Fatigue: Fatigue can be a problem but for brain... - Headway


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Fatigue can be a problem but for brain injury survivors it can be worse.

I was in a shop today, Home Bargains, and I saw a pack of maca powder.

If you know me, you know I go for natural foods for medication rather than that pharmaceutical rubbish.

Maca is apparently a great substitute for coffee. I have not tried it but will one day.

I say “I have not tried it” but I mean I haven’t had it on it’s own. I’ve had it in a combo with cacao powder before and that is nice too.

Anyway, according to the back of the pack of maca, it has thiamin (thiamine), vitamin B1 which can help with drowsiness/fatigue.

This got me thinking, does this mean brain injury survivors are actually deficient in vitamin B1?

It would’t surprise me.

As I have said before, I have turned my diet around to a more nutritional diet now and my fatigue has heightened, I think.

21 Replies

I take B12 with my Keppra for Epilepsy that I've had since young, and I feel so tired all the time lol ..mind you the dog pushed me out of bed at 2 am So went in another bed but fatigue is awful..Good luck xx

I’m apparently mildly deficient in Vit D when the GP ran some bloods a few years back, only thing that did show up.

As ever with Brain Injury it’s difficult (generally) to see the damage.

Looking at my tests at the assessment, can see various functions have dropped somewhat so my brain is working hard a lot of the time so not really surprising I’m and others are tired well all the time!

No, it’s not surprising.

At a cognitive course I went through with my Headway that our current manager lead, she put it like this.

The group were sitting at tables in a U shape and person A would pass on a message to the person at one end of the U, which would get passed on from person to person until the message reaches the other end and given to person B.

(There were a few single letters there so sorry for any confusion but I hope you can understand the analogy :D)

So in other words the message from person A takes longer to get to person B and that can be an example of how fatigue can work.

I know what she means.

Where my balance has gone to pot, I have to work double time to stay upright when walking. I get very hot and passers by probably think “His face is like a volcano”.

At the end of the day, I can look and feel washed out.

I was in a health food shop yesterday, I was there to buy some natural yeast flakes.

These are vegan and they naturally contain B12, which I have read is used for all cells in the body and most people are likely deficient in B12.

Also these natural yeast flakes are high in energy too and boy have I and my mum seen a difference it has made.

Anyway, she was speaking to a couple of people who work there about my fatigue and when I am tired you can see it in my face, apparently.

My face drops as if it is heavy and anything you say to me doesn’t really compute and so on.

Walking with poor or even just impaired balance is surprisingly tiring,

I’m ridiculous fit but I find walking distances tiring both cognitive and some hip pain.

hi I had a massive stroke 3 months ago and i am suffering fitigue i am also am my final year studying psychology so the truth is they dont know why brain injury causes fatigue but it probally has to do with the brain injury and the brain having to work harder to try and repair its self, sorry its not a scientific or clear answer but it is the best science has got so far

Matt2584 in reply to Cjk81


I do believe in some science but I don’t believe in all science.

But when it comes to fatigue and brain injury, it is most probably the injury itself that causes the fatigue.

As I said in another comment, I have balance issues and I have to concentrate even more on my balance than others.

At the end of a day I could be exhausted because of spending most of the day keeping my balance.

But balance alone does not explain fatigue I mean, somedays I could tireder than others, same with other BI folk.

But as i have also pointed out in another comment was that Vitamin B12 and high energy levels in natural yeast flakes.

