In the traditional medical world when patients have a problem, first they visit the general practitioner who then sends them on to a specialist. For hormones, see the endocrinologist, for joint pain see the orthopedist , for arthritis see the rheumatologist and so on. But who can be seen when energy is low? - The vitalogist, the oomphologist? The fact that fatigue is the most frequently mentioned symptom among all patients and that there is no specialist to treat low energy, is revealing in many ways.
Low energy, this one symptom, is proof in itself that the medical model of treating parts is flawed. Every time an MD hears the complaint of fatigue, it is a direct reminder that the traditional form of health care, the one they have practiced for decades and spent hundreds of thousands of dollars to master and propagate, is greatly insufficient. That is not to say that the alternative healthcare world is ideal. It too has limits and has far too often fallen short in the area of energy restoration. But, its approach, the one that seeks to understand human dysfunction and correct it at its source, is, in my opinion, the superior method. Why? Because the destruction of the normal energy pathways can happen for a variety of reasons and those reasons rarely occur in isolation. This means that looking at each of the major systems of the body and treating them simultaneously is likely to be the best hope, not only for energy enhancement, but for whatever ailments may exist.
What Is Energy? Energy is ATP, or adenosine tri-phosphate. It has been estimated that if suddenly had all of the ATP were removed from the body, survival would last a total of three seconds. ATP is one molecule of adenosine with three phosphate groups attached. All reactions, intracellular, extracellular or otherwise, are dependent upon the donation of one phosphate molecule from ATP to another molecule. This successful donation of these phosphates is what we know as energy. If there is an abundance of ATP, then there is energy to burn. ATP is formed by adding a phosphate molecule to adenosine to make the single (mono) phosphate molecule AMP, then by adding another phosphate to make the two (di) phosphate ADP, and the process is completed with the addition of a third phosphate to make the desired three (tri) phosphate, ATP. If all goes well there will be energy to burn. However, this is rarely the case.
Most people will state that there energy is just fine. They can get out of bed in the morning and start their day (with one or many cups of coffee), make it through the afternoon dip (with a sugary or chocolate snack), stay alert throughout the evening (with the TV or computer lights blasting) and then fall asleep (from exhaustion). The reason they make it through the day and are somewhat productive is because only about 10 to 20% of total energy is required to navigate civilized life – wake up, wash, work at a desk, watch TV, etc. The majority of the energy required daily is used in neurological function, digestion, repair, detoxification, metabolism, immune system function and other internal functions carried on automatically via the autonomic nervous system. It is in these areas that things break down first. Looking closer at the person above, it is likely that they have a plethora of low energy related symptoms such as interrupted sleep (toss and turn or trouble falling asleep), digestive problems, headaches, menstrual irregularities, trouble losing weight, repeated infections, loss of libido and so on. The principle health feature of “normal” people is that they survive, not thrive. Like a car on the interstate in second gear that will eventually reach its destination, they exist in a state of energy starvation requiring the down regulation of certain systems so that others may be preserved.
Energy production takes place in two phases, each with two steps. The first phase is called glycolysis, the second, oxidative phosphorylation. If all is well
Figure 1 Basic Energy Production
Figure 1 demonstrates the basic steps of the energy cycle beginning with step 1, the digestion of proteins, carbohydrates and fats. Each of these macromolecules must be broken down in order to make the end product called, acetyl CoA. Getting from one glucose molecule to acetyl CoA creates only 8 of the desired 38 ATP. To obtain the rest of the desired ATP acetyl CoA must go through the two steps of phase 2. Once acetyl CoA is made it must then be taken up by the Kreb’s cycle, this is step 2. Step 3 is the spinning of the Kreb’s cycle, that is, the conversion of one type of molecule into another type until eventually getting back to the start. This may sound futile, but it is not. Another 2 ATP are created by the Kreb’s cycle along with a host of very important chemicals that are used throughout the brain and body. Now, with two-thirds of the energy cycle completed, a total of 10 of the necessary 38 ATP have been created. This means step 4, the final step, is where lion’s share of ATP is found. Step 4 is called the electron transport chain. Here ADP is turned into ATP and the final 28 of the 38 ATP are created.
