Effective Treatment Of Chronic Fatigue Syndrome And fibromyalgia Previous
A COMPREHENSIVE APPROACH
Chronic fatigue and fibromyalgia are two common names of an overlapping spectrum of disabling syndrome.
Research suggests that mitochondrial and hypovolemic dysfunction are the common denominators in these syndromes. Dysfunction of hormonal, sleep and autonomic control all centered in the hypothalamus and energy production centers can explain the large number of symptoms and why most patients have similar set of complaints. Other causes include hormonal dysfunction, infection, heavy metals, hypoxia ( low oxygen), autoimmune, immune dysfunction and brain dysfunction.
To make it easier to explain, we used the model of circuit breaker in the house.
If the energy demands in the body are more than it can meet, the body blows a fuse. The ensuing fatigue forces the person to use less energy, protecting her from harm. On the other hand, although a circuit breaker may protect the circuit in the home, it does little good for you if you do not know how to turn it back on, or that it even exists. Research of mitochondrial disease shows not only simple muscle changes, but also changes in the hypothalamic area of the brain. Restoring adequate energy production to a nutritional hormonal and sleep support and eliminating the stresses that over-utilize energy, such as infections and situational stress, needs to be done. We need to restore function of the hypothalamic circuit breaker and allow muscles to release, thus allowing pain to resolve.
A SIMPLE DIAGNOSTIC APPROACH:
I follow a simple diagnostic approach to combat the severe fatigue seen in these patients with depression, as well as fibromyalgia.
Many patients can only sleep solidly for 3-5 hours a night with multiple awakenings. Even more problematic is the loss of deep stage 3 or 4 restorative sleep. I use natural therapies and/or medications that increase deep restorative sleep so the patient gets 7 to 9 hours of solid sleep without waking up with a hangover. It is critical. The treatments are adjusted each night until the patient is sleeping 8 hours.
The natural sleep remedies that I recommend you begin with include herbal preparations such as valerian root, theanine, dogwood and many others. Melatonin, starting at 0.5 mg to 5 mg or higher at bedtime can be increased as needed. Remember to take it 1 to 2 hours before going to sleep. Additionally, the smell of lavender helps sleep, 2 to 3 sprays in the pillow at bedtime. There are other natural remedies, which I use at low doses if the natural remedies are not adequate. Of significance is 5-hydroxytryptophan, as well as low-dose lithium, which I take myself, along with melatonin, and a blood-based product that I call sleep and anxiety formula. It works for me.
EVALUATION AND TREATMENT OF HORMONAL DYSFUNCTION:
Hormonal dysfunctions are common in chronic fatigue fibromyalgia. Most blood tests use two standard deviations to define blood test norms. By definition, only the lowest or the highest 2.5% of the population is in the abnormal range. This is the treatment range. This does not work well if over 2.5% of the population has the problem. For example, it is estimated that as many as 20% of women over 60 have positive anti TPO antibodies and may be hyperthyroid. Total body auto antibodies is evaluated.
The goal is to restore optimal function while keeping the labs in normal range for safety.
Suboptimal thyroid function is a big problem. Symptoms include cold hands, cold feet, brittle nails, dry skin, constipation, thinning hair, high cholesterol, depression, edema, and loss of lateral aspect of the eyebrows. Many other symptoms are other seen and the patient also complains of coldness and intolerant to cold weather. Many patients have difficulty in converting T4, the inactive thyroid hormone, to T3 active thyroid hormones. In addition, T3 receptor resistance may be present requiring higher doses of T3.
Synthroid contains only an active T4 while desiccated thyroid or compounded T4/T3 combination has both inactive T4 and active T3. I used substance with a combination of T4 and T3, starting at allow dose and titrate up to the patient’s needs, always keeping the blood test in the normal range. Because of the hypothalamic suppression, TSH may be low despite adequate hormonal dosing. As T3 is largely produced and functions intracellularly, we do not have a normal range for exogenous given T3. Therefore, I predominantly use clinical signs and symptoms to adjust therapy while keeping free T4 levels in the normal range for safety.
As stated elsewhere in the website, this is a big problem in these patients. The hypothalamic pituitary adrenal access is not functioning well. As discussed elsewhere in this site, I use Cortef, up to 20 mg a day, which is hydrocortisone. It is approximately equivalent to the potency of 4 to 5 mg of prednisone. Symptoms of underactive adrenal include weakness, low blood pressure, dizziness, sugar cravings, irritability when hungry and recurrent infections. These patients are usually tired in the morning and may stay up until late at night. The needed natural therapies include adrenal glandulars which contain most of the building blocks needed for adrenal repair. Licorice root, vitamin C, B6, benzoic acid are also needed. Before and after therapy, either salivary or 24-hour urines are obtained. Research has shown, as discussed elsewhere in my website, that optimum adrenal function may be instituted before thyroid is instituted.
Most women need 5 to 10 mg of DHEA and most men need 25 to 50 mg. I use the middle of normal range for a 29 year old, keeping DHEA-S levels at 150 to 180 mcg/dL in women and 350 to 480 mcg/dL in men. Too high of a dose in women can cause elevated testosterone resulting in acne, darkening of facial hair and insulin resistance.
LOW ESTROGEN AND TESTOSTERONE:
I think it is essential to check hormone levels in all my patients. Hormones need to be balanced. We use bioidentical and never use synthetic. I prefer transdermal creams since they are not metabolized through the liver.
IMMUNE DYSFUNCTION AND INFECTIONS:
There are literally dozens of infections present in these patients including viral, parasitic, candida, and fungal. Most of these seem to resolve on their own as the immune system recovers. I also see lyme, ehrlichia,babesia, bartonella,, cmv, ebv, mycoplasma, hhv6 and others. which may need specific treatment.
Chronic sinusitis responds poorly to antibiotics so saline nasal rinses and avoiding refined carbohydrates are needed. At times, antifungals used topically in the nose are needed.
Chronic sinusitis is predominantly caused by sensitivity reaction to yeast with secondary bacterial infections due to swelling and obstruction. I have seen many patients with MRSA that need other treatment. When initially treating these sinusitis patients, I use a compounded nose spray containing a combination of Sporanox, xylitol, Bactroban, and occasionally low-dose basis and cortisone.
I use an acidophilus preparation of 250 billion and at times Diflucan or Sporanox. I use a vast array of intravenous nutritionals to raise the immunity and rebuild the cell wall. Of course, a multispectral vitamin with fish oil and vitamin D is also needed.
IV glutathione, and especially IV ozone has also been shown to improve these patients due to a methylation block and this is addressed in all patients.
I restore digestive ecology and restore the antioxidant protection and lower oxidative stress and free radical damage. The patient must be in an alkaline environment which is also extremely important.
These are prevalent in every patient. I use a high potency nutritional powdered vitamin that I take myself. I add to this, D-Ribose, taking several scoops a day.
If the ferritin is under 60, I supplement with iron. It should not be taken within 6 hours of thyroid, since iron blocks thyroid absorption. Continued treatment until the ferritin level is over 60. If B12 level is under 450, I recommend B12 injections with methyl carbamate which is the active B12. Other supplements include Co-enzyme Q10, acetylcarnitine, etc.
GENERAL PAIN RELIEF:
As noted elsewhere in my site, I have severe back pain, myself, and have formulated an integrated, nonnarcotic pain program. I use a combination of transdermal homeopathics, as well as transdermal prescription drugs when needed. I also use a lysine generator, as well as a pulse electromagnetic field generator which stimulates a field of 19,000. At times, local injections are also performed. Using these modalities, patients have the best chance of pain relief. I also use prolozone for pain.