<B<Introduction
The disorder we call chronic fatigue syndrome (CFS) does not appear to be new. The current interest in attempting to define and treat it stems from several studies in the mid-1980s that found elevated levels of antibody to Epstein-Barr virus in people with CFS-like symptoms, most of who had had a history of infectious mononucleosis a few years earlier. When it later became apparent that healthy people could also have elevated Epstein-Barr virus antibody titers while some CFS sufferers had normal titers, the U.S. Centers for Disease Control and Prevention developed a research case definition that defined the syndrome by its most common presenting characteristics. In 1994, the International CFS Study Group published a revised and more inclusive case definition which defines chronic fatigue syndrome.
Despite considerable worldwide efforts, no single etiology has been found to explain the syndrome. It is likely that multiple factors promote its development, sometimes with the same factors both causing and being caused by the syndrome. Many of these factors constitute specific pathophysiological entities that characterize certain subsets of chronic fatigue patients. Numerous factors appear to promote the development of the syndrome.
This review of the nutritional literature focuses on those nutrients for which the evidence most strongly supports relevance to treatment. The scientific literature is fairly sparse, and promising nutritional treatments usually lack adequate scientific proof. For these reasons, when examining studies of CFS patients, this review will also focus on studies of patients presenting with individual aspects of the syndrome, such as fatigue or an impaired immune response to viral infections.
General Considerations
A disturbed immune system plays a central role in chronic fatigue syndrome (CFS).
Fibromyalgia and multiple chemical sensitivity disorder have symptoms similar to those of CFS.
Chronic fatigue can be caused by a variety of physical and psychological factors other than the chronic fatigue syndrome.
A person’s energy level and emotional state are determined by interplay between two primary factors: internal focus and physiology.
One of the most common findings in individuals with impaired immune function is gastrointestinal overgrowth of Candida albicans.
As far back as 1930, chronic fatigue was recognized as a key feature of food allergies.
The mind and attitude play a critical role in determining the status of the immune system and energy levels. SEE TM BELOW
A deficiency of virtually any nutrient can produce the symptoms of fatigue and render the body more susceptible to infection.
Breathing with the diaphragm, good posture, and bodywork (massage, spinal manipulation, etc.) are all important in helping to relieve the stress that is a common contributor to fatigue.
Siberian ginseng has been shown to exert a number of beneficial effects that may be useful in the treatment of CFS.
Successful treatment of CFS requires a comprehensive approach.
Pre-Disposing Factors:
a. Viral infection (Mono., Hepatitis, Epstein-Barr, CMV, etc.).
b. Candida or other fungal infections.
c. Parasites.
d. Carbohydrate sensitivity.
e. Magnesium deficiency.
f. Heavy metal body burden.
g. Digestive dysfunction resulting in inflammation or colon bacterial imbalance.
h. “Leaky-Gut” Syndrome
Dietary Recommendations
The initial thing we need to do is heal the intestinal tract; heal the leaky gut that has been associated as a main contributory cause of Fibromyalgia and Chronic Fatigue.
Successful treatment of CFS requires a comprehensive approach. Especially important is identifying underlying factors which may be impacting energy levels or the immune system.
Identify and control food allergies. Increase your consumption of water (sipping 2 to 3 oz every 30 minutes and more if your are sweating) while eliminating consumption of caffeine containing drinks and alcohol. Adopt a diet of whole, organically grown foods. Control hypoglycemia through the elimination of sugar and other refined foods and the regular consumption of small meals and snacks.
Incorporate the use of coconut oil in your diet (about 1 to 3 teaspoonsful daily) as this healthy oil is extremely anti-bacterial and anti-viral.
Lifestyle
Especially important is a regular exercise program, with low-intensity activities producing the greatest benefits.
ALSO, the practice of Transcendental Meditation (TM) is of great benefit in reducing stress and rebuilding the immune system.
