Chronic Fatigue: Is Your Brain on Fire?

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People who suffer with chronic fatigue syndrome or symptoms of chronic fatigue have a unique challenge- they are dealing with a health issue that affects the brain, and therefore their ability to interpret and respond to the world because their brains aren’t working the way they should. Because the organ system affected is the brain and the nervous system, it is easy to feel like you are losing your mind. Even worse is the fact that the intense brain fog makes it impossible to clearly think through and troubleshoot the health issue on your own, like most of us like to do before we seek medical attention. Furthermore, when we finally DO seek medical support, it may take a while for a provider to recognize the issue, since labs and other tests are usually normal. Lastly, chronic fatigue is tremendously isolating. Even if the doctors make the diagnosis and your family and friends know that you are dealing with chronic fatigue syndrome (CFS/ME), few people really understand the devastating impact it has on your ability to function normally. Most people just think you are tired and will recover quickly with a little rest. This could not be further from the truth.

The Truth of Chronic Fatigue Syndrome

It has long been suspected that chronic neuroinflammation (inflammation of the nerve tissues) is present and a cause of chronic fatigue/myalgic encephalopathy (CFS/ME). Based on the understanding that nerve cells conduct information using electricity and voltage, it would stand to reason that when someone is experiencing “slow thinking or processing” or “brain fog,” that there is something wrong with the flow of the electricity or the impulse carrying the information. We also know that cellular inflammation leads to dysfunction of organs and results in disease. In a 2020 article published by Harvard Medical School, they recognize that inflammation is the cause of the top health issues that plague our country:

“Although there may never be such a single path, mounting evidence suggests a common underlying cause of major degenerative diseases. The four horsemen of the medical apocalypse — coronary artery disease, diabetes, cancer, and Alzheimer’s — may be riding the same steed: inflammation.”[1]

A Deeper Look Into What We Know About the Mechanism of Chronic Fatigue

Japanese researchers have been making recent efforts to investigate how your run-of-the-mill fatigue can be turned into chronic fatigue in order to find solutions to the health issue that seems to be plaguing over one third of their population. It is well established that chronic fatigue is linked to higher risks of chronic illnesses such as cardiovascular disease, seizure disorders and premature death, so the goal was to find the root cause in order to reverse and prevent the condition.

Their research was strikingly clear that there is indeed direct evidence that people suffering from ongoing symptoms of fatigue experience true neuroinflammation (their brains ARE on fire).

Chronic Fatigue Research Summary

Here is a summary of the findings from their chronic fatigue research:

  • Less dopamine is found in brains of patients with CFS/ME and this contributes to reduced ability for the motor cortex of the brain to be able to do its job of recruiting muscles for movement. They call this “central fatigue,” since the problem originates in the brain and not the muscle.[2] In other words, your physical body literally is unable to get up and go, not because of muscle fatigue, but because the brain is unable to communicate effectively to the muscles that make you move.
    (Dopamine is an important neurotransmitter that stimulates pleasure and is involved in many other brain functions including memory, movement, motivation, mood, attention and more.)
  • They identified a communication pathway between important parts of the brain- the limbic system, thalamus, prefrontal cortex, the orbitofrontal cortex and the anterior cingulate cortex.[3] This pathway, which they called the” facilitation circuit,” is one that allows us to push through mental fatigue. The researchers found that it is not working correctly in people suffering from chronic fatigue.
  • Their research suggests the presence of another nerve communication system called the “fatigue inhibition circuit or fatigue-inducing circuit.” They suggest that this communication pathway, which is present in those suffering from chronic fatigue, promotes complete blockage of the ability of the brain to recruit more muscles when fatigued. The normal response in healthy individuals is for the brain to be able to effectively recruit more muscles to coordinate activity when fatigue sets in. Furthermore, when this pathway is activated, it not only blocks the normal activity of the brain to recruit more muscles to maintain function, but it also promotes increased central fatigue.
  • They also showed that when they pushed the facilitation circuit by overwork or prolonged stress, that it enhanced the activity of the “fatigue-inducing circuit.” Translation: when you push through extreme fatigue, it is counterproductive and leads to complete shutdown of energy. You crash completely.

