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Hacking Fatigue: Where "Why" Rules with David Haase, MD

Hacking Fatigue: Where “Why” Rules

Are you ready to take charge of your health? Schedule your free 20-minute discovery call with our New Patient Coordinator to see how you can become a patient at MaxWell Clinic and start your healing journey today.

What would it feel like to wake up with rejuvenating energy that lasts all day long? If you’re someone who experiences fatigue, this might seem like a fantasy. But fatigue is like a courier delivering a very important message directly to you – and the message is that there is dysfunction, disease, or disability in your body that you need to pay attention to.

Dr. Haase has trained 8000+ physicians on advanced approaches to assessing and treating fatigue. He has a deep passion to see people live at the height of their energy.

Watch the video as we demystify fatigue:

  • Discover the 3 major forms of fatigue that must be understood to move forward.
  • Learn what your fatigue may be telling you, and how finding out can promote a better quality of life and a longer life.
  • And learn how to take the next step towards a life of better, more robust energy.

Understanding the Link Between Fatigue and Health

Feeling constantly tired is something many people can relate to. It’s a pervasive problem that can interfere with our daily lives, affecting our work, relationships, and overall well-being. But what is fatigue, and what is it telling us about our health? In this blog post, we’ll dive into the intricacies of fatigue, its underlying causes, and potential treatments to help you regain your energy and vitality.

The Complexity of Fatigue

Fatigue isn’t just about feeling tired after a long day at work or a sleepless night. It can be a multifaceted issue influenced by a variety of factors. Dr. David Haase, from Maxwell Clinic, discusses different aspects of fatigue in the video presentation above. His insights shed light on the interplay between our bodies, brain, and immune system. Let’s take a closer look.

One crucial point Dr. Haase mentions is the distinction between central and peripheral fatigue. Central fatigue relates to problems in the brain, while peripheral fatigue is associated with issues in the muscles and other body parts. Understanding this difference is the first step in pinpointing the cause of your fatigue.

Potential Causes of Fatigue

To address fatigue effectively, it’s essential to identify its root causes. Fatigue can be the result of various factors, including:

  1. Mitochondrial Dysfunction: The mitochondria are tiny powerhouses inside our cells responsible for producing energy (ATP). When they don’t function optimally, it can lead to fatigue. Dr. Haase introduces a supplement called “mitochondrioline,” which supports mitochondrial activity, energy production, and even longevity.
  2. Infections: Chronic infections, such as Chlamydia pneumoniae, can lead to persistent fatigue. Intravenous (IV) therapies like glutathione and ozone have been found to help address these underlying issues and boost overall energy levels.
  3. Autoimmune Disorders: Fatigue is a common symptom of many autoimmune disorders. IV therapies with micronutrients can support immune function, potentially alleviating fatigue in autoimmune patients.
  4. Medications: Many drugs, especially those that interfere with the body’s natural processes, can lead to fatigue. Examples include beta blockers, calcium channel blockers, antihistamines, and some psychiatric medications. If you suspect your medication might be causing fatigue, consult your healthcare provider for alternatives.
  5. Emotional Factors: Grief, stress, and trauma can all contribute to fatigue. The mind-body connection is profound, and addressing emotional issues is crucial in managing fatigue.

Investigating Your Living Environment

Sometimes, fatigue might be related to your living environment. As Dr. Haase’s presentation highlights, it’s possible for entire families to experience fatigue due to environmental factors. For example:

  • Mold exposure: Living in a mold-infested house can lead to a range of health problems, including fatigue. Mold remediation and ensuring a clean living space can significantly improve your energy levels.
  • Grief and emotional health: As mentioned earlier, emotional factors can play a significant role in fatigue. If your family is collectively experiencing fatigue, consider seeking professional help or counseling to address underlying emotional issues.

Fatigue and Neurodegeneration

One intriguing link between fatigue and health is the connection with neurodegenerative diseases like Alzheimer’s. These diseases often involve inflammation, immune dysfunction, and mitochondrial issues, which can manifest as fatigue or depression. This further underscores the importance of early intervention and lifestyle changes to protect your long-term cognitive health.


Fatigue isn’t a mere inconvenience; it’s your body’s way of communicating that something might be amiss. Don’t ignore it. Investigate the potential causes, from infections and autoimmune disorders to emotional factors and your living environment. And always consult with a healthcare provider to ensure you’re addressing the root of the problem.

In the pursuit of better health, fatigue can serve as a guiding light, helping you identify and overcome issues that might otherwise go unnoticed. So, remember, your health is worth the effort, and you have the power to make positive changes that can lead to increased vitality and well-being.

Take Dr. Haase’s advice to heart, “continue to stay curious and do your best to be the best version of yourself.” Each of us is unique, and our health is a precious gift. Don’t let fatigue hold you back from experiencing life to its fullest.

For more information on managing fatigue, consider consulting a healthcare professional or medical expert. Knowledge is your most valuable asset when it comes to optimizing your health.

