PATIENT ENQUIRY

Chronic Fatigue (Syndrome)


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What Is?
What is Chronic Fatigue (Syndrome)
How to Treat Chronic Fatigue
Natural Treatments for Chronic Fatigue

What is chronic fatigue?

Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) refers to a condition that is set apart by abnormal fatigue, widespread inflammation, and multisystemic neuropathology. When a person works hard, participates in strenuous activity, or is under constant stress at work or home fatigue usually follows, but resolves after a period of rest or a relaxing holiday. However, CFS not resolve after rest or a relaxing holiday.

Exhaustion is extreme to the point that some people with CFS are get out of bed. Many CFS sufferers visit a number of specialist doctors such as a physician, neurologist, endocrinologist, or psychiatrists, only to be told that tests are normal and the fatigue and other symptoms are psychosomatic or ‘all in the mind’. At that point, a person will often seek alternative treatment with a naturopath or homeopath, for a solution.

CFS is an ill-defined, multisystem disorder of unknown cause. Up to 2.5% of the population are affected by chronic fatigue, depending on the intensity of the diagnostic criteria used. CFS predominantly affects young adults, with a peak age of onset between 20 and 40 years of age. Women are affected more than men, typically in a ratio of 2–3:1, but this may be because women are more likely than men to see a doctor about health problems. CFS appears to be more common among socially disadvantaged groups than those from socially advantaged groups, contrary to the earlier name of ‘yuppie flu’. CFS has shed the dismissive tag of ‘yuppie flu’ and is no longer thought to be only a psychiatric condition.

Extreme fatigue after physical or mental activity is the main feature of CFS, which can happen straight away or the next day and last several days. A serious ‘crash’ or relapse can last weeks, months, or even years and also involves worsening of other CFS symptoms, which can include muscle and joint pain, sore throat, sore and swollen lymph nodes, headaches, cognitive difficulties, muscle weakness, sensitivity to noise, smells, and light, orthostatic intolerance, digestive disturbances, and depression.

The physiological response to activity includes abnormal exhaustion after any form of exertion, compared with people without CFS. The response depends on the amount and type of exertion. Even small tasks such as a short walk, showering and getting ready for work, or housework can be followed by unusual tiredness that lasts longer than expected.

During the past two decades, public acceptance and awareness of CFS has improved. Living with a chronic disease that impacts much of your life is difficult enough, but living with a chronic disease that people are skeptical about makes coping with CFS even harder.

The clinical presentation of chronic fatigue syndrome

The clinical presentation of chronic fatigue syndrome

Pronounced and disabling, chronic or relapsing fatigue is the classic presenting feature of CFS. The fatigue substantially impacts upon previous levels of occupational, educational, social, and personal activities.

Fatigue is associated with many illnesses, such as infections or psychological disorders, and so clinical evaluation must include ruling out other illnesses as a cause of persistent or excessive fatigue.

In Australia, a medical diagnosis of CFS is given when a person is clinically evaluated and found to have unexplained, persistent, or relapsing fatigue persistent for six months or more, that is:

  • Fatigue of new or definite onset
  • Fatigue not the result of ongoing exertion
  • Fatigue not substantially alleviated by rest, and
  • Fatigue responsible for substantial reduction in previous levels of occupational, educational, social, or personal activities.

Other symptoms for CFS include four or more of the following symptoms that are concurrent and persistent for six months or more, which did not predate the fatigue:

  • Impaired short term memory or concentration
  • Sore throat
  • Tender lymph nodes in the neck or either armpit
  • Muscle pain
  • Multi-joint pain without arthritis
  • Headaches of a new type, pattern, or severity
  • Unrefreshing sleep, and
  • Post-exertion (physical or mental) malaise lasting more than 24 hours.

Symptoms that usually accompany CFS include:

  • Impaired neurocognitive function, manifest as impaired concentration and short-term memory, impaired mental processing and reduced executive functioning, mood swings and emotional lability, anxiety, and agitation
  • Autonomic dysfunction – sleep disturbance, insomnia, impaired visual processing, tinnitus, dizziness, vasomotor instability, paresthesia
  • Reduced metabolic function – decreased exertional capacity, post exertional malaise, and exercise-induced muscle soreness and weakness
  • Heightened immune activation – persistent or recurrent sore throat, lymphodynia, night sweats, headache, arthralgia,
  • and

  • Depression is not unusual (was usual) and feelings of frustration, impatience, and agitation predominate.

