Unveiling The Shadows: Tackling Chronic Fatigue

Introduction to Chronic Fatigue 0:00

Welcome back to ADHD, Autism and Chronic Disease Parenting Summit. I'm here with the fantastic Evan Hirsch, founder of energy MD. Looking forward to chatting about this topic. Super interesting. Chronic fatigue. Very, you know, much more in the news, much more in our thoughts these days. And, with everything going on. So thank you for being here. And thank you for sharing your wisdom. Thanks for having me on, Jill. Appreciate it. So let's just start with what chronic fatigue is, because I think that's, you know, kind of a difficult definition for some people in terms of, well, you know, teenagers or we're tired sometimes.

So how do we know whether it's chronic fatigue versus have a normal teenager fatigue or, you know, even a normal adult fatigue? So how do you how do you delineate between those and and how do you decide that we're moving into a space that's not normal? Yeah. And it really is. It's a little bit subjective, but we're going to start off with the objective stuff as much as we can. And so when we're looking at chronic fatigue in terms of like an actual definition or a diagnosis of myalgic encephalitis or chronic fatigue syndrome, oftentimes that requires a number of symptoms that are persisting for a period of time.

So generally for about six months when someone has fatigue that can't be relieved with rest, when they have cognitive issues or all of a sudden their brain is not working quite right. Oftentimes they'll have post exertional malaise where they exert themselves and then they rest and they're still tired and they're really just not recovering particularly well where things that they could they used to be able to do, they can no longer do. And then they'll have, un refreshing sleep, you know, so we're waking up in the morning and they're groggy.

And if that's happening for six months or so with a little bit of body pain, that can lead to a diagnosis. But the reality is, is that it really runs the gamut, you know, and oftentimes it's a change in behavior. In the teenager that includes these symptoms

How Chronic Fatigue Is Defined 2:06

that I just mentioned, the fatigue, the cognitive issues, the post exertional malaise, the UN refreshing sleep. So, the and the simplest way of thinking about this is that it's fatigue that's not resolved with rest. So generally, if you know somebody is burning the candle at both ends, they're studying, they've got all these extracurricular activities, and then they're able to kind of like recover, by sleeping through the weekend or, you know, like, what did we do in in high school and college with our final exams, oftentimes you would come home and you'd sleep for a couple of weeks, but then you'd get back to a normal baseline.

And it's that lack of recovery back to the normal baseline that's indicating that there are more things at play. And you know, least when I learned about this and it's still kind of more of a a new I would say I mean it's been around forever I'm sure. But it's more you know we're more aware of it at this point. And at least one additional thing that that I learned, I just wanted to confirm that with you is that it would be something that you would diagnose clinically after you've looked into everything else and not found some other medical cause, like a thyroid issue or sleep apnea or something like that.

Is that correct in terms of the the definition for it? Well, so conventionally that is correct because the, you know, the the conventional diagnosis that you would look at are limited. So it's something not explained by, a conventional diagnosis, but the when you start to expand and you get into functional medicine and environmental medicine, you know, we're looking at 38 different potential causes. And everybody that I see who has chronic fatigue has a combination of about 20 of those. So that really doesn't fit into the scientific method and into conventional medicine.

And so we kind of all of a sudden that thought has to change where it's like, yes, there's always a cause. Let's keep digging and figuring out what those causes are. Okay. And before we jump into causes, which I want to talk about next, I'm just curious in terms of statistics or anything, in terms of your knowledge of whether you feel like this is happening more frequently in the last few years. I mean, certainly heard about it more, and I know we're going to mostly talk about teenagers. I think that's an unimportant group.

But are you seeing it in any younger kids or certainly seeing it in adults, but are you seeing any in kids that are younger than teenagers? As well. So yeah. Unfortunately we are, you know, ever since Covid. Yeah. We've, we're seeing more and more of it now in terms of the stats. It's hard. You know, you look at different sources and you're getting different numbers, but it seems like it's gone from about 5% of the population of kids, up to about 10% or even a little bit higher. But in terms of just what I'm seeing clinically and the people who come into my practice, I'm definitely seeing more of it.

