About a year ago I became ill for about 2 weeks, felt like a flu just worse - whole body aches, cold to the bone, sore throat and inflamed glands etc. Even after blood tests from the hospital they couldn’t tell me what it was and even though I tested negative for it, they said it was probably glandular fever as a lot of people test negative and still have It.
Now, for as long as I can remember after that I’m constantly tired. I do a very physical job and climb some evenings but even when I take time off, I feel just as fatigued.
Any ideas? Is it worth getting looked at privately?
I would guess that you contracted Epstein-Barr virus or CMV. (human herpes virus 4 and 5 respectively) HHV4 is usually the pathogen that causes mononucleosis. (It could also have been Covid though?)
The cause of post viral fatigue syndrome is that viruses deplete the molecule NAD+, which is one of the essential molecules in all life and for all lifeforms (including viruses) together with amino acids and ATP. Cells infected with a pathogen upregulate enzymes that help in fighting the infection that require NAD. (PARP) Viruses can also use up the NAD+ in cells to propagate themselves. Since NAD+ is essential to so many cellular processes,
including ATP/energy synthesis, it`s depletion can leave you feeling dead tired until it`s eventually restored. It`s the same thing that happens with ageing basically, but in young people it will come back in time.
The way to get out of this fast is to oxidize fat, since there is a 4:1 ratio in terms of ATP synthesis between glycolysis-TCA and fat oxidation/ketone metabolism and TCA. The biochemistry is a bit complex, but this is basic biology and not controversial at all. So fat oxidation will save NAD, which is one of the main reasons that ketogenic diets and fasting regimes etc. work. I`m not certain what is the best strategy here, but a nutrient dense Paleo/keto diet, exogenous ketones, NMN or NR supplementation and long term fasting would all have some of the same effects. Maybe the first alternative is the best one. Of course plenty of sleep and sunlight etc. is also important.
Illustrated below; The 4:1 ratio of energy synthesis with glucose, (4 NAD+ are "used up") and ketone body BHB (only 1 NAD+ to NADH conversion necessary.