Are you ready to take charge of your health? Schedule your free 20-minute discovery call with our New Patient Coordinator to see how you can become a patient at MaxWell Clinic and start your healing journey today.

hello everybody uh again it’s dr
david haasey with maxwell clinic and i’m super excited to be here tonight
because i have a topic i’m going to share with you i have a lot of energy around
and it’s kind of weird that i have energy around it because the topic is fatigue
so i’m going to share my screen here with you and we’re going to pop into some
slides and i’m going to kind of come back and forth from those um and uh and the topic tonight is called
hacking fatigue and um and i like the the subtitle i’ve given the talk tonight is uh where why
rules okay because uh we’re going to see very clearly that
fatigue is gives us an amazing opportunity to dig into the why of our health and and what we can do so
without fur with further ado uh this is the slide that i start with
as i am teaching uh basically basically every almost every doctor that has ever been
certified in functional medicine i’m the one who teaches them about fatigue so that’s all um and along with the other
teaching i do in fatigue it’s about over eight thousand physicians that i have engaged in this topic i think fatigue is
fascinating and um and it really is that topic that pulls us into a real deep
curiosity about what’s going on with that patient and what’s happening underneath um
any of you have i think the institute for functional medicine does an amazing job of
training and certifying clinicians to start this path of practicing why based medicine
so anyway this was a slide uh the cover slide from one of the talks that i did for ifm
just about a month ago and um and uh yeah fun stuff so anyway
fatigue wow what a big topic almost everybody listening and i’m for everybody’s
listening at some point in time has experienced fatigue and it has a massive cost
um it it you know has a financial cost of missed work and um and the the
emotional cost of feeling pain anxiety that comes along with fatigue
feeling overwhelmed brain fog the stress the decreased productivity
all of these things really layer on when we think of fatigue and there’s a huge cost to society as
well fatigued workers cost employers over 136 billion dollars annually in
health related lost productivity time and when you’re fatigued you know i like this tip of the iceberg analogy
you can see the fatigue but underneath there are errors our accidents our compliance variations turnover overtime
absenteeism a whole bunch of issues that come along with this so it’s a really important topic from an economic
standpoint but and from personal standpoint so let’s dive in do we often ask the
questions like what is fatigue now it kind of sounds sim simple because we all know what fatigue is right we’ve all
experienced it but let me give you a definition so that we can start on the same ground so fatigue is a persistent
subjective sense of physical emotional and or cognitive tiredness or exhaustion that
significantly interferes with desired functioning i take care of some
very high level athletes and some high performing business executives and what they will
call fatigue another person would call you know ultimate energy because it really all
the matters you know what is your desired level of functioning that’s what determines what fatigue is
and so we have to trust an individual’s reporting of that symptom
so let’s think about you’ve heard of chronic fatigue syndrome now it’s had many different names like myalgic
encephalitis syndrome or uh but it is it’s a group of symptoms that come
together and the cdc made up this term so that we could start studying this
fatigue that we can’t really figure out what the cause is and i think it’s really interesting to dig into because
it helps us understand just what a complex topic fatigue is because in order to diagnose somebody
with chronic fatigue syndrome you have to do a whole bunch of exclusions that’s
right so if to get the diagnosis of chronic fatigue you may not have hypothyroidism adrenal insufficiency
hypopituitary emphysema cirrhosis cardiac failure renal failure hiv aids sleep apnea narcolepsy epilepsy on and
on and on and on and on because all of these conditions you see on this page
we know that they will cause or they are at least deeply associated with fatigue and not only do
you need to exclude people from physical causes of fatigue you have to exclude people from mental emotional causes so
anybody that has had bipolar schizophrenia dementia major depression anorexia ptsd alcohol abuse substance
abuse if they have had any of that in the last five years you can’t say they have chronic fatigue syndrome
but they still have fatigue right all of these conditions may be associated with fatigue
and so there’s a nice little study done saying hey of these people that actually met all those exclusion criteria and had
this severe form of fatigue for a period of time how much worse off were they than all of those people that got
excluded because of this disease or that disease and it turns out people with chronic fatigue syndrome have no worse
fatigue than people who are fatigued for any other reason so the the cause of the
fatigue doesn’t really speak to the severity of it and just
because you call something chronic fatigue syndrome doesn’t really give you any answers it’s just basically saying
hey we really have no clue what that is but there are a lot of answers for people with chronic fatigue syndrome it
turns out that a lot of it happens to be mitochondrial in nature now the mitochondria are the energy factories of
the cell they make atp and many of these cases of mitochondrial
disorders and secondary mitochondrial disease are actually what cause the fatigue
so here’s an interesting question i don’t know if you’ve ever had been asked this but i think it’s
really important and i train the doctors to do training with me is try to figure out what kind of fatigue
it is and there are three major causes or three major kinds of fatigue
the first kind of fatigue is a central fatigue really have a brain fatigue
this is neurotransmitter based and and it really has to do with how much
effort do you think something is how quickly are you going to get worn out about it now what’s interesting about
this that your your mood has a lot to do with your perceived effort i mean you just have to have a teenager who
doesn’t want to do something and oh my gosh are they fatigued right
or instead you um this is often the fatigue that goes along with depression
so they really have a neurotransmitter issue at present and it’s it’s actually the build-up of a neurotransmitter
called tryptophan and two of its cousins called kinerinate and quinolate and we can find those on amino acid testing and