Nutritional Supplements
Primary Nutrients:
1. BIO-MULTI PLUS – 1 tablet, 3 times daily after meals.
2. BIO-C PLUS 1000 – 1 tablet, 3 times daily after meals.
3. M S M POWDER – 1/2 teaspoonful 2 to 4 times daily depending on the severity of symptoms. NOTE: Always take MSM with your Vitamin C.
4. BIOMEGA-3 – 4 – 5 capsules, twice daily after meals for 1 month, then 4 – 5 capsules once daily thereafter M – F of the week.
5. STAMINA CAPS – 2 capsules, twice daily after meals.
6. B 12-2000 LOZENGES – 1 tablet, chewed/dissolved in mouth after a meal.
FOR THE 1ST MONTH – DETOX PROGRAM
a) M C S – 2 capsules after breakfast and 1 capsule after lunch for 1 month.
b) BETA TCP – 2 tablets, 3 times daily after meals.
c) A D H S – 2 tablets after breakfast and 1 tablet after lunch. Do not take after 1PM.
d) 21ST CENTURY HOMEOPATHICS REMEDY # 1 – Detoxification- 1 capful daily until all the bottle is taken.
AFTER DETOXIFICATION, BEGIN WITH SPECIFIC NUTRIENTS.
Specific Nutrients: When symptoms begin to subside, gradually, as needed, wean yourself from the Specific Nutrients & stay on the Primary Nutrients. If any symptoms re-occur resume taking Specific Nutrients.
7. E-MULSION 200 ??? 2 capsules, once daily after a meal.
8. CO Q-ZYME 30 (Emulsified) ??? 2 tablets once daily with a meal
9. ADP ??? 2 tablets, 3 times daily 15 minutes before meals for 14 days, then discontinue.
10. LACTOZYME ??? 3 tablets, 3 times daily 15 – 30 minutes before meals
1`. BUTYRIC-CAL-MAG – 2 capsules, 3 times daily for 3 months then discontinue.
11. I P S ??? 2 capsules, 3 times daily for 3 months then discontinue.
12. MG-ZYME ??? 4 tablets, once daily at bedtime. Increase by 1 tablet daily until bowel tolerance is reached (loose stool). Use for 3 months, then discontinue.
Botanical Medicines
Dosages are three times per day.
Siberian Ginseng (Eleutherococcus senticosus):
Dried root: 2-4 gm
Tincture (1:5): 10-20 ml
Fluid extract (1: 1): 2.0-4. 0 ml
Solid (dry powdered) extract (20:1 or standardized to contain greater than 1% eleutheroside E): 100-200 mg
Licorice (Glycyrrhiza glabra):
Powdered root: 1-2 gm
Fluid extract (1: 1): 2-4 ml
Solid (dry powdered) extract (4: 1):250-500 mg
Counseling
Seek guidance from your physician or a professional counselor. Establish a regular pattern of mental, emotional, and spiritual affirmations. SEE ALSO TM ABOVE.
ADDENDUM
L-Carnitine
Carnitine and its esters prevent toxic accumulations of fatty acids in the cellular cytoplasm, and of acyl CoA in the mitochondria, while providing acetyl CoA for mitochondrial energy production.
Because of its important role in muscle metabolism, carnitine deficiency may well impair mitochondrial function. If so, it could cause symptoms of generalized fatigue along with myalgia, muscle weakness, and malaise following physical exertion.
The evidence to date suggests some CFS patients may suffer from a clinically-relevant carnitine deficiency. While findings concerning free serum carnitine levels have been mixed, studies have found significant decreases in serum acylcarnitine. Moreover, a third study found an increased ratio of acylcarnitine to free carnitine, a finding which suggests insufficient carnitine is available for metabolic requirements.
Most importantly from a clinical perspective, one of these studies found both total and free serum carnitine levels were inversely correlated with patient symptoms, and serum carnitine levels were directly correlated with capacity to function. Moreover, another of these studies found a similar relationship between serum acylcarnitine, symptoms, and functional capacity. In other words, in CFS, serum carnitine levels appear to be a biochemical marker for both symptom severity and ability to function.