Frankincense essential oil has also helped me out with fatigue.

sulbutiamine - evidence for fatigue improvement

One study has been conducted on chronic postinfectious fatigue (CPIF) with sulbutiamine at either 400 or 600mg daily for 28 days noted that both groups had significantly less fatigue than placebo, but that for the most part there was no significant difference between groups with the 600mg group inconsistently performing better at times.[9] A similar study using a large (uncontrolled, unblinded) sample of persons seeing their doctors about infection who reported at least one symptom of fatigue given 400mg Sulbutiamine at breakfast daily for 15 days alongside their anti-infective treatment noted complete resolution of self-reported asthenic symptoms in 51.7% of the study population.[10]

Improvement has also been noted regarding fatigue in 91.37% of persons tested (n=60) with Multiple Sclerosis, with 74.13% of the sample reporting the improvement as 'substantial' (analysis was done via subjective improvement) with no reported exacerbation in fatigue state.[11]

benfotiamine - evidence on blood flow

One study using 2x50mg Benfotiamine (alongside methylcobalamin at 2x500mcg and pyridoxine at 2x50mg) noted that over 12 weeks in persons with Rheumatoid Arthritis was associated with an improvement in endothelial dependent blood flow, but not endothelial independent; suggesting an ability to increase nitric oxide bioavailability.

Maca - evidence on libido

An increase in libido appears to occur following Maca ingestion, which is notable as it appears to influence all demographics and is not associated with systemic hormones

Maca - evidence on memory and cognition

A comparative study in ovariectomized female rats using 1g/kg Maca (Red, Yellow, and Black) all three forms appeared to improve cognition as assessed by a water finding task with Black outperforming the other variants.[9] A similar task was employed with Black Maca in a test to see neuroprotective effects against scopalamine, and it was found that the Maca treated groups trended (nonsignificant) to outperform control.

Is showing trends to improve cognition in otherwise normal rats, but is not overly significant and mechanisms unknown.

Vitamin B1 - evidence on formulations and variants

Benfotiamine and Sulbutiamine are two stand-alone supplements related to the thiamine molecule, with the former being a fat-soluble derivative and the latter two thiamine molecules bound together. While sulbutamine has drastically different properties, benfotiamine is claimed to be a pro-drug for thiamine (converting into thiamine after ingestion) with at least one study suggesting a 2.7-fold greater bioavailability when compared to thiamine HCl[7] and another claiming that only 40% of the oral dose is needed if aiming for the same circulating levels of thiamine after supplementation.

Thiamine (vitamin B1) is ubiquitous and essential for cell energy supply in all organisms as a vital metabolic cofactor, known for over a century. Transport mechanisms are required to mediate the movement of this polar metabolite from source to sink tissue to activate key enzymes in cellular energy generating pathways but are currently unknown. Similar to thiamine, polyamines are an essential set of charged molecules required for diverse aspects of growth and development, the homeostasis of which necessitates long-distance transport processes that have remained elusive.

Analogous to thiamine, polyamines are charged molecules at physiological pH essential for the growth and survival of all organisms. The diverse range of activities include regulation of cell division, developmental processes such as those of root formation and flowering initiation, as well as environmental stress responses (Alcázar et al., 2010; Kumar et al., 1997; Kusano et al., 2008). Key representative molecules include putrescine (Put), spermidine (Spd), and spermine (Spm), all three of which are derived from the amino acid Arg via the intermediate agmatine (Agm), as well as cadaverine (Cad) that is derived from Lys (Supplemental Fig. S1B).

Agmatine - evidence for pain and depression

Pain - In the trial on lumbar disc-associated radiculopathy, the degree of pain alleviation was fairly notable relative to placebo and persisted for two months after supplementation was ceased.

Depression - Strong evidence - One very preliminary study exists, but remission was achieved in all three subjects with 2-3g agmatine. Oral ingestion of 2-3g agmatine over 6-8 weeks in three subjects who were diagnosed with either major depressive disorder or unipolar depression, who were not on any pharmaceuticals nor did they have treatment resistant depression, was able to induce remission of depressive symptoms in all subjects. Trial length: 16 months.

Other fatigue bashers with notable evidence

Rhodiola Rosea - The decrease in fatigue appears to be quite strong and somewhat reliable when a low dose is given over a prolonged period of time or a high dose is given acutely - 8 studies.

Creatine - 400 mg/kg/day in children and adolescents subject to traumatic brain injury reduces fatigue frequency from around 90% down to near 10%. Fatigue is also reduced, though to a lesser degree, in cases of sleep deprivation - 7 studies.