And so what you mentioned causes. So maybe we can go there next. And there certainly are a lot of them, and probably we'll continue to find more cases as we dive into this a little bit more with, with research and understanding. But what are some of the main triggers that you found in your practice? Absolutely. And I think that's important to note that what you just said in terms of that

Common Causes and the Toxic Five 5:00

we're always finding new causes. You know, COVID's like the newest come around block. But there's you know, we always have to be flexible in our thinking and always have to be more aware and make sure that we're not missing anything. So when I look at causes, I like to categorize them into deficiencies. These are things that are not in the body that are supposed to be there. And then toxicity. These these are things that are in the body that aren't supposed to be there, that have kind of accumulated over time.

And, you know, we're going to talk about these 38 different causes. But I just want people who are listening and watching this not to get overwhelmed by this, because the reality is, is that when you know what causes you have, you can just match them up with the treatment, move through a process, and then you're going to be better. And, you know, 6 to 12, 18 months, however long it takes. But you know that you're not going to be missing anything. So just wanted to put that out there. So when we're looking at deficiencies it's like deficiencies in hormones.

So like the adrenals thyroid sex hormones oftentimes can be deficient. Deficiencies in mitochondria. So the mitochondria produces 70 to 90% of our energy found in every cell in the body except for red blood cells. And so that's that's one that gets compromised. And we'll talk a little bit about the relationship of these deficiencies to the toxicities in just a moment. There are deficiencies in vitamins and minerals. So people are very familiar with vitamin B, B12, vitamin D, and then minerals like iron and magnesium.

Then there's deficiencies in lifestyle habits. So not enough good sleep, not enough good food, not enough good movement and not enough good water. Right. So all of those things, you know, that's where people can really feel empowered is that if they work on those lifestyle habits, oftentimes that can make a significant difference in their lives. If that doesn't work, and then they start to replace deficiencies like we just talked about with the hormones and the nutrients, etc.. And they're still not better then at this point they really need to look at the toxins.

And so I call the toxins the toxic five. And this is an accumulation of toxins that have kind of built up in the body over time. Oftentimes we come out of the womb with these toxins. You know, there's studies to show that over 300 different chemicals are found in babies cord blood. So that means that they're kind of getting that in the womb, and they're coming out with it. And so these toxins are things like heavy metals, chemicals, molds, infections and trauma. And oftentimes, you know, we think about trauma as something, you know, with a, as we call big T trauma where there's significant abuse.

But that doesn't have to be the case. You know, there can be stress during pregnancy. There can be, bullying, that kids can experience, you know, they can change the way they look at the world that can end up causing what I call or a lot of people call little T trauma where it's still significant even though it's not considered abuse. Now, what's important to note about the The Toxic Five is that they cause 80% of the deficiencies, right? So you can replace the hormones and the nutrients, and people and kids will feel better when you do that.

But the reality is, is that they're not going to get all the way better until you remove those toxic five that are damaging the mitochondria and de-stressing. It's a it's it's ability to make energy that are that are causing stress on the human organism that's compromising the adrenals, the thyroid, etc.. So, it that's that's an important nuance to all of this. And it can't be easy to, to treat this right, because I would think that this is something where people want quick results, and this is not something that you're necessarily going to get quick results.

I mean, you might feel better if you replace some things, but, this is the kind of issue where it's built up over a long time. And then oftentimes I would think it would take a long time, to, to resolve the symptoms. So can you speak to, you know, especially, I'm sure, with teens, not not the easiest population to get to follow any sort of protocol. So what what are some of your tips or some of the things that, that you guys, would work on to kind of move things in a little bit better direction?

Yeah. The first thing is to set up correct expectation because you're absolutely right. You know, I mean, everybody wants to be better yesterday, and that's what I want for them as well. But the reality is, is that you didn't get here overnight. And in order to resolve these, this, these things and the body likes small changes. And so,

Treatment Expectations and Teen Compliance 9:30

you know, all of our programs are 12 months in length because that's generally the amount of time that it takes for some people. And that doesn't mean that it takes 12 months until you feel until you feel a little bit better, because you're going to feel better all throughout the process. But the reality is, is in order to get complete removal of all these toxins, it takes that amount of time. Now, sometimes it can take less time for teenagers than it does for adults. But, you still have to have that expectation and then you have to try to make things as easy as possible.