organic acid testing and when those build up in the system they actually
attach themselves to neurons and start to send the message that whoa
make it harder to send a signal and actually send the signal to the central processing unit in the brain that you’re
doing too much or we’re doing something we don’t want to do or you’re doing it too frequently and so you actually have
a neurologic message that says slow down don’t do that and creates the
emotion of fatigue because central fatigue is actually an emotion
much like pain is a complex emotion we know it’s an emotion because you know
hey you’re incredibly fatigued terrible central fatigue and a kid runs out in
front of a bus and all of a sudden boom all your fatigue is gone zoom you run out and rescue that kid
and with no fatigue same thing with pain you know if you have no if you have a bunch of pain all of a sudden poof it’s gone if you have an emergency
and then it comes back uh when everything comes back down to normal so central fatigue think of it as
a neurotransmitter based fatigue and these are the things that stimulants and
things like that can make a difference in changing now there’s a second kind of fatigue
which is peripheral fatigue so think of it as the actual this is an energy deficit
where you’re not you’re not making as much atp as you need to atp is the energy of your cells it’s
called adenosine triphosphate and when you eat um you’re gonna you go through this very
long process of breaking down your fats carbohydrates and proteins into their
constituent parts uh going through the krebs acid site the krebs cycle
making nadh and fadh and that going into the electron transport chain
inside the mitochondria to make atp now if all that sound like greek don’t worry
you don’t need to remember it just remember that atp is what
makes things go it’s the gasoline for your molecules and you need you need atp in order to
function if you if eight one atp breaks down it breaks down in this called adp
adenosine triphosphate to adenosine diphosphate and if you have
a buildup of the breakdown adp that’s a signal that your
to your body saying wow we’re running out of energy we better throw on the brakes before we
truly conk out this is a difference between somebody who is massively fatigued they have used
up all their energy they’re at the end of that ironman race you know sometimes you see the iron man race finish on tv
and these people are coming in just wobbling everywhere they’ve lost their bow and bladder function they’re just
basic noodles they have used up every bit of atp they can if a kid ran out in
front of a bus there’s no way in earth they could zip out in front and do anything about
it they had truly run out of energy that’s called peripheral fatigue and so when you have inflammation and
oxidative stress you can really use up your atp or if you have a
mitochondrial problem you can have a decrease in the on the amount of atp that you can produce and that causes a
type of fatigue and then the third type of fatigue is actually sleepiness and the sleepiness
is an epidemic because we’re not getting in near enough sleep as a as a culture
so i hope that helps because even when you’re starting to understand trying to understand your own fatigue or the
fatigue of somebody else is it is it neurotransmitter based is it truly running out of fuel based or is it
not getting enough sleep based that’s the first place to start okay now what causes fatigue we’ve
already gone through all these diseases and things like that that cause fatigue when you engage
somebody does systems medicine or functional medicine and you have a main problem with fatigue where do you start
what do you what do you do well one of the first places to look is the gut
because the gut has an intimate relationship with the brain and the brain has an intimate
relationship with the gut you know there are molecules that come from the gut that go to the brain and there’s
molecules that come from the brain that go to the gut and there’s nerves that send electrical signals from the
gut to the brain and the brain sends electrical signals down to the gut as well it’s a
bi-directional biochemical and electrical relationship
and so this two-way street makes a big difference and inside the gut you have sewage
right you have gram-negative bacteria when they break down their cell walls are made of something called
lipopolysaccharide lps and lps is also known as endotoxin it is
the most inflammatory substance that is known it
it is the thing that angers our immune system more than any other molecule and with good reason because it’s the
breakdown product of the wall of a bacteria that if it were allowed to proliferate
would would consume us so we definitely want to rev up our immune system if that molecule is around
so they did a study they said huh well what happens if we get some medical
students because they’re expendable and let’s inject them with lipopolysaccharide that’s right let’s
inject their bodies with endotoxin and see what happens
you know what could go wrong well what they and so they this is a
double-blind randomized placebo-controlled trial done very well and they measured their cytokine levels
which are molecules that tell the immune system what to do and they measured
scales of depression fatigue and social interest you know how much do you care about going out and doing things
well uh they also measured the amount of glucose metabolism that goes on in the brain in various brain regions and they
wanted to see what happened in these cases and it was really interesting because
when um and this is an interesting you know i wonder if i can write on the screen i’d be so excited if i can well
it looks like i can so right up here this is called minimally modified ldl
and um pamps pathogen associated molecular patterns
and and these two damaged molecules have the capacity to intersect and turn
on the tlr4 receptor so why do you care why do you care well
this is what we’ve been talking about this is endotoxin it’s a pathogen a pathogen-associated molecular pattern
or a pamp i like to call we can remember that because pamps uh which are basically gram-negative
bacteria live in pampers right this is the stuff we have in stool so these nasty molecules that are in
stool that if you have a leaky gut actually are leaking into your bloodstream
and and they interact with this receptor in this cell and it goes through a whole
bunch of flow charts [Laughter] these are molecular pathways that turn
on a huge number of signals in the genes to then turn on the genetic
production of inflammatory signals so
this is how an out something that’s outside your cell sends a message inside your cell that
causes your immune system to rev up make inflammation and then that inflammation then goes on
to produce oxidative stress which is basically burnt molecules