Possible complications of chronic fatigue syndrome include:

  • Depression secondary to employment, lifestyle, and social restrictions
  • Inability to perform basic daily routines, attend social functions, and participate in sport, and
  • Increased work absences and inability to hold down a job.
Chronic fatigue syndrome is an organic dysfunctional syndrome

Chronic fatigue syndrome is an organic dysfunctional syndrome

CFS is an organic dysfunctional syndrome that involves disturbance of the neurohumoral control mechanisms and, despite its ill-defined nature and the lack of a unifying pathogenic mechanism, is not a psychological or psychiatric illness.

Patients with CFS are an inhomogenous group with much overlap of symptoms of other disorders, in particular fibromyalgia and multiple chemical sensitivity. All display substantial fatigue problems, differing only in the degree of symptom predominance. Myalgia and painful myofascial trigger points predominate in fibromyalgia, while neurocognitive disability and chemical sensitivity reactions predominate in multiple chemical sensitivity.

However, there are differences between these illnesses. Fibromyalgia patients usually have elevated levels of substance P in the spinal fluid, with impaired serotonin metabolism and reduced pain thresholds, but CFS patients usually do not. Fibromyalgia patients experience fatigue secondary to pain-related chronic sleep disruption, whilst in CFS patients, fatigue is due to primary neuronal dysfunction. In the clinical setting careful, individual patient assessment is necessary for a correct diagnosis and treatment, in order to achieve optimal patients outcomes.

What causes chronic fatigue syndrome?

What causes chronic fatigue syndrome?

A person with CFS can often identify a severe infectious episode, of viral, bacterial, or parasitic nature prior to the onset of chronic fatigue. However, despite extensive research, the exact cause remains unclear, because several medical problems can cause CFS, including infection, hormonal imbalance, and immune system problems. A 2011 study from Norway found much support for the theory that CFS is a disorder of the immune system preceded in the majority of patients by an infection of some type.

Some suspect viruses thought to trigger CFS include Epstein-Barr, human herpesvirus 6, and mouse leukaemia viruses. In Australia, entero virus, retrovirus, Barmah Forest Virus, Ross River virus and other non-viral infections (Q fever, rikettsia, Lyme disease, mycoplasma) have been shown to trigger CFS.

Rather than recover fully after a few weeks of rest and treatment, CFS sufferers continue to experience multiple clinical problems for an extended period, even several years or decades.
The immune system of a person with CFS is slightly impaired, but whether the immune impairment actually causes the disorder or is a consequence remains unclear.
People with CFS often exhibit abnormal hormone function of the hypothalamic-pituitary-adrenal axis, a major regulatory component of the neuroendocrine system, which determines how a person reacts to stress and important bodily functions such as reproduction, immune system, digestion, energy storage and expenditure, moods, and emotions

Immunological abnormalities associated with chronic fatigue syndrome

Immunological abnormalities associated with chronic fatigue syndrome

A variety of immunological abnormalities have been associated with CFS, including:

  • Abnormalities of T-cell function, particularly altered CD4/CD8 ratio and depressed ‘killer-cell’ activity, elevated cytokine levels, and impaired cell mediated immune system function
  • Elevated Rnase-L levels, particularly involving production of a low molecular weight (LMW) 37 kDa particle, compared to the more usual 80kDa molecule produced by viral infection, and this LMW particle apparently interferes with ribosomal
  • metabolism, mito-chondrial energy production, and the programmed death of damaged cells

  • Increased LMW Rnase-L also correlates with higher levels of Interferon-gamma, which has antiviral properties and a high LMW/HMW Rnase-L ratio correlates with higher IL-2 levels in CFS patients compared with controls, and
  • Increased immunoglobulin levels, particularly IgG immunoglobulin.
Neurophysiological abnormalities associated with chronic fatigue syndrome

Neurophysiological abnormalities associated with chronic fatigue syndrome

Neurophysiological abnormalities occur more frequently in CFS patients than in other control groups, and often includes:

  • Autonomic nervous system dysfunction with resultant dysregulation of circulatory control and vascular tone
  • Neuroendocrine disorder, particularly reduced activity of the Hypothalamic-pituitary-adrenal pathway, but also involving depressed anabolic hormone production
  • Impaired central nervous system function as demonstrated by reduced cerebral perfusion on SPECT and PET scanning, particularly evident during cognitive task performance, and
  • Patchy neuronal damage as demonstrated by diffuse abnormalities on MRI scans.