Modafinil - Fatigue is notably reduced with modafinil supplementation, particularly during instances of sleep deprivation or hypersomnia - 6 studies. Re: Strong anti -Sedation effect. Modafinil (300mg) taken prior to sleep is as potent as 20mg D-amphetamine in reducing the need to sleep and improving cognitive performance during intentional sleep deprivation. Modafinil appears to be able to reduce symptoms of ADHD in children when taken as a daily preventative at the lowest active dose. While it is illegal to sell modafinil in the UK without a prescription, it is not illegal to buy.

Sources above: Examine.com searches for "vitamin B1"," fatigue"

Had maca in my smoothie this morning with cacao. I love how it makes me feel, a definite positive energetic outcome after. Best wishes Matt, hope you are keeping well. If your fatigue has heightened, I suggest you are doing some serious healing. Go with the flow, but ensure the flow is clear internally to detox whatever the body is trying to excrete. Regular short exercise of 15 mins morning and evening to not stress body, but drive lymphatics will help. Whether that be weights, cardio in your bedroom or living room, or a nip around the block. Stay focused, you will move through it and come out the other side. I know your diet is supportive with low sugar so I am confident you will overcome this glitch!


I'm sure even many very qualified people would admit that fatigue is still something of a mystery, not helped, I would suggest by the use of the word appropriately and otherwise to cover a wide range of reality, different to each different person.

I have had fatigue issues for two years. I have also had a VP shunt for hydrocephalus since birth. The two issues may be unconnected, they may be connected, but the truth is that it is something to which the world probably doesn't have an answer to and all who claim to have the 'answer' should be treated with healthy suspicion, at best.

Post operative fatigue on top of what I generally feel and that experienced when well are different to me, both in cause and effect. If I seek a solution, as opposed to just making the best of the way it is, it will be through medication and care via medically and psychologically trained professionals.

If we believe something will benefit us, the chances are that it will, regardless of any scientific proof...that's the brain for you. Sadly, this fact is seized upon by some who will advocate certain things with little more than hearsay or poor 'research' to back up the claims.

Personally, if something works for an individual, I don't care what has made it work as long as it has. If your mindset is that a 'solution' will come from medication, it probably will and if you think it will come from elsewhere, regardless of any respected evidence existing or not, there's probably where you'll find the answer.

Matt2584 in reply to Froggiefrog

When you say “If we believe something will benefit us, chances are that it will, regardless of any scientific proof... that’s the brain for you.”... what do you mean by that?

I mean I could read somewhere on the internet that lemon juice can help get rid of a chesty cough and that wouldn’t mean that I would 100% believe in it because it is silly to go believing “rumours” BUT I would probably try it out for myself.

Why would I try it out?

Well, it is only lemon juice, what harm could it do?

If I found that it actually was affective at getting rid of the cough then I would believe in the article I read... And then I would be thinking “So why do chemists sell many different treatments for a chesty cough (which are usually over a pound and some may have side effects too) when you can use one fruit/food that is more effective and you can buy 4 or 5 in a pouch for a pound!”

It sounds to me like the pharmaceutical industry are a big business.

And I am just using lemon as one example here.

There are many other fruits and veg out there that are better and cheaper than chemists.

So some fruit benefitted me (regardless of scientific proof, just some random website) and apparently that is the brain for me... is it?

What I meant when I made the statement is that psychologically, something you think will benefit you is more likely to do so than an equally potentially beneficial thing you don't believe in.

There aren't many situations where fruit will be unhelpful, but my last concern when I need medication is how big and wealthy the company is that made it and the Marxist theory of lemons could not be further from my mind.

I'm confident when I go to see a medical professional, that their advice is based on sound science and knowledge. Other sources I'd be utterly unsure of. This is a choice that has served me well, although others may see things differently and it's their right to do so.

Hi Frog, Having read your post, I edited my post and cited the source for the comment I made above in relation to vitamin B1 and fatigue to reply to Matt.