and those burnt molecules that oxidative stress then continues to cause other
problems as we will see because after you’ve injected these medical students with this endotoxin
what happens wow depression skyrockets and this is in three hours
fatigue levels go way up in the majority of individuals and social interest the
desire to go out and do things drops so this is interesting right so we just
injected a little bit of the substance that kind of courses through your bloodstream when your gut is a little
bit leaky and depression fatigue and social interest uh change
dramatically this should really this is the reason we spend so much time
assessing the gut and working on how to help the gut work better to help the immune system to calm down to
remove things that are irritating the immune system because the more your immune system is activated the more
depression fatigue you’re going to have and the less engagement you’re going to want to have
in your world and this is awful you think of a young mother that is dealing
with this silent problem in the background and they think oh my gosh it’s just because my my kids aren’t
sleeping or they haven’t you we give any number of reasons as to why we’re
fatigued but rarely do we think it’s our gut and and it’s hard enough being a
mother like the most important job in the world um uh and and to have uh inflamed gut on
top of it is really tough so what did we learn about this so it was
very interesting this lipo polysaccharide this endotoxin we injected in causes acute fatigue depression social withdrawal via this
cytokine localized brain metabolic changes because
what we’re going to see here is that the biochemistry that i showed you in that little flow sheet actually changed the
brain directly and was interesting not all individuals were affected to the same degree right
that person was immune system was ready to go it was revved up it was already
inflamed by something else you can bet it only took a little bit of additional
irritation to cause a whole lot more pain fatigue depression and social
withdrawal yeah pain is also in other studies so but let’s go a little farther down
this rabbit hole okay so because depression and fatigue are deeply tied together right and a lot of
times people that come in that say hey i’m fatigued immediately get put on an antidepressant as a standard medical
treatment not bad it’s just not finding and addressing the cause
so what they did is individuals had severe light long-standing depression that actually died of suicide
they went in and looked at the brain and they recognized that there was this elevated quinolate right this is one of
these the very thing that was created when we injected lipopolysaccharide into these
individuals a large amount of quinolate in the white blood cells and the
supportive cells in a specific part of the brain something called
the cingulate sub-regions and and this area it was really the
anterior cingulate region we can see it right here these this red dot and the two blue dots
showed molecular scarring actually showed cellular scarring
in individuals that had long-standing depression individuals that died via an accident or about the same age
they used those as controls and so what this means is that these are the very same areas that got
inflamed in the individuals that were injected with lipopolysaccharide
so this is the insula and the anterior cingulate cortex
and so what happens is that when you have a symptom of depression
it is very likely a symptom of inflammation of the brain and that
inflammation in the brain scars the brain it’s very important to take depression
seriously because every depressive episode is actually
telling you at least that there is uh a problem underneath the hood it may
be inflammation maybe several other things but the more often depression happens the more of this metabolic
scarring happens in the brain and the more the more depression the
more inflammation is present now remember this study was done on individuals very severe
depression and eventual suicide so you don’t don’t become depressed by this information but i do believe i said for
a long time that depression is a form of pre-dementia there is
the symptom of depression and fatigue are telling you that the brain believes
it is having to do more than it is capable of doing uh and it’s one of our breaks
for doing that so the first thing about conquering fatigue and depression these things is to be honest about them
and then to start engaging it with the word why why what is the body trying to say
symptoms are meaningful symptoms are a gift uh if we’re only
open to listening to them and so when we are
having this symptom of fatigue um and we’re trying to teach this to
new docs we actually use something you know called this energy clinical decision tree
and if this looks mind-numbingly complex just know that i spend about 90
minutes teaching this one slide so and because we have to look from everywhere we have
to think about the medical history you know what’s happened before what’s your genetic history family history what type
of biochemistry is going on underneath the hood what’s happening with the brain you know
do a quantitative eeg and see what’s happening with brain function
in take look at blood tests hormone levels uh and and not be afraid to dive
into um a more esoteric testing because we’re usually taking one layer at a time
so i’m not going to take the time to go through all of this we can take take care of some specific questions and
question and answer so please put your questions in because i’ll be getting those at the end of this talk we can talk about more particular issues
but what is fatigue is is such an important symptom and we have to approach it by
trying to find the underlying causes and addressing all of them simultaneously
and doing it aggressively you know missing out on a day because you have low energy is it
missing out on a day of your life and you don’t know how many of those you get
so this is another slide that i use to help at uh clinicians start thinking about
what are all the underlying causes i should be thinking of let’s go into the middle of this matrix
area just to think about this you know fatigue fatigue is definitely associated
with you know past trauma early childhood events and adversity are
deeply linked to later in life fatigue so address recognizing that thinking huh yeah i had
a horrible childhood or i had a difficult childhood et cetera et cetera you can get better okay you can get
better you are not stuck there it’s not necessarily going to be a a snap of the fingers but there’s lots of things it
can do um learned helplessness you know just believing that you can’t have
energy again you’re probably right so breaking out of that learned