Metabolic disturbance associated with chronic fatigue syndrome

Metabolic disturbance has been well documented in CFS patients, including:

  • Impaired mitochondrial integrity and function, with more rapid exercise-induced lactic acid production and reduced aerobic capacity
  • Decreased post-exertional muscle glycogen recovery
  • Increased urinary citric acid and other markers of metabolic disruption and muscle catabolism, such as increased 3’methylhistidine and tyrosine excretion
  • Increased xenobiotic chemical levels have been identified in CFS patients compared to healthy controls and correlated to fatigue and pain scores, and
  • Altered bowel flora (bacteria) has been identified in CFS patients compared to healthy controls.

Chronic fatigue syndrome is a serious medical condition that can cause long-term illness and disability. However, with an accurate diagnosis, appropriate medical treatment, and lifestyle management to reduce exertion many people improve over time.

How is chronic fatigue syndrome diagnosed?

How is chronic fatigue syndrome diagnosed?

Because of the complex nature of chronic fatigue syndrome (CFS), no single test exists to confirm a diagnosis of CFS. The fatigue and other symptoms of CFS mimic many other medical problems and so these need to be ruled out first.
Other medical problems that cause fatigue include:

  • Sleep disorders – a sleep study can determine the quality of sleep and whether sleep is being disturbed by obstructive sleep apnoea, restless leg syndrome, or insomnia.
  • Other medical problems that have significant fatigue as a symptom include anemia, diabetes mellitus, underactive thyroid (hypothyroidism) and autoimmune disease, which can be diagnoses through appropriate blood tests.
  • Mental health problems – significant fatigue accompanies several mental health problems including depression, anxiety, bipolar disorder, and schizophrenia. A psychiatrist can establish if any one of these is the cause of fatigue.
    The prime diagnostic criteria for chronic fatigue syndrome is unexplained fatigue that persists for six months or longer
  • and accompanied by at least four of the following eight signs and symptoms:

    • Impaired short term memory or concentration
    • Sore throat ~ persistent or recurrent
    • Tender lymph nodes in the neck or armpit region
    • Muscle pain without injury
    • Multi-joint pain without arthritis
    • Headaches of a new type, pattern, or severity
    • Unrefreshed sleep, and
    • Post-exertion (physical or mental) malaise lasting more than 24 hours.
How is chronic fatigue syndrome diagnosed?

How is chronic fatigue syndrome diagnosed?

Factors that may increase a person’s risk for CFS include:

  • Age – CFS can occur at any age, but it most commonly affects people between 20 and 40 years of
  • Gender – women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor, and
  • Lifestyle – people who are overweight and inactive are more likely to develop chronic fatigue syndrome, and stress also appears to be a factor.

Various types of infections have been studied to determine if they might cause or trigger CFS:

  • Epstein-Barr virus infection, also known as glandular fever
  • Human herpesvirus 6 infection, a virus that can cause problems for people with impaired immune systems, such as AIDS patients or organ transplant recipients taking immune-suppressant drugs
  • Enterovirus infection, a type of virus that enters through the gastrointestinal track and can have no symptoms,
  • mild flu-like symptoms, or rarely severe and even deadly symptoms

  • Rubella, a viral infection also known as German measles
  • Candida albicans, a fungus that causes yeast infections
  • Bornaviruses, which cause borna disease, an infectious neurological syndrome
  • Mycoplasma pneumonia , a cause of atypical pneumonia
  • Ross River virus, which causes Ross River Fever, a mosquito-borne tropical disease
  • Coxiella burnetti, the agent that causes Q fever, and
  • Human retrovirus infection, such as HIV (the virus that causes AIDS) or xenotropic murine leukemia virus-related virus (XMRV)
  • What are some related conditions?