I would like to raise awareness of fruit which can impact negatively. For me, fruit was a sugar source. Such was the sensitivity I had after a BI. I had got rid of using white sugar, then removed the brown sugar, then removed all the dried fruit (highly concentrated sugar), that left fresh fruit. And once I cut fresh fruit out of my diet, then my body started to work properly (no fatigue or overstimulation). I started reintroducing one fruit at a time, to identify the problem fruits.

Today, I only eat those select fruits that didn't seem to provide negative impact on the body. As a proportion of my overall diet, I eat about one third of the fruit that I ate before the BI.

Not for everyone, but for me, it was key to turning things around, along with dietary monotony to baseline body response so body could focus on just brain healing with "no stimulation diet" daily regularity ( 2-3months). For me, the sugar (glucose metabolism) impacted via the vagus nerve stimulation, the pancreatic, adrenaline, blood pressure and homeostasis response in the body.

If attention is given to understand this, I think brain injury healing could be simplified in certain (many?) cases. As doctors only discovered brain lymphatic system within the last 10 years, I would stick my neck out and theorise that if the body (several systems at once) is being over stimulated, brain lymphatic system doesn't work as well.

Missing link found between brain, immune system

by University of Virginia June 01, 2015. Link below:


As I've said in another post, the body is like an orchestra with many instruments playing and harmonising (or not in the case of bad BI symptoms). Diet is the conductor at the front.

I am glad you found a medical professional that provided you with the necessary advice to ease your suffering. That is not always the case for BI aftercare.

I agree the placebo effect has some weight in research.

Best wishes.

As with anything, if it works for you that makes it right for you.

Take Care

Matt2584 in reply to Froggiefrog

When I was little, I used to think that taking certain medication,(being cough medicine or whatever) would benefit me/treat the infection/virus because that is what I was TOLD by so called “professionals” and mainstream media.

And lemons, well we were TOLD that these are just foods to fill our bellies.

So as we were TOLD that, we believe that.

But now we have the internet and the internet holds a wealth of information.

You could easily find information where certain fruits/veg have more nutrition and can treat viruses more affectively and cheaply than modern med.

So are you saying that we could all believe that modern meds work one minute, then read certain info about fruits/veg and reprogram our brains toward them the next?

I think what we were TOLD back then about modern meds being right of way and fruit/veg being food only was all just a cover up for the pharmaceutical industry to make loads and loads of unneeded money.

“The love for money is the root of all evil”

“Let food be thy medicine and medicine be thy food”

2 brilliant quotes I stand by.

“Something you think will benefit you is more likely to do so than an equally potentially beneficial thing you don’t believe in.”

Now, the way I see that, “equally potentially beneficial thing”.

Natural lemons are not equal to modern medication that is flavoured with lemon.

Most modern meds have sugar in them for a start which isn’t exactly going to help the healing process.

Maybe this is why modern meds take longer to “treat” a person.

So in other words, you are not really bothered that the pharmaceutical industry make millions and millions, they use our poor health as a business.

If there was no pharmaceutical industry then there would likely be no poverty or less poverty.

I know you would also say that there would also be a lot of dead people too if there was no pharmaceutical industry.

Have you ever heard of the phrase,

“Money talks, bullsh!t walks”

Another great quote and very true as well.

Because of money many things have been covered up.

I used to be confident in listening to my GP.

I remember one year I was diagnosed with pharyngitis and my GP prescribed me with antibiotics.

So I did as any numb-nuts would do and obey the GPs request... very silly of me.

Well the antib’s did help... after about 2 weeks but I was then diagnosed with thrush on my tongue.

See that is the beauty of antibiotics. They fight off the bad bacteria in the body while also fighting off the good bacteria in the body, something doctors don’t tell you about but should really.

So because I had less good bacteria I picked up another virus... thanks doc :|.

I’m not trying to change your mind here but I am spreading knowledge.

Continue to use modern meds if you think it serves you well but I would rather get rid of a virus/infection within a few days rather than a few weeks or even prevent said virus/infection.

