COURSE XV: Chronic Fatigue

The first part of this lesson is an in depth interview with Dr Sarah Myhill who has extensive experience both in clinical practice and research in fatigue states. Sharing her appreciation of fatigue as a disorder of mitochondria, she offers some wonderful insights into key drivers and practical tools for support of patients. We then seek to unravel the interconnected threads that lead to mitochondria dysfunction by focusing on the great antioxidant glutathione, key in buffering oxidant stress. This takes us on a journey through protein synthesis, detoxification, innate immunity and the methylation cycle and sulfation pathway. We then focus in on the downstream consequences of low glutathione. Shifting the focus to cellular energy generation, we consider the impacts on different organ and hormonal systems when this is compromised. This then enables an appreciation of the clinical presentation of fatigue as well as its drivers. Bringing the learning together, the understanding of these diverse systems, helps us build a map to support the return of vitality.