How to Treat Chronic Fatigue with Energy Nutrition (2019)

Energy Nutrition is Essential to Chronic Fatigue Recovery

Energy nutrition is absolutely essential to heal chronic fatigue no matter what the underlying causes.

Your grandma was right after all: “You are what you eat.” Literally.

The constituents of our food—each individual protein, fat, carbohydrate, and molecule we ingest—become our proteins, fats, carbohydrates, and the molecules that run all the business of our bodies—including the making of energy.

Food becomes our energy. And without the right energy nutrition, food becomes an energy roadblock that must be fixed to recover from chronic fatigue.

Food: Our Tools and Materials for Creating Energy

Creating energy with food is like building a house. Not only do you need fuel, but you’ve got to have the right materials and tools, right? And nothing can be missing, or you’re in trouble. Neglect a beam or a few nails? Yikes.

Our bodies need the same level of care and attention to detail as the house we are building. We’ve got to have the fuel and all the right materials and tools—nutritious food, special nutrients to address unique needs, good eating habits, healthy digestion, and avoidance of food irritants and toxins.

Consider Joy, one of countless clients who’ve reclaimed their lives through the power of energy nutrition.

Joy’s Story

Joy was a world of hurt after years severe chronic fatigue and back pain. She’d just about given up hope after consulting with many medical specialists over the years and receiving countless therapies that did not work—including drug and surgical interventions that added to her suffering.

She decided to consult with me as a last ditch effort. After listening to her story, it was clear that her nutrient-poor standard American diet was playing an important role in her suffering.

We decided to treat her with the basics: a nutrient-dense food plan that removed food irritants, healed her gut, reduced inflammation, and flooded her body with healing energy nutrition.

To our delight, when she returned in one month, her energy was soaring, and she had experienced complete resolution of all back pain. Her head was clear, and her headaches were gone. She felt like a new woman. Because of the dramatic nature of her response to these relatively simple interventions, she was highly motivated to continue them for life.

Joy was amazed at the change that was possible. But I wasn’t. Joy’s is not an unusual story at all. The crux of Joy’s chronic fatigue was inadequate nutrient intake that is an inevitable part of eating the standard American diet. So, although the result of fixing things was profound, the fix, itself, was easy—eating healthy energy-enhancing food, personalized to her needs.

Bottom line? If we eat healthy energy food, we get better at making energy. To reverse chronic fatigue, we must optimize the body’s energy nutrition.

How the Body Makes Energy: The Brain-Thyroid-Adrenal-Mitochondrial (BTAM) Energy Operating System

Here’s a review of energy biology from my previous article: What Goes Wrong in Chronic Fatigue Syndrome–Introduction to the Brain-Thyroid-Adrenal-Mitochondrial (BTAM) Energy Operating System.

Each step in our energy physiology requires optimal energy nutrition to function at its best.

What Causes Deficiencies of Energy Nutrients in Chronic Fatigue?

Nutrient availability for energy production is simple supply and demand.

We have to have sufficient intake of energy nutrition to meet the energy demands of our bodies. When supply comes up short, so does energy.

Higher Nutritional Demands

What goes wrong? In addition to eating food that is nutrient poor, we’re increasingly challenged by environmental stresses and toxicities that increase our nutrient requirements for energy.

Energy

High stress requires high energy—the whole point of stress biology is to ramp up our bodies’ energy producing systems to help us rise to our challenges—including chronic illness. But energy production is expensive, requiring an enormous array of hormones, enzymes, vitamins, minerals, and cofactors to operate.

Where do these come from? We make them from the food we eat.

Detoxification

Likewise, toxin removal from the body is necessary to sustain life. Detoxification is also energy and nutrient expensive. We’ve got to support it every day with the nutrients we get from food. Sluggishness in detoxification, which occurs when nutrient need outweighs supply, is a common cause of chronic fatigue.

A yearly detox program won’t magically fix this need-supply mismatch. Detoxification is a 24/7 operation that requires healthy protein, fat, vitamins, minerals, and antioxidants from food.

In the face of high need for energy nutrition we must have nutrient dense diets to meet those demands.

Abundance of Bad Food

The sheer abundance of poor-quality food that is part of the standard American diet contributes greatly to our epidemic of chronic fatigue.

