Who is Dr. Susan Swanston?
“Fueling Relief”: When General Medicine Explores the Low-Carb Pathway Against Fibromyalgia and Chronic Fatigue
by Laurent Glatz – for Athletic Carnivore
Dr. Susan Swanston is neither a health influencer nor a fundamental lab researcher. She is an Australian general practitioner, facing daily the reality of chronic patients. It is precisely this frontline position that gives weight to her talk titled:
“Fueling Relief: How Low-Carb Diets Can Support Fibromyalgia & Chronic Fatigue.”
Her argument does not arise from ideological debate. It stems from clinical frustration.
A General Practitioner Facing “Difficult Patients”
In her presentation, Dr. Swanston candidly describes the common feelings doctors experience when treating patients with fibromyalgia or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Diffuse pain, constant exhaustion, cognitive fog, hypersensitivity, non-restorative sleep, post-exertional malaise. Biological tests often reveal little. Available treatments provide partial, rarely lasting relief.
Fibromyalgia affects approximately 2 to 4% of the population. Chronic fatigue syndrome has a similar prevalence. The two conditions overlap significantly.
Many patients undergo antidepressants, analgesics, sometimes antiepileptics like pregabalin. Few speak of recovery.
It is in this context that Dr. Swanston sought a different approach.
Her Central Hypothesis: A Cellular Energy Problem
Her reasoning is based on a solid biological hypothesis: mitochondrial dysfunction.
Mitochondria produce ATP, the universal energy molecule. If their efficiency declines, energy production drops. The patient lives in a state of chronic energy deficit.
Several studies support this avenue:
- Altered oxidative metabolism in ME/CFS patients
- Increased oxidative stress
- Dysregulation of oxidative phosphorylation
- Slightly elevated inflammatory markers
She adopts the “energy bucket” metaphor popularized by Dr. Sarah Myhill: patients have a reduced and leaky energy reservoir. Both filling the bucket and patching the leaks are necessary.
Why Low-Carb?
Dr. Swanston observes that modern diets are dominated by:
- Refined sugars
- Processed carbohydrates
- Industrial vegetable oils rich in omega-6
This combination promotes:
- Glycemic instability
- Hyperinsulinemia
- Systemic inflammation
- Oxidative stress
These mechanisms precisely worsen mitochondrial dysfunction.
Low-carb and ketogenic diets enable:
- Glycemic stabilization
- Reduction of insulin spikes
- Production of ketone bodies
- Improved mitochondrial efficiency
- Decreased inflammation
Beta-hydroxybutyrate (BHB), the main ketone body, is not just an alternative fuel. It acts as an anti-inflammatory signaling molecule, notably inhibiting the NLRP3 inflammasome. It enhances cellular energy efficiency.
Biologically, the approach is coherent.
Available Scientific Data
Dr. Swanston acknowledges that specific trials on fibromyalgia and ketogenic diets remain limited.
However:
- Studies on chronic pain show improvement in about 80% of selected low-carb trials
- Research on obese women with chronic pain shows improvement parallel to weight loss
- Emerging data indicate improved inflammatory markers under ketosis
She does not claim a cure. She speaks of functional improvement.
Two Revealing Clinical Cases
In her presentation, she describes two patients.
A 41-year-old man, entrepreneur, unable to maintain professional activity due to severe fatigue and brain fog. After starting a ketogenic diet, he lost weight, improved cognitively, and gradually returned to work.
A 63-year-old woman with fibromyalgia, BMI 32, debilitating pain. After three months on a ketogenic diet and replacing intense cardio with gentle training and planned rest: she lost 9 kilos, hand pain disappeared, and sleep improved.
In both cases: clear improvement, but not total recovery.
An Integrative Approach
Dr. Swanston emphasizes that nutrition alone is not enough.
Her approach includes:
- Pacing effort to avoid post-exertional crashes
- Sleep improvement
- Reduction of environmental toxins
- Gentle resistance training
- Sometimes low-dose naltrexone (LDN) to modulate neuroglial inflammation
She also highlights that depression observed in these patients is often secondary to chronic exhaustion.
Her Positioning
Dr. Susan Swanston is not a fundamental researcher. She is a clinician. Her authority rests on repeated observation and physiological coherence.
She does not reject conventional medicine. She acknowledges its limits.
Her message is measured:
- This is not a panacea
- This is not a universal replacement for treatments
- This is not a promise of cure
But it is a coherent metabolic strategy, low-risk when properly supervised, that gives patients a lever of action.
Why Her Message Resonates
Because it puts biology back at the center.
Chronic fatigue and fibromyalgia are not just diagnoses of exclusion or poorly defined psychological disorders. They could be, at least in part, states of energy and inflammatory dysregulation.
And if we act on cellular energy, we can improve function.
The title of her talk sums up her vision:
“Fueling Relief” — nourishing relief.
Not masking pain.
But supporting metabolism.
In a field where many patients have lost hope, this approach offers something essential: a credible biological explanation and a concrete therapeutic direction.
To better understand your energy profile, you can [take the free questionnaire](/en/questionnaire-neuroprofil.html).
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