You know, I've gone from using a lot of, capsules to moving to more tinctures that we can kind of combine together that they can take once a day, in order to make things as easy as possible for parent and child. And then there is quite a bit of feedback that is required, that sometimes it's hard to get that information from the teenager. So, you know, if they if you're addressing a number of infections that can make them feel better or worse, you need to get that information from them so that you can ask me and we can change the protocol a little bit, maybe give them a little bit more die off support.

If you're killing bugs, they're feeling a little bit worse. Their sleep is maybe a little bit worse. Maybe they're a little bit tired. All you have to do is increase some of these other tinctures that get the those dying bugs out of the system. We call that die off or a Horkheimer reaction. And then they can then they can feel better. But it does require that give and take. And so keeping track of of those things and asking on a regular basis, you know, with potentially an already contentious relationship between teenager and parent can definitely be challenging.

So it's, you know, it's trying to make them see kind of the big picture. I think it's kind of it's a little bit like getting Invisalign or braces where it's uncomfortable for the teenager, but they when they understand the big picture, they're more willing to do it right. And so it's kind of like, you know, do you want to get back to the energy that you had? Do you want to be prepared for college? That's kind of like a big thing that we talk about. And so it's kind of it's navigating, you know, do you want to be prepared for summer vacation?

You know, whatever it is. But oftentimes having those carrots or having that sort of big picture, it seems to help. And are you finding that infections are triggering, this in a lot of your patients? Because I feel like, you know, with Monroe, let's say, you know, EBV, that's something that that people have understood for a long time that, you know, you can get something like mono and then you're super tired for a couple months, not necessarily chronic fatigue where it's lasting for, you know, six months or a year.

But but obviously that, that those symptoms are possible after getting an infection. But I feel like there's a lot more discussion in medicine these days, certainly in integrative medicine around pans and pandas, Covid, and other infection. So is that something that you're noticing? And I'm thinking maybe that was just always there and we're more recognizing it now. But, do you feel like that's a big trigger, too? Absolutely. Yeah. You know, Borrelia, Bartonella, bobcat, you know, a number of these Lyme type infections.

And I don't like to use the word Lyme anymore because it has such a stigma, but it's just the number of infections that kind of end up becoming more opportunistic in the body with the more heavy metals, chemicals and molds that we acquire. So molds and infections are really huge. And the more that I do this work, the more the less testing that I'm doing, because I'm finding that everybody who gets to a point of chronic fatigue

Infections as a Major Trigger 13:00

has all of these toxins, the toxic five that have built up in the body over time. And so I'm testing less for them, and I'm just treating them because what ends up happening when I, when I used to test, you know, every three months or whatever, they would all end up coming out over the course of a year. There were always heavy metals, there were always chemicals, there were always molds and mycotoxins, and there were always infections. And all of them had to be addressed. And so in order to make sure we leave no stone unturned and they're going to be doing well for the rest of their lives, it's really important to make sure we're addressing these things.

So that's just kind of something that I've learned over the and I've kind of changed how I'm doing things over the last six months after seeing this. Time and time again over the last several years. Yeah, it makes a lot of sense. And then I guess, you know, I always try to finish off with, with some positivity and kind of some actionable steps for, for this week or today. And I feel like with something like chronic fatigue, it's not simple. It's not something that necessarily you're going to be able to resolve on your own.

Maybe you can, but I think it would be good to just maybe go through some of the first steps that people can think through, keeping in mind that everybody's different. And certainly, you know, this is a more complicated case, which it generally would be if you're getting to the point of chronic chronic fatigue, that you may want to work with a practitioner who's literate in this to kind of guide you through it, because, you know, like you said, again, there's a lot of things that you probably can do for most people, but then there might be an an almost always will be some specifics that are going to be unique to you.

That would be very helpful to get you that last, you know, 15, 20% or whatever it is to get you back to 100%. Absolutely. Yeah. And so, you know, some of those things are the lifestyle habits, you know, making sure that the diet is good, that people are sleeping better, that they're getting enough water, that they, that they're getting enough movement. You know, though sometimes if you're so pretty, you can't get enough movement. So what that looks like is, you know, as a, as a teenager, going to bed as early as possible, you know, even before 10:00, oftentimes can be incredibly supportive, making sure that the phones are not in the bedroom.

