I meet a lot of clients that feel lethargic, fatigued, or just not like themselves. In my field of work, we act as detectives to explore the possible reasons a person may feel poorly. Fatigue is one of those symptoms that can occur for a variety of reasons and what makes my job interesting (and difficult) is that each person may have a completely different reason for the same symptom. This article’s topic is inflammation and how it can contribute to fatigue through its action on cortisol.

What is Acute Inflammation?

The term inflammation is used a lot but what does it really mean? Inflammation is the process of your immune system doing its normal job to fix damaged tissues or to attack and defend you against a foreign invader. It’s intended to be an acute, short-term response, leaving you feeling normal and healthy again after the event. If you cut your finger, inflammation is the swelling, redness, and pain you feel while your immune system heals the cut. It’s pretty miraculous. When you’re sick with a virus, inflammation is the sore throat, stuffy nose, fatigue, and body aches you feel while your immune system fights off the virus. Inflammation is our defense and repair mechanism.

What is Chronic Inflammation?

Ongoing, chronic inflammation is a problem. Since inflammation is a natural response to fix damaged tissues prolonged injuries, such as knee pain that never goes away, causes chronic inflammation. Since inflammation is also a defense system against invaders eating sugar, artificial ingredients and alcohol will trigger inflammation because your immune system can think those foods are foreign. Food sensitivities are a reaction from your immune system with inflammation such as gluten sensitivity. Chronic digestive issues can also perpetuate inflammation.

Inflammation is physical stress to your body and stress can cause fatigue

Your body’s reaction to stress, both emotional and physical, creates a cortisol release through the hypothalamus-pituitary-adrenal axis (HPA axis). Cortisol is a hormone that, when balanced, gives us energy at appropriate times. It increases in the morning and daytime and decreases at night so we can sleep. Stress can cause an imbalance to our normal daily cortisol rhythm and leave us feeling tired during the day but wired at night.

The HPA axis is designed to regulate an acute reaction to stress. When your brain perceives stress, it tells your adrenal glands to secrete cortisol. The classic example is the fight or flight response: You’re driving and relaxed listening to your favorite music. The car in front of you stops suddenly. You react quickly by slamming on your brakes. You narrowly avoid hitting the car in front of you. You feel your heart racing and palms sweating. You feel the need to catch your breath. Traffic starts moving again normally. You feel calm again. Here’s what just happened to your HPA axis:

Your brain quickly noticed the stress. (Potential car accident.)
Your brain told your adrenals to send out cortisol.
Cortisol gave you the quick reflexes and energy to react. (Slam on the brakes, increase heart rate, increase breathing.)
Once the stress was over, your brain sent another signal to tell your adrenals to stop secreting excess cortisol. (You felt calm again.) This is the negative feedback loop of the HPA axis.

If your cortisol feedback loop is working appropriately, you get a sudden burst of energy to respond and then cortisol reduces to bring you back to your normal resting place. The same process happens with physical stress, such as cutting your finger, which creates acute inflammation which should recede after the body is healed.

How Inflammation Impacts Cortisol and Fatigue

When your body is inflamed, your adrenals secrete cortisol. At first, cortisol acts as in an anti-inflammatory manner to modulate the inflammation, or “put out the fire,” and heal the damaged tissue. If the inflammation continues and becomes chronic, eventually cortisol can turn pro-inflammatory. Prolonged stress and inflammation can cause a hyper-cortisol state with eventual dysregulation to the HPA axis, causing a downregulation of cortisol. This happens because your body knows that too much cortisol is damaging in the long term. The result is fatigue. It is your body’s way to slow you down and rest.

The takeaway is that when you are chronically inflamed, your brain perceives that you’re stressed, injured, under attack, or not healing, so it sends your body a message to rest. This message comes in the form of fatigue.

By reducing inflammation, your cortisol levels can readjust and your energy can bounce back.

What Causes Inflammation?

