Fatigue is a common complaint. Often, the fatigue is transient or can be attributed to a definable organic illness. Some patients present with persistent and disabling fatigue, but show no abnormalities on physical examination or screening laboratory tests. In these cases, the diagnosis of chronic fatigue syndrome should be considered.
   Fatigue may be due to depression, lack of exercise, poor diet with lack of adequate protein, anemia, diabetes, hepatitis, thyroid disorders, cancer, occult infections, autoimmune disorders, sleep apnea or sleep disturbances, or adrenal insufficiency.
   If a full medical evaluation is completed and no major causes are found, certain supplements may be tried to increase energy levels.  

There are many nutrients and herbs that help reduce fatigue, including:

B Vitamin and coenzyme complex which you can find Vitamin-B-Coenzyme here.
Carnitine can fight fatigue, see Carnitine for more information.
Creatine can fight muscle fatigue
Pantothenic acid is a b vitamin that can help reduce fatigue
Trimethylglycine-tmg can fight fatigue and improve mood
Ginseng is an herb used to improve fatigue
Maca is an herb from South America that helps fight fatigue, you can find Maca supplement here for sale.
Royal jelly can improve fatigue
Spirulina can benefit fatigue

Cause of fatigue
Anemia - Anemia is a common cause of fatigue in women who have heavy menstrual cycles, have fibroid tumors or uterine polyps. The blood loss may cause anemia due to the loss of iron. Other causes of anemia include iron deficiency, low levels of folic acid, or vitamin B12.

Low thyroid (hypothyroidism) - If you are generally sluggish, run down, and even a little depressed, the cause could by a poorly functioning thyroid gland.

Poor quality sleep is a common cause of fatigue

Lack of exercise can cause fatigue

Overeating and obesity

Hidden food allergies

Excess use of caffeine or stimulants

Heart disease

Difference between fatigue and tired
"It's important to recognize the difference between tiredness and fatigue, because fatigue is a marker that the body is not able to keep up," says Dr. Karin Olson, with the faculty of nursing at the University of Alberta. Olson has studied fatigue in cancer patients, people diagnosed with chronic fatigue syndrome and depression, as well as shift workers and athletes. These populations were chosen because they experienced fatigue for different reasons -- illness, work, or leisure activities. People who are tired still have a fair bit of energy but are apt to feel forgetful and impatient and experience muscle weakness following work, which is often alleviated by rest. People who have fatigue experience difficulty concentrating, anxiety, a gradual decrease in stamina, difficulty sleeping, and increased sensitivity to light. They also may skip social engagements once viewed as important to them. People who suffer from exhaustion report frank confusion that resembles delirium, emotional numbness, sudden loss of energy, difficulty in staying awake as well as in sleeping and complete social withdrawal. While exercise may relieve tiredness, it may decrease the ability to adapt in people who are suffering from fatigue or exhaustion. If it's fatigue or exhaustion, caffeine and other stimulants should be avoided as these substances fool the body into thinking it has more energy that it actually does. Oncology Nursing Forum 2007.

Fatigue study
L carnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue.
Pistone G,. University of Catania, Catania, Italy. Drugs Aging. 2003;20(10):761-7.
AIM: L carnitine is an important contributor to cellular energy metabolism. This study aims to evaluate the effects of carnitine supplementation on body composition, lipid profile and fatigue in elderly subjects with rapid muscle fatigue. This was a placebo-controlled, randomised, double-blind, two-phase study. Eighty-four elderly subjects with onset of fatigue following slight physical activity were recruited to the study. Prior to randomisation all patients entered a 2-week normalisation phase where they were given an 'ad libitum diet, according to the National Cholesterol Education Program (Step 2). Subjects were asked to record their daily food intake every 2 days. Before the 30-day treatment phase, subjects were randomly assigned to two groups (matched for male/female ratio, age and body mass index). One group received carnitine 2g twice daily (n = 42) and the other placebo (n = 42). Efficacy measures included changes in total fat mass, total muscle mass, serum triglyceride, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein (apo)A1, and apoB levels. The Wessely and Powell scale was used to evaluate physical and mental fatigue. Subjects were assessed at the beginning and end of the study period. At the end of the study, compared with placebo, the carnitine-treated patients showed significant improvements in the following parameters: total fat mass, total muscle mass, total cholesterol, LDL-C, HDL-C, triglycerides, apoA1, and apoB. Wessely and Powell scores decreased significantly by 40% (physical fatigue) and 45% (mental fatigue) in subjects taking carnitine, compared with 11% and 8%, respectively, in the placebo group. No adverse events were reported in any treatment group. Administration of carnitine to healthy elderly subjects resulted in a reduction of total fat mass, an increase of total muscle mass, and appeared to exert a favourable effect on fatigue and serum lipids.

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Fatigue vitamins and supplements questions
Q. What supplements do you suggest to help my adrenal fatigue symptoms? I am tired of taking anti-depressants, ADD meds, etc., and would prefer products more natural.
   A. Firstly, the underlying cause of the fatigue has to be determined, some people think their fatigue is due to the adrenal glands, but there could be other causes. We suggest you discuss the natural treatment options and supplements discussed on this page with your doctor.

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