Fatigue is certainly one of the the most common problems in people who live with inflammatory bowel disease.

My wife, an ulcerative colitis sufferer, used to suffer terribly with tiredness. Every day was a real struggle and if we ever went out for the day she would be completely wiped out by the end of it (and for many days afterwards!).

However, while fatigue is certainly common in people with IBD it should not be accepted as being ‘normal’, as there are always things that can be done to help resolve it.

The exhaustion can and will affect every aspect of someone’s life; it will affect their performance at work  / business (and, therefore, earnings), clarity of thinking, their social life, relationship with children and partner, sex drive, and performance in their chosen sport / exercise (and much more).

I’m pleased to say wife managed to turn her energy levels around and is now symptom and medication free (click to read her story) and feeling better than ever (she has even joined a gym which is something I NEVER thought I’d see!).  Therefore, in this article I’m going to share with you the main culprits causing fatigue in someone with IBD, and tips on how to overcome it:

B12 Absorption

Low vitamin B12 levels are really common in people who suffer with IBD, yet B12 is a critical vitamin for energy. If someone has low B12 levels, they will almost certainly feel fatigued.

Many sufferers do end up requiring B12 injections once it has been identified that their levels are low which can often provide a significant increase in energy. However, this is not a solution as it doesn’t help to understand WHY absorption is so poor in the first place (as relying on B12 injections for the rest of someone’s life certainly isn’t a solution).

B12 is primarily absorbed in the small intestine, and when that is damaged or severely inflamed (as it often is with Crohn’s sufferers in particular) then absorption of this really important vitamin is impaired. That’s why, with my clients, one of the things I will help them with is reducing inflammation for the long term.  There are many ways to do that; obviously reducing the cause of the inflammation is most important (addressing things such as diet, stress, infections, leaky gut, toxins, and more), but certain supplements such as turmeric and fish oil can also be really effective here.

Low B12 Intake

Following on from the above, B12 levels may be low not solely because absorption is being impaired but because insufficient amounts are being taken in through the diet.

There are many food sources of B12 but unfortunately, so many people aren’t eating anywhere near enough of them.

Meat, fish, and eggs can all be good sources of B12.  However, for more tips on the foods to eat and avoid when living with IBD check out this free online event where I talk through the step by step process to transforming health when living with Crohn’s or Ulcerative Colitis.

Cortisol Production

Our hormones are critical for our overall health and energy levels. We have a number of hormones in our body and cortisol is a really important one.

Cortisol is released in response to stress. “Stress” can be any stressor on the body; not just mental/emotional stress as most people think about it but also physical stress such as eating food you are intolerant to, having a gut infection/parasite, or even a bowel operation.

In particular, Cortisol raises someone’s blood sugar for energy and acts as an anti-inflammatory and pain killer. However, over time, if the body is under constant stress, then the body often stops being able to produce sufficient amounts. So what happens? Energy levels drop and inflammation increases.

Because of the above, a huge percentage of people suffering with IBD have cortisol levels that are too low relative to the amount of stress they are under and it’s a fundamental reason that constant fatigue is so prevalent.  Knowing this helps us to put in place protocols that help return cortisol levels to where they should be and often helps to massively increase someone’s energy levels.

DHEA and Testosterone levels are too low

Two other really important hormones for energy are DHEA and Testosterone. They have been shown to boost energy, reduce stress, improve libido, reduce body fat, increase muscle mass and improved sense of overall well-being.

A number of factors can reduce the levels of these hormones but, in particular, when the body is under a chronic amount of stress it means that cortisol levels increase (though as per above, these eventually reduce) and DHEA and testosterone levels lower.

Addressing the root cause

When someone continually suffers with a number of symptoms, and/or fails to stay in remission for any length of time, then it can mean that the underlying cause of their IBD is affecting the normal healthy function of the body, and leading to low energy. Addressing the underlying cause (and a focus on building health rather than solely trying to mask symptoms) is the approach I take with my clients and is fundamental in getting them to a place where that are able to lead a happy healthy life not controlled by their symptoms.

If someone is eating foods they are intolerant to, are constantly stressed, or have gut problems such as the presence of parasites or bacterial overgrowth, then these can all be significant contributors towards someone’s low energy levels. Quite often it won’t just be one thing, there will be a number of these issues at hand.