    What are some related conditions?

    Fibromyalgia is a chronic pain syndrome charaterised by long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. After osteoarthritis, fibromyalgia is the second most common musculoskeletal ailment. Women are 10 times more likely to get this disease than men and onset age ranges between 25 to 60 years of age.

    Fibromyalgia has been linked with CFA and shares many of the same symptoms, such as fatigue, sleep problems, headaches, depression, and anxiety. However, Fibromyalgia patients usually exhibit abnormal pain responses to mild stimulation, and extensive tender points in specific locations. This feature usually differentiates FM from CFS.

    Multiple chemical sensitivity (MCS) syndrome has a high association with CFS. A person with MCS reacts to low-level chemical exposure. Symptoms are numerous and differ widely among MCS patients. The cause is thought to be due to allergic reaction, toxic effects, or neurobiologial sensitisation.

    Common chemicals that cause irritation are cigarette smoke, paint fumes, gasoline fumes, and the fragrances included in cleaning products, perfumes, candles, and hygiene products. Not everyone with MCS is sensitive to the same thing. Sensitivity could be from smelling or ingesting the chemical, or physical contact. The true cause remains unknown but the connection with CFS is well known and many cases start after high-level exposure to a toxic chemical.

    Many CFS patients have hypoglycemia and the symptoms overlap. Hypoglycaemia means low blood glucose (sugar) levels, but the real problem is unstable fluctuations in blood glucose levels characterised by high insulin production and insulin resistance.

    A glucose tolerance test can determine whether a person has hypoglycemia syndrome, which means the body has problems converting carbohydrates into adenosine triphosphate (ATP). The body and brain require an adequate supply of biological energy supplied by the conversion of carbohydrates to ATP in order to function normally. CFS sufferers lack the necessary biological energy needed to power cells, which is needed for basic daily activities.

    When blood glucose drops from high to low levels, the body’s natural response is to release stress hormones, such as adrenaline, which converts energy stored in the liver back into glucose. This can lead to adrenal insufficiency and a weak immune system.

    How can chronic fatigue be prevented?

    How can chronic fatigue be prevented?

    Because a number of different viruses and bacterial infections have been identified as triggers for CFS, preventing the disease remains somewhat difficult. Keeping healthy by eating nutritious foods and taking regular exercise helps build a healthy immune system. Taking time out for adequate rest when a virus or bacterial infection hits makes sense and will increase a person’s chance of full recovery sooner.

    Researchers have found that CFS is associated with problems involving:

    • The body’s ability to produce and transport energy
    • The immune, neurological, and hormonal systems
    • Viral or other infections
    • Blood pressure, the circulatory, and cardiac systems
    • Adequate digestion of food, and
    • Biochemical abnormalities.

    Conventional medical treatments doctors use to treat chronic fatigue

    People who receive an early diagnosis and early treatment enjoy better health outcomes. Support from family and friends, people at school and work, and health workers who understand the potential seriousness of CFS, can make a significant difference to recovery. Find a good doctor you trust – a doctor who is sympathetic to CFS and knows how to treat the problem.

    The treatment goal should be enhancement towards and preservation of an individual’s best functional capacity. The lifestyle restrictions associated with CFS can lead to isolation, frustration, and in turn secondary depression. Low doses of an antidepressant drug can treat depression, improve sleep quality, and relieve pain.

    No one treatment has been shown to cure CFS and so symptoms are treated as needed. The most effective treatment for CFA can be an energy-management strategy called pacing – knowing when enough is enough and not overdoing mental or physical exertion.

    A doctor will usually treat the most disruptive symptoms first, which usually includes:

    • Fatigue and sleep problems
    • Pain
    • Memory and concentration problems
    • Depression and anxiety, or
    • Dizziness and light-headedness.

    The most commonly used medications and supplements are:

    • Antibiotics for infections
    • Sleeping tablets to enable quality sleep
    • Antidepressants to manage depression
    • Analgesics or nonsteroidal anti-inflammatory drugs to reduce pain
    • Antifungal drugs to treat candida albicans
    • Antihistamines for seasonal allergies
    • Antiviral drugs
    • Calcium channel blockers
    • Beta blockers for low blood pressure
    • Sedatives
    • Antioxidants to reduce oxidative stress, and
    • Anticonvulsants to treat neuropathic pain, anxiety, or insomnia.

