CFS (Chronic Fatigue Syndrome)

Chronic Fatigue Syndrome (CFS) is defined as debilitating fatigue, primarily affecting women, with associated symptoms lasting at least 6 months. Although there is no known cure for this illness, prognosis for patients is usually good through the treatment of symptoms. Preliminary studies also indicate that there may be a genetic predisposition to CFS.

Some experts believe CFS to be closely related to another chronic condition, fibromyalgia (FMS). A preliminary follow-up study by the Centers for Disease Control reveals that, for those individuals whose chronic fatigue does not significantly improve after a 5-year duration, the most prominent symptom changes from fatigue to muscle pain. This muscle pain is the prominent symptom of fibromyalgia.

Clinically evaluated, unexplained chronic fatigue can be classified as Chronic Fatigue Syndrome if the following criteria are met:

  1. Unexplained, persistent, or relapsing fatigue that is not a result of ongoing exertion, is new (not lifelong), is not alleviated by rest, and results in a substantial reduction in previous levels of occupational, social, or personal activity, and…
  2. The concurrence of four or more of the following symptoms that have persisted or recurred for 6 or more consecutive months and that do not predate the fatigue:
  • Substantial impairment in short-term memory or concentration
  • Sore throat
  • Tender lymph nodes
  • Muscle pain
  • Multi-joint pain without swelling or redness
  • Headaches of a new type, pattern, or severity
  • Un-refreshing and/or interrupted sleep
  • Post-exertional malaise lasting more that 24 hours
  • Sensitivity to odors, noise, bright lights, medications and various foods

Possible Causes
The causes of CFS are as yet undetermined, but studies have shown that multiple nutrient deficiencies, food intolerance, or extreme physical or mental stress may trigger chronic fatigue. Studies have also indicated that CFS may be activated by the immune system, various hormonal abnormalities, or by the reactivation of certain infectious agents in the body, such as the Epstein Barr Virus.

Some CFS patients were found to have low levels of PBMC beta-endorphin and other neurotransmitters. Thyroid deficiency may also be a contributing factor in chronic fatigue syndrome.

Virus and C.F.S
Symptoms of CFS resemble a post-viral state and, for this reason, chronic viral conditions have been thought to contribute to CFS in some patients. Medical tests for herpes, Epstein-Barr virus, and Cytomegalovirus antibody activity are recommended.

If you are infected with a chronic, energy-depleting virus, there are conventional and alternative therapies that may be of help. It should be noted that most individuals have been exposed to pathogenic viruses that can be reactivated by adverse environmental conditions and cause chronic fatigue and other diseases. Studies indicate that the Epstein-Barr virus may be suppressed with bilberry extract (anthocyanins), curcumin, carotenoids, and chlorophyll. Intravenous therapy with hydrogen peroxide is highly effective for elimination of viruses.

A 1991 NIH panel recommended a standard panel of laboratory tests for initial patient examination:

  1. Complete blood Count with differential (CBC)
  2. Erythrocyte sedimentation rate (ESR)
  3. Serum chemistries (electrolytes, blood urea nitrogen, glucose, creatine, calcium, thyroid function test)
  4. Antinuclear antibodies (ANA)
  5. Urinalysis (UA)
  6. Tuberculin test (Tine Test)

Other more specific laboratories include:

  1. Serum Cortisol
  2. Rheumatoid factor
  3. Magnesium and other mineral levels
  4. Serum B-12 levels
  5. Immunoglobulin levels
  6. Lyme serology in endemic areas
  7. HIV antibodies
  8. Epstein Barr virus antibodies
  9. CD4:CD8 (natural killer cells) T Cell ratios. Recent studies show that higher ratios of CD4:CD8 T cell are related with a chronic immunologically mediated inflammatory process of the central nervous system.

Patient Management of C.F.S
Physicians advise patients to pace themselves carefully and to avoid unusual emotional or physical stress. Follow a regular and manageable daily routine and engage in modest, regular exercise supervised by a physician or physical therapist. In some instances, acupuncture, aquatic therapy, chiropractic care, massage, self-hypnosis, stretching, tai chi, therapeutic touch, and yoga have proven helpful in managing CFS. Certain psychotherapies such as family therapy have shown promise in the development of coping skills necessary to counter the adverse effects of chronic illness on the family or patient caregiver.

