probably until 2011. So good two or three years to really find my feet and cultivate a good stable sense of energy and well-being again.

That also came hand in hand with me discovering CrossFit in the very early days before CrossFit was so mainstream. And I loved it, it really appealed to my competitive nature. I would push myself very hard physically.

And it was fantastic. From the community aspect. I made so many friends and connections and I really felt like I was part of something, which is something very important that had been missing when I first moved to London. I think it was also really, really intense. I would frequently get a bit run down and get some colds and flus, I think my immune system was still a little bit compromised at the time.

I remember I was just about to do my first big CrossFit competition, and I had been training so hard for this competition. And then, the week before, I was just struck down with the most awful flu. And honestly, I don’t think I have been that ill since that day, it was a proper flu with body pain, and fever and fatigue, and all of those things that we would associate with the full-blown flu.

Obviously, it’s not nice to have the flu, it’s not nice to have those experiences. But actually, the ability of the body to generate a strong fever is a sign of a healthy and robust immune system. So there’s a reason why I share this is because I had that flu, or I got that flu on a Sunday, and I was due to compete by the Saturday.

And by Saturday, I was feeling okay, but I wasn’t fully recovered. I pushed my body to complete the competition because I had been training so hard for it. I didn’t want to not compete. But in hindsight, which is always 2020, I think back now, and I think I probably was like a small beginning of the end because I think I pushed my body too hard when it wasn’t ready.

I remember it taking quite a few weeks after that competition for me to feel like I could train again and like I could exercise again. Then from that point in time, I’d say the wheels started to come off a little bit, and I started to develop some niggling injuries. By the end of that year, I remember taking time off for Christmas, and I had mouth ulcers and aches and pains in my body, and I just wasn’t feeling very good. So there were those niggling symptoms creeping back in.

And it was nothing major, nothing. When you’re busy, young, and doing things, you just sweep these things under the rug, and you keep on going. And it wasn’t something that was impacting my life in a huge way.

So I just kept on going. Then I was offered the opportunity to do my master’s degree in personalized nutrition. I took that opportunity up. And so again, I was working, and I was studying. And it was things that I enjoyed, but it was still a lot to be taking on.

Then additionally, I was training very hard. So that went on for a period of time, and I met my now husband Ben, and we decided that we wanted to move to where I live now, which is the southwest coast of England. And 2014, we decided to make the move, I had just finished my master’s.

I had been working on taking my business online to prepare for the move because prior to that, I’d had a very physical in-person practice. Now I needed to take things online so that I would still have a job as we moved. So that all happened. And in some ways, that was a really great move. I love being on the southwest coast, I love living by the beach, I was never really into the big city.

I think that was something that was also quite a lot of stress and strain on my nervous system. But at the same time, there were a lot of additional challenges that came with taking my business online, there was new technology that I needed to learn, and there’s this idea, your work is always just there on your laptop or your phone. And it’s very easy to be available to people all the time.

I had invested all of my savings in working with a business mentor because I realized I didn’t know what I was doing. I needed help. So although that was a fantastic investment, it really helped me grow my business and achieve a lot of business success. There was also a lot of pressure to make things work. And I was learning so much so quickly growing so much so quickly.

And it was amazing. But at the same time, it was also just a lot. That was probably the trend for the next couple of years. So at that point in time, because of my background in fitness, I started an online weight loss program. And the program was really successful.

I think in the best year in business, we turned over 180,000 pounds. That was with a small team. So there I had an assistant, full time assistant and sales representative who worked for me, I had a coach who worked with me, I had a you know, various contractors, designers, someone who helped me with Facebook ads, various bits and bobs.

And it was also investing a lot of the money that was being made back into the business and also into my own education and skill set. So I was running this business and traveling to America to do my functional medicine training. Also, running retreats, traveling to Italy and Bali, and upholding the business day to day was also a lot of pressure.

And so there was just so much going on. I think even though the business was earning good money and felt like just as soon as the money was coming in, it was also going out. Therefore I constantly felt financial scarcity.

There was always pressure every month to make sure we onboard enough new clients to keep the machine keep feeding the machine of the business. I think that was a really big thing that started to take its toll on my body. At the same time as traveling internationally with jet lag, I was pushing myself very hard in the gym.

