Fatigue can be caused by a number of factors, most of them not serious, but it is important to have a medical evaluation if the fatigue persists over many weeks and is associated with weight loss or other symptoms.

Natural supplements for fatigue help
You can fight fatigue with an excellent doctor-formulated multivitamin product. You may also consider reading about chronic fatigue syndrome.

There are many nutrients and herbs that help reduce fatigue, including:
Carnitine is an important contributor to cellular energy metabolism.
Creatine for muscle strength and bigger muscles
Some people find Carnosine to be good for improving fatigue.
CoQ10 is helpful for energy enhancement usually at a dose of 30 to 50 mg.
Spirulina for fatigue. You can find Spirulina here.
Some people claim Ribose is helpful but no good research is yet available.

Fatigue and cancer
Among women diagnosed with breast cancer, fatigue is the symptom most strongly associated with a worse overall quality of life. One year after women are diagnosed with breast cancer, the most symptoms women report are fatigue, sleeping problems, pain, and symptoms involving the arms.

Fatigue Research Update
L carnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue.
Pistone G,. University of Catania, Catania, Italy. Drugs Aging. 2003;20(10):761-7.
This study aims to evaluate the effects of carnitine supplementation on body composition, lipid profile and fatigue in elderly subjects with rapid muscle fatigue. This was a placebo-controlled, randomised, double-blind, two-phase study. Eighty-four elderly subjects with onset of fatigue following slight physical activity were recruited to the study. Prior to randomisation all patients entered a 2-week normalisation phase where they were given an 'ad libitum diet, according to the National Cholesterol Education Program (Step 2). Subjects were asked to record their daily food intake every 2 days. Before the 30-day treatment phase, subjects were randomly assigned to two groups (matched for male/female ratio, age and body mass index). One group received carnitine 2g twice daily (n = 42) and the other placebo (n = 42). Efficacy measures included changes in total fat mass, total muscle mass, serum triglyceride, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein (apo)A1, and apoB levels. The Wessely and Powell scale was used to evaluate physical and mental fatigue. Subjects were assessed at the beginning and end of the study period. At the end of the study, compared with placebo, the carnitine-treated patients showed significant improvements in the following parameters: total fat mass, total muscle mass (+2.1 vs +0.2 kg), total cholesterol, LDL-C, HDL-C, triglycerides, apoA1, and apoB. Wessely and Powell scores decreased significantly by 40% (physical fatigue) and 45% (mental fatigue) in subjects taking carnitine, compared with 11% and 8%, respectively, in the placebo group. No adverse events were reported in any treatment group. Administration of carnitine to healthy elderly subjects resulted in a reduction of total fat mass, an increase of total muscle mass, and appeared to exert a favourable effect on fatigue and serum lipids.

Fatigue questions
Q. I am suffering from low motivation, fatigue and depression. Which of these supplements would you recommend to be the most effective? Mind Power Rx or SAM-e.
   A. It is very difficult to predict which formula or individual supplement will help with fatigue or depression. Sometimes it take trial and error to find the best option or sometimes alternating different products works for some people. Please discuss with your doctor. Yoga certainly helps with both fatigue and low mood.

