Chronic Fatigue Syndrome Treatment
When the first case of chronic fatigue syndrome was identified in the 1980s, and patience and a small Nevada, this strange disease marked principally by deep fatigue and muscle aches was dubbed “Yuppie Flu” because it seemed to be concentrated him on the young, affluent, and white professionals. Since that time, chronic fatigue and immune dysfunction syndrome has become epidemic, and crossed all ethnic and academic barriers. It is now recognized as a severe debilitating illness although the previously distal missive attitude persists in some doctors.
A recent study estimated that 100,000 persons in the US suffer from chronic fatigue syndrome, and that 90% of patients have not been diagnosed and are not receiving appropriate treatment.
The criteria for diagnosing chronic fatigue syndrome were also initially defined by the CDC in 1988 and revised in 2001. The criteria include persistent or relapsing fatigue of new onset or definite onset, and not a result of ongoing exertion, not alleviated by rest, which resulted in a substantial reduction in the previous levels of occupational, social, and personal activity. There may be also reported short term memory loss or loss of concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain, headache, poor sleep, and post exertional malaise.
Additional symptoms may include allergies, chemical sensitivities, digestive disturbances such as chronic constipation or diarrhea, night sweats, PMS, and vision problems.
POSSIBLE CAUSES OF CHRONIC FATIGUE:
Studies have shown that multiple nutrient deficiencies, food intolerance, or extreme physical and mental stress may convert to chronic fatigue. Studies have indicated that CFS may be activated by the immune system and various abnormalities of the hypothalamic pituitary axis or by the reactivation of certain infectious agents in the body. Some patients are found to have low levels of endorphins and other neurotransmitters. Adrenal abnormalities such as hypothyroidism and adrenal disease may also be noted.
VIRUS AND CFS:
Symptoms of CFS resemble a post viral state and for this reason chronic viral conditions and/or parasites or Lyme and co-infections have been thought to contribute. These viruses include herpes virus, especially the human herpes virus 6, cmv, mycoplasm, chymaldia , Epstein-Barr virus, or herpes virus which causes infectious mononucleosis, cytomegalovirus, and coxsackie virus B1 and B4 and others.
IMMUNE RESPONSE TO BACTERIAL AND VIRAL ANTIGENS:
There are two different types of T helper cells that defect and against different organisms. That T helper 1 cells called the TH1 fight intercellular pathogens and virus his. The T helper 2 cells fight organisms that are found outside the cells. They are involved with antibody-mated immunity. Chronic fatigue patients often have an activation of T helper 2 cells, which suppresses the T helper 1 activity, especially there is suppression of natural killer cells, otherwise known as NK cells. It is found that patients with chronic fatigue syndrome are often found to have decreased levels of NK killer cells and abnormal TH1 and TH2 ratios. I also measure t reg cells and th 17 cells.
INFECTION AND INFLAMMATION:
It is thought that chronic infections whether from virus, parasites or possibly Lyme and its co-infections incites an inflammatory cascade with chronic inflammation, which is detrimental to the body.
ROLE OF ENDOCRINE SYSTEM
REDUCED CORTISOL LEVELS:
Cortisol levels were found to be low in chronic fatigue patients in multiple studies; although it is interesting to note that cortisol levels are sometimes elevated in depressed patients.
I perform salivary testing and a 24-hour urine testing to look at free cortisol levels. Alternatives of that are blood drawn in the morning and again in the afternoon.
Adrenal fatigue has been proposed to be a cause of CFS, which is a mild form of adrenal insufficiency. Improvement in some patients has occurred after supplementation with low-dose hydrocortisone or mineral corticoids.
THYROID AND CHRONIC FATIGUE:
A major, and often overlooked cause of CFS is underactive thyroid gland. This gland is the largest of the body’s seven endocrine glands and its role in all aspects of healthy body function is paramount; yet is probably the most overlooked factor in many health problems like chronic fatigue.
When the thyroid is underactive, every cell and organ in the body generally become hypoactive as well. The signs and symptoms of low thyroid include cold hand, cold feet, brittle nails, dry skin, constipation, depression, increased body weight, loss of the lateral aspect of the eyebrows, thinning hair, as well as low body temperatures. I perform a battery of thyroid testing using blood and urine.
METAL SENSITIVITY AND HEAVY METAL TOXICITY:
Heavy metals including mercury, nickle, cadmium, and others have been shown to lower killer cell activity and interfere with glutathione, which is necessary in the body. Some studies have shown a significant number of patients have metal-specific lymphocytes in their blood with resultant fatigue. Followup of dental amalgam removal showed improvement in most patients.
OXIDATIVE STRESS OR FREE RADICALS:
Studies have shown that free radicals play a role in the development of chronic fatigue syndrome. Free radicals are produced as a bi-product of normal metabolic function. When there are not enough free radical scavengers present such as glutathione and various other antioxidants, the body does not function normally. Mitochondrial assessment is preformed.
TREATING THE INDIVIDUAL:
As a syndrome, CFS patients present as an array of symptoms that may appear unrelated. There is an imbalance in the body produced by multiple simultaneous infections and/or accompanying endocrine abnormalities, free radicals, low immunity and other factors.
It develops as a result of the combination of nutritional deficiencies, acquired toxicities from the environment, food, dental amalgams, dental infections or drugs, poor stress coping abilities, acquired systemic infections which are often due to the excessive use of antibiotics resulting in Candidiasis and parasite overgrowth with a resultant vicious cycle of lowered immune function, allergy, more infection, and further-depleted energy reserve.
The successful in treating of these patients utilizes a treatment plan tailored to the individual’s needs. A whole-patient approach to chronic fatigue is necessary.
TESTING FOR CHRONIC FATIGUE:
Testing for chronic fatigue involves a paradigm of looking at looking at a combination of conventional laboratory tests as well as novel testing.
These include adrenal, thyroid and other endocrine hormone levels.
Immune system tests including low killer cells and T4/T8 cell ratios are obtained as well as cytokine panels. The patient is evaluated for markers of inflammation using a cardiac CRP and assessments of oxidative stress. AUTOIMMUNE IS ALSO ADDRESSED.
Toxin analysis including heavy metals, pesticides and organic chemicals is sometimes obtained.
Parasites, viral infections, Lyme and other co-infections seen with Lyme are addressed.
Glutathione deficiency is also ruled out by appropriate testing.
TREATING CHRONIC FATIGUE SYNDROME:
Each patient is addressed with a sustained and multi-pronged approach to healing. At times, traditional medicines are used, although I believe that things like diet, nutrition and exercise are crucial.
Diet is crucial to reinforcing the immune system in conquering CFS. Poor digestion and intestinal dysfunction should be addressed. The patient must take multivitamins as well as mineral supplements after appropriate testing is done. Immune enhancers are also used. Interestingly of is note that magnesium deficiency is usually seen with CFS patients. A review of studies involving a total of 3000 patients found that 75 to 91% of those treated with potassium and magnesium experienced pronounced relief of fatigue, usually after four or five days. The essential fatty acids, NADH, Q10, ribose, Pqq, and carnitine are also used. After appropriate testing, adrenal support is instituted. Transfer factor with various cholesterin preparations may also be used. Of course, if there is an infection present after appropriate testing, it is treated. There is also evidence that there are neurotransmitter imbalances, and these are addressed appropriately. Of course, side effects from prescription drugs are always a cause for concern.