helplessness cascade is going to be exceedingly important if you want a different outcome in life
feelings of low self-worth cognitive decline itself neurodegeneration very frequently has
fatigue as it’s one of its symptoms and and the issue is shame
you know just you’re putting yourself down literally putting yourself down on the couch
so there’s many other things so we’re looking at heavy metal accumulations
mold toxins various medications buildup of iron in the body
certain medications can cause fatigue iron deficiency anemia
sleep apnea low blood sugar all types of chronic infections and
allergies can be an issue traumatic brain injury intestinal permeability
hormone issues you know issues with the adrenal glands sex hormone deficiencies thyroid hormone
abnormalities neurotransmitter imbalances man we can go on and on and we haven’t even gotten to all the
personal lifestyle modifiable factors so so fatigue
is is your body is trying to get your attention and um so what do you do what can you do
about fatigue well here’s the here’s the first one of our fatigue hacks is be
curious be curious be honest about just how much challenge you’re having with regard to
fatigue and and recognize that you know if you didn’t always feel this
way it’s very likely something new has come into your into your midst and the first
thing is do everything possible to find and treat the causes in maxwell care
this is one of the reasons we use a programmatic approach of relationship of a long-term
engagement together because finding and addressing the cause of something this complex is not something that’s done in
an urgent care center it just doesn’t happen it requires time it requires a relationship to be digging into these
issues so and if you’re not getting help with anybody you’re currently working with
be honest about that say hey i want more i want better be greedy okay
you’re the world is not helped by you being
less than your optimal potential maxwell maxwell is really about i mean
maxwell means you know the the fullest expression of your genetic spiritual psychologic and
neural neurological potential that’s what maxwell means and that’s what we endeavor to do here so
find and treat the causes second get enough sleep um if you i i wear this little ring here
called an aura ring and the aura ring o-u-r-a is a really good tracker i don’t
like wearing things on my wrist like a fit bit or something like that and i like wearing this because it’s
non-obtrusive and it tracks how much sleep i actually got it’s a denial buster and it also checks my heart rate
variability and helps me understand how well i’ve recovered on the evening because if you’re not getting enough
sleep then oh that’s something we can’t fix here
you’ve got to go to bed and if you’re not going to bed then tell us that and so why right we’re just going to come
back to why why aren’t you getting to bed at night well maybe you just don’t want to share the bed with that person that you’re going
to bed with or maybe you’re you’re a for you’ve had a traumatic experience and
you’re you actually just can’t bear the dark you don’t want to go to bed we’ve had those patients and worked through those
issues maybe you know you just have a different view of
what’s important in your life and you didn’t really realize what a big deal it was that you were missing so much sleep
um and and all of the things with regard to sleep hygiene man we’ve had a great
seminar and sleep please go back and look at that because sleep hygiene is profound all right that’s number one
number one hack get to get to bed next is cold a.m shower so
a very cold shower first thing in the morning yeah it doesn’t sound pleasant
you know you get used to it and the amount of energy that you will have in those next hours of the day is
profound and it helps turn on your mitochondrial biogenesis making more and better and healthy mitochondria which
helps you make more atp which is the second kind of energy so cold shower in the morning um you know
and that can be five ten minutes of a cold shower is going to help you make more of the
neurology of energy as well as help you make more atp so the cells can produce
more energy exercise yep and that this kind of seems bizarre
that you can actually treat fatigue by doing something that tires you out but if you utilize this in a dosed fashion
using a small amount of exercise not not so much that you don’t recover
your body learns wow um i need to change my physiology i need to
make more and better molecules cells tissues organs in order to
meet the demand that’s being placed upon me if you’re not exercising you’re not telling your body that
it needs to deal with situations that are low energy
so we just call this graded exercise so start where start with what you know you’re comfortable with and then do a
little bit more the next day or maybe the day after the next day um because
the the phenomena of dramatic fatigue after exertion like
hours after the day after maybe even a couple of days after is it is a sign you
have a lot of oxidative stress and a lot of inflammation going on and you need to get to the bottom of that because
it may be really really difficult even impossible to exercise your way out of that type of fatigue
um think positively yes your attitude matters you know the you
know it’s amazing that you know when the um when the first person to break the
four-minute mile broke the four-minute mile that next year 12 people broke the four-minute mile everybody thought it
was impossible before then and so our minds have a lot to do with
just how much fatigue we experience and you wake up in the morning i encourage you to
hold on to the belief that you got exactly as much sleep as you needed for your optimal functioning that day
and then get to bed earlier the next night if you need to um but the a positive attitude
gives you more performance ability so this is something you can nurture
through cognitive behavioral therapy self-talk you are creating your reality
if you don’t think you are tell me who is because you are the one who controls
what comes in your eyes what comes in your ears if it’s not serving you if it’s not serving your highest values get
rid of it change it it’s up to you you’re not a victim
so and then beware the caffeine cycle right because some people uh start pounding
caffeine first thing in the morning don’t talk to them until they have had their cup of coffee um but
that caffeine may actually not metabolize fully by the time you’re getting to bed that night
and it will actually prevent you from becoming recovered in the evening so
even though you go like oh no i can fall asleep fine and you very well may because you may be so freaking exhausted
you may not be getting restorative sleep because of your use of caffeine even
early in the day if you’re a slow metabolizer we do have genetic studies available to help you understand your capacity for