Our obsession with sugar and processed grain products (which are digested into sugar) leads to dangerous exposure to the number one toxin in the Western world today (you guessed it—sugar!). Sugar is an important factor in energy nutrition-depleted diets.

The Energy Nutrition Deficiency-Chronic Fatigue Solution

Our first order of business in healing from chronic fatigue is to eat well and use high quality nutritional supplements when necessary. To do this we concentrate on two key factors:

• Letting go of food that is nutrient-poor, toxic, or irritating.
• Consuming an energy nutrition-rich diet.

Energy Nutrition Healing: Call Back Your Power to Choose

Eating well can be hard at first as you learn new things. But you can do hard things—you’ve done them before. First, you’ve got to call your power back.

It’s a simple lifestyle choice to eat poorly or in a way that doesn’t meet our needs. There are consequences. And the choice is a question of balance. Making everything from scratch is not feasible for most families. But eating nothing but processed, nutrient-poor food is not feasible for the body. It’s all a question of balance, and always a decision, however consciously or unconsciously those decisions are made.

Realizing it’s a choice is the first step to improving how you eat.

Do you find healthy choices hard even when you know they’re what you need? You’re not alone. There may be a tenacious story standing in your way. Work with the five common stories that slam the brakes on healing every time.

Not Enough Time to Eat Well?

You can decide what and how to eat. Many will say they don’t have time for that. But “not enough time” is just a story. It’s always an excuse. We must create the space and time for adding energy-rich healthy food to our lives. But no one expects you to suddenly start growing and preparing all your food. Starting with baby steps (remember, the “rule of threes”?), we can all become more conscious and thoughtful about how and what we eat. I’m here to help.

How to Build a Nutrient-Rich Energy Food Plan

It’s hard to say what the specifics of any one person’s food plan should be without knowing them. Our food plans work the best for us as individuals when they address our unique needs, as well as our personal likes and dislikes. Asking someone to switch to a diet they can’t stand eating is not going to work.

So, while you will have to tailor my suggested food plan to your own circumstances, I would like to present to you the core energy food plan I teach to my own clients: The Foundational Intensive Nutrition Energy (FINE) food plan.

Special Note for Vegans and Vegetarians

My food plan will be a challenge for vegetarians and vegans in the protein and complete nutrition departments. Without animal flesh, fish, dairy products, eggs, beans, or legumes as protein sources, you will have to be much more mindful of the protein content of the foods that you eat. You will likely need to incorporate healthy protein supplements into your diet, particularly if you are active. Some important nutrients can only be obtained from animal products in levels that are adequate to support optimal health (vitamin B12, choline, omega-3 fatty acids, many minerals, iron, and vitamin D). Consider working with a trusted health practitioner or functional nutrition specialist well versed in this style of eating.

Your Challenge in Energy-Rich Eating

Success starts with a decision—a commitment.

I challenge you to commit to six weeks of complete strictness to your chosen food plan.

Keep a food journal and carefully document your food and liquid intake as well as any symptoms. If you experience symptoms, such as pain, fatigue, or brain fog, rate them daily on a scale of zero to ten. Observe the change.

Once the six-week introduction period is over, if you decide to stray, do so mindfully. Choose your “off-plan” food carefully, eat it joyfully, and document what you did so you can observe the consequences. Many food sensitivity-related symptoms don’t occur right away, but as long as several days later.

If you are not able to achieve a six-week trial at this time, you may benefit from shorter periods. In general, it takes six to twelve weeks to correct the immune and hormonal responses that cause many chronic symptoms, including fatigue. However, in just two weeks (shorter periods than two weeks may not allow you to get over the initial period of not feeling well) you may get to experience some of the benefits of flooding your body with energy nutrition.

You May Feel Worse Before You Feel Better

Remember, many people feel worse before they feel better, especially those who are making a dramatic overhaul of their usual eating plan. This will last a few days up to a few weeks. Track your symptoms carefully and hang in there. If you are concerned, talk to your trusted healthcare provider before giving up.

The Foundational Intensive Nutrition Energy (FINE) Food Plan to Reverse Chronic Fatigue

In some ways this food plan is about going back to our roots. It’s about eating real food, grown in favorable conditions, prepared simply and deliciously, shared with those we love, eaten slowly, and just enough to meet our needs.