Clinical trials of oral L-carnitine, using up to 1 gm three to four times daily, have shown mixed results. Plioplys believes this is because only one-third of CFS patients are carnitine responders. Of the responders, some improve so dramatically that, even if they were fully disabled initially, they return to normal functioning and remain well if they continue taking the supplement. Unfortunately, he found baseline serum levels of L-carnitine failed to predict who would respond.
Coenzyme Q10
Since CoQ10 facilitates cellular respiration, and because clinicians believe it is of therapeutic value, it has long been prescribed to CFS patients. Judy presented a formal study of 20 female patients who required bed rest following mild exercise. They were compared to 20 sedentary sex-, age-, and weight-matched normal controls. Eighty percent were deficient in CoQ10, which further decreased following mild exercise or over the course of normal daytime activity. Three months following supplementation with 100 mg CoQ10 daily, exercise tolerance (400 kg-meters of work) more than doubled; all patients had improved. Ninety percent had reduction and/or disappearance of clinical symptoms, and 85 percent had decreased post-exercise fatigue.
Essential Fatty Acids
Low levels of essential fatty acids (EFAs) appear to be a common finding in chronic fatigue syndrome. It has been theorized this finding is due to abnormalities in EFA metabolism. Gray and Martinovic found changes in the ratio of biologically active EFA metabolites such as would be expected as an exaggeration of normal physiological response to excessive or prolonged stress. They postulated these changes in EFA metabolites, in turn, could cause the immune, endocrine, and sympathetic nervous system dysfunctions seen in CFS.
Horrobin has noted that viruses, as part of their attack strategy, may reduce the ability of cells to make 6-desaturated EFAs while interferon requires 6-desaturated EFAs in order to exert its antiviral effects. In addition, it is quite possible that supplementation with essential fatty acids may improve the hemorrheological abnormalities found in CFS alluded to earlier. The formation of prostaglandin E1, for example, can be enhanced by increasing intake of omega-6 fatty acids. This prostaglandin has been shown to improve erythrocyte membrane fluidity and filterability; i.e., the ability of erythrocytes to pass through a small membrane filter. Moreover, supplementation with both evening primrose oil, a source of omega-6 fatty acids, and fish oils, a source of omega-3 fatty acids, has been shown to improve erythrocyte filterability.
Early research suggests EFA supplementation may be effective for the treatment of CFS. The best study to date concerned a group of 63 patients with a good employment and mental health history who had post-viral fatigue syndrome for at least one year. As expected, their baseline plasma EFA levels were found to be low. They randomly received four capsules twice daily of either an olive oil placebo or a mixture of 80-percent evening primrose oil and 20-percent concentrated fish oil (35 mg GLA and 17 mg EPA per capsule). After three months, 85 percent of treated patients rated themselves as better than at baseline compared to 17 percent of those on placebo, a highly significant difference. Without exception, the individual symptoms, including fatigue, aches and pains, and depression, showed a significantly greater improvement on the fatty acid supplement than on placebo. Moreover, in the treated group only, plasma EFA levels rose to normal and monounsaturated and saturated fatty acid levels, which had been elevated, normalized.
A recent attempt to replicate these results was unsuccessful. However, there were positive findings in an open trial of a group of 29 CFS patients who had been ill for an average of 5.9 years. They received essential fatty acid supplements along with psychological help and graded exercise. Only two of these patients showed any improvement in the 12 months prior to starting the program, while 27 of them significantly improved within the program’s first three months. Twenty-eight of the 29 patients were followed-up an average of 16 months later. All but one of them were still improved compared to before treatment, and 20 of 28 had made further progress.
LINKS:
SEE: HYPOTHYROIDISM This Site
CFS – Holistic Healing Web Page