Better Health


Why am I so tired?

Fatigue is a very common complaint among adults. That concern is understandable, as not having energy or stamina robs us of a lot of joy in life and limits our daily productivity.

Here are some reasons (some not so obvious) why we struggle through the day:

  • Lack of high-quality, restful sleep (not just hours in bed). This includes interrupted or fitful sleep, or could be due to inadequate blood oxygen during sleep, most commonly from sleep apnea, often associated with snoring
  • A diet that is not energizing, perhaps too high in carbs, fat, or alcohol
  • Lack of regular physical activity, which could be exercise, but can include other forms of activity
  • Side effects of medications, prescription or non-prescription
  • Caffeine withdrawal, if you are accustomed to caffeine
  • Anemia, not always due to iron deficiency
  • Hypothyroid (underactive thyroid)
  • Various heart and lung conditions (a reduction of oxygen in the blood causes fatigue)
  • Depression
  • Chronic stress or anxiety
  • Excess body weight
  • Undiagnosed pain or chronic medical conditions
  • Overcommitting to work or activities

Some believe vitamins can make up for lost sleep or lack of exercise; however, they cannot. Whatever is missing needs to be addressed head-on. Sometimes we tend to put up with feeling tired, but it usually does not have to be that way.


Aspirin Sensitivity and Resistance

Since the 1970s, doctors have been recommending that people, especially men, who are at increased risk of coronary heart disease take a preventive aspirin daily. Most have focused on the low dose of 81 mg, although there have been suggestions that 162 mg is more effective. A recent study in the heart journal Circulation (3) examined the phenomenon of why some people do not benefit from the daily aspirin in terms of prevention. It has long been thought that to protect the lining of the stomach from the erosive effects of aspirin, the aspirin should have an enteric coating that slows the absorption of the aspirin until it gets past the stomach. It was thought that between 5 and 40% of the population was aspirin resistant, and those were the people who were not benefitting from aspirin use as a preventive. The investigators could not find aspirin resistance, but did find a lack of aspirin absorption due to its coating.

Since there is still concern about protecting the stomach from aspirin, perhaps the 162 mg dose (or two of the 81 mg tablets) taken in the enteric-coated form might be a solution. It is difficult to find the 81 mg aspirin that is not coated, and bleeding from aspirin is still a concern.

Interestingly, in a small study performed in Texas (4), it was found that chewing an uncoated 325 mg aspirin for about 30 seconds, if a heart attack occurs, is the fastest and most effective way to get the platelet blocking effect of aspirin into the circulatory system.





The Truth About Calcium Supplements

Most believe that calcium supplements only benefit adults (except, maybe, those with kidney stones), protecting them from declining bone strength. Some may believe these supplements could help those with osteoporosis (weak bones) specifically, but recent research places calcium supplements under scrutiny.

Recently, Annals of Internal Medicine reported that, according to the US Preventive Services Task Force (USPSTF), postmenopausal women do not appear to experience bone-strengthening benefits of calcium plus vitamin D supplements that was originally hoped. Calcium recommendations suggest most daily calcium intake should come from dietary forms, such as dairy or spinach, rather than from calcium supplements. Vitamin D, required for the body’s absorption and processing of calcium, is too low for many people since the production of vitamin D in the skin by sun exposure is variable for individuals. In 2010, the Institute of Medicine recommended daily intake of 1,200 mg of calcium daily and 600-800 IU of vitamin D daily. Those amounts are attainable with diet alone, but reaching those values in your daily diet requires some effort, especially if you are not digesting and absorbing the calcium and vitamin D well.

Even more curious, at least two reports, the most recent from the National Institutes of Health (NIH), indicate as much as a 20% increased risk of heart disease deaths in men who took 1,000 mg or more of calcium supplements daily (1). The theory: high calcium intake without sufficient magnesium results in artery plaque formation. The results are less compelling in women, who tend to take calcium supplements more frequently. So, the key may be to balance the intake of calcium and magnesium to some degree. Magnesium glycinate and magnesium malate forms seem to be well absorbed. The Mayo Clinic website recommends about 300 mg of magnesium daily through a combination of diet and supplements (2). Too much magnesium in the form of magnesium supplements can cause side effects such as diarrhea, so the bulk of magnesium should be found in the foods like fish, yogurt, milk, spinach, beans, and almonds. Many calcium supplements now also contain magnesium and vitamin D (and some contain zinc, also) for proper absorption and a balance of the ingredients. There should be more scientific analysis of these results in the near future.