Submitted by: Katie Donnelly, Adv Dip HSc Naturopathy
Client: Male, 28 years old
Initial presentation: Male experiencing symptoms of brain fog and lethargy. He has noticed waning energy levels over the past two months and is feeling consistently tired. At work, he is struggling to focus and recall simple information and has found he is making mistakes more regularly. He is lacking drive.
Recent bouts of anxiety have been experienced with no known cause and are unrelated to specific events. He finds work stressful and is unhappy in his role. He has a happy home life with his long-term partner and one child, aged 8.
The client has had some digestive disturbances recently, including increased belching, bloating, and flatulence. Regular bowel movements are experienced and are well-formed. Dietary changes include increased sugar to counteract feelings of tiredness, and coffee intake increased from two coffees to three throughout the day.
Sleep has been consistent and undisturbed. He does go to bed late, between 11.30 pm to 2 am, and wakes around 8 am by alarm. This is due to the change to working from home, with later waking an option now. He has noticed worsened symptoms in relation to later bedtimes.
He has been taking a magnesium supplement for muscle spasms and has followed a strict vegan diet for the past 18 months.
Herbal formula (200mL):
Reishi (Ganoderma lucidum) 1:2 60 mL
Withania (Withania somnifera) 1:2 60 mL
Ginkgo (Ginkgo biloba) 3:2 60 mL
American ginseng (Panax quinquefolium) 1:2 20 mL
Ginger (Zingiber officinale) 1:2 10 mL
Total 210 mL
Daily Dosage: 7.5mL in the morning and 7.5mL in the afternoon.
Additional recommendations:
Change is difficult for the client, so initial recommendations have been kept to a minimum to ensure it is achievable. Primary focus is to improve sleep patterns and introduce the daily herbal formula.
Sleep hygiene:
- Set a regular bedtime of 10 pm. This allows downtime in the evening after work but still enables sufficient sleep. Doing this daily will help to nurture new sleep patterns.
- Avoid blue screen light within an hour of bedtime. Choose a physical book to read, or try and have some meditation time or listen to gentle music.
- When the weather is cooler, have a warm bath in the evening with Epsom salts to aid with sleep.
- Exercise in the afternoon to get the body moving and encourage sleep in the evening.
- Reduce intake of sugars and caffeine after midday and avoid completely within 2 hours of bedtime.
Dietary suggestions:
- Reduce coffee intake from 3 daily down to 2. This will help with anxiety and circadian rhythms, and prevent mineral loss. Slow change is important.
- Try to incorporate fruits as a snack, including berries, pineapple, oranges, and apples to provide some sugars balanced with fibre and nutrients and reduce the need to grab for sugary options as often.
- Consider blood testing for iron and B12 levels. May require supplementation.
Follow up:
After 2 weeks: The client has been taking the herbal formula fairly regularly but has missed the occasional day. He has said that it might be helping, with improved clarity with work and focus, but he still feels tired. Has reduced coffee and sugar and says he is feeling a bit better and bloating has reduced.
Sleep suggestions have not been followed as the client had a deadline that was highly stressful. Advised that we will revisit sleep goals and introduce a formula for the evening, to aid in routine.
Night herbal formula:
Passionflower (Passiflora incarnata) 1:2 40 mL
Hops (Humulus lupulus) 1:2 40 mL
Valerian (Valeriana offincalis) 1:2 40 mL
Green Oats (Avena sativa) 1:2 40 mL
Lemon balm (Melissa officinalis) 1:2 40 mL
Total 200 mL
Daily Dosage: 7.5mL in the evening, 2 hours before bed. 7.5mL again just before sleep.
Stress-management suggestions:
- Take regular breaks during the work day. Get outside, move around, stretch, and try to get some direct sunlight.
- Poor sleep will worsen the stress response, so focus on sleep is really important.
- Breathing exercises can help to regulate the stress response.
- Try to cut back on coffee from 2 cups to 1.
- Continue with daytime herbal formula also for stress and cognitive support.
Follow up:
After 4 weeks: The client has been taking the night formula and has made notable progress with sleep patterns. He is feeling more positive and changes are noticeable in his eyes – reduced bags and redness- and more colour in his face.
He had a big deadline to get through last week and says he feels ‘free’ from that burden now. Work/life balance has been discussed and the importance of taking time for himself each day. Eating regular, nutrient-dense foods and getting sufficient sleep is crucial to managing this.
He has had good success with both herbal formulas, helping him to get into a routine. Does not enjoy the flavour but has been diluting it with water. He feels as though he can take on further changes now and feels more optimistic about his ability to maintain the routine.
Additional Dietary Support:
- Aim to have a diet of whole foods. Convenience vegan options are full of additives, just like any highly processed foods are.
- Taking a day to meal prep will allow thoughtful choices and quality meals on hand.
- Include quality protein sources to maintain energy levels. This may include lentils, nuts, tempeh, quinoa, buckwheat, brown rice. When paired with a hearty sauce and plenty of vegetables - like leafy greens and quality starches like kumara, pumpkin, potato, beetroot and sweetcorn - this will make a substantial meal that will help with maintaining energy levels and focus.
- Include bitters in the diet – rocket, asparagus, vinegarettes, etc – to help stimulate bile flow for digestion.