metabolizing caffeine as well as many other genetic variables please talk to your clinician
about that but that’s one thing to be thinking about so
and you go like well yeah those are hard things and uh can i just take a pill
i can’t tell you the number of doctors that ask me that hey well what kind of pill can i take for fatigue and and um
inside my lecture i will go over in my lectures i go over probably 50 different ingredients for
various supplements that have some role in the realm of helping cellular fatigue
and brain fatigue but um
but again i keep coming back to find and treat the cause because
if you’re using something to just kind of cover over the problem that’s that’s a that’s a big problem
with all that being said there are a couple of ideas you can have while you’re figuring out the cause i think
these are a couple of really useful supplements one of them uh these are both available from creating health one
of them is called clean energy that’s right clean energy
i actually used to be a big fan of red bull red bull uh helped me not fall asleep in
the car after i had done an overnight er shift so i became a big fan of red bull but
then i realized oh that what is in here is not serving me
so i actually formulated this product and this is um this is has a tremendous number of
things in it to help give immediate energy there is caffeine in it there’s caffeine that’s bonded to
pterostilbene which is one of the really interesting phytonutrients in blueberries
and and that gives us a time release effect from caffeine i encourage people
to take this early in the morning there’s compounds in here that increase the production of glutathione which is
your most important antioxidant there are electrolytes so that this works very
well as a pre-workout drink because caffeine increases our improves
our workouts because we don’t have as much perceived fatigue in the brain
and you know some of the other aspects that there’s additional antioxidants
present here and additional magnesium which is great for mitochondrial
function so this was meant to be something that does help with the central fatigue
you know which is displacing adenosine from some of the fatigue receptors but also
uh helping to nurture and support the production of actual
cellular energy so that if you’re using this you’re not worse off as a result of doing it but still use it early in the
day so you don’t get caught in that caffeine cycle secondly and so that’s really i would
say something for more the central fatigue problem for people that have more peripheral fatigue their mitochondria aren’t functioning as they
are we have one of the most ridiculously named supplements on the face of the planet the mitochondrioline energetic
packets so why is it called that well mitochondria lean because this supports
mitochondrial activity there are components in there that help to battle central obesity and
fat accumulation especially in the middle and there’s components that up regulates the
sertuan gene complex which have a lot to do with longevity so so it’s mitochondria leanness
longevity and energy all together in one ridiculously long name so these are little packets
for people who are going to exercise this it’s a very good pre-workout
packet because it’s going to open up the blood vessels and allow more blood flow
to muscles uh which then paired with i would use there’s another comma called build nrg which is branch chain amino
acids and taking that 30 minutes ahead of an exercise as well that’s you’re going to get more muscle building
signals and uh that happens to be another treatment for fatigue that was that actually is called build nrg
um so these are a couple of things that you can try um really high quality compounds but again
finding and treating the cause is the most important reason the most important thing that you can do if you’re
suffering from a symptom of fatigue so in closing fatigue like any symptom
is really an invitation to listen to your body and to solve the underlying
bigger problems okay so with that i’m i’m going to say
we’re going to stop this particular screen share we’re going to go into some questions and answers and go from there
excellent so so first of all oh great question so does nutritional
ivs with glutathione create fatigue also so let’s just start with that so
glutathione is a body’s master antioxidant and
it’s it’s one of the most important molecules in the body to help decrease the
amount of oxidative stress that exists and what is oxidative stress well it’s basically rusting of your molecules
and it’s wonderful to be given iv because we can get a lot of it to the brain
especially for parkinson’s dr david promutter did a study randomizing individuals to get actual
glutathione and a placebo and they were able to see that parkinson’s symptoms and progression was
diminished as long as that glutathione was taken iv glutathione is made by your mitochondria
about 15 percent of your body’s glutathione stores live in your mitochondria so it’s intimately related
with energy production however so in it and it should should not give you fatigue if giving it getting an iv
however glutathione does one other thing and it actually like n-acetylcysteine
can break down the cross-linkages of an infection called chlamydia pneumonia
that is very common we use call this we call this walking pneumonia whenever i say chlamydia
pneumonia we also have to warn you no no it’s not the sexually transmitted disease chlamydia uh it’s this walking
pneumonia you probably got infected with 20 years ago and didn’t know about and uh your clinician can run tests for
that and if that’s elevated is very interesting because chlamydia
pneumonia spends a lot of its life cycle hanging out in the on the red blood cell in in a a form
called the elemental body and when you take iv glutathione or you take oral and acetylcysteine that
elemental body says hey it’s uh conditions are right for us to reproduce
but at that time your immune system can now seed a little bugger and it will go after and start killing
the chlamydia which is what we’re trying to get done but
if your immune system revs up yeah that could cause some transient inflammation and some more symptoms from
there so that would be one of the things again life is diagnostic
your entire life are clues about how you function and how you can function better so the more observant you are
and you shouldn’t just say oh i can’t take that instead it’s like hey i have not been
able to take that in the past or this had a particular effect on me and then have curiosity about well well
why might that have been the case right okay also after recovering from covid how do
you help increase your energy great question we are dealing with a lot
of patients that have a coveted long-haul syndrome where they’ve had covid and they just