And there was an emotional component to running the business as well. I was working with women who wanted to lose weight, a lot of them are really struggling with their bodies their body image and as someone who is very highly sensitive and caring, and it was a lot to hold those emotional experiences of others. Because that was actually something that I still needed to learn to do for myself.

Often, when we run our own business, it shows us the lessons we need to learn. I had a lot of lessons I needed to learn around. I still do have a lot of lessons I need to learn about pleasing people, setting good boundaries, work-life balance, and taking on the emotional energies of other people.

So all those things were also invisible stresses the inability to set boundaries and constantly trying to help others at the expense of my own self-care. And people-pleasing, poor boundaries, all of that, that was something that was silently also creating wear and tear on my system. So I had the financial stress, those hidden emotional stresses, the stress of travel and disruption to my circadian rhythms, imbalances that were probably niggling away at my body from before, like gut imbalances.

Then the stress of just pushing myself hard in the gym and training very hard. And throughout this whole time I ate well, so it wasn’t like I had a bad diet, I was definitely eating well to support my body. When I wasn’t straddling time zones, I was good at making my sleep a priority.

I slept well. I was into yoga, I was into meditation. And I found Joe Dispenza in 2017. And I love Joe Dispenza. And I would do his hour-long meditations. I attended his three day retreat.

So it wasn’t like I wasn’t taking care of myself. There was a lot that I was doing to support my body. But there was also a lot of stress on my body. And something that I also probably now only realize in hindsight, is I think, when we first moved down to poor Bournemouth in 2014, we temporarily lived in a home, which I think possibly had mold. And it’s actually from that point in time, that I started to get these little niggles of fatigue, and feeling a little bit more flu, like after training a little bit too hard.

I’ll never know for sure. But I wonder if I had put it down to the stress of everything going on at the time. But I wonder if that’s when I had mold exposure, which also had a bout of some sort of gastric flu about the same time. Then it was my whole system, I like to think of it as circling the drain.

So my system began to circle the drain from that point onwards, and I wasn’t ignoring my body completely. I did various testing, took supplements, and working on supporting my gut. But what I didn’t have at the time was a framework for really understanding what was going on.

I’ll talk about this framework in more detail in future episodes. And what I know now from what I say with my clients is that when someone experiences chronic fatigue and burnout, it’s usually because the system is being worn down over time. There’s often one big thing, which is the straw that breaks the camel’s back, but not always.

Often, it’s a collection of things. This collection of things is essentially what I’m sharing with my story as I share it with you. So you can understand my unique connection or collection of things. But your collection may look totally different. Once we’ve got these sorts of different things which are wearing down the system over time, it’s like dominoes.

So different body systems begin to become dysfunctional because it’s trying to make adjustments so that you can continue going so that you can cope, and so that you can survive. And so that’s where these little clues come in, like the digestive imbalances, the hormone imbalances, the immune system niggles, they’re all just little signs, which are showing you that your body needs some attention and care. Unfortunately, I couldn’t see the bigger picture of all of the loads on my body.

Therefore I was just going in at the sort of surface level and thinking, Oh, well, I’ll fix my gut, or I’ll take some supplements for my adrenal glands. Instead of thinking, Whoa, there’s a lot of pressure on me here. What do I need to change within myself?

And what do I need to change in terms of lifestyle and business that will really support my body? I just tried to put bandaids or plasters over the wounds instead of really getting to the bottom of what was going on. So this pattern continued for a number of years.

Then I remember in 2016, it had been a really big year for me. I had gotten married, I had done various international travel, and Ben and I were in the process of buying our first flat. I just got back from a trip to Japan.

So lots of jetlags. I just never felt the same after that trip. I started to just feel really fatigued, and foggy, and just demotivated, which wasn’t like me at all, I was a very high energy driven person, very focused, and then just didn’t have that anymore.

But it wasn’t that bad. It’s just like, waxed and waned and waxed and waned, and I’d go back to the gym, take some time off, or do too much. I’d feel really foggy and inflamed, but then I’d rest a bit, and it will be okay for a bit.

So I was just keeping on going, but never taking that big step back to see the bigger picture and say, what is really going on here? I thought I had it all sorted, I was eating well, I was sleeping well, and I was doing loads of meditation and yoga, but just nothing seemed to be giving me the real traction that I needed. So that was 2016.

This pattern continued through 2017 and 2018. Each year, just getting back a little bit worse and a little bit worse. Then eventually, at the beginning of 2019, I went to Sri Lanka, I took a month out of my business, which was a really big deal for me.

