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Tired? Check your gut!

Wednesday, 7th October, 2020 1:45pm

By Dr Deirdre O’Donovan

Stress-related illness due to the Covid-19 is definitely a thing. It’s not just about the virus, it’s also about everything else that’s changed because of the virus. But Covid-19 may not be the cause of everyone’s constant malaise, low energy levels and brain-fog.

We are all familiar with that desire to take a nap after a large meal or dinner. Fatigue, however, is different. It is defined as a feeling of constant tiredness, no energy with a greater need to sleep. Fatigue also causes a reduction in alertness, being more irritable than usual, being frustrated by tasks, having difficulty concentrating or being uncommunicative.

Watch what you eat

Meal composition is important; we want a nice balance of macronutrients to allow an easier digestive process.

Many conditions, like coeliac disease, when untreated, cause fatigue because patients are not absorbing necessary nutrients, especially iron, from their diet.

Other gut-related diseases which cause bleeding from the bowel can also result in anaemia, and lack of energy may be the only sign to alert someone that something is wrong.

For others, dysbiosis/alterations in the natural gut flora can contribute to what many refer to as ‘brain fog’ and profound tiredness, and this can be helped by introducing a good probiotic. Alflorex is one I generally recommend.

What is happening in our guts

Depending on the cause, feeling rundown can reflect an underlying anaemia (like low iron, or vitamin B12). In those cases, your gut ‘villi’ (the finger-like projections that absorb iron) may be altered, as in the case of coeliac disease, or there may be antibodies floating around in the blood preventing the absorption of B12, as in the case of pernicious anaemia.

What is very interesting is that a large proportion of our immune system is based in our gut and our resident gut flora likely interacts with this on a daily basis, potentially switching on and off certain immune responses.

This is an area where a lot of research is happening currently, so we await the outcome of those investigations and whether there is some way we might be able to profile in detail what’s happening to our gut flora during periods of stress in our lives, and how our immune systems respond to these changes; more importantly, how we might influence them positively.

Manage your gut health

People often ask if there is anything they can do to help their gut health, the answer is supportive management, get a good night’s sleep, reduce alcohol and caffeine, get regular exercise, eat a balanced diet and consider taking a probiotic.

Be aware of how stress affects you as an individual. We are not designed to cope with stress 24/7 so make sure to keep up that idea of ‘self care’. Going for a walk, learning to say no, mindfulness, medication and complementary therapies such as acupuncture can all play a role.

Also, there’s always the debate of ‘nature versus nurture’, but we can’t blame genetics for everything. We see certain conditions affecting the bowel like inflammatory bowel disease where genetics is important, but often, the timing of the disease presenting itself is influenced by a stressful period in one’s life affecting immune responses.

It sounds corny, but we all need to listen to our bodies. Try and respect them as outlined above. Most people have a sense that something is not right, so act on that ‘gut feeling!

Dr Deirdre O’Donovan is a consultant gastroenterologist at Blackrock Clinic.

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