Energy Zapped There are many factors that will lead to energy disruption. Each chapter of this book is devoted to one of the major energy zappers. Some affect only parts of the energy pathway, whereas others affect the whole. Regardless, any major system that is not operating as designed will utilize the resources of other systems in order to limp along. No part (or system) acts independently of the other parts. All systems are pulled down by the gravity of the ones in need.
Each step of the energy pathway has specific requirements. If these requirements are not met, then energy production can go no further. In step 1, if the digestive system is compromised, proteins, carbohydrates and fats are not properly broken down resulting in low levels of acetyl CoA. It is like a new car; the parts are all put together, but without some gas in the tank, it won’t be going anywhere. So, what if digestion is working fine and there is gas in the tank? The next potential problem is a hormonal one. Step 2 is dependent upon proper functioning of the thyroid gland. If the thyroid gland is under-functioning, then acetyl CoA is not shuffled into the Kreb’s cycle. This is why people with hypothyroidism are tired. The analogy at this step would be a broken fuel pump – the gas is in the tank, but the fuel cannot be pushed into the pistons. In order to spin the Kreb’s cycle many important ingredients must be present. Step 3 requires specific B vitamins and the right form of magnesium. These are the sparks of the energy cycle. Fuel in the pistons without a spark from the plugs is useless. Finally, step 4 – a broken transmission. The engine in a car provides the power and the transmission makes the axle spin and the wheels turn. If steps 1 – 3 are working then the body is moving down the road, but if step 4 is amiss, it will never get into high gear. Step 4 requires the emperor of all nutrients – oxygen. Those who are iron or B12 deficient – the nutrients used in the body to carry oxygen - will not be able to supply ample amounts of oxygen to their cells and will always be tired as is the case with any form of anemia.
The reality is, when one part of the energy system is under-functioning, other parts are likely to as well. The energy system is dependent upon properly functioning nervous, hormonal, digestive, musculoskeletal and emotional systems. When any one of these systems is out of balance, there will be negative effects on total energy - sooner rather than later.
Burn Fat, Not Muscle If the body is unable to move from glycolysis (phase I) into oxidative phosphorylation (Phase II) then the total energy supply will be around ONE FIFTH of its designed capacity. This degree of energy deficit requires emergency measures, and the body is forced to take them. In an attempt to generate at least some of the necessary ATP to stay alive, the body resorts to a process called gluconeogenesis – the creation of glucose from other molecules. The preferred method is through the destruction of muscle tissue in order to
Figure 2: Potholes in the Pathway
The example is all too common. The once fit female in her twenties and thirties turns forty and now everything seems to fall apart. The signs of the shift were there all along, but being that she is of a competitive spirit and has wholeheartedly swallowed the no pain, no gain approach (and why not, it has worked up to this point), she ignores the signs and presses through her workouts expecting that the same results of a tight tummy and better fitting clothes are just a few less bites and a few extra reps away. But things are not as they once were. A lifetime of forcing the body to respond and adapt to exercise and/or emotional stress has led to the dysregulation of critical energy systems and the depletion of nutrients; nutrients essential for fat conversion, stored sugar (glycogen) utilization, brain neurotransmitter balance, insulin regulation, and immune system equilibrium. Now, as she once again calls upon her metabolism to switch into a higher gear, her body is unable to respond. Gradually, despite extensive effort on her part, the fat increases and the muscle decreases. Like quicksand, the more she struggles to free herself through the tried and true methods, the more she is trapped. She is stuck in phase I. Sadly, that is not the end of the bad news. The same stressors that poisoned phase 1 have likely contaminated phase 2 as well. This means that she cannot turn ADP into ATP – the highest ATP-yielding part of the entire cycle. Remember, if energy production becomes stuck in glycolysis or at ADP and is unable to proceed to ATP then the net loss in total energy can be as much as 80%. Clearly an energy level this meager equates to a poor quality of life. To avoid this dismal state, the body would surely avail itself of any alternative measures should they be obtainable. There are, and it does, but the cost is high.
Escaping Glycolysis – Phase I Repair Most are stuck in glycolysis – storing fat and burning muscle. To escape this phase and move into the Kreb’s cycle five questions must be answered?