    Antidepressant drugs are the most widely used treatment for CFS/ME. Most CFS patients have low amounts of seratonin and dopamine, two neurochemicals that affect sleep, cognitive function, and digestion. The antidepressants commonly prescribed include selective seritonin reuptake inhibitors (SSRIs), seritonin norephinephrine reuptake inhibitors (SNRIs), and tyicyclic antidepressants, which increase norepinephrine levels in the brain. All have been shown to improve sleep quality, energy levels, and cognitive function. Also, SSRIs and SNRIs provide anti-inflammatory and immunomodulatory effects, which can reduce symptoms.

    Many people with CFS report an increased susceptibility to drug side effects, so any new medications should start with a small dose to assess tolerance. Start just one new treatment at a time to assess effectiveness. CFS symptoms reoccur so keep medications and supplement in case they are needed later on, just check the expiry date before reuse.

    Speaking with a psychological counsellor might help a person to cope better with lifestyle limitations. An objective perspective from someone who cares can provide solutions to challenges and make a person feel more capable and in control, which in turn will improve a person’s outlook on life.

    If depression is a problem, a general practitioner or psychiatrist might suggest a drug that inhibits serotonin reuptake called an SSRI (Specific serotonin Reuptake Inhibitor). Serotonin is a neurotransmitter that aims to maintain emotional stability and extend the ability to cope with symptoms.

    Cognitive behavioural therapy aims to change the way a person thinks about problems and how he or she responds to frustrating circumstances, in order to reduce emotional stress. Accepting the diagnosis of CFS, challenging negative thoughts that might inhibit improvement, and focusing on the positive aspects of life are all part of cognitive behavioural therapy, which is used to help people cope with a number of chronic medical problems.

    Eating a balanced diet leads to better health in general and will assist a person with any chronic medical condition.

    https://www.mja.com.au/journal/2002/176/9/chronic-fatigue-syndrome

    Self-help measures for a person with chronic fatigue syndrome

    Self-help measures for a person with chronic fatigue syndrome

    The following recommendations can help control chronic fatigue syndrome:

    • Avoid stressful situations
    • Avoid alcohol, caffeine, sugar, and sweeteners
    • Avoid any food and drink that you are allergic or sensitive to
    • Eat small, regular meals to help reduce any nausea
    • Spend quality time relaxing but try not to nap excessively as this will disrupt sleep patterns
    • Maintain a consistent time for going to bed and rising, and
    • Keep in touch with family and friends, and
    • Accept offers of help from those who understand.

    Pacing, or keeping within your activity limits, will ensure that you don’t overdo social activity or physical exercise, which could lead to a ‘crash’ or relapse of symptoms. Carefully plan a list of activities for the day first thing, to ensure periods of activity and rest are balanced, energy is preserve, and over exertion is avoided. Establish a level of mental and physical activity safely below the ‘tipping point’ that might cause fatigue. Even when feeling more energetic than normal, ignore that and take regular rest periods.
    Getting a good night of restful sleep is essential for everyone, in particular those with CFA. Regular sleep patterns are essential. Every hour of sleep before midnight is worth two hours after. Avoiding foods and drinks that contain caffeine will help. Use prescription sleep medication as a last resort for short periods, to deal with sleep deprivation or intensely stressful periods.

    Regular gentle exercise, such as a brisk morning walk outdoors, will improve general well being and overcome any frustrations of being stuck at home. If unsure, speak with your doctor, physiotherapist or private trainer about graded exercise training, which means starting light and building the intensity as fitness improves through a structured program customised to suit an individual’s symptoms and capacity.

    Inactive people can begin with range-of-motion and stretching exercises for just five minutes a day, even lying on the floor, and build the time and activity, depending on fatigue levels. Strength and endurance will improve as you gradually increase the length and intensity of exercise.