Previous research suggests that damage to areas of the brain can lead to symptoms of chronic fatigue. The Japanese researchers suggest that the brain damage can be structural (trauma or developmental), metabolic (biotoxins, toxins) or functional (missing nutrients). Furthermore, they narrowed their focus to the region of the prefrontal cortex, known as the dorsolateral prefrontal cortex, because this region is involved in functions that are often significantly affected in chronic fatigue syndrome:

  1. Sensory input- hyperstimulation from sound or lights, anyone?
  2. Working memory- “Say that again, please?”
  3. Decision making abilities- “Well, we could do this.. Or we could do that. What do you think?”
  4. Attention/focus- “Wait, what? Squirrel!”
  5. Emotions- “Who’s emotional? Not me..”
  6. Self-control

Understanding Mental Fatigue

To Put It All Together
When you begin experiencing mental fatigue, your body and nervous system automatically responds by turning on the “facilitation circuit” to allow you to push through and maintain your mental performance. This is primarily turned on by the dopamine receptors in the frontal cortex. Unfortunately, folks with ongoing exhaustion from CFS/ME have fewer of these receptors, so they are unable to turn on push-through-it “facilitation circuit” as effectively as others.

As the push-through-it facilitation circuit is stimulated more frequently, which occurs in those of us with CFS/ME, it leads to the fatigue-inducing circuit of neurons to be activated causing reduced mental performance. The areas of your brain involved in interpreting your environment become oversensitive and you cannot focus on any one thing. You forget things that you just heard or learned and need multiple reminders when learning new information. Because you can’t focus and are overstimulated, you simply cannot make a decision to save your life- even small ones make you feel overwhelmed. And finally, with all the overwhelm, difficulty interpreting and remembering, who wouldn’t be emotional?

But the resounding point is that you are not crazy, even if you feel like it. The brain is organically on fire and reacting the same way that electrical circuits in your car act when they overheat- THEY SHUT DOWN.

The Good News: You Can Recover From Chronic Fatigue

In the ever-growing area of health research, there is hope for cellular inflammation, like that which causes chronic fatigue syndrome. The three key factors that will significantly help improve your symptoms include the following:

Improved drainage from your brain by stimulating a healthy brain lymphatic (glymphatic) flow. This is done by enhancing the quality of your sleep.
Reduce your exposure to daily toxins. Some of my guilty pleasures that clearly caused increases in brain fog included my occasional big brand non-organic coffee (Starbucks, Peets,ect). I would feel a temporary boost in energy followed by a significant and lasting crash every time I “treated myself” to one of those guilty pleasures. But, more ubiquitous, is what we find in our pantries. Clean.Living.Basics. Clean up those basic necessities (cleaning products, soaps, beauty products and snacks)- remove chemicals and replace them with natural options.
Support the body’s effort in detoxification. In chronic fatigue, your detox pathways are super sluggish and need a bit of a nudge. Make sure to give those pathways of elimination their best opportunity to kick into gear. This is done with a well ordered detox protocol that starts with making sure you are moving your bowels. So, start there.

You will slowly begin to see the fog lift when you introduce some strategic lifestyle approaches, giving you the ability to tackle the root cause of your health struggle with more clarity and intention. There is hope that you are able to overcome the constant feeling of living life like a zombie. Take a few powerful steps today and prevent the helplessness that comes when you develop the chronic diseases that are caused by decades of unmanaged neuro-inflammation.

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[1]Inflammation: A unifying theory of disease? – Harvard Health
[2] Tanaka M, Ishii A, Watanabe Y. Regulatory mechanism of performance in chronic cognitive fatigue. Med Hypotheses. 2014 May;82(5):567-71. doi: 10.1016/j.mehy.2014.02.013. Epub 2014 Feb 17. PMID: 24594236.
[3]Tanaka M, Ishii A, Watanabe Y. Neural mechanism of facilitation system during physical fatigue. PLoS One. 2013 Nov 20;8(11):e80731. doi: 10.1371/journal.pone.0080731. PMID: 24278313; PMCID: PMC3835560.

Chronic Fatigue Syndrome and Cardiovascular Disease: JACC State-of-the-Art Review – ScienceDirect

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