Q. I am a 40 year old male. I lived approximately 9 miles away from a nuclear plant for about 3 years (unknowingly). Over those three years my health deteriorated, I was diagnosed with osteopenia which after countless amounts of testing by a endocrinologist he attributed to hypocalcurria (he put me on a water pill that was supposed to hold vitamin d in my system). After a year of taking the water pill I got a new scan of my back which revealed that my condition got worse. I also went to my family doctor, after explaining to the doctor about my problems he thought I might have depression. He perscibed me with anti-depressants (this made me worse). That is when I discovered the nuclear plant through a friend. When I read about the nuclear plant and the chemicals that were being released, I thought it was possible that this could be the problem. I have since moved away from there and tried a natural approach. Through the advice of a family friend I started taking Sun Chlorella, Zell Oygen W/Royal Jelly, Wobenzym, Gaba Powder, Coral Mix, Zinc, Folic Acid, Jarrow Bone-Up, Magnesium, Capricin, L-Phenylalanine and Pau D' Arco. His beilief was that my main problems were revolving around being unhealthy and having a low immune system. Within days I started noticing a difference my bone and muscle aches went away. My stomach which was a mess also improved dramatically. I was so impressed at how quickly things improved. I also started taking L-Tyrosine, L-Arginine, Pycogenol, Selenium, Ginkgo Bilboa and Korean Ginseng (to increase my sexual desire). That also has helped alot. Which leaves me with the only thing that I can not seem to kick: fatigue, tired, unmotivated and like staring into space. Do you see any potential problems with the supplements I am presently taking?
   A. We can't give individual advice but to say that one cause of fatigue is taking too many supplements that disrupt sleep patterns. It is a good idea to learn how each supplement works by itself.

Q. I am a 43-year-old female. For the last six months, I have suffered from debilitating fatigue, hot and cold sweats, insomnia and terrible headaches. These symptoms presented after a considerable shock to my system following a glucose tolerance test. My blood sugar dropped significantly low, and I was diagnosed with reactive hypoglycemia. For some reason, I have not recovered from this test. I have subsequently followed a healthy hypoglycemic diet, and have even checked my glucose levels regularly during the last few months with a blood glucose monitor, and my blood sugar levels are always in good range. However, I still suffer from fatigue and these debilitating symptoms. Under the care of an endocrinologist and, later, an Internal Medicine doctor specializing in chronic fatigue syndrome, I have undergone comprehensive diagnostic tests for these persistent symptoms. Everything has come back within normal range except a slightly low but normal cortisol level and a significantly low pregnenolone level. I was told that the "normal" range for Pregnenolone is 10 - 230, and my blood work came back as 28 for this hormone. My Internal Medicine doctor suggested pregnenolone supplementation at 100mg / day to bring up this low level, but I immediately discovered that this is too much for my system. Please note, as well, that in my case, pregnenolone absolutely knocks me out. I must take it at night because it makes me incredibly sleepy.

Q. Could you recommend herbs for fatigue. I can't loose weight, I've joined a gym, I have the blood pressure of a 20 year old I'm told, the medical profession have given up on me. I have IBS but can live with it. I'm 48 but feel 88 at times.
I have no energy and feel like crawling into bed all the time. I would be extremely grateful if you could advise me on herb medication in this regard.
   A. We can't give any specific advice but you could ask your doctor to read this page on fatigue and consider some of the supplements that are mentioned.

Q. I am experiencing extreme emotional, mental, and physical fatigue. Please inform me of your products that will treat all of these symptoms without using excessive supplements. I am aware that Acetyl-l-Carnitine if for mental and emotional fatigue and on the other hand L-Carnitine is for physical fatigue. Please inform me of the appropriate product that you provide and dosage to treat this issue.
   A. There are many causes of fatigue and it is important for a doctor to find out the cause or causes before starting therapy. If there are no serous causes, and if your doctor approves, a good supplement to begin with is MultiVit Rx.

Q. I have been diagnosed with adrenal fatigue by Dr. Lee St. Petery and the results of the saliva test. The problem is that I have mitral-valve prolapse, so I don't want to be over stimulated. This doctor wanted me to take ADR by Pure which has licorice, 2 types of ginseng, and adrenal glandulars. Another consultant said to take drops of pregnenolone and dhea. I once had a very bad reaction when taking 25mg. or preg. and DHEA, which was suggested by a doctor for fatigue.

Q. I (male 41) feel sometimes (but not always) extreme fatigue, so tired that the whole body feels painfully uncomfortable and its extremely difficult to remain functional. This partial or complete energy collapse lasts for a few hours to a few days, then for a few days, sometimes longer i feel ok until the next crisis. What could be the cause of this extreme fatigue?
   A. Extreme fatigue has many causes and a full evaluation by a doctor is required to rule out serious causes.

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