Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, everybody, and welcome to Rev Up Health. Today we're going to talk about fatigue. Who doesn't get fatigued? Why are we so tired? In daily life you wonder, "Why do I get up and, my goodness, I've got to have all this caffeine to get going? I feel so fatigued during the day, midday, and then I get home and I'm just beat." So what can we do? What are the things causing this? I'm Dr. Mark, and I'm Tandi, and we're going to get this started.
Sleep: Quantity and Quality
The first thing on the list, which I'd think is a big contributing factor, is lack of sleep. Tandi, is this something you think the majority of people out there have trouble with — whether poor quality of sleep or just not enough of it?
Yes, absolutely, I think both of those things are a problem. People have a hard time getting enough sleep, and people are often under the misconception that you really don't need that much sleep, when studies tell us that 7 to 8 hours of sleep is really what you need.
I think you're one of those people who used to not get much sleep. That's right. I used to basically power all day, and then if I could take a little nap in the evening, I could wake back up again and just work, and then have to physically make myself go to sleep because I'd be all wound up and ready to go. Well, the next day I'd wake up fatigued and trying to get going for the day, and it's tough to do. I'd be one of those who wouldn't think I needed a lot of sleep, and I'd just power through the days, and things would do okay — but my activity level was quite high. Through a lot of research and information in our process of studying, I found out that sleep is when we repair; that's when we recharge our batteries. If you don't get good sleep, you don't recharge your batteries, so you're going to be fatigued. It's better to be functioning on all cylinders than on just a few, and that's kind of what happens — we all get into that grind of daily life. Getting sleep is going to be so much more helpful to help us heal and repair.
The other part of that, especially in our 9-to-5 practice of medicine, is that we see a lot of folks with sleep apnea. So we see people who are getting sleep but not getting good quality sleep, and that is also a huge thing. And not only sleep apnea — there are other things that decrease your quality of sleep. Drinking alcohol in the evening before bed will disrupt your sleep; eating too close to bed will disrupt your sleep. There are a multitude of things you can do to get better and better-quality sleep. But certainly there are other things causing us fatigue — it's not just sleep, right?
Stress and Screens
At this point, obviously, stress is also a big component of that sleep situation. Folks who have a high level of stress during the day, during your job, carry that home, and then what are you doing? You're thinking about it all night while you're in bed, or you have trouble turning off your brain so you can actually get some sleep. There's a lot you can do to promote that and get yourself ready to sleep at nighttime. Stress is a huge component, and it's been shown to affect more than just your quality of sleep — stress affects everything from your GI tract to your mental thinking to your hormone imbalances. It's a multitude of things that stress affects.
Screens are another thing that's certainly a big problem these days with the internet. I grew up without internet a long time ago, so I didn't have that problem like the kids do these days — but obviously adults are having that same problem now, with screens, the internet, and televisions in the bedrooms. You just can't do that, because it does not shut the brain off.
A Sedentary Lifestyle
I think another contributing factor is a sedentary lifestyle. I've noticed that my sleep quality and my ability to get more sleep is always better when I've been active. Everybody knows that when you get out there and work your body and move and do things, you're more tired at the end of the day, right?
Yeah, any type of activity — it's best to try to move that activity earlier in the day, so you can prepare yourself for the day. It wakes you up, gets your hormones moving, and gets the blood pumping. Then, in the evening, you're ready for bed. Exercising in the evening, which I do often, especially in the winter because it's so cold and dark first thing in the morning — exercising later in the day makes it really difficult to actually get ready and prepared for sleep.
I think another thing that has us a little off-kilter as far as getting ready for sleep is that when you work long hours — obviously in healthcare there are a lot of folks who work 12-hour shifts — if you think about working a 12-hour shift and then coming home and winding down and all the things, our work life is often something that's contributing to our ability to get enough sleep and have enough time to do the things we need to do at the end of the day. Because ultimately, you still have to do all the things, right?
Other Drivers of Fatigue
With the other components that affect our sleep and fatigue — you touched on alcohol, but it's not just alcohol these days; with marijuana and other types of chemical influences, those things affect our quality of sleep and our ability to prepare for sleep. You may feel tired after you have a glass of wine or two in the evening, and you may go to sleep quickly, but your sleep is going to be so fragmented and sporadic in the middle of the night that you just don't get that good quality REM sleep — you need a couple of hours of that to really recharge and feel fresh the next day.
