Where Do We Get Our Energy?

I felt like I'd been unplugged

In 2018 I had surgery to repair a damaged leg artery. I was recovering nicely for the first week, and then something changed. It was like I had been unplugged. For 2 days, I could barely get out of bed. It was hard to keep my eyes open. The trip downstairs to the couch was so taxing I'd nap for hours. I recall wondering if I'd ever get back to normal.

To this day, I don't know what happened. After 2 days, my energy improved and I got back to recovering from the surgery. When I think back, I feel gratitude that my energy was restored and 

But what  if you have fatigue and it's not getting better? What if you're not recovering? I frequently evaluate and treat people for whom fatigue is a daily struggle.


Fatigue is one of the most common complaints that lead people to see a physician. Unfortunately, an explanation for fatigue is not always available, even after thoughtful analysis and testing. If you are experiencing fatigue, I would recommend having a medical evaluation to look for treatable causes ( and if you find small amounts of physical exertion wipe you out for days, find a physician familiar with ME/CFS, as this is a special type of fatigue that should be considered).

But what can you do if no cause for fatigue is discovered?

How we get our energy

Human systems use carbohydrates, fats, and proteins (yes, and alcohol too) to produce energy, primarily in the form of a molecule called ATP, which is used to run our body's systems. Energy production requires both proper fuel and proper functioning systems to turn that fuel into energy. Attention to both of these, the fuel and the systems, are important for you to feel at your best.

If you're battling fatigue, one thing to consider is whether you can improve your fuel or your energy-producing systems. Often this can be done by addressing lifestyle factors like nutrition, movement, and sleep.

Fuel burning

Metabolic Flexibility is need for your body to use energy effectively. Metabolic flexibility is the ability of your body (1) to efficiently use carbohydrate for energy, (2) to efficiently use fat sources for energy, and (3) to efficiently switch back and forth between fat and carbohydrate depending on what source is available in the moment.

People with inflexible metabolisms can reach a state where it is very difficult to get into a fat burning mode. Two of the best ways you can improve or maintain your metabolic flexibility are to move your body regularly with exercise and maintain a healthy body weight.

Nutrition and Energy

Of course nutrition is important for energy production. Here are a few helpful ways you might think about nutrition and energy:

  • Consider food quality. In the past calories and nutrients generally came in the same foods. With modern agriculture and factory production techniques and the availability of inexpensive starches, sweeteners, and fats this is no longer true. It is now possible to be "overfed but undernourished," a condition which affects much of our population. Choose foods that are rich in nutrients - vegetables, fruits, and whole-grains being great choices.
  • Think about inflammation and healing. Your body has remarkable ability to repair damage, and you want your body's repair system to be functioning well. Excess inflammation can impair healing and is associated with many adverse health outcomes such as heart disease and diabetes. Ways you can help:
    • Choose unsaturated fat over saturated fat (there is controversy about saturated fat currently but the scientific literature would clearly support that unsaturated fat has greater health benefit)
    • Increase your intake of omega-3 fatty acids 
    • Choose carbohydrates that come from vegetables, fruits, and whole grains
    • Avoid or limit added sugars, refined grains, and highly-processed foods
  • Look for small ways to improve your diet. Don't fall into the trap of trying to define the perfect diet, finding it is so far away from where you are that change seems impossible, and then making no changes. Pick an area or two you think you could "level up," and then focus on those. When you feel comfortable with those changes, pick another place to focus. For example,, here are thoughts about increasing vegetable intake, something many of us might benefit from:
    • Experiment with different vegetables and cooking/preparation methods to find some you like (roasting Brussels sprouts, broccoli, or green beans is fairly easy and I think quite satisfying in the winter months)
    • Try to eat 3 different colors of vegetables every week
    • Search the internet for tips on increasing vegetable intake and try 2 of these tips

This week

What is your energy like overall? Do you have enough to reach your goals? Was there anything on the list above that struck you as an area that you might work to improve? What steps will you take this week to make that happen?

I hope it's a good week for you.


Dr. Topher Fox


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