The FINE food plan provides intensive nutrition to support energy and all of our body’s needs while eliminating foods that cause inflammation, toxicity, elevated blood sugar levels, and damage to our metabolism. Those who eat this way get to enjoy robust energy, reversal of inflammatory conditions, clearer thinking, attainment of ideal body weight, and more joyful lives.

The FINE Food Plan Is Simple

• Eat real food only and always.
• Avoid all processed, refined, or altered (other than cooking or blending) foods.
• Avoid all sugars (most of the time), aside from those occurring naturally in healthy plant foods (we’ll get into what “healthy” is in a bit).
• Eat healthy fat.
• Eat enough healthy protein to meet your needs.
• Eat mostly plants.
• Eat a variety of plants of many colors.
• Feed your microbiome (the microorganisms that share your body with you!).
• Eat fresh food, farm-to-table, seasonably.
• Eat mindfully, joyfully, and socially.
• Don’t overeat.

Foods to Include in Your FINE Food Plan

Healthy meat choices, eggs, and fish

Eat only grass-fed beef options, free-range poultry and eggs, wild game, and wild-caught fatty fish such as salmon, herring and sardines.

Use organ meat from pasture-raised animal.

Include protein in every meal and refer to the protein counter on my website to determine your total daily protein needs and plan your meals and snacks accordingly. Most people will need four to six ounces—approximately the size of a deck of cards—of protein at a meal to meet their protein requirements.

Non-Starchy Vegetables

Eat mostly greens but make sure to include a multitude of other colors.

Eat dark-green leafy vegetables daily—spinach, kale, collard, arugula, chard.

Emphasize the crucifer family: cabbage, kale, broccoli, broccoli sprouts, and Brussels sprouts.

Include garlic and onions liberally.

Minimize starchy vegetables such as carrots, yams, and potatoes but do include them in small quantities, as they are rich in nutrition.

A simple guideline for quantity is that veggies should take up two-thirds of your plate at each meal, or eight to twelve cups total (when raw—note that steamed and sautéed vegetables will shrink considerably).

Those with metabolic syndrome (high blood pressure, high blood sugar, diabetes, vascular disease, or obesity): avoid starchy veggies altogether!

Low Sugar-Content Fruit

Eat mostly berries (blueberries, raspberries, blackberries, and so on), and may include apples and pears. Pomegranates and cranberries are good options. Save sweeter fruits (e.g. peaches, bananas, apples, pineapple) for special treats and desserts.

Those with metabolic syndrome: avoid all fruit other than berries, tart apples, cranberries and pomegranates.

Nuts and seeds

Stick to raw, fresh options and avoid peanuts (these are legumes and can promote inflammation). Roasting can damage the fats in many nuts, making them more toxic.

Nuts and seeds contain healthy fats, which are vital to our good health; however, be aware of their high calorie content to avoid over-consumption. Ground flax and hemp seeds and whole chia seeds provide a lot of fiber, protein, and healthy fats—include these daily. They mix well in smoothies.

Bone Broth

Make bone broth from the leftover bones of free-range chickens, grass-fed beef, or game. Include it in soups and stews, sauté vegetables with it, or drink it by itself. You may add beef-derived collagen hydrosylate (see below) to increase protein content and make a substantial meal or snack out of it. Plus, your dog will love you for adding bone broth to his/her food!

Spices, Condiments, Food Supplements

Some of my favorite highly nutritive varieties of spices and flavoring agents are cinnamon, turmeric, cayenne, cardamom, black pepper, paprika, ginger, rosemary, thyme, basil, Sencha ground green tea, vegetable proteins (such as hemp and pea proteins), gelatin or hydrolyzed collagen derived from grass-fed cows (to use as a protein supplement).

Healthy Fats

Coconut oil and coconut milk:

For coconut milk, use the full-fat culinary version sold in cans or make your own. Avoid the diluted version of coconut milk sold in cartons. Make sure your coconut milk and oil are organically sourced. The fats in coconut are rich in medium-chain triglycerides, important for structure and energy production. They are also rich in fats (lauric acid, caprylic acid, capric acid) that may have important antimicrobial effects.

Avocados and Avocado oil:

These contain potent antioxidants known as carotenoids, phytosteroids, and polyhydroxylated fatty alcohols, all of which help modulate inflammation in the body. The oleic acid in avocados is a monounsaturated fat that reduces the risk of vascular disease.