1.) Is fat being mobilized properly? The process of releasing stored fat from the adipose tissue is called lipolysis. Many nutrients are required for this to happen and can be hindered by too much adrenaline. The two most likely nutrients to aid in this step are carnitine and magnesium phosphate as well as the enzyme lipase.
2.) Is fat being utilized properly? Once the fat is released and circulating in the blood stream as triglycerides, these too must be fully broken down into their smaller parts (fewer carbon units) to eventually wind up as acetyl CoA. A specific form of vitamin B3 (niacin) is usually what is required if a deficiency here turns out to be present. Niacin has several activated forms. One called NADH is needed about 70% of the time, whereas NADP and NADPH are required the other 30%.
3.) Is the thyroid happy? The two major thyroid hormones (T3 and T4) are both required for proper movement of acetyl CoA into the Kreb’s cycle. It is rare to find a thyroid problem in isolation. Often, the thyroid is secondarily troubled by too much insulin, which interferes with the T3 and T4 receptor sites. If T3 is the primary hormonal issue, then selenium is often an important nutrient. If T4 is the problem, then iodine is critical (except in the cases of auto-immune thyroid called Hashimoto’s).
4.) Is glycogen being made properly? After meals, extra glucose is likely. This extra glucose is either stored as glycogen in the liver and/or muscles, or is converted into fat. Some, because of too much adrenaline, do not store glycogen properly, making its stores too low. This becomes apparent between meals when the body is looking for its primary fuel, glucose, in order to feed the brain and other tissues. If there are insignificant amounts of glycogen, then hypoglycemic symptoms such as shaking or lightheadedness, as well as strong sweet cravings are likely. The antidote to this problem is often too increase cortisol levels by repairing tired adrenal glands and by finding the appropriate form of calcium (and often potassium).
5.) Is glycogen being utilized properly? There may be plenty of glycogen in the liver and muscles, but if it can’t be reached then it is of no value. This problem of failing to release glycogen is almost always related to a vitamin B6 need. The activated form, pyridoxal-5-phosphate or the basic form, pyridoxine will be the B6 of choice. Adrenaline is also required for glycogen release. My experience is that increasing adrenaline is rarely required since most people are full of this excitatory hormone already.
Finishing Strong – Phase II Repair Phase II, as you know by now is made up of the Kreb’s cycle and the electron transport chain. Here are the two most likely scenarios for a breakdown in one or both of these steps:
1.) Do you have enough B-vitamins? The Kreb’s cycle is the least affected of the four steps of the energy pathway for a variety of reasons. The ones who need it supported the most are the athletes/weekend warriors. Most people are too sick to handle a b-complex or even a multi vitamin, and yet one or both of these is the first choice for those feeling run down. The temporary energy boost felt from these supplements is more like a caffeine buzz than a healthy lift to the energy system and does have its unwanted side effects. However, for the athlete, the demand for proper levels of B-vitamins is high and with them, the Kreb’s cycle suffers.
2.) Adding the final phosphate? As shown above, ADP must, with the addition of a third phosphate, be made into ATP. This apparently requires some heavy lifting, metabolically speaking, since this final and most rewarding step is compromised as often as the first step in phase I. Here too, insulin is the primary disruptor as it is in the case of fat breakdown. Now however, iron and vitamin B12 are revealed as ultra critical. One clue is, if the medical profession understands how important a nutrient is (B12, Iron, Folic acid), it must be really important. And they are. Without iron and B12, oxygen is not properly carried throughout the cell and the mitochondria where the energy pathway resides. One of the activated forms of B12 called, adenosylcobalamin and iron phosphate are frequently the required forms. The last nutrient of importance for energy production is magnesium. There are over 4000 known enzymes in the human body and 70% of these require magnesium! As you may have guessed at this point, not just any magnesium will do. In the case of energy, magnesium phosphate is the best choice.
Lifestyle Balance As described above, it is quite possible to dissect the energy pathway, fix the broken pieces and restart the metabolic engine. Regrettably, the repair can quickly become undone if certain lifestyle changes are not made; namely, the incorporation of a hypoglycemic diet and the initiation of an aerobic-only exercise program. Both of these topics have been discussed in previous articles. Click the highlighted links above to read more.