By Dr Alain Butnaru

A feeling of fatigue must not be underestimated. Fatigue is expressed differently in every patient and sufferers may experience a multitude of physical and psychological symptoms. It is caused by many different factors and must be treated with an integrative approach.

Physical and psychological symptoms

Though there is not always a serious illness at play, a feeling of fatigue can ruin a patient’s life and should therefore not be taken lightly. From the age of fifty, fatigue manifests itself in a more recurrent way. If it is recent, the cause may be an overload of work or emotions. In this case, rest and energy-boosting nutritional supplements should improve things after a month. If the fatigue is physical, a cure of NADH (an antioxidant coenzyme), vitamin B, magnesium, vitamin C and ginseng will be prescribed to boost the metabolism. If it is psychological, I suggest taking nutritional supplements that target the neurotransmitters.

If the feeling of fatigue lasts longer than two months, it is important to see a doctor who, depending on how the consultation and clinical examination go, will prescribe further tests and/or scans.

Medical causes

The main causes are metabolic – such as hypo or hyperthy- roidism, diabetes or kidney failure –, haematological – such a anaemia and leukaemia – and all cancers. Cardio-pulmonary, neurological, viral and infectious diseases, including Lyme disease, are an ever-growing cause of chronic fatigue. A number of medicines can also lead to fatigue, as well as sleep apnoea, which needs treating.

Psychological causes

All types of psychological suffering, from anxiety to grief, depression and mental illness, lead to significant fatigue. The constraints often imposed on women, such as a career, children, etc. result in physical fatigue and a kind of weariness that makes them feel exhausted and overwhelmed. In this case, I teach them ways to manage their stress (cardiac coherence, neuro-feedback, meditation) and, depending on their complaints – which might include trouble falling asleep, trouble waking up, feeling permanently on edge, feeling dejected – I prescribe micro-nutritional supplements to boost the production of neurotransmitters in the brain, which should be taken until their fatigue and mental energy improve.

Hormonal causes

In peri-menopausal women, the halted production of female hormones can lead to fatigue, which must be treated if the patient is suffering and if there are no counterindications (hormone-de- pendent cancers). For the latter, or for women who do not wish to take HRT, micro-nutritional supplements are recommended. In men, the andropause or Testosterone Deficiency Syndrome (TDS), which signals a drop in the production of testosterone, can also have consequences: dwindling libido, sexual activity and erectile function, asthenia, an increased susceptibility to fatigue, and fits of temper. I invite the patient to answer a series of questionnaires, coupled with a blood test, to get an accurate idea of their state of health and to diagnose either anxiety or depression, or a proven testosterone deficiency.

With these elements, and providing there are no counterindi- cations, I prescribe a testosterone gel to be applied to the skin every evening. It is vital to monitor the patient. The follow-up prescriptions will depend on how the patient feels and on their regular tests.

Burn out, a very specific  type  of  fatigue Professional burn-out, according to the WHO, is characterised by “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy”. This syndrome is already at play six to eight years before it comes to light.

Dr Alain Butnaru

Graduate of the Paris Medical Faculty. Aesthetic and Anti-Aging Medicine since 1985. Permanent member of the French Society of Aesthetic Medicine. Degrees in Morphological and Anti-Aging Medicine,  Micronutrition, Auriculotherapy and Hypnosis.


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