Modern, or as I prefer to call it, proper medication has put me to sleep and woken me up twice in the last month, kept me alive when asleep, given me pain relief and treated the infection to my brain hardware that caused me to be hospitalised.

Yes, modern medication has served me extremely well. Who makes it? Couldn't care less, but it is prescribed and administered, in my case by trained professionals, whose qualifications are worldwide accepted and not bought off the internet or found in the bottom of a cereal packet. I'll stick to solutions I have confidence in, just as anyone else can and avoid those I think that are, at best no different to my choice and not as well policed.

I think I'm thick skinned enough to survive been referred to , by inference, as a numb nuts, but then having realistic expectations and no trendy axe to grind means I get first rate care from the GP, doctors and nurses, so my nuts are fine, without a hint of numbness. Can't stop, it's time for my antibiotics...they work, by the way, as everyone apart from those with an agenda will hopefully be glad to hear.

Matt2584 in reply to Froggiefrog

It can be a chore to get through to the indoctrinated.

Froggiefrog in reply to Matt2584

A chore indeed. How very self aware of you. They say that recognising your problem is the path to solving it. At least that does you more credit than taking a pop at someone for whom the real world stuff has worked simply because it does not fit with your conspiracy theory. Luckily, those of us who are more level headed still wish everyone well, regardless of their lack of empathy, their bitterness and their confrontational responses . Maybe it's the antibiotics that make those of is who trust medicine so forgiving?

Some say make 'allowances' for those affected by brain injury. I answer that, to a degree, that is reasonable. When I add, however, that it can be frustrating when others dismiss conventional wisdom in an off hand way, to date explaining what I mean has been difficult. At least now it is no more complicated than cut and paste.

I repeat, I wish you no ill will, but this is no place for dismissing proven medical practice...not everyone is as thick skinned as I and you could hurt vulnerable people who don't deserve it with your manner.

Matt2584 in reply to Froggiefrog

MY conspiracy theory... ha... I think you will find that there are thousands, if not millions, of other people who would agree with what I have said.

Carry on sleeping if you wish.

Froggiefrog in reply to Matt2584

Once again, confrontational...Why? I don't need to make claims about how many people place their trust in science over quack remedies, I'm not threatened in the same way as other people seem to be...and in such a nasty way too. Maybe it's time to take a look at yourself, as opposed to belittle others and their positive experiences with proper medicine and leave the Marxist theory alone for a while.

Matt2584 in reply to Froggiefrog

Leave the “Marxist” theory alone for a while.

I can’t do that otherwise I’ll most probably end up in hospital again.

It was because I believed in what the mainstream media/government/pharmaceutical industry say that, most likely gave me 2 brain tumours and many operations.

Around that time is when I had a terrible junk food diet and now that I have come far away from that rubbish diet I am feeling so much better in myself and out and have not had any hospital visits for almost 10 years now.

So “leave the Marxist theory alone for a while”, I think not.

You can carry on living/believing what you do if you want to.

Just end this now cos I’m getting annoyed.

Froggiefrog in reply to Matt2584

Thank you for 'allowing' me to continue to believe the factual over the fatuous. Feel free to end your unpleasantness, lack of good will to those benefitting from real medicine and victim mentality...Feel free.

A chore indeed. How very self aware of you. They say that recognising your problem is the path to solving it. At least that does you more credit than taking a pop at someone for whom the real world stuff has worked simply because it does not fit with your conspiracy theory. Luckily, those of us who are more level headed still wish everyone well, regardless of their lack of empathy, their bitterness and their confrontational responses . Maybe it's the antibiotics that make those of is who trust medicine so forgiving?

Some say make 'allowances' for those affected by brain injury. I answer that, to a degree, that is reasonable. When I add, however, that it can be frustrating when others dismiss conventional wisdom in an off hand way, to date explaining what I mean has been difficult. At least now it is no more complicated than cut and paste.

I repeat, I wish you no ill will, but this is no place for dismissing proven medical practice...not everyone is as thick skinned as I and you could hurt vulnerable people who don't deserve it with your manner.

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