We are talking a lot about sleep, because that does contribute to fatigue, but fatigue in general is not just about sleep and being tired and ready to go to bed. Fatigue is also just the body feeling tired and weak. There are things like heart disease — atrial fibrillation. People who have AFib are often very tired and don't feel like they have a lot of stamina, so that's another thing that can be fatiguing.
Sugar — we all know what that feels like when you've had a lot of sugar and then have the crash afterward, and that causes fatigue and sleepiness. Sugar equilibrates to carbohydrate load too, so it's not just eating sugar; it's eating all the breads and pastas that taste so good that also cause the spikes and crashes, which lead to fatigue. Ever wonder why at Thanksgiving, or during the midday after you've had lunch, about 3:00 in the afternoon it's like, "Oh my goodness, am I ever going to be able to get done with work today?" and you've got to have that extra cup of coffee to get through? Those crashes with our blood sugar make a difference in our fatigue throughout certain times of the day.
Even the ultra-processed foods we eat are a contributor to generalized fatigue in our system, whether through the hormonal disruptions they cause or the disruptions in our body chemistry that lead to generalized fatigue and deficiencies — basically deficiencies in our intake of nutrients and minerals.
What Can We Do? Circadian Rhythm and Sleep Hygiene
So what can we do? There are a lot of things, and we've spoken about some of them randomly as we describe the reasons we're fatigued. We'll start with simply improving your circadian rhythm, and a newer topic around sleep hygiene. This is something I hadn't heard of until recently — I believe Dr. Matthew Walker may be the one who kind of started this. He has a really great book on sleep, and since that book I've heard a lot more about sleep hygiene.
The circadian rhythm is certainly a contributing part to benefiting our sleep, because recent studies have actually shown that if you're able to watch the sunrise and watch the sunset, those color variations we experience during the sunrise and sunset are a great way to reset our circadian rhythm, which is going to prepare us for a good night's sleep. So your sleep hygiene actually starts first thing in the morning, making sure you're getting access to daylight in the morning so you've got that good start to the day.
With our work life, it's not always easy to watch a sunrise or sunset, but anything you can do will help. Getting direct exposure during the day, maybe over a lunch hour, or sitting near windows — getting yourself in a situation where you can present light to your eyes will help you a lot.
Morning Exercise and Smart Caffeine Timing
One thing I've really found helps me with fatigue and sleep in general is to have a good morning exercise routine, even if it's five minutes of doing push-ups, sit-ups, and curls. It's better to do something rather than nothing. Now, if I can spend a good hour getting a good run in during the morning, that makes me feel really good throughout the day. It gets your endorphins going, you get the dopamine rush, and it sets the mood for the day and improves your daily mood in general.
The other thing is caffeine, and this is one I think Mark struggled with a little bit. I used to always drink coffee all day long, every day, and I slowly got out of that. Now Mark has switched over to decaf when he drinks coffee in the afternoon. Getting that caffeine earlier in the day, and then avoiding caffeine in the afternoon if you can, helps your body prepare for what's to come in the evening.
For myself, I just like the flavor of coffee, and I won't pass up a good espresso shake either if somebody offers it, but I like to have at least half-caffeinated — I don't want the full espresso stuff. I'm not dependent on caffeine to get me going throughout the day. Caffeine can be somewhat of a disruptor for folks from an endocrine standpoint. That's certainly something that affects a lot of people, because they feel like they have to have it all day — well, then you have caffeine all day, and what happens at night? Then you start having trouble getting your sleep regulated. It's a cycle that people get into.
Meditation
One thing — Tandi, I'll let you talk about this — but meditation has been something that's hard for me to do, because it's hard for me to sit still and just be present and in my thoughts. That's something you have a lot more experience in than I do, and I'm finding out that with our stressful lives these days, it's good to just take a few minutes, even if it's doing some box breathing.
Definitely. One thing to remember — and you just said it, "I'm not very good at this because I can't sit still" — the key to meditation is that it's a practice, and in order to get better at it, you have to practice. But it's something that, added into your day, can really just give you a little reset. So instead of taking a nap, so to speak, just do some meditation or mindfulness. I like to listen to guided meditations quite frequently, just because, like everyone, I have a hard time sometimes sitting there and letting my thoughts take over and getting sidetracked. Meditation is a great tool to help with sleep.
