Fatigue and what you can do about it…

fatigue, energy, menopause, henpicked

Are your energy levels always low?

fatigue, energy, menopause, henpickedAs part of our Lunch & Learn series we spoke to Jackie Lynch, the founder of the WellWellWell Nutrition Clinic, who specialises in women’s health and the menopause.

In this session we discussed fatigue during the menopause. This is one of the most frequent symptoms women tell us they experience at some point. So if you’re finding your energy on the carpet and don’t know what to do about it, here’s what Jackie has to say.

Henpicked: Can you tell us more about fatigue. There are different types, aren’t there?

Jackie Lynch: Yes there are. And we’re in almost a fatigue epidemic. One in five GP appointments relate to low energy and fatigue, and there’s no formal diagnosis – it’s a subjective description for the way you’re feeling. If you have persistent tiredness that’s unrelieved by rest then you do need to see a doctor. It could be sign of a medical condition like underactive thyroid. Interestingly, the symptoms of underactive thyroid are very similar to menopause symptoms, such as fatigue and anxiety. It’s always worth going to check these things out as a first step.

Henpicked: We often hear from women saying fatigue was a big problem in menopause. Why is this?

Jackie Lynch: Any big hormonal change is going to be exhausting. Think of teenagers, they sleep all the time. We can’t, won’t or don’t do this, as we’re often too busy rushing around. But they’ve got the right idea. All that sleep is helping their brains to rewire and hormones to settle down.

Some women also suffer with insomnia during menopause, and struggle to get good-quality sleep. But it’s worth remembering, assuming there’s no medical condition at the heart of your fatigue, the chances are diet and lifestyle can make a huge difference.

The first thing we need to do is work out exactly what kind of fatigue it is. Lack of stamina, physical weakness, lack of mental energy, poor concentration, highs and lows of energy… or just tired all the time. Each could relate to being deficient in different nutrients.

The most common thing women assume is they must have low iron levels. But we need to be careful here, because without a diagnosis from a blood test, it’s not great to take iron tablets when you don’t need them. It can cause build up in your tissues. But anaemia is quite common in perimenopause as a lot of women have much heavier and more frequent periods. So if you’re found to be deficient, you might need to be thinking about getting more iron in your diet.

Henpicked: What actually causes such low energy, what’s going on in our bodies?

Jackie Lynch: The energy production process in the body is a complicated chain reaction. Each link in the chain is a different nutrient. If you’re low in any of them, the catalyst to move to the next part of chain simply isn’t there. Let’s start with magnesium. It’s every menopausal women’s best friend. It does loads of great stuff, but in terms of energy it’s our ignition key. Every enzymatic action in the body that involves energy has an absolute requirement for magnesium. 

Without it, you won’t get off the starting blocks and can feel permanently tired, operating on sheer willpower.

See also  How CBT helps during menopause

Try to have a good few handfuls of food containing magnesium every day – leafy greens like spinach, kale, watercress and broccoli will all give you a boost. Wholegrains, too, brown rice in particular. If you’re not a fan of leafy greens have an Epsom salts bath. This allows magnesium to be absorbed through your skin. If you take a supplement, check with your doctor first. Magnesium can lower blood pressure, so if you’re on blood pressure medication it’s best to check before taking. You can take up to 400mg a day, but listen to your body.

More is not necessarily better, plus certain minerals work in opposition to each other, and too much of one (in supplement form) can affect the balance of another. 

B vitamins are also a catalyst nutrient, like spark plugs in a car, that ensure the smooth running. If you’re low in these you might become more fatigued. Alcohol can deplete B vitamins. And try not to boil your veg. B vitamins are water-soluble, so all that green water you pour away is the vitamin content of the vegetables.

Henpicked: We often reach for sugary snacks when we’re tired. How can we avoid this?

Jackie Lynch: The highs and lows of energy come down to blood sugar. Every time your blood sugar crashes, your body releases stress hormones. They want to take emergency action, as they believe they’re there to save your life. If your blood sugar is low, that’s a problem for these hormones. Technically, sugar is our primary source of energy. This generates a powerful craving for a quick fix, which your body instinctively knows will give you what you need.

So we reach for sugary food, lots of carbs, a cup of coffee or glass of wine. What we crave might depend on the time of day. If you’re prone to sugar cravings or rely on sugar or caffeine to keep you going, the trick is to keep your blood sugar nice and stable.

First, think about fibre – complex carbs like brown bread, brown rice, brown pasta, vegetables and fruits with edible skin. Then match that with protein. This is hard to digest and slows down the release of carbohydrates and keeps you nice and full. If you get this balance right there isn’t the chance for your blood sugar to crash. So you’re not going to be prone to cravings or reliance on sugar or caffeine for energy.