Therapies and Supplementation
A recent report in the Annual Review of Medicine stated that CFS “is an illness characterized by activation of the immune system, various abnormalities of several hypothalamic-pituitary axes, and reactivation of certain infectious agents.” This suggests that the sufferer of CFS should follow a regimen that involves protecting and enhancing the immune system with proper nutritional supplements, proteins, and hormones. Free radicals (extremely active atoms or molecules that are very unstable and highly reactive) play a role in causing damage to the immune system.

1.     Alpha-lipoic acid, works as a potent antioxidant.  According to Dr. Lester Parker of the University of California, the “ideal antioxidant” should meet all of the following criteria:

  • Neutralize free radicals
  • Be absorbed and utilized rapidly and easily by the body.
  • Be capable of enhancing the effects of other antioxidants.
  • Chelate free metal ions.
  • Promote normal gene expression.
  • Lipoic acid, in combination with it’s metabolite, dihydrolipoic acid, is the only known antioxidant that meets all these criteria. It might be termed a “broad-spectrum” antioxidant, with actions against a wide range of free radical species, including the superoxide anion, hydroxyl radical, singlet oxygen and transition metals like copper, cadmium, lead and mercury. It’s unique size (larger than Vitamin C. but smaller than vitamin E) gives the lipoic acid molecule an important structural advantage. Unlike any other antioxidant, it can dissolve in both water and fats. This unique ability to go “both ways” gives lipoic acid access to virtually all body systems. The Lipoic Acid has improved energy levels in some people.   Boosting energy levels is necessary for people suffering from CFS.

2.     Coenzyme Q10 (or ubiquinone) is an antioxidant that penetrates the mitocondria to become a fundamental constituent of the electron transport system of the respiratory chain and plays an essential role in oxidative phosphorylation- the process by which ATP (energy) is produced. Coenzyme-Q10 often helps victims of severe chronic fatigue syndrome. It is important to note that new studies show that Coenzyme-Q10 requires fat for optimal assimilation into the bloodstream. It should be taken with the heaviest meal of the day, or with essential fatty acids such as GLA, EPA/DHA, and/or flax seed oil.

3.     Another energy-boosting therapy involves taking NADH (the reduced form of nicotinamide-adenine-dinucleotide)  which is the first and most energetic element in the chain of chemical reactions (oxidative phosphorylation) that produces energy within mitochondria. The more energy a cell needs , the more NADH it needs. For example, muscle and brain cells contain about 50 micrograms of NADH per gram of tissue, heart cells contain 90 micrograms of NADH per gram of tissue, but red blood cells, which have much lower energy needs, contain only 4 micrograms of NADH per gram. NADH also stimulates the biosynthesis of neurotransmitters such as dopamine and noradrenaline. Don’t take vitamin C, Malic Acid, Lipoic Acid or other acids within 2 to 3 hours of NADH, as acid destroys NADH.

4.     The L-Carnitine is not an amino acid in the strictest sense (it is actually a substance related to the B vitamins). However, because it has a chemical structure similar to that amino acid, it is usually considered  together with them. Unlike true amino acids, carnitine is not used for protein  synthesis or as a neurotransmitter. Its main function in the body is to help transport long-chain fatty acids, which are burned within the cells to provide energy. This is a major source of energy for the muscles. Carnitine thus increases the use of fat as an energy source.  The amino acid L-carnitine is known to boost energy levels. This prevents fatty buildup, especially in the heart, liver, and skeletal muscles. Carnitine can be manufactured by the body if sufficient amounts of iron, vitamin B1, B6, and the amino acids  lysine and methionine are available. The synthesis of carnitine also depends on the presence of adequate levels of vitamin C. Inadequate intake of any of these nutrients can result in a carnitine deficiency. Taking 1000 to 2000 mg a day of acetyl-L-carnitine has helped people with low energy.

5.     Deficiencies in brain hormones and neurotransmitters are also known to cause low levels of energy. The amino acids phenylalanine or tyrosine, are precursors or building blocks of neurotransmitters and can boost epinephrine and norepinephrine levels. Phenylalanine and tyrosine are available in capsule and powder forms.

6.     The European anti-anxiety medication, Adapton, has been shown to alleviate chronic fatigue symptoms when 2 to 4 capsules a day are taken.