I spent a month in Sri Lanka doing my yoga teacher training. That was an incredible experience I had, I was mindful of this tendency towards fatigue, but actually taking the month out being in the sunshine, the fresh air, meeting wonderful people, and just doing yoga was really good for me. My diets weren’t very good because of what was available at the time.

My sleep wasn’t very good, I think because of my diet. But otherwise, the experience was really positive. But when I came back, and then I almost felt like I’ve taken all of this timeout, and I really need to hit the ground running, and do everything and get back into the business and start earning money again, then that’s when the wheels just started to fall off.

I just couldn’t seem to cope with reentering my life as it was. Eventually, that’s when I went to the doctor, I had the symptoms of chronic fatigue syndrome printed out from the NHS website. I knew it was a new hat, and I had pretty much all of them.

I just didn’t know what to do. I just felt like I needed some help. And being trained in functional medicine and nutritional therapy. I did feel a little bit skeptical about going to the doctor and what they could do to help me, but it was also really scary to be experiencing what I was experiencing and not really know what to do and where to turn because I felt like I was doing so much or really just supporting my body.

And so went to the doctor ugly cried in the doctor’s office. She was very sweet. She said are you experiencing a bit of stress right now? And I was like, No, I’m not stressed. Classic.

You know, I was completely disconnected from what was really going on. I was very stressed, and obviously, experiencing that experience is inherently stressful. Anyway, the doctor ran some tests. And this will be very familiar to all of you, which is pretty much normal. They would like one or two markers that were off, I think maybe like my neutrophils or white blood cells, one of the full blood count markers.

Then just to come back in six to eight weeks and retested, everything was fine. At that point in time, I almost jumped ship on the diagnosis process because I think when you’re overwhelmed with what’s happening to your body, you have to show up at appointments and advocate for yourself to get the appointments and get tested. I just felt like I didn’t need to know that this is a thing or that I have this thing.

I don’t need this diagnosis to begin to move forward with my health. So I decided to work with a contact I met through my functional medicine training. I had developed a friendship with a wonderful woman, Dr. Lacey Chittle, who had an autoimmune condition and fatigue associated with that autoimmune condition.

And she was thriving. So I reached out to her and said, I think I need your help. So we began to work together. And the work that we did together was invaluable. She really just helped me with a lot of my blind spots.

So although I was trained in Functional Medicine, I was trained as a nutritional therapist, and I had more than a decade of experience at this point in time. We all have blind spots, we all have the things that we can’t see for ourselves, and it takes somebody outside of us to help us see those things, I learned so much from her professionally because different practitioners have different levels of experience in different areas and different skill sets. And it was really expensive for me, not just personally in my fatigue recovery but in my own sort of professional growth as a professional.

So that first year from 2019 to 2020, I actually did really, really well. I was progressing, and things were heading in the right direction. But at the end of the year, for a short period of time, about two or three months, I ended up living in my mom’s flat while she was back in South Africa. And at that point in time, I didn’t know it at the time, I think I had another mold exposure.

Episode 1 – Welcome to the Chronic Fatigue and Burnout Recovery Podcast

Anna Marsh — Fri, 02 Sep 2022 19:42:56 +0000

Show Notes

Welcome to the Chronic Fatigue and Burnout Recovery Podcast. Your host, Anna Marsh, introduces herself and explains what you can expect from listening to the show. Anna is a Trauma-informed Functional Medicine Nutritional Therapist who has worked in the health industry for over two decades.

However, when her health began to circle the drain, and she was eventually diagnosed with Chronic Fatigue Syndrome (CFS),
Anna realised there was so much she didn’t know she didn’t know about health generally and fatigue specifically.

In her fatigue recovery journey, she realised there weren’t many valuable podcasts dedicated to fatigue recovery.

The Podcasts that did exist were from people who had recovered but didn’t have the scientific background OR those who had scientific knowledge but not a personal experience of the debilitating effects of fatigue.

Then there were those with a nervous system-centred background but without a deep understanding of where Functional Medicine meets trauma-informed care.

Anna’s goal for this podcast is to offer insight from a deep understanding of the experience from a Functional Medicine and Trauma-informed lens while integrating her personal experience overcoming the condition.

