Part 4: Unexpected Reasons You Might Have Fatigue

by Gavin Guard, PA-C, MPAS, CISSN, Pn1

Medical Director, Roots Integrated Care

If you missed it, be sure to check out part 1 through 3 of this series. Let’s pick up with reason #4: Dietary Mismatch. Here are the most common examples from my clinical experience:

Too much food

Too many calories and food can contribute to weight gain, poor blood sugar, inflammation, and hormone imbalances. All of which can contribute to fatigue.

Unfortunately, 90% of the population is characterized as overweight. Too many of us are eating too many calories but not enough nutrients to match our energy demands.

Nonetheless, saying “just eat less” is not only unhelpful, but potentially dangerous. It’s important to get a coach to help you work through single practices at a time without overly restrictive diets. That is exactly how I help patients through nutrition coaching.

Too little food

On the other end of the spectrum are those who are not getting enough food. This is less common than overeating but it still happens.

I see this trend more commonly in more active adults and in younger women who are trying to get fit by overly-restricting their diets.

Eating too little food also poses a risk of getting an insufficient amount of vital nutrients such as magnesium, zinc, B12, omega-3 fatty acids, calcium, and iron.

For most individuals, you probably want to get a balance of protein, carbs, healthy fats, and plenty of veggies/fruits that work well for your digestive system. Not enough of these can certainly lead to symptoms such as fatigue.

Fiber intolerance

Many health gurus claim that since fiber feeds your “gut bugs”, then more fiber is better. However, seemingly healthy high-fiber foods (e.g. broccoli, avocados) can be problematic for some folks, especially for those with digestive issues.

Why is this?

Fiber intolerance → poor gut health→ inflammation and immune system dysfunction→ fatigue and low energy

A dietary template that addresses fiber intolerance is called the low FODMAP diet. A low FODMAP diet has been shown in many studies to improve IBS, inflammatory bowel disease, pain, fibromyalgia, and overall quality of life.

Histamine intolerance

Another type of dietary mismatch that can contribute to fatigue includes too much histamine ingestion. This is another example of how seemingly healthy foods can be problematic. High-histamine foods include spinach, sauerkraut, fermented foods, aged cheeses, and alcohol.

Histamine intolerance affects about 1% of the population and up to ½ of those with digestive issues.

Addressing histamine intolerance can lead to improvement of energy and symptoms such as brain fog as found in one study.

There’s less research on histamine intolerance as compared to other studies so I usually wait to use this for patients unless they have a clear need for it.

How to address dietary mismatch

With anything else, work through a stepwise approach to your nutrition. Start with the fundamentals and work through more nuanced dietary templates if you don’t get adequate response from the fundamentals.