Sprinting While Sitting Down - Where Is My Energy?
Most people would prefer to have additional energy instead of just pushing through the day, which is why fatigue is perhaps the most frequent symptom associated with all doctor visits. If you have been reading my newsletters within the past few months, then you will not be surprised to hear that energy loss is related to one or more of the common topics I have addressed lately such as: insulin resistance, Hashimoto’s, nutritional deficiencies, digestive complaints, adrenal gland fatigue and more. Remember, that these issues are often interrelated – one causing or sustaining the other, and vice versa. It is the mechanism underneath that we will look at this month. Again, this article will have a few technical components.
For all people, in order to have, “energy to burn” we must create a chemical called ATP (adenosine triphosphate). You have two primary pathways with which to accomplish ATP creation. One does not require oxygen, the other does. To keep it simple, let’s call the first one, Anaerobic (non-oxygen) Metabolism and the second, Aerobic (oxygen) Metabolism.
Anaerobic Metabolism is rapid and provides immediate ATP, but the yields are very low. Aerobic Metabolism takes much longer but the yields are very high. This second, more efficient oxygen-using pathway is the desirable one as you will see, but it is also the one that is easily short-circuited. Most people have had this pathway set aside in favor of the less efficient, low yielding anaerobic pathway because of the Stress Response and specifically, a chemical called, adrenaline. I will discuss the reasons for this shortly. We first need to understand these pathways a little better.
To engage in ATP production, all food must be broken down into smaller more useable components. Ultimately, we want the three food sources: fats, proteins and carbohydrates, to be broken into a foundational chemical called Acetyl CoA. Once reduced to this point, Acetyl CoA can take part in Aerobic Metabolism, yielding great returns of energy. The generation of Acetyl CoA does not require oxygen. Below are the basic steps to ATP creation:
Foods (Proteins, Fats, Carbohydrates) Anaerobic (non -oxygen) – 2 ATP ↓ Acetyl CoA ↓
Krebs Cycle Aerobic Metabolism – 36 ATP ↓2 ATP Oxidative Phosphorylation / Electron Transport Chain ↓ 34 ATP
Anaerobic Metabolism (aka Glycolysis) uses 2 ATP in order to generate 4 ATP, yielding a net gain of 2 ATP units. Glucose, or blood sugar, is the fuel source. Anaerobic Metabolism used when a sprinter runs the 100 meter dash. Stored glucose, called glycogen is found in the liver and the muscles. There is only a small amount of glucose in storage and when accessed, is depleted rapidly. That is why no one sprints for a mile.
Aerobic Metabolism is 18 times more effective at manufacturing ATP. It is responsible for generating 36 units of ATP as compared to only 2 units with Anaerobic Metabolism. This is why it is so important to utilize this method. In order for this abundant ATP to be tapped, two processes must be completed. The first is called the Krebs Cycle and the second is called Oxidative Phosphorylation. The problem is that Aerobic Metabolism has many steps within these two processes, each of which has certain specific requirements, which, if not met, results in less than the full yield of ATP.
There are three major reasons why someone does not produce enough ATP. Two of them have to do with an incomplete use of the Aerobic Metabolism, and the third bypasses it altogether.
1.) Not digesting foods into their simplest components (acetyl CoA) Without proper digestion, that is, the breakdown and assimilation of nutrients from foods, obtaining foundational components is incomplete and becomes taxing. The body must draw from its reserves of vitamins, minerals and enzymes in order to completely provide the raw materials necessary for all physiologic processes. This is the primary reason why many are nutritionally deficient. Even if they begin to eat better foods with higher levels of nutrients, they will not extract those nutrients without first correcting the broken digestive mechanisms. This often means healing an inflamed digestive tract, replacing lost beneficial organisms (probiotics), and avoiding foods that create immune responses (allergies).
2.) Incomplete Aerobic Metabolism due to a lack of required nutrients. As mentioned above, when the body is not working efficiently, or when it is under excessive physical, emotional or chemical stress, additional nutrient reserves are utilized for assistance. In the Krebs Cycle, many B-vitamins are required as well as certain amino acids to advance to the next step of ATP production. Likewise, CoQ-10 and many other Co-enzymes are required in the Oxidative Phosphorylation pathway. CoQ-10 for example is depleted by most prescription medications. If you are taking any, you should include this important nutrient in your supplement regime. Insufficiency with any required nutrient will short-circuit the Krebs cycle and prevent full ATP production.
3.) Bypassing the Aerobic Metabolism because of the Stress Response. This is the least understood, but most common reason for low energy. When the stress response is underway because of mental, structural or physical troubles, the body preferentially uses the Anaerobic Metabolism for quick energy. It was made this way by design. It is called the “Fight or Flight” response. You were never meant to manage stress for prolonged periods of time, but that is exactly what people do every day. Stress in the form of finances, fractured relationships, lack of rest, and poor diet keeps them revving an engine that should have been shut off shortly after it was turned on. The primary chemical involved in the Stress Response is adrenaline (aka epinephrine). Others, such as cortisol and insulin get involved as well, each with their own numerous injurious effects. Overutilization of these three hormones leads to Metabolic Syndrome, which in turn leads to diabetes, cardiovascular disease, immune dysregulation, dysbiosis (digestive problems) and an abundance of other familiar conditions. Being stuck in the “Fight or Flight” response results in over half of the symptoms on my 150 question health assessment.
In order to hope to regain energy, the following must be evaluated and treated if found:
Digestive System – Leaky Gut Syndrome & Dysbiosis lead to poor absorption of necessary nutrients. Increased ingestion of adequate foods and elimination of harmful foods and organisms is critical.
Nutritional Status – replacing depleted nutrients for energy production and other important functions. Key nutrients include: Vitamins B1, B2, B3, & B5; Minerals: magnesium and manganese; Amino acids carnitine, glutamine, argentine, & glycine; and other important factors like lipoic acid.
Adrenaline, cortisol and DHEA (adrenal glands)
Insulin – too much (insulin resistance), too little (pre-diabetes).
In addition to those mentioned above, two lifestyle changes are critical. The first is aerobic exercise and the second is regular protein intake to manage blood sugar. 1.) Aerobic exercise can be determined by measuring the heart rate. The body will automatically begin pumping out more adrenalin when the heart rate is too fast. This is exactly the opposite of what we want to accomplish. Therefore, keeping the heart rate low and sustained during exercise is essential. The equation for most people is 175 – Age. Take this number as the top of the range and ten points less as the bottom. This is the range in which you should remain throughout your entire exercise routine. For most, this will mean walking. See my article on exercise for more details.
2.) Blood Sugar Management – Your body will sacrifice many other systems in order to maintain a regular supply of glucose for the brain. I estimate that 80-90% of my patients have some degree of blood sugar abnormality (insulin resistance mostly). The way to combat this is with specific nutrition and by regular small protein meals. This means never eating a cookie by itself, but a cookie with a protein dinner may work for some. For more information, please see my article on insulin resistance.
By combining lifestyle, nutritional and stress reduction protocol, most are able to begin to see a significant improvement in their energy level within a few weeks.
Summary In order to have a high level of energy, the body must make adequate amounts of ATP. This process can be short-circuited if foods are not properly broken down into their most foundational components; if the levels of vitamins, minerals and other metabolic elements are inadequate for the completion of the high ATP generating pathways; or, if there is an ongoing stress-immune response, thereby sacrificing long-term health for short-term energy to support basic life functions. Persistent use of the Anaerobic Metabolism leads to Metabolic Syndrome and eventually to many of the known life-threatening diseases. In order to reverse this detrimental trend, addressing each of these issues, often simultaneously, is required.
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