Olives and Olive Oil:

Olive oil is one of the healthiest foods on the planet. Not only is it rich in heart and vasculature-protective monounsaturated fats, but it also contains a diverse array of antioxidant and anti-inflammatory nutrients that have been shown to reduce inflammation, cancer risk, allergies, cardiovascular problems, osteoporosis and more. Buy only organic, unrefined varieties and store in dark containers in cool areas to prevent spoilage. Buy only “extra virgin” or “fresh pressed” varieties.

Omega-3 Fats (fish oil, algae-derived DHA):

These have many health benefits as necessary structural fats for cell membranes and anti-inflammatory molecules. If you don’t eat fatty fish like wild-caught salmon regularly, you would benefit from supplementing with a good quality DHA and/or (the major omega-3-fatty acids) extract.

Beans and Legumes

Use the full spectrum of beans, legumes, lentils, and other split legumes. Limit the amount you consume to keep your dietary sugar content low. Omit them entirely if you suspect you have food sensitivities.

Teas

You may include unsweetened green tea (preferably Sencha ground green tea powder, which is grown in the sun and higher in antioxidants while lower in caffeine content compared to matcha, which is grown in the shade), black and white tea varieties, rooibos, and all herbal teas in your food plan.

Fermented Foods

Fermented vegetables such as sauerkraut and kimchi are allowed and provide essential probiotic organisms. Kombucha may be consumed in moderation (one half to one cup per day).

Fluids

It is important to stay well hydrated. Most people need a minimum of two quarts of liquid per day. You may use filtered water, mineral water, green tea, herbal tea, and bone broth.

Smoothies

This is a convenient and potentially delicious way to create a meal while on this plan. Simply include only those foods allowed on the plan. Include hydrolyzed collagen as your protein, some fat and water and/or coconut milk to create a meal that includes all major food groups to sustain you through part of your day.

Nutritional Supplements

Most nutritional supplements that have been specifically prescribed for you to meet your unique needs are allowed on the FINE food plan if manufacturers have been careful to exclude the undesirable ingredients. Work with your Functional Medicine practitioner on this if necessary.

Foods to Avoid on Your FINE Food Plan

All Grains (wheat, rye, barley, oats, corn, rice)

Grains can be irritants to the immune system as well as the lining of the gastrointestinal tract. All of today’s genetically engineered grain varieties are high in sugar content and release excesses of sugar through the digestive process.

Check with your nutrition consultant, but some “pseudo-grains,” such as quinoa and millet, which are actually seeds, may be allowed.

All Animal Milk Products (includes cow, goat, and sheep’s milk)

Animal milk is proinflammatory by virtue of its major protein, casein, and one of its predominant fats, arachadonic acid. Casomorphins are produced in the digestive process of milk and behave like opiates that can cause mood and cognitive dysfunction in susceptible individuals.

All Processed, Synthetic Foods, Preservatives and Additives

Most of these are manufactured molecules that displace real food, are void of nutrition, often high in calories, and can be irritants harmful to human health.

Unhealthy Meats

These include commercial corn-fed feedlot beef, commercial poultry and eggs, many farm-raised fish and all large predator fish (such as tuna and swordfish). (The status of farm-raised fish is changing as growers are responding to the need for ethically and nutritionally raised fish. See National Resources Defense Council’s, NRDC, website for more information.)

Feedlot beef are treated with the utmost cruelty and are obese, unhealthy animals. Their meat is less nutritious than their pasture-raised counterparts, containing an abundance of unhealthy fats and higher levels of pesticide and antibiotic residues.

Fish not wild-caught as well as larger predator fish are suspect for pesticides or heavy metal contamination. Refer to the NRDC’s detailed guide about choosing fish with the lowest mercury content.

Excesses of Sugar

This includes the sugar naturally occurring in fruits and vegetables (sweet fruit and starchy veggies). The literature is now huge on negative health impact of dietary sugars.

Artificial and Non-Nutritive Sweeteners

Avoid all sugar substitutes and artificial sweeteners that add sweetness to food and beverages but have no nutritional value. These include sucralose, Splenda, aspartame and sugar alcohols (such as mannitol, sorbitol, dextrose and xylitol).