Useful links:

Website: https://annamarsh.co.uk/

Instagram: https://www.instagram.com/anna_marsh_nutrition/

Fatigue Recovery Quiz: https://app.annamarsh.co.uk/quiz

Welcome to the chronic fatigue and burnout recovery podcast.

I am your host Anna Marsh, a trauma-informed Functional Medicine and nutritional therapist, which I appreciate is a bit of a mouthful.

I just wanted to create this introduction episode today to talk to you a little bit about the podcast, and a teeny tiny bit about myself, so that you can know what to expect. And if it’s appropriate to keep on listening, I’ll be sharing a much more detailed account of my own fatigue recovery story in the next episode, but for today, I thought I would keep it brief and just share some of the bare bones back.

So I have been practicing now as a nutritional therapist since 2009. Over time, I’ve also done my certification with the Institute of functional medicine.

Although my master’s degree is in personalized nutrition, I am South African, if you can hear a little tinge of my accent. I grew up in South Africa and did my first degree in South Africa, in what was called Human Kinetics and Ergonomics, which I usually say to people is the same as Sports Science and Biochemistry.

I have a lot of training in the human body and its workings, including working with clients.

Despite all this experience and knowledge, I was not invincible. In 2019, I hit my health rock button or my energy crisis. I was diagnosed with chronic fatigue syndrome. When I was diagnosed, I began to search for more information.

Of course, I was at an advantage because I already had a background in health and was already connected to various people, practitioners, and thinking frameworks.

So maybe it was a little bit easier to find the information, but I found having a lived experience of chronic fatigue. Combining that with what I knew from professional practice made my professional practice so much more powerful. It helps me understand that unless you’ve lived through the trauma of having a chronic illness or burnout, it’s tough to understand what that’s like.

And yet when I was searching for podcasts and information to help me understand the condition better and why I couldn’t exercise and keep on getting this post-exertional malaise and all the extra challenges that we experienced that we don’t fully understand and know how to address. There were hardly any podcasts available on chronic fatigue syndrome specifically.

I found that what was available was either created by practitioners sharing information about the condition without a lived experience or those who had experienced the condition but didn’t necessarily have the practical scientific and biochemistry knowledge I needed.

The shared information was surface-level, and I wanted to go deep. So that’s what I hope this podcast will share with you.

I hope this podcast will bring a combination of that lived experience and a deeper scientific understanding of what’s going on in your body and how you can address it. Not just the basic stuff at the surface level, but understanding the nuance and complexity of what may be happening in your body.

Since having this chronic fatigue experience and sharing it online, I have attracted clients who are also going through the same thing. And I have the privilege and the honor of working with women with all types of fatigue conditions, whether burnout, fibromyalgia, chronic fatigue syndrome, and all the nuances in between. And I run many tests on my clients and see many test results.

There are similarities in every case, yet every case can be unique and need its approach. And therefore, my job is to tease out what each person needs based on how they’re doing because sometimes we can also need the same things. But our nervous system isn’t necessarily ready to implement and apply those things at that specific time.

So really, what I’m trying to say and communicate is that there’s a broad range of interventions we can use to support burnout. We can use it to help with chronic fatigue, syndrome, and other complex energy conditions.

Different things work for other people. Some things are inappropriate for some people. And some things are universal.

Nevertheless, we all want to pay attention to some items as we work towards better health, more energy, thriving, and aliveness.

That is why I hope this podcast will bring a combination of science, the nuance within science, and lived experience perspective.

Finally, something I haven’t touched on yet, which is the trauma-informed piece, is also combining this with an understanding of the nervous system and how we need to work within the capacity of the nervous system to make the interventions required to heal and become fully well and fully thrive.

I hope you enjoy the journey with me. I have done podcasts before with a co-host, but this is my first time as a solo host. It feels weird sitting here talking to myself. I hope to bring you some great content over the next few weeks, months, and hopefully years.

And I would love it if you could subscribe to the podcast. The intention is to release a weekly episode. So you can get that in your app, inbox, or wherever these things go weekly.

Leave a review if you’d like the content because podcasts are generally found and ranked based on reviews and downloads.

So if you are enjoying what I’m sharing, leaving a review helps other people find these podcasts, and then the podcasts can help them, too. So that is everything for me today.

In the next episode, I’ll talk a lot more about my personal story as we kick off all the information and everything to come.

I’ll see you in the next episode.