haven’t gotten their brain back they haven’t gotten their energy back and and that’s a really big deal um
one of the there’s many there’s many components here number one we want to make sure the gut is as healthy as
possible because that’s kind of the base drum of the immune system if the gut’s not healthy
then you have the issue of you can’t work with more of the finer
points but one of the things we’ve found to be very useful in covid is iv nad
nad is a direct therapy for mitochondria and we utilize this for chronic fatigue we’ve
noticed like we’ve been dealing with this for many years and giving this therapy we’ve noticed some other can iv
places have started to offer iv nad when we’ve looked into it they’re giving minuscule doses they even even advertise
they say oh hey our nad you won’t you won’t you don’t feel bad when you take ours well because they’re not giving
much we found out and um i mean what nad is is a really
remarkable molecule that is the raw material for nadh
nadh is one of the the intermediates in between food and atp
the more nadh you have the more atp you can make
if you give somebody nad it’s the raw material to make nadh
but what’s interesting is you give a lot of nad inside somebody’s blood vessel it
goes up way higher than what it’s used to and the body thinks oh my gosh the ratio
of this spent molecule nad to nadh is so high it must i must be terribly
cellularly exhausted because this only happens when i’m exhausted so iv nad is
kind of like having an iron man in a bottle and so the body turns on the molecular
machinery to change genetic expression and genetic expression has uh can then
you start making more and better mitochondria and and more and
that in turn starts decreasing the amount of oxidative stress improving repair and
we’ve seen people being able to pull out of that postcovid syndrome
now um that’s been the most effective therapy
uh there’s another iv therapy that um ozone that has also been effective
and but that’s been we’ve only used that when we have something else where we know we’re
anyway something else that we’re trying to treat simultaneously because whenever
we’re tasked with choosing a therapy right patient has a problem we’ve done
investigations we have ideas our job is to select the therapy that has the most
likelihood of doing good of not doing harm and of creating health
right the longer we do this therapy the less we’re going to need it we don’t really want to have a lot of long-term
supportive therapies you know sometimes we need to do that with regard to food and supplements because yeah we we used
them they came in one end they did their job they went out the other end and we have to keep replacing some things but
a lot of the job of we feel our job is to help change genetic expression so that we
have improved function overall okay um another oh hey i have uh i have
multiple sclerosis and uh it’s associated with a lot of fatigue but one of my friends with
multiple sclerosis doesn’t have fatigue why is that oh my gosh i have other slides about
this um didn’t put them in here but fatigue doesn’t just have isn’t just
localized in certain parts of the brain like i showed you there’s there’s parts of the brain called the anterior cingulate and the and the um
anterior insula these are areas that are affected when a person has this leaky gut
and it causes inflammation inside the brain and um and that causes a symptom of fatigue
well it turns out that there’s also anatomy inside the brain an area called the anterior fornix
that if a person with multiple sclerosis has a lesion in in the part of the brain
that regulates energy they’re going to have a lot more fatigue than if they don’t have a lesion in that part of the
brain because in with ms you know lesions can pop up all over the brain
and um and so yeah that’s that’s why it really has a lot to do with anatomy but also
interesting i just mentioned chlamydia pneumonia and um that is deeply associated with multiple
sclerosis interestingly enough so in the treatment of committing pneumonia we have seen several patients with ms
have a very substantial incremental improvement from eradicating that chronic infection
okay is there iv therapy for autoimmune disorders uh yeah there are but uh so i think we
can take the uh what i’ve just mentioned here like for instance iv ozone has been really
helpful for individuals that have an infection that is
perpetuating the autoimmune disease because what you have to think about is why is there an autoimmune disorder
right why why has the body’s immune system decided to turn on itself
how did it lose its way and many times that happens as a result
of the immune system being accosted by or engaging something called molecular
mimicry so if you have a gram-negative bacteria such as proteus or klebsiella
or campylobacter they have molecules on those particular bacteria that look like molecules in our
body so we get an infection our body says hey i gotta fight off that infection let’s make an antibody let’s go after that bug
but our antibodies those antibodies look suspiciously like some of our own proteins and now we start to attack
ourselves and because the immune system has a set point of inflammation
you know maybe not having enough omega-3 fatty acids around a high amount of stress
a whole bunch of reasons that perpetuate that disease forward you develop an autoimmune disease
now uh so the uh micronutrient ivs can be really helpful
several of these are inexpensive ivs and can be done frequently um
and your clinician can okay you to get them just really you can just kind of call in
and say when you want one and these have vitamin c
b vitamins magnesium and a few other things in there that
actually support mitochondrial function and
and it’s a wonderful sense of well-being that comes over people once you’ve had
all these micronutrients support ivs uh and and by having improved
mitochondrial function you have less aberrant immune activation
so i’ve kind of talked around that because there’s not one other thing is plasma exchange so we
just had a physician who is in here today having plasma exchange done and this is our
procedure that we also utilize to slow down neurodegenerative disease
or we put a big iv in each arm and we actually pull out the blood and separate the blood
and clean it out well its standard standard fda approved indications are
mostly all autoimmune disease so very like very severe uh multiple sclerosis
neuromyelitis optica guillain-barre syndrome a whole host of terrible
sounding diseases um if we remove their antibodies that are
causing the offense that causes a decrease in the amount of tissue damage and less tissue damage
slows down the progression of those diseases so plasma exchange is another one of those
okay um okay uh another question um i’ve been