Stevia and monk fruit may be consumed sparingly—the sweet taste leads to insulin release, promotion of inflammation, and may support sugar addiction.

Unhealthy Fats

Omit all trans or hydrogenated fats, fat from commercial meats, damaged fats found in rancid oils or fatty foods exposed to excess heat. Protect your oils from excess exposure to heat or ambient air. Consume only raw fresh nuts to avoid damaged fats produced by excess heat. Store nuts and oils in the refrigerator if you don’t plan to use them within a few days.

Processed and rancid fats promote inflammation and lead to tissue damage and disease. Avoid consuming and cooking with vegetable oils derived from canola, sunflower, or safflower as they are easily damaged both on the shelf and through the cooking process.

Beyond FINE for Chronic Fatigue Resolution: Ketogentic Diets and Intermittent Fasting

In addition to the energy nutrition of my FINE food plan, many people benefit from more intensive carbohydrate restriction (ketogenic diet or intermittent fasting) as further ways to support energy and reverse chronic fatigue.

There is growing evidence that ketogenic diets, low in carbohydrates and high in healthy fats, are good for the brain by enhancing energy production and neuroplasticity. In my experience, once a ketogenic diet becomes a well-established part of someone’s lifestyle, increased energy is the most common outcome.

Nutritional Healing for Chronic Fatigue and Autoimmunity

Chronic fatigue often accompanies autoimmunity and inflammatory disorders. Common autoimmune disorders include autoimmune thyroid disease, rheumatoid arthritis, lupus, multiple sclerosis (MS), psoriasis, inflammatory bowel diseases (ulcerative colitis and Crohn’s disease), and many others.

The common denominators of all autoimmune disorders are genetic susceptibility, impaired gut permeability, and a trigger (or triggers).

If you are suffering with chronic fatigue and also have an autoimmune disorder, or if you suspect you might have an autoimmune disorder, please work with the Gut-Immune Restoration Intensive Nutrition (GRIN) food plan.

Last Thoughts About Energy Nutrition

Feeling daunted? Bring in some help! Work with a nutrition specialist or physician trained in Functional Medicine (FM) and FM nutrition. This is big stuff and may involve big change—let a pro help you get knowledgeable, organized, and create a plan that fits you and your needs. Follow up with them as often as you need to create deep sustainable changes in the way you eat and live. And if the food changes leave you feeling deprived, learn to transform that powerful energy into something empowering—work with my deprivation exercise.

Resources

Karyn Shanks MD. Heal: A Nine-Stage Roadmap to Recover Energy, Reverse Chronic Illness, and Claim the Potential of a Vibrant New You. 2019.

Karyn Shanks MD. How to Overcome Chronic Fatigue Syndrome. 2019 (Expert Guide).

Karyn Shanks MD. How to Treat Chronic Fatigue for Life (Expert Guide). 2019.

Karyn Shanks MD. A Detoxification Primer. 2018.

Karyn Shanks MD. Sugar is a Toxin. 2016.

Karyn Shanks MD. Five Common Stories that Slam the Brakes On Healing Every Time. 2019.

Karyn Shanks MD. Yes, You DO Have the Time! 2018.

Karyn Shanks MD. Simple is Better: the “Rule of Threes”. 2017.

Karyn Shanks MD. Protein: A Primer. 2018.

Karyn Shanks MD. Protein: How Much Do We Need to Support Optimal Health? 2016.

Sarah Ballantyne, PhD. The Paleo Mom: The Autoimmune Protocol. Introduction to nutrition that reverses inflammation and autoimmunity.

Karyn Shanks MD. Deprivation: The Challenge of Lifestyle Change. 2017.

Chris Kresser. A Complete Guide to the Keto Diet. 2019.

Anthony Gustin, DC, MS. The Ultimate Start Up Guide to The Ketogenic Diet. 2018.

Karyn Shanks MD. Intermittent Fasting: How it Energizes My True Life. 2017.

Karyn Shanks MD. Nutritional Ketosis: Heal and Protect Your Brain. 2017.

Karyn Shanks MD. The Gut-Immune Restoration Intensive Nutrition (GRIN) Food Plan. 2019. Section of the larger article, How to Heal Chronic Fatigue: Your Beautiful Energy Roadmap. 2019.