Handouts Simpler Approaches to Tricky Problems: Dr John Briffa

Fatigue: 1. Low blood sugar. Refined carbohydrates raise blood glucose too quickly and cause a surge of insulin which causes a ‘rebound’ hypoglycaemia; this low blood sugar causes lethargy and fatigue and also mood changes and food cravings. Therefore avoid carbohydrates from table 1 and substitute those on table 2 wherever possible. Also eat small and often, eat healthy snacks such as fruit and nuts and base your diet more on those foods that release sugar slowly such as fish, meat, eggs, nuts, green vegetables, legumes, nuts and seeds.

Fatigue: 2. Wheat allergy. Avoid wheat and substitute oats, rye or rice.

Fatigue:3. Caffeine. Caffeine wakes you up, but some fatigue is caused by caffeine withdrawal. Most people who stop caffeine get more energy by 2 weeks.

Fatigue: 4 Drink more water – enough to keep urine a pale yellow colour. Make sure you always have water immediately available.

Fatigue: 5. Iron deficiency – especially in women and vegans. Don’t rely solely on Hb. Ferritin below 50 suggests iron shortage. Iron rich foods are eggs, meat (esp liver) and dark chocolate. Floradix 10 mls bd is the recommended iron supplement.

Fatigue: 6 Hypothyroidism. Beware low normal values; if they have the symptoms, they may well benefit from thyroid. Note morning exacerbation of symptoms and morning axillary temperature < 36.5.

Headaches and Migraine: Dehydration (the number one cause!), caffeine withdrawal, wheat allergy, low blood sugar, aspartame, magnesium deficiency (especially if they get cramps)

Restless Legs: Sometimes magnesium deficiency – especially if they have muscle cramps or twitches, cardiac arrhythmias or any spasms elsewhere – migraine, oesophageal spasm, detrusor instability. Good dietary sources are nuts and seeds, but a supplement of 300- 400 mgm of Magnesium per day is often worth a try.

Insomnia: caffeine is a common culprit. Also hypoglycaemia – evening meal is best if mainly protein and bananas and nuts are a very good late snack.

Dry Eyes (and dry skin). Often can be helped with a supplement of alpha linolenic acid in the form of flax-seed oil 1 or 2 tablespoons per day.

Dyspepsia: usually not related to high levels of stomach acid! Simple rules to aid digestion: chew food thoroughly, avoid large or late meals, don’t drink too much with food (dilutes enzymes), avoid combining starch and protein, consider additional digestive enzymes.

Some common carbohydrate foods; the higher the glycaemic index, the more likely they are to cause symptoms

Table 1

Glucose 100

French baguette 95

Baked potato 85

Cornflakes 83

Rice Crispies 82

Pretzels 81

Rice cakes 77

Doughnut 76

French fries 75

Corn chips 74

Potato – mashed 73

Bagel – white 72

Sultana Bran 71

Bread – wheat, white 71

Shredded Wheat 69Bread

– wheat, wholemeal 69

Croissant 67

Gnocchi 67

Pineapple 66

Cantaloupe melon 65


Table 2

Pear 37

Chickpeas 33

Butterbeans 31

Apricots – dried 31

Soy milk 30

Kidney beans 29

Lentils 29

Grapefruit 25

Cherries 22

Dr John Briffa:    Drjbriffa@aol.com    www.drbriffa.com