Sugar – I know, I love it too, but sugar is a classic cause of inflammation. It’s ubiquitous in our food and our lives so it’s an effort to cut back.
Alcohol – this is another form of sugar and viewed as a foreign invader to your immune system.
Processed foods and artificial ingredients – think Doritos, that color is not natural.
Chronic injuries – such as joints and ligaments that continually cause pain.
Seasonal allergies – your immune system is fighting off pollen.
Poor sleep – leads to an increase of cortisol since your body cannot fully regenerate overnight as deep sleep allows. Plus, cortisol should be lowest at night, so insomnia is commonly from inappropriate elevations of cortisol at this hour.
Blood sugar balances – low blood sugar causes your adrenals to secrete cortisol to pull you out of the low blood sugar crash. This process itself causes inflammation plus the additional needed release of cortisol. A double whammy.
Toxins – from air pollution, household cleaning supplies, chemicals in body care products, plastics; our world is unfortunately full of chemicals that your immune system considers foreign invaders.
Digestion – your gut is home to a large portion of your immune cells which work closely with your microbiome to decide which foods are inflammatory (red dye #40) or anti-inflammatory (broccoli). Digestive upsets such as heartburn, bloating, gas, nausea, and bowel movement inconsistencies are signs that you’re not digesting your food properly and/or your microbiome is out of balance. This is a source of inflammation.
Illness, especially from viruses, flare up inflammation as your immune system protects you.
Food sensitivities – an immune response to foods; these are specific from person to person.
Overnight shift work – puts demands on the body to secrete more cortisol to stay awake during normal sleeping hours.

How Nutrition Can Help Inflammation-Related Fatigue

Finding sources of inflammation specific to your body is a big part of our nutrition work with clients. Making changes to your diet is an excellent way to reduce overall inflammation.

Eat an anti-inflammatory diet. This is equally about eating MORE unprocessed vegetables, fruits, whole grains, lean meats, fish, and healthy fats as it is about NOT eating excessive amounts of sugar, alcohol, processed and packaged foods, fast food, and restaurant meals. This includes keeping your blood sugar balanced by eating fiber, protein, and healthy fat with each meal. Download our Free Anti-Inflammatory Nutrition Guide https://www.bebalancedhealing.com/downloads/ for a list of what to eat and what to limit.
Balance your digestion and microbiome. As described above, your gut is the home to most of your immune system. When we’re talking about inflammation as a strategy to balance cortisol and increase your energy, your gut is important. Digestive symptoms may cause inflammation and fatigue. Download our Free Digestion Reset Nutrition Guide https://www.bebalancedhealing.com/downloads/ or set up a 20-minute exploratory consult with me (Jen Marshall) to decide if you need help getting your gut feeling good. https://bebalancedhealingscheduling.as.me/schedule/60676a18
Movement and sweating for natural detox. Toxins are a source of inflammation and fatigue. Your body has mechanisms to help you excrete toxins. Movement will trigger the lymphatic system, your body’s waste disposal system, to start mobilizing toxins for excretion. Sweating is one excretion pathway (the kidneys through urine and the digestive tract through bowel movements are the other pathways). Find a type of movement that you enjoy such as walking, dancing, riding a bike, gardening, hiking. It does not have to be a traditional gym workout to get your body moving and sweating.
Prioritize good sleep and resolve sleep issues. If you’re not getting adequate sleep and feeling rested in the morning, sleep is likely a contributor to fatigue. Strive for 7-9 hours each night and adjust your schedule if needed. Most people want to get more sleep but have difficulty falling asleep or staying asleep. Test your iron and ferritin levels as low iron can be a cause of insomnia and restless legs syndrome. Low blood sugar can disrupt sleep so consider if you’re hungry at night from eating an early dinner or fasting. If you’re peri-menopausal or menopausal, consider hormone balance support as low progesterone or estrogen can contribute to sleep issues.

While acute inflammation is a miraculous way of healing the body, chronic inflammation is a sign that your immune system is continually fighting and needs rest. If you are experiencing fatigue, consider if it’s from inflammation and investigate the contributors.

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4263906

https://journals.sagepub.com/doi/full/10.2203/dose-response.10-013.Yeager

Disclaimer: Nutrition therapy is not intended as a diagnosis, treatment, prescription, or cure for any disease, or as a substitute for medical care. Jen Marshall, Stacy St Germain, and Jill Dopp are not licensed medical providers. Nutrition plans are not intended as a substitution for traditional medical care, nor should be interpreted as medical advice, but instead is an adjunctive and supportive therapy.

Is Inflammation Making You Fatigued?