To help get to the root cause, I will look at someone’s diet, supplementation, rest, sleep, exercise, mindset, stress levels, skincare products and toxin exposure. I’ll also often use a range of comprehensive lab testing that looks at gut function, the presence of parasites, yeast growth, and bacterial imbalances, digestive function, nutrient deficiencies, and much more – things that absolutely must be sorted if you are to feel as good as you possibly can.

For more help identifying root causes of symptoms (including fatigue) then check out this online webinar where I talk through my 5 step process for doing just that.

Starting the day all wrong

The things eaten at breakfast are critical for energy levels for the rest of the day. Most people will start the day with some toast and orange juice, or maybe some cereal. These are all things that are very high in carbohydrates, and low in fats and protein.

However, contrary to popular belief, having lots of carbs first thing in the morning isn’t the best way to provide your body with energy for the rest of the day and a few simple tweaks to what you eat for breakfast can make the world of difference.

Iron Levels

As well as vitamin B12, there are many other common nutrient deficiencies in people with IBD.

For example, low iron levels can be very common. This again will severely impact energy. The reason for low iron can vary but is often due to significant blood loss, poor nutrient absorption and low iron intake. Getting to the root cause to reduce blood loss and improve absorption, is obviously important, but getting enough iron from the diet will also be critical.

One product that has been designed to help a Crohn’s or Ulcerative Colitis sufferer to combat fatigue, and contains nutrients that help to enhance iron absorption is Advanced Vitality, filled with natural, well-absorbed nutrients that, over time, can help to improve energy levels.  Click here for more information.

Vitamin D is another common deficiency that is associated both with low energy, as well as flares and symptoms in people with Crohn’s and Ulcerative Colitis.   Sun exposure is generally the best way to keep vitamin D levels topped up, but because most people don’t get sufficient amounts of sun, then supplementation is often necessary.  For a high-quality Vitamin D3 supplement then click here.

Not eating enough

You’ve heard of calories, right? Well, all that calories are is a unit of energy. Therefore, if someone isn’t taking enough calories from the diet, this can lead to energy problems.

This is the case for everyone, but if someone is going to the toilet frequently (as is the case with many people struggling with IBD) then they can actually have a higher calorie requirement because so much is lost through the frequent bowel movements.I’m not telling you to go out and eat a load of junk food to get calories on board (like some doctors and dieticians have been known to do), but at the same time you do need to be making sure you eat enough (and yes, I do appreciate that it can sometimes be difficult if you are in pain and struggling to find anything that doesn’t irritate your gut or pass straight through you).

Additionally, when someone is struggling with pain, or knowing that whatever they may eat can make them rush to the toilet, then typically they want less food (and therefore will often be taking in less calories and less nutrients).  Now obviously I wouldn’t advise that someone goes out and eats a lot of junk food in order to consume plenty of calories (as many doctors and dieticians have been known to do), but at the same time sufficient calories are needed and so doing that through “good” foods that don’t increase inflammation levels is important for energy.

Not getting enough quality sleep

This is probably fairly obvious but sleep is really important for energy levels. Several studies, in fact, have now shown that there is a definite link between lack of sleep and the onset of flares with Crohn’s and Ulcerative Colitis. gg tired woman bed

Now I will hold my hands up and admit that when someone suffers with IBD and is extremely fatigue they do need more than just a good night’s sleep.  But this list would be incomplete without sleep because the fact is that if someone isn’t sleeping well then that certainly will be affecting their energy.

There are a number of strategies that can be used to help improve sleep. However, I believe 7-9 hours sleep per night is normally optimal for most people, and that should preferably be uninterrupted sleep.  Waking up even just once for a wee before going back to sleep is an interruption and even though it might not seem like much, it really can affect sleep quality. Very few people have a bladder so weak that they MUST go to the toilet in the night but so many people do. It’s actually normally something else waking them up (perhaps stress or blood glucose issues) and resolving that can result is drastically improved sleep quality.

Your Turn

My wife and many others have been able to completely overcome the crippling fatigue (some have run marathons and completed triathlons) yet not too long ago could barely get out of bed! If you are interested in learning more about how they have achieved this, then check out this free online event where I go through the process.

Finally, I really would appreciate if you could share this article on social media to help other Crohn’s and Colitis sufferers who would benefit from this information. Thanks!

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