taking coq10 uh and um how do i know when it’s enough
um the brand is jarrow so um well coq10 is a coq10 is a molecule that’s
very important in the production of energy uh it is
uh it’s one of the things that shuttles a an electron back and forth and
as we get older we stop making as much coq10 as we did when we were younger
low coq10 in individuals with even mild heart failure doubles the sudden cardiac
death rate a really good study called the q symbio trial gave people 200 milligrams of
coq10 three times a day when they had heart failure and they were able to show that it decreased by
half the incidence of all-cause mortality and
and improve their heart failure so they actually had improved cardiac function
nice thing about coq10 is we can do a blood test for it and that’s the way it should be measured don’t believe you’re getting it absorbed coq10 is a very
difficult molecule to have absorbed it’s an expensive molecule um it’s it’s
you can’t it’s not like vitamin c where it can be mass produced it has to be uh
fermented and made with yeast and extracted and it’s a very fragile molecule so has to be taken care of
the coq10 that i like best is one that we’ve mixed with a highly absorbable
fish oil so it’s a monopure coq10 so there’s a little bit of fish oil in
there but that that fish oil is three times more absorbable than a standard fish oil
our mono pure line and and that actually also increases the absorbability of the coq10 that comes
along with it so i i think the proof is just inputting you know
measure those levels we we want coq10 levels to be above 1.7 in everybody uh
and if there’s a heart disease that we like to see goes above three and if anybody’s taking a statin i do believe
that they should be on coq10 that can help decrease the fatigue that is associated with statins
okay what medications are associated with fatigue a lot of them
you know because drugs are drugs are designed as well-dosed poisons
that’s why you need a license to prescribe them and i’m glad we have them all because everything has a purpose
under heaven uh but i do think that we have a um
so many of these medications cause fatigue such as beta blockers for high blood pressure um
calcium channel blockers for high blood pressure anti-histamines
anti-psychotics anti-depressants anti-anxiety agents do you hear what i’m saying anti-blocker
inhibitor that’s what i mean these are well-dosed poisons and um
and they so they work by inhibiting some normal functioning of the body that’s
how they work and and that and and so the side effect frequently is the body saying wow
something’s not working quite right out there maybe we should slow down this organism
so that it doesn’t burn up or burn out or do too much work and hurt itself because that’s what the symptom or the
emotion of fatigue is for us to protect ours protect us from ourselves in many ways
okay another question um everybody in my family is fatigued
could there be something wrong with my house um yes so good sleuthing right i would ask you
when were you last well right when was your your family last well
um you know we had another patient who was similar to that that came and talked
about how fatigued they were and i asked well how’s your family well they’re all really fatigued they’re all really
having a hard time so well what happened and there was a a really tragic death in the family only a few months earlier
and they were going through grief now some people had far worse fatigue
because no two individuals are going to experience the same loss or trauma in
the same way and no two individuals have the same
predisposing problems but it was actually some really useful to
have that conversation and to to ask well what could this fatigue be telling you
and um and what do you need to do about it this family actually engaged in true family counseling and started working
together about this item of grief that was in the in the space
but likewise um another family uh imam was kind of the index case
incredible fatigue brain fog you know body wide aches and pains
and we we found that she had um a lot of immune activation so we
measured things called tgf beta complements c3a complements c4ad and we recognized that
her immune system was really angry and found out her house was full of mold
and and as we continued to dig into that and try to find what was going on uh the whole family
decided just to take a vacation and as they left uh within two weeks uh four
out of the five people felt amazing and they recognized oh yes it is the house
uh and with with good mold remediation and cleanup um it’s quite a bit of work for them
they all had very substantial improvements in their function so again find and treat the cause what is your
fatigue telling you and and how can that not just decrease the symptom of fatigue
but give you a blessing uh by removing something that is even more
erosive in your well-being all right okay this last question i’ll take right
here is what type of are there any is fatigue a symptom of
neurodegeneration or alzheimer’s disease you know that’s really an interesting
question because alzheimer’s disease almost always has some degree of
inflammation associated with it you know immune dysfunction and
mitochondrial dysfunction are two of the pillars upon which dementia progresses
and so it’s is not uncommon for people with neurodegenerative disease that is
brewing to have a symptom of fatigue or depression
this is why we shouldn’t accept anything but the best from our lives
because um even a slight dysfunction could be the clue we need
to prevent the development of a very severe long-term problem
love yourself you’re worth it your health is worth it you
there’s nobody on the earth like you you have a unique gift to bring
and i want to encourage you to um do everything possible to bring yourself
forward continue to stay curious and continue to do your best to be
maxwell to to understand uh to enable and to
enjoy that highest sense of well-being that’s possible for you i’m really
thankful for all of you it’s a privilege to get to be on this journey with you uh to be training any of your clinicians
and to be seeing how we can make a difference in healthcare at large so
again there’s dr david haasey with maxwell clinic this is your maxwell care
group visit for this week and it was really a pleasure to be with you okay thank you all

This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment. This blog does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. We cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this blog or website.

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Dr. David Haase

Dr. Haase is the Founder and CEO of MaxWell Clinic- a Collaborative-Care, Functional Medicine Clinic. He is committed to finding and addressing the underlying causes of illness in his patients.