Meditation is something that, if you haven't done it, it's difficult to get into, but get into a private, quiet place where you can just sit still. That's all you have to do — just stop moving. Once you start to sit still and listen, you can clear your mind, and that's going to help reset a lot of stuff too. The benefits of meditation are certainly out there in the studies.
Winding Down at Home
Now we've gone through what you're doing during the day to be ready at night, but there are definitely things you need to focus on when you're at home getting ready for bed — making that transition to where your body knows, "Okay, we're gearing up for sleep now, this is where we get to wind down." Whether it's turning down the lights in the house, turning off screens, not eating for 2 to 4 hours before bed, or taking a hot bath — it's been shown that heating up your body before bed, and then as your body begins to cool down, is helpful for getting you to fall asleep. Make sure the bedroom is cool, and block light if you can. I know there are some people who get really into this, and when they travel they take tape and put it over the lights in hotel rooms and things like that. Just give yourself this time to transition from being awake to knowing, "Okay, sleep is upon us."
Natural Sleep Supports
Other than lifestyle, what are some other things you can do to help you fall asleep faster and get better quality sleep? You're looking at other options. Obviously, people who have trouble with alcohol in the evening — you've just got to get away from that, and any other influences, chemical or otherwise. A lot of folks take sleep aids, but they've been proven not to be very successful, and downright near addicting to an extent. But there are some things we can do that are more of a natural approach.
For folks who have a hormone imbalance — and frequently we do have hormone imbalances — for women especially, postmenopausal women, progesterone in the evening by mouth has been shown to be a great way to promote sleep and get a person prepared for sleep. It's also good for your system even if you don't have a uterus — it's still good to have progesterone. And that's not just postmenopausal; perimenopausal women can also benefit from that, pre- and peri-.
Then there's melatonin. I've tried it before, and melatonin works very well. It's not something that's going to make you sleepy the following day, and it can be given in variable doses for folks to improve or promote that onset of sleepiness. One thing I hear most often is people saying, "Oh, I tried melatonin, it doesn't work for me." The truth is, everything is unique and specific to every body, and that's why it's so important to find a healthcare practitioner to help you through these things. Melatonin is part of our normal circadian rhythm, and you can basically work past it. When you were a kid — or really at any age — if you're ever really tired and then you power through, and power through, all of a sudden you're not tired anymore, and then you're not going to sleep because you've missed that opportunity. Melatonin works in that way. So once you take your melatonin, you need to do that at a time when you know you're going to be getting ready to go to sleep, because you need to be falling asleep when it's peaking. That's why a lot of times people say it doesn't work for them — but you do need to make sure you're giving it every chance to do what it's supposed to do.
Yeah, get yourself in a dark, quiet environment, reduce the stimulation, take your melatonin, and go to bed, so you know you're going to be in a good state to fall asleep and get some rest. Melatonin is not only good for sleep, but also has an excellent benefit for the rest of our body, including hormone balance, which people don't realize. It's good for helping to balance your thyroid and your other sex hormones, and it's also good for the immune system — a great immune booster.
Moving on, another thing people have heard about is magnesium. Magnesium is a great sleep aid for people in the evening. There are several different types of magnesium, and they all help with different things — I think it's magnesium glycinate that they use most often to really help with sleep. Yes, we've confirmed magnesium glycinate. There are teas you can take, or supplements. I also have a magnesium spray that I use on my feet sometimes for sleep, so there are lots of different ways to let magnesium help you out. Magnesium glycinate will actually help a lot with overall anxiousness for folks, so it helps to alleviate that even for people who have an anxiety issue. And there are even magnesium salts you can take baths in that will help too. Combine your hot bath with a little magnesium salt or magnesium flakes.
It Snowballs
So as you can see, there are multiple things we can do to help reduce stress, reduce the anxieties of the day, and help decrease our levels of fatigue. If we can do just one or two of these things to help reduce our generalized fatigue during the day, it's going to snowball. After you start resetting the brain to getting used to reducing these outside influences, it's going to start to show the benefits in your generalized health too.
That is absolutely right. We've actually also come up with several things that might be good ideas for other podcasts, so if you heard a little snippet of anything today where you're like, "I want to learn more about that," give us a note and we'll do it. You can find us at revelationhealthandwellbeing.com and on social media at Revelation Health and Wellbeing. We'd love to hear your comments and know what you were interested in learning about. We're so glad you joined us today and look forward to talking again soon. Have a great day, and thank you for joining us on Rev Up Health.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.