7.     DHEA (dehydroepiandrosterone) has been reported to improve energy levels in chronic fatigue patients, improved neurological function (including memory, mood enhancement, and EEG readings), immune surveillance, and stress disorders. DHEA replacement therapy has become popular as an anti-aging regimen and offers aging patients help in preventing diseases such as osteoporosis, fatigue, depression, atherosclerosis, and cancer. DHEA is a precursor building block that allows our bodies to more easily create hormones that may be in decline because of age, disease, prescription medications, or other factors. Hormones such as testosterone and estrogen as well as serum DHEA levels begin to decline between 25 and 30 years of age and may be reduced by 95% of youthful peak levels by age 85. DHEA turns into both estrogen and testosterone. DHEA is definitely a brain chemical. It’s not utilized by the brain, it’s manufactured by it. DHEA is the only hormone besides Cortisol that has consistently been linked with depression. It was studied as far back as the 1950s as an antidepressant. Back then, researchers reported that it gave people energy and confidence, and made them less depressed. While it seemed to work great, no one followed up on the studies. Researchers at Cambridge University discovered that young kids with major depression have abnormally low levels of DHEA (and abnormally high levels of Cortisol).  One study showed the value of DHEA and vitamin C infusion treatment in the control of chronic fatigue syndrome.

8.     Magnesium is involved in over eighty-two different body functions but is routinely low in the American diet as a result of food processing. The average American diet supplies less than 300 milligrams of magnesium per day. Magnesium Glycinate has shown effectiveness in people who have low levels of magnesium in their red blood cells. If your magnesium is low, your muscles will stay in spasm and your fibromyalgia will not resolve. This is one of the reasons that taking magnesium is so critical.

In addition, magnesium  is important for the muscles’ and body’s strength and energy. Take the  magnesium for eight to ten months, since it may take this long to replace your deficits.  Keep in  mind that magnesium blood tests do not drop below normal until severe magnesium depletion occurs.

9.     Vitamin B-12 is needed to prevent anemia. It aids folic acid in regulating the formation of red blood cells and helps in the utilization of iron. This vitamin is also required for proper digestion, absorption of foods, the synthesis of protein, and the metabolism of carbohydrates and fats. It aids in cell formation and cellular longevity. In addition, vitamin B-12 prevents nerve damage, maintains fertility, and promotes normal growth and development by maintaining the fatty sheaths that cover and protect nerve ending. Vitamin B-12 is linked to the production of acetyl-choline, a neurotransmitter that assists memory and learning. It is recommended  vitamin B-12 500mg with Folic Acid 400 mcg (sublingually – under the tongue). Anti-gout medications, anti-coagulant drugs, and potassium supplements  may block the absorption of vitamin B-12 from the digestive tract.

10.  EFAs (Essential fatty acids): Fatty acids are the basic building blocks of which fats and oils are composed. The fatty acids that necessary for health and that cannot be made by the body are called essential fatty acids (EFAs). They improve the skin and hair, reduce blood pressure, aid in the prevention of arthritis, lower cholesterol and triglycerides levels, and reduce the risk of blood clot formation. They are beneficial for candidiasis, cardiovascular disease, ezcema, and psoriasis. Every living cell in the body needs essential fatty acids. They are essential for rebuilding and producing new cells. EFAs are also used by the body for the production of prostaglandins, hormone-like substances that act as chemical messengers and regulators of various body processes. There are two basic categoties of EFAs: designated omega-3- and omega-6.  There are a number of sources of essential fatty acids like: fish oils, flaxseeds oil, grape seed oil, and primrose oil.

11.  Green foods: Emerald Energy is a good brand, and it contains vitamin A, C , B complex , iodine, phosphorus, choline, chlorophyll, and spirulina. Spirulina is recognized as the most promising of all microalgae. It represents a breakthrough in the production of food, producing twenty times as much protein as soybeans growing on an equal-sized area of land. Spirulina contains concentration of nutrients unlike any other single grain, herb, or plant. It contains  gamma-linolenic acid (GLA), linoleic and arachidonic  acids, vitamin B12, essential amino acids, the nucleic acids RNA and DNA, chlorophyll and phycocyanin, a blue pigment that is found in only in blue green algae and that has increased the survival rate of mice with liver cancer in laboratory experiments.

12.  Multivitamins without iron (Multigenics) 1 THREE TIMES A DAY.

13.  If anemia with iron deficiency, then Floradix, Iron glycerate, or Iron Fumarate.

14.  Tryptophan is an essential amino acid that is necessary for the production of vitamin B3(niacin). It is used by the  brain to produce serotonin, a necessary neurotransmitter that transfer nerve impulses from one cell to another and is responsible for normal sleep. A sufficient amount of vitamin B6 is necessary for the formation of tryptophan, which