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.