And this sometimes can be really contentious, especially if they're having a hard time sleeping. And so sometimes they're listening to things at night in order to help them. And so there does need to be a negotiation. It's not an absolute I definitely have kids who need their phones for some anxiety issues or whatnot, but shutting off different components of their phone. So utilizing some of these, apps, you know, like a studio shoe

Lifestyle Strategies for Recovery 15:30

studio or some bar or some of these other ones where you can monitor what they're using and then when they are using them. So oftentimes I'll coach parents to, you know, turn off the YouTube in the Instagram and just allow, you know, things that they can listen to, like Spotify, you know, if they need them in the night. But making sure that sleep is very much protected, that everybody's doing it, everybody's talking about sleep and that all of your actions after dinner are are for fostering good sleep.

Right? You're not they're not acting. They're not watching, things that are too stimulating or horror films or anything like that, or thinking too much about, I mean, yes, there might be some homework that has to be done, but really trying to, you know, listen to relaxing music and getting into a softer space and getting ready for bed and then having a really nice environment, dark curtains, etc. to to make it a really nice cocoon and make them excited about going to sleep. It's it's really my I have a 15 year old and it's really disturbing to hear how many kids are not going to bed until like 1 to 3:00 in the morning, and then they're supposed to get up for school the next day, and I think so.

And yeah, and so and having these conversations also about social media, you know, if you want your kid to be insecure and to have negative thinking, just let them wake up in the morning and go on to Facebook and start comparing themselves to others. Go into their email where other people are asking them to do things right, and so then all of a sudden there's an urgency and there's like stress, right? So all of a sudden you're you're feeling more insecure. And this is something that also parents don't really realize because you know, we we haven't taken classes on how to really manage our, social media intake and our news intake.

Right. News is so hyperbolic these days and whatnot and so contentious. And then kids are picking that up if it's playing in the house, you know. So oftentimes we're talking about decreasing and getting rid of all of these inputs. That can be really challenging. And then, you know, two liters of water a day for kids, sometimes up to three liters if they're adult sized over about 120 pounds, when they're going through a program like ours where you're actually removing a lot of these toxins out of the body, that can be incredibly helpful.

You know, if they do need to come home in the afternoon and lie down, just getting horizontal can be really good for the adrenals, which manage stress in the body. And oftentimes they can be fatigued because their blood pressure is not getting up to their brains because of how the adrenals are compromised by the number of toxins that are in the body. So that's sleep and that's water. And then, you know, making good choices with food, you know, you know, meat and veggies is really ideal to think about.

But avoiding things like gluten and dairy and sugars, really, you know, such a big one. And any sort of, packaged foods, you know, wanting to avoid those as much as possible, but really focusing on the vegetables a little bit of fruit and then meat or protein is going to be incredibly beneficial for these kids because their immune systems are hyperactive and they're going to be more reactive to a number of these foods that are caustic to the body. So those are those are some things that people would just pick one of those things and just start feeling empowered, start to get your kid to have a gratitude practice.

We take people through a force four step mindset practice, that's available on our website actually. But, just starting with gratitude and expressing gratitude every day, modeling that for your teenager, and having them do that with you can be really beneficial as well. That's a great list. I mean, I couldn't said it better myself. Those are all almost exactly the things, you know, if I was talking about this, I mean, I get asked this a lot in terms of medicine and, you know, my list is called the Seeds of Health, stress, environment and toxins, exercise, diet, sleep.

But same exact list. Basically, everyone's got their own mnemonic, whatever it is. So that was really beautifully said. And I think, super helpful and actionable. So, you know, great, great list of tips.

Where to Find Evan Hirsch 19:30

And before we go, can you just tell people, where to find you about your book if they want to work with you, any of that kind of stuff? Sure. So I'm at energy MD method. Welcome. And once you get to our website, you can go to the free stuff and check out what we have there. There's some quizzes on whether or not people have long Covid or some of these different infections that we've talked about today. There's a way to determine a number of your causes based off of your symptoms. You can actually text me from the website.

We can have a conversation, and then we can get on a free 20 minute call to see if we're a good fit to work together. And we have a program for almost every single budget, from a course up to our one on ones, and including a group program, too. So, we're here to help. Okay, great. Well, thank you so much for for being here and being a part of this and all that you do for families. And thank you, everyone for listening. We'll see you in the next the next session.