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Summary
On episode 474 of 40+ Fitness, Coach Allan sits down with Dr. Sarah Myhill, who qualified in medicine with honors from Middlesex Hospital Medical School in 1981 and has spent her career identifying and treating the underlying causes of chronic illness, especially the diseases of civilization we tend to blame on getting older.
Dr. Myhill argues that fatigue is the most common symptom in Western medicine and the worst treated, and that age itself causes nothing. She lays out the thinking behind her book The Energy Equation, From the Naked Ape to the Knackered Ape, and explains why calorie counting fails for weight loss: cut calories too hard and the body reads it as famine, shuts down energy production, and leaves you foggy, depressed, and exhausted.
The conversation covers the low carbohydrate paleo ketogenic diet, the specific supplements that most often fix sluggish mitochondria, why persistent organic pollutants stored in body fat can make weight loss feel bad, and her tiered “Groundhog” system for matching the intervention to how sick or well a person currently is.
Links
- https://www.drmyhill.co.uk
- Episode 284 – Paleo ketogenic with Dr. Sarah Myhill
Key Takeaways
- Age doesn’t cause fatigue, it just gets blamed for it. Dr. Myhill says age is a clinical picture, not a mechanism. When someone feels tired all the time, the real drivers are treatable: diet, toxin load, sleep, and hormone balance, not the number of birthdays.
- Cutting calories backfires on both weight and energy. When you eat less, the body interprets it as a famine and slows metabolism to protect itself. That drop in energy burning is what produces fatigue, brain fog, depression, and anxiety, so calorie restriction alone rarely delivers lasting weight loss.
- Think of energy as a bucket with a limited daily supply. Roughly two-thirds of the energy the body generates goes just to staying alive, with the liver alone using about 27 percent because it has to detoxify whatever comes from the gut. A cleaner diet reduces that liver workload and frees up energy for actually living.
- The “car” needs four things working together for good energy. Dr. Myhill compares the body to a car that needs the right fuel (ketones, not sugar), a strong mitochondrial engine, a thyroid accelerator pedal, and an adrenal gearbox that can shift up for stress and back down to rest. The five supplements she sees fix sluggish mitochondria most often are coenzyme Q10, acetyl carnitine, vitamin B3, magnesium, and D-ribose.
- Resting pulse is a simple clue to mitochondrial fitness. Elite endurance athletes develop very low resting heart rates because their hearts are packed with mitochondria and beat powerfully. Chronic fatigue patients often show the opposite, a resting pulse in the 85 to 95 range, signaling fewer and weaker-functioning mitochondria.
- Both aerobic and anaerobic exercise build more engines. Lactic acid burn from harder efforts is what stimulates new mitochondria, while aerobic training makes the mitochondria you have work more efficiently. Dr. Myhill recommends a mix of both most days rather than picking one style permanently.
- Losing fat releases stored toxins and can make you feel worse before better. Persistent organic pollutants concentrate in fat at roughly a thousand times the level found in blood, so rapid fat loss can mobilize enough of them to cause real malaise. Weekly heating regimes such as a hot bath, sauna, or sweaty exercise followed by a shower help clear them, but must be paired with electrolyte replacement (not just sodium and potassium, but magnesium, copper, chromium, selenium, and boron) to avoid dangerous deficiencies.
- Treatment intensity should match how unwell you are. Dr. Myhill’s “Groundhog” framework has three tiers: Groundhog Basic (the paleo ketogenic diet, core supplements, sleep, and exercise everyone should maintain), Groundhog Acute (extra measures like vitamin C to bowel tolerance at the first sign of infection), and Groundhog Chronic (the basic regime done harder for anyone already dealing with serious disease).
- Dr. Myhill’s three strategies to get and stay well: get the diet right first by cutting refined junk food and carbohydrates, since sugar is a poor fuel for mitochondria and will eventually wreck the system the way the wrong fuel wrecks an engine; keep carbohydrate intake low as the foundation everything else builds on; and address food allergies, since an allergic immune response burns energy through inflammation on top of causing its own symptoms.
“Age doesn’t cause anything. Age is not a mechanism. Age is a clinical picture.”
Dr. Sarah Myhill
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