    Alternative medicine for the treatment of chronic fatigue

    Alternative medicine for the treatment of chronic fatigue


    Pain associated with chronic fatigue syndrome can be eased using alternative medical treatments that relax the musculoskeletal system, including:

    • Osteopathic treatment
    • Acupuncture
    • Therapeutic massage, and
    • Yoga, Qui gong, or tai chi.

    Current medical treatment for CFS can’t cure the problem, but patients benefit greatly when treatments reduce the physical and emotional effects of symptoms, and extend physical and emotional capacity and resilience.

    Nutritional medicine treatment for chronic fatigue syndrome

    For the nutrition medicine practitioner treating chronic fatigue syndrome (CFS), there are several points of special note. Symptoms of bowel disturbance are extremely common and appear to be related to bowel dysbiosis and maldigestion. A person with CFS is likely to have atopic diathesis, which means a tendency to get hayfever, allergic rhinitis, bronchial asthma, or atopic dermatitis. Multiple food or chemical sensitivity reactions are common and exacerbate CFS symptoms and bowel disturbance.

    Marked sensitivity to alcohol, volatile hydrocarbons (propellants in aerosol sprays), and petrochemical fumes is likely. These substances will trigger neurocognitive and autonomic symptoms. Usually sensitivities emerge following the onset of CFS and reflect accompanying immune system disturbance.

    Due to the nature of CFS, nutritional treatment has to be individualised because every patient has a different set of nutritional deficiencies, infections, or inflammations. Nutritional therapy requires careful assessment and management, with regular review by a nutritional therapy specialist.
    If hyperinsulinemia and insulin resistance are present, a low Glycaemic Index (GI) diet will prevent episodes of hypoglycemia.
    Vitamin and mineral supplement will usually include vitamin B12 (preferably injections), folic acid, zinc, calcium, chromium, magnesium, iron, and copper.
    Hormones and other supplements for improved energy will usually include DHEA, melatonin, Coenzyme Q10, Evening Primrose Oil, omega-3 fatty acid or Max EPA.
    A person with CFS who includes more vegetables, legumes, whole grains, protein (from lean meat), and essential fatty acids found in nuts, seeds, and cold water fish will enjoy improved energy levels and immune system function. Nutritional medicine specialists also recommend avoiding refined and processed foods that contain added sugar and saturated fats, and avoiding stimulants such as caffeine and alcohol.
    The following supplements may help reduce symptoms of CFS. Ask your doctor before taking a supplement and work with a knowledgeable nutritional medicine specialist.

    • Magnesium combined with malic acid may reduce fatigue and boost energy levels
    • Essential fatty acids, such as those found in fish oil and evening primrose oil may also help reduce fatigue. If you also take blood-thinners or aspirin check with your doctor before taking these supplements.
    • NADH – a naturally occurring chemical involved in energy production in the body shown to reduce symptoms of CFS.
    • DHEA – a hormone produced by the body that improves energy levels. The body uses DHEA to make the hormones testosterone and estrogen. Check with your nutritional specialist if you are at risk for breast cancer, prostate cancer, or any other hormonally influenced illness before taking DHEA. DHEA should not be taken while pregnant or breast feeding and DHEA can interfere with medications used to treat high cholesterol, liver disease, depression, anxiety and bipolar disorder.
    • Vitamin B12 injections have been shown to improve energy in people who are not getting enough B12 or who have a functional B12 deficiency.
    • Beta-carotene (a precursor to Vitamin A) will strengthen immune function.
    • L-carnitine will support energy production at a cellular level. A person who takes thyroid hormone or blood-thinners should check with a nutritional specialist before taking l-carnitine.
    • Vitamin D levels are lower in people with CFS, who are at risk of osteoporosis due to reduced physical activity. Too much time indoors leads to reduced vitamin D synthesis, which also worsens CFS symptoms.

    University of Maryland Medical Center

    http://umm.edu/health/medical/altmed/condition/chronic-fatigue-syndrome
    The goals of nutritional medicine treatment of chronic fatigue are to treat underlying pathogens and improve energy levels.

    Food intolerances and chronic fatigue syndrome

    Food intolerances and chronic fatigue syndrome

    CFS is linked to the immune system dysfunction, and this could explain why some sufferers believe certain foods worsen their symptoms.

