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Knowing Your Triggers

This post was originally written for beneficiaries of the Salus Fatigue Foundation salus.org.uk


If you have a fatigue-related condition, you almost certainly don’t just have fatigue. The range of associated symptoms is broad and somewhat unpredictable leaving many of us feeling baffled and at times even defeated. How do you proceed when multiple systems in your body are affected? Where do you start? 


It’s worth taking a fresh look at how we typically consider and deal with illness. The conventional approach is to take ourselves and our health concerns to the doctor who will make a diagnosis and prescribe the relevant medication so that we can get better quickly and carry on with life. Much of this is completely irrelevant in respect of a multi-symptom fatigue condition, but that needn’t be the disaster that it may initially feel like. First and foremost, your body constantly seeks to restore balance and good health. This may seem like a wild claim, after all, it can feel like your body has let you down and is stopping you from living as you wish. So it’s really worth remembering that some people make a good or even very good recovery from such conditions and they almost always accept or even welcome the new take on life that the experience has given them. So what did they do?


There’s no one-size-fits-all approach to these conditions, but there are generalisations that can be personalised and then put to good use. This post will consider the sharp end of nutrition. The sharp end? It’s often relatively easy to add new foods into one’s diet. It’s another thing, however, to remove those that are causing harm and preventing the body from succeeding in its fervent quest to heal. These are trigger foods which, put simply, make us feel worse. There’s no easy resolution here other than to avoid them and for so many reasons, this can prove to be a significant challenge. 


The food(s) in question may have been problematic for some time, but were either hidden from us or ignored by us as our former good health enabled us to carry on despite the background disturbances. Equally, they may be completely new. We know that fatigue conditions are often accompanied by varying levels of dysbiosis in the gut (a compromised microbiome with insufficient ‘friendly’ microbes). This could easily explain new sensitivities or even allergies and many different foods may be implicated, but for the sake of ease, we'll take a look at the two most common ones here. Dairy and gluten. 


The clues to look out for in respect of a dairy intolerance may include digestive discomfort at some point after consuming it, although not necessarily immediately afterwards. Skin issues such as eczema often correlate with dairy as does seasonal rhinitis, better known as hay fever. But there’s also another, less well documented and not scientifically examined clue which nevertheless appears with frequency in those who develop food sensitivities. The food causing the problem may well be a frequently consumed, big favourite! It will come as no surprise that the big dairy favourite is often cheese. There is a particularly good reason for cheese to be so loved as it contains the protein casein that can trigger a dopamine reaction in some people. So if it feels as though you can’t possibly live without cheese, it may be the casein keeping you hooked and not any kind of flawed personality on your part.


Gluten, the protein comprising gliadin and glutenin and found in certain grains such as wheat, is almost as challenging as dairy since wheat is so prevalent in most western societies. A problem with gluten can also lead to digestive issues. It is worth consulting a healthcare professional if this seems to be happening as it’s important to investigate the possibility of coeliac disease. But there’s another, less obvious symptom experienced by some people who develop an intolerance to the grains containing gluten. There can be neurological challenges where mood may be affected. This is now acknowledged in some of the scientific literature so if you experience a downshift in mood after eating gluten (again, it may not be triggered immediately after eating) then the culprit may be in your food.


Does this mean that dairy or wheat, or any foods causing symptoms or worsening of symptoms have to be given up? Once you have clarity, which can be achieved by eliminating the possible trigger for a few days at least, then yes, the offending food needs to be avoided for the simple reason that your body cannot heal effectively with the repeated onslaught of a food that is causing an inflammatory response every time it’s consumed. Unfortunately, this is not something that just ‘gets better’ by being ignored, in fact the only typical trajectory is that it gets worse. Imagine constantly scratching the skin on the back of your hand day after day. As it becomes redder and more sore, would you expect it to heal if you kept scratching it? This is not dissimilar to the action in the body of a food that cannot be tolerated. Moreover, the challenge is intensified in anyone dealing with a health condition; all available energy is needed to support the body back to wellness and any persistent firefighting to put out the flames of food-induced inflammation will take what little energy there is available to deal with that.


Before you conclude that this is a story of doom, may I try to persuade you that it can be managed better than you may think, and may even open up your world to new possibilities? It is beyond the scope of this post to detail foods which can replace the nutrition of the foods referred to here, not to mention the bigger initial challenge for most of how to re-organise meals. This is usually the most challenging part, but it gets easier and you get the reward, more often than not, of feeling better. You soon figure out that the nutrition comes, not necessarily from the foods you’re using as substitutes, but from other sources which you may choose to increase in your diet. I’ll suggest one easy example to illustrate: when dairy becomes problematic, most of us have a sudden rush of worry about calcium and subsequently our bone health. This ‘truth’ about milk and calcium has been instilled in us almost since birth, and milk is indeed a source of calcium, but it’s absolutely worth knowing that around 70% of the world’s population are intolerant to dairy products and thus avoid them, getting their calcium instead from a range of other foods such as leafy greens. This is just one example, but it merits a reference because apart from being good sources of calcium, leafy greens also supply vitamin K which is key for bone health, too. Additionally, like other vegetables and fresh fruits, they contain anti-inflammatory compounds which your body is likely to appreciate, along with the fibre that the ‘friendly’ microbes in the gut are eager to have access to. And once the microbiome is more robust, certain foods can be gently reintroduced, but go easy as they may still trigger a set-back. A trial and error approach, one ‘trigger’ food at a time is needed for this.


A fatigue-related illness presents many challenges and it may well require that we make changes that are initially unwelcome to us. But the opposite of change is stagnation, which never leads to new realisations and new experiences. You’re not wrong to resist change, it’s a natural response, but sometimes it makes more sense to allow life to take us somewhere new.

~ Annette Henry



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