Published: April 23, 2025
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READ THIS IF YOU ARE ALWAYS TIRED (no matter how much you rest). It's not in your head. It's not normal, but it is fixable. Let's talk about what causes FATIGUE + TIREDNESS, and what you can do about it to have flying energy levels for life:

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Mitochondria are the engines of your cells, and thus your body. They take food and oxygen, and convert it into usable energy. If they aren't working optimally, your “battery” never charges. Focusing on them is thus the key to solving low energy, so that is what we will do:

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Vitamins & minerals are needed for your cells to create energy from food. ⬩B1 ⬩B2 ⬩B3 ⬩B6 ⬩Magnesium ⬩Zinc ⬩Copper ⬩Iron ⬩Sulfur ⬩CoQ10 ⬩K2 ⬩Creatine Just to name a few. If you're low on any, you're already screwed.

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Vitamin B1 megadosing can cure fatigue. 600 - 1,500 mg of thiamine (B1) reduced fatigue severity by ~40% Multiple studies showing this. Perhaps the most important nutrient for the mitochondria. More on that below.

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Coenzyme Q10 has potent energizing properties. 60 mg per day prevented and even improved fatigue in patients with heart failure. CoQ10 is a central compound in mitochondria: a lack of it impairs our ability to generate energy i.e you get tired.

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Magnesium cuts fatigue in half. People with persistent fatigue have depleted magnesium stores, but 6 weeks of magnesium, subjective energy level improves by >50%. Magnesium is necessary to form cellular energy in the form of ATP, and supports multiple energy producing enzymes.

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Mitochondria don’t just run on vitamins and minerals though, you need to EAT ENOUGH CALORIES, Restricting calories also body drops thyroid hormone and leptin to conserve energy. You’re not just eating less, you’re telling your body to produce less energy. More on that below.

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When mitochondria can’t generate ATP properly, your cells fall back on glycolysis - a less efficient form of energy production. This leads to excess lactic acid buildup, especially after activity. This is a hallmark of chronic fatigue.

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And it’s not just in your muscles. Studies show people with chronic fatigue have elevated lactate in the brain’s cerebrospinal fluid. Again, this is a sign of impaired energy generation in the brain.

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NAD+ is a coenzyme that carries electrons for energy production. Low NAD+/NADH ratio = stalled mitochondrial output and higher lactic acid production. Higher ratio = more ability to burn energy. The ratio drops when energy production is off, and further shuts down the system.

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Nicotinamide Mononucleotide (NMN) reduces fatigue. Raising NAD+ with precursors (NMN, NR, niacinamide) restores energy production in mitochondria, since it is often limited by NAD+ availability. 250mg here was shown to have an energizing effect.

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ENDOTOXIN (LPS) is a primary driver of impaired energy generation. This is a part of most gut bacteria, and circulate systemically if your gut health is poor. Endotoxin inhibits mitochondrial energy production at multiple levels. This is a very common cause of fatigue.

Image in tweet by Analyze & Optimize
Image in tweet by Analyze & Optimize

Eating meals higher in fat can increase the absorption of endotoxin into the blood. This is especially problematic if you already have bacterial overgrowth / dysbiosis and leaky gut. Lower fat / higher fiber can help mitigate, but ultimately you need to fix the gut.

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Fatigue doesn’t come far behind once digestion becomes burdened. Consistently and strongly associated with elevated levels of intestinal permeability, gut bacterial toxicity and subsequent inflammation.

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Image in tweet by Analyze & Optimize

Chronic fatigue often starts in the gut. An overproduction of D-Lactic acid bacteria are prominent in chronic fatigue, contributing to brain fog and tiredness. Antibiotics can reverse it.

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Image in tweet by Analyze & Optimize

Chronic fatigue caused by candida. These fungi can: ◇ Drive chronic inflammation ◇ Suppress the immune system, increasing pathogenic load Contributing to fatigue pathology. Anti-fungal interventions can resolve Chronic Fatigue Syndrome. More on tackling it below.

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That means you MUST focus on the gut if you want to overcome chronic fatigue. Lucky for you, I have a guide on how to do just that below:

Inflammation is one of the primary mitochondrial inhibitors. ⇒ Inhibits mitochondrial enzymes ⇒ Fragments them into inefficient pieces ⇒ Triggers oxidative stress (damages structure + stop energy uptake) This is why you get tired when you get sick, but you can have chronic

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Chronic fatigue is really chronic inflammation. Microglia (inflammatory cells, red/yellow) in the brain are directly tied to symptoms of: △ Cognitive impairment △ Depression △ Pain △ Lethargy interventions that address inflammation will be key in solving it.

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Viruses are a primary trigger of fatigue. Some researchers think that MOST cases of chronic fatigue are initiated by a virus. Common ones: ⇨ EBV reduces mitochondrial DNA replication. ⇨ HHV-6B and CMV increase oxidative stress All viruses can ramp up inflammation and derail

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CRH is the first step to producing cortisol. CRH activates microglia - immune cells in your brain that drive neuroinflammation, again which is directly tied to fatigue symptoms. Thus, lowering stress is going to be key. My guide on doing just that is below.

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Thyroid hormone is the PRIMARY energizing hormone. It acts on nearly every possible way to benefit mitochondrial health. If you're always tired, you're likely low on thyroid (+ should check out this guide to optimizing it):

Stress also blunts thyroid function ➜ High cortisol blocks the conversion of inactive T4 to active T3 ➜ Free fatty acids inhibit thyroid signaling at the nuclear level No thyroid signaling = no mitochondrial activation = no energy.

Reduced blood flow is another hallmark of persistent fatigue. This lack of blood flow into the brain can cause fatigue by impairing oxygen delivery, which is needed for energy production. One primary factor for improving oxygen delivery + blood flow is CARBON DIOXIDE. I

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Methylene blue enhances cognitive function, in part by improving blood flow to the brain. Many folks report increased energy levels with it in the mix.

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Ginkgo biloba reverses fatigue. 240 mg / day here. Ginkgo works in part by improving blood flow to the brain, which increases energy production by enhancing nutrient / oxygen delivery.

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Red light therapy stimulates blood flow to the brain. 610 nm wavelength. One of the many reasons it is so beneficial for cognitive health (more on that below).

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People with chronic fatigue have 10X more microclots. Excessive blood clotting impedes blood flow, and thus oxygen delivery. ⇨ Aspirin ⇨ Proteolytic enzymes, ⇨ Reducing omega-6 / omega-3 ratio can slow this process, but they are primarily driven by oxidative stress.

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Image in tweet by Analyze & Optimize

High homocysteine inflames vessels and accelerates clot formation. It becomes elevated with deficiencies of: ⬩Glycine ⬩Choline ⬩B2 ⬩B6 ⬩B9 ⬩B12 and directly drives inflammation + mitochondrial dysfunction.

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Antioxidant status is also vital for energy production. Oxidative stress ➞ Damages mitochondria ➞ Damages blood vessels - worsens blood flow ➞ Increases inflammation ➞ Impedes energy import into cells The basics of antioxidant support are below:

High dose vitamin C prevents fatigue, lowers cortisol. 6g a day for 2 weeks: ◇ Cuts fatigue scores ◇ Improves insulin sensitivity ◇ Cut cortisol ◇ Lowers liver enzymes ◇ Decreases inflammation Vitamin C is a primary antioxidant supportive nutrient.

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