Henpicked: How do we get started on this journey?

Jackie Lynch: They say the longest journey starts with a single step. The first thing is to get breakfast right, as once you’re on the highs-and-lows seesaw it can be really hard to get off.

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Think about having wholemeal toast with unsweetened nut butter, cottage cheese or egg – something with lots of protein – or cereal/muesli with ground flaxseed or chopped nuts.

. I’m not saying don’t have tea or coffee, but don’t have this as well as orange juice, as this contains a lot of sugar.

By the time you move to your next meal you’ll be hungry but not desperate. A good place to be, as you’re more likely to continue making good choices. Be prepared and do your meal planning, so you have the right food in the house.

Menopause is not the time to be removing major food groups from your diet or following fad diets.

Henpicked: What about supplements?

Jackie Lynch: Supplements are just that, a supplement. They can be helpful, but you need to get the basics of your diet right first. Fruit and veg all contain a broad range of different vitamins and minerals, which is a more effective approach than stuffing yourself with single supplements. These can’t offset a bad diet.

Nutrient absorption can make a difference. A lot of women in midlife can suffer from things like bloating and indigestion – so even if you’re eating the best diet in the world you won’t be absorbing as much. So sometimes a good-quality multivitamin and mineral can be helpful.

This will contain all the right stuff: vitamins A, B, C, E, probably K, and minerals like magnesium, selenium and manganese, which all work together to support energy levels.

Most multivitamins don’t contain iron, as a man may not need iron every day. If you think you need iron you’ll need a multivitamin specifically for women. And most supplements for women over 50 don’t contain iron at all as menstruation has finished.

The smart move is to get a blood test to see if you’re iron deficient. You can also ask for your folate levels to be checked. This plays a big role in red blood cell production. If our red blood cells are low they can’t transport oxygen around our body. And it’s oxygen we use to make energy. The body takes the food we eat, combines it with oxygen and creates energy.

Your doctor is your first port of call. If you say you’re tired all the time they should check your iron, vitamin B12 and folate levels, as well as your thyroid.

Henpicked: What role do alcohol and caffeine play?

Jackie Lynch: I’d never say cut out everything. But sometimes a good month off can give our body a break. Alcohol can deplete zinc, B12, vitamin C… all the things our body uses to produce energy. Have you started to get into habits, a few glasses of wine every night? As we go through menopause we can become more sensitive to the effects of alcohol, so think about easing back. Try for three consecutive alcohol-free days a week. This gives your liver chance to work on energy production.

See also  Exercise: the key to protecting your bones during menopause

Henpicked: Are we more likely to experience food sensitivities in menopause?

Jackie Lynch: Clinically, I have found that. Women come to see me and find that certain food is making them tired or bloated. Common intolerances are dairy and wheat, as they contain natural irritants to the gut. We have oestrogen receptors all over our body, including the gut. If these are not working as well as usual, we’re not generating the same level of beneficial bacteria, which supports our immune system. And 70-80% of immune cells are in the gut wall. So if you’re finding bread or milk is making you tired and sluggish, try swapping for different things and see how you go.

Henpicked: What should we be aiming for in terms of sleep?

Jackie Lynch: By now, most of us know roughly how much sleep works for us. But there are four ‘golden hours’ which are 10pm-2am, which are the most likely to give us restorative sleep when the body is undertaking repair and regeneration of cells. 

And there’s nothing wrong with a nap during the day, but try not to have more than about 45 minutes. Much longer and you’ll go into a deep sleep and wake feeling dreadful. Also, try not to nap too late as it could impact your sleep at bedtime.
Henpicked: Any other tips?

Jackie Lynch: The protein and fibre balance is nutrition 101. Go for a fist-sized portion of each, to take up half your plate, and fill the other half with vegetables. You could also look at phyto-oestrogens, plant compounds which mimic the action of oestrogen in the body.

You’ll find those in things like fermented soya, miso, and fermented tofu. Flax seed is also great, a few spoons in your smoothie or cereal can help with things like hot flushes. Whole foods like chickpeas and lentils are also relatively good sources of phyto-oestrogens.

Watch the video here:

menopause, fatigue, nutrition


Jackie Lynch is the founder of the WellWellWell Nutrition Clinic where she specialises in women’s health and the menopause.

She’s a regular contributor of nutrition features in the media and her clinical work has inspired her to publish the following books:

  • Va Va Voom: The 10-Day Energy Diet (Headline, 2017)
  • The Right Bite: Smart Food Choices for Eating on the Go (Nourish 2016)
  • And her amazing latest book, The Happy Menopause – smart nutrition to help you flourish (2020).

She’s also the host of the popular diet & lifestyle podcast, The Happy Menopause – you can find out more here:

Check out the rest of Henpicked’s Lunch & Learn video series!