    The best way to identify whether a person is intolerant to a specific food or not, is to follow a food elimination or exclusion diet. The former involves removing suspected foods from the diet to see if symptoms improve, and the latter involves reverting to a very basic diet for a period of time before gradually reintroducing additional foods one at a time, to identify problem foods.

    Elimination and exclusion diets could involve removing essential nutrients from the diet and so adequate supervision by a nutritional medicine specialist is recommended.

    Another good place to start when indentifying food sensitivities is to keep a food diary of what you eat and when you experience the worsening of symptoms. This could help you to spot any patterns.

    Long-term treatment of chronic fatigue syndrome

    Long-term treatment of chronic fatigue syndrome

    Antioxidants are known to lower oxidative stress. Runaway oxidative stress leads to ATP depletion, which is an important part of the energy cycle in cells. The inhibition of mitochondrial activity due to oxidative stress can affect any organ or body tissue, but because the heart acts as a muscular pump that works non-stop the implications for the heart are profound.

    Antioxidant status is affected in patients with CFS/ME and vitamin E is an important antioxidant, which is low in CFS/ME patients. Bile from the liver and stored in the gallbladder contains taurine, which is powerful anti-inflammatory and antioxidant. Omega-3 fatty acids from fish oil and flaxseed oil counter the harmful effects of peroxidation. Other supplements that inhibit free radical damage are alpha lipoic acid, and vitamins E, C and B12.

    Antioxidants used to combat free radical damage and treat CFS include:

    • Vitamins – A, C, and E
    • Vitamin co-factors – co-enzyme Q10
    • Minerals – manganese, selenium, zinc
    • Hormones – melatonin
    • Flavonoids – quercetin, pycnogenol, grape seed extract, ecklonia cava
    • Phenols – silymarin
    • Plant sources – capsaicin, bilberry
    • Others – N-actyl cysteine, alpha lipoic acid, essential fatty acids, glutathione, taurine

    Amino acids – Carnitine, Glutamine
    It’s likely that marginal deficiencies not only contribute to clinical manifestations of CFIDS, but also are detrimental to the healing processes,” explains physician Melvin R. Werbach.

    Functional B12 deficiency and chronic fatigue syndrome

    Functional B12 deficiency and chronic fatigue syndrome

    Contemporary studies report that excessive Nitrous Oxide (was NO) production within neurones inhibits the vitamin B12-dependent metabolic pathway whereby homocysteine is converted back to methionine, causing a functional B12 insufficiency that leads to impaired neuronal function and increased risk of degenerative disease and cerebral arteriosclerosis. Supplemental B12, B6, and folic acid are reported to reduce homocysteine levels and retard development of degenerative neurological and cerebrovascular disease.

    Nutritional medicine treatment for chronic fatigue - summary

    Nutritional medicine treatment for chronic fatigue – summary

    With the sympathetic support from appropriate health professionals, a person with chronic fatigue syndrome can work towards maintaining and restoring good health.

    Some of the necessary changes to lifestyle are difficult when physical, mental, and emotional stamina is low.

    Treatment needs to be general but also targeted to an individual’s problem, which might be a combination of many symptoms such as fatigue, bowel problems, breathing problems, fibromyalgia, arthritis, or food and chemical sensitivity.
    Treatment Summary:

    • Eat a Stone Age diet
    • Take nutritional supplements, including a daily dose of the outdoors and sunshine
    • Maintain good sleep habits – adequate sleep is vital for repair
    • Strike a healthy balance between work, rest, and play
    • Take regular exercise, within capacity
    • Reduce any chemical load – clean up of your environment and avoid artificial food chemicals
    • Adopt regular systemic detoxification regimes through regular exercise or taking saunas, and
    • Take good care of the good bacteria on the skin, gut, and genital area.

    Tailored nutritional therapy is achieved through individual consultation and assessment, in order to establish a detailed history. A nutritional therapist then formulates a customised diet and supplement program.

