Nutrition: Fatigue (tiredness)

Friday 04 May 2018


Fatigue, ongoing tiredness not remedied by a good night sleep. An absolutely awful feeling, limbs are heavy, real brain fog,  no enthusiasm, the smallest thing seems to blow out of proportion and you cannot see the wood for trees. This is a real problem for people with cancer and even those in remission can suffer fatigue for several months or even a year after treatment has stopped.

According to Cancer Help UK, fatigue is the symptom that has the most impact on people with cancer.

Why does fatigue occur?

There are so many reasons why fatigue occurs ranging from an increase in the body’s production of cytokines, which are chemicals produced by the cells as a means of communication, low iron levels resulting in anaemia, loss of appetite, nausea and diarrhoea, usually as a result of treatment and low mood can all be contributors. It is a very real problem and many visitors I see ask me about fatigue and what they can do to improve their energy levels.

How can food help fatigue?

  • Control blood sugar One of the most important steps that can be taken is to control blood sugar. I wrote about this in my last blog. Not to allow blood sugar levels to become too high or too low by choosing foods that release their sugar in to the blood stream slowly. Try to eat Protein foods with each meal and snack is recommended because protein helps to stabilise blood sugar. Snack on foods like nuts, seeds, oatcakes, whole meal bread, oats, nut butters and humus etc. Erratic blood sugar can be one of the biggest causes of fatigue. It also can have an adverse effect on mood, concentration and quality of sleep. If you need a refresher on blood sugar and how it can affect you, why not have a look at my blog from last week, or if you have any specific questions then please feel free to contact me directly.
  • Obviously it is also important to try and eat enough food to give yourself sufficient calories, In my second blog I recommended that some foods from each of the food groups should be eaten in order to nourish the body and supply enough energy, and in blog 5 posted the Blueberry and Avocado drink that could be used for those with a reduced appetite to not only to nourish but to add vital calories to the diet.
  • Apart from all of that information there are particular nutrients that need to be focused on that should help to combat fatigue. These nutrients are fundamental for the mitochondria in the cell (the energy centre) to produce energy. These are namely Magnesium, Co-enzyme Q10 and vitamin B3. These nutrients can be easily lost through treatment and stress.

    Magnesium is involved in over 300 different enzyme activities in the body in particular those involved in energy production. Magnesium rich foods are;
    Nuts, seeds, dark green leafy vegetables, wheat bran, millet, peas, beans and lentils and to a lesser degree, brown rice, dried fruit, avocado and parsley. So it would be a good idea to try and include these regularly in your daily eating, see my recipe below for a luscious lentil soup. A supplement may be useful, 300-500mg of magnesium glycinate would be recommended. Before taking any supplements it is important to check with your medical team at the hospital to make sure that there are no contraindications important if you are still having treatment.

    Co-enzyme Q10 is involved in the production of the energy currency in the cell. A role similar to a spark plug and a car engine. Just as the car cannot function without the initial spark the human body cannot function without  co-enzyme Q10, which would make sense of its importance. Q10 is found in every plant and animal cell. However the amount of Q10 from dietary sources is probably insufficient to combat fatigue. In this case a supplement may be helpful  but again check with your medical team. If you do decide to take a supplement 100mgs of Q10 daily would be recommended.
    Vitamin B3 known Niacin, also plays a vital role in energy production, in particular carbohydrate metabolism. Foods rich in niacin are;

    Organ meats like liver, eggs, fish, peanuts (unsalted), peas, beans and lentils, whole grain foods (like whole wheat flour products, oats and brown rice and avocados as are most of the  B vitamins.

    I would not recommend taking B3 as a supplement in isolation. It is always better to have a B complex as all the B vitamins work in synergy as a team. Again check with your medical team before embarking on any supplements.

    Another recommendation that I usually make is to reduce or cut out the amount of red meat that is eaten. The theory behind this is very simple. In order to digest and metabolise red meat the body uses up a lot of energy. This is energy that could be used in better ways. I can remember years ago when I was first training as a teacher we had to study ‘feeding convalescents!’ which involved learning how to steam white fish!!! The logic being that it was light for the digestive system which now makes perfect sense. Not that I am saying that you should stick to steamed white fish. Things have moved on from then.   However red meat is of course a good source of easily absorbed iron and as we know, anaemia can also contribute to fatigue and is very common in people receiving cancer treatment. Well to overcome this I have listed below the foods that are rich in iron other than meat.
    Food sources of iron other than meat;

    Molasses
    Cocoa
    Oat germ
    Seeds,
    Millet
    Almonds
    Prunes,
    Parsley
    Curry powder
    Dark green leafy vegetables
    Pulses
    Dried apricots
    Egg yolks
    Black treacle
    fortified breakfast cereals.


    Note that iron from these foods is better absorbed if vitamin C is present so by adding a tomato, or slices of pepper or an orange or any fresh fruit and vegetable will give you some vitamin C and enhance the iron absorption.
    Simple Ideas could be; a tomato omelette with rocket, or dried apricots soaked overnight served with live bio yogurt and topped with ground almonds and some seeds. Or Lentil soup or curried vegetables with brown rice.

    Of course if you are suffering from fatigue then it is very important to pace yourself, get plenty of rest but also try and build in some gentle exercise as this stimulates circulation and the immune system.

    I am actually a huge fan of soups as they are economical to make, nourishing, easy to eat, not difficult to prepare and will freeze for days when you are particularly tired.

Lentil and tomato soup a nourishing soup which can be served on its own or with a wholemeal role, or some cooked brown rice stirred in before serving or eaten with some oat cakes.
1 tbsp olive oil or coconut oil
1 large onion peeled and finely diced.
2 large carrots washed and grated
2 tsps ground coriander
1 tin of chopped tomatoes.
8oz red lentils.
1 ¼ pts of water.
Seasoning.

  1. Saute the onion and carrot in the oil till soft about 5 mins., stir in the coriander and lentils, mix well.
  2. Pour in the tomatoes and water and bring to the boil.

Turn down and simmer for about 20 min till lentils are soft and falling. Take off heat and cool slightly then liquidize till smooth and creamy, season to taste and serve.

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