    Stone Age diet for the treatment of chronic fatigue syndrome

    Stone Age diet for the treatment of chronic fatigue syndrome

    • Meat – choose from chicken, beef, lamb, pork, turkey, duck, venison, pheasant, goose, bacon and ham, salami, liver, kidney and offal are fine too.
    • Eggs – an excellent source of lecithin
    • Fish – fresh or smoked salmon, mackerel, cod, haddock, shrimps, prawns, mussels, or tinned fish in brine or olive oil
    • Any green vegetables
    • All salads – avocado, lettuce, tomato, cucumber, celery, peppers, onion, cress, bamboo shoots, mushrooms
    • French dressing – from olive oil, lemon juice, coconut, garlic, mustard
    • Cold pressed nut and seed oils liberally, such as sunflower, coconut, olive, sesame, grape seed, hemp, linseed
    • Spices and herbs – chilli, cumin, ginger, coriander, pepper, cloves, vanilla pods (sugar-free), sea salt

    Glossary

    Adenosine triphosphate (ATP) – transports chemical energy with cells for metabolism
    Anabolic hormone – promotes muscle growth and the growth of other complex living tissue in the body and blocks catabolic hormones, which erode muscle tissue.
    Antibiotics – kill microbes or inhibit their growth
    Arthralgia – joint pain usually a symptom of inflammation, injury, infection, allergic reaction
    Atopic diathesis – hereditary or constitutional predisposition to develop one or more of hay fever, allergic rhinitis, bronchial asthma, or atopic dermatitis
    Autonomic dysfunction – malfunction of the autonomic nervous system, which controls blood pressure, heart rate, sweating, food digestion
    Bowel dysbiosis – microbal imbalance of the digestive tract associated with CFS
    Chronic fatigue syndrome (CFS) – a complicated disorder characterised by extreme fatigue that can’t be explained by any underlying medical condition
    Dysregulation – a poorly modulated response
    Coxiella burnetti – the agent that causes Q fever
    Diabetes insipidus – when the body can’t regulate how it handles fluids due to abnormal production, storage, release, or response to vasopressin
    Emotional lability – rapid and ofen exaggerated changes in mood
    Enterovirus infection – a type of virus that enters through the gastrointestinal tract
    Epstein-Barr virus infection – medical name for glandular fever
    Exertional capacity – ability to handle physical exertion
    Fibromyalgia – chronic condition characterised by widespread pain
    Human herpesvirus 6 infection – a virus that can cause problems for people with impaired immune systems
    Human retrovirus infection – such as HIV, the virus that causes AIDS
    Hypoactivity – an inhibition of behavioral or locomotor activity
    Hypoglycemia – low blood glucose levels
    Hypothalamic-pituitary-adrenal axis – the hypothalamus releases CRF in response to stress, which binds to receptors in pituitary gland, which produces ACTH, which is transported to adrenal gland to stimulate cortisol, which alleviates the harmful effects of stress through negative feedback to the hypothalamus and anterior pituitary gland.
    Maldigestion – an inability to digest food in the gut
    Mycoplasma pneumona – a cause of atypical pneumonia
    Mitochondria – produce energy at a cellular level in every cell of the body except the red blood cells
    Neuroendocrine disorder – failure of the hypothalamic-pituitary-adrenal axis to produce the correct amount of either ACTH, cortisol, or CRF due to tumour, inflammation, or deficiency
    Neurohumoral activation – increased activity of the sympathetic nervous system, which contributes to the transition from ventricular dysfunction to clinical heart failure
    Neurophysiological – pertaining to the function of the nervous system
    Organic – a living entity
    Orthostotic hypotension – unable to maintain normal blood pressure when erect
    Paresthesia – burning, prickling, or ‘pins and needles’ sensation of any part of the body, but is usually felt in the distal limbs, hands or feet
    Post-exertional malaise – fatigue and other flu-like symptoms after physical exertion
    Ross River virus – which causes Ross River Fever, a mosquito-borne tropical disease
    Tinnitus – relentless ringing sound in the ears
    3-methylhistidine excretion – used as an index of myofibrillar protein catabolism in neuromuscular disease, which is increased in CFS patients
    Tyrosine excretion – an amino acid which increased in CFS patients
    Vasomotor instability – inability to regulate body temperature and an indicator of underlying disease or syndrome, such as CFS
    Volatile hydrocarbons – organic compounds that have a high vapour pressure used as propellants in aerosol sprays instead of CFCs, which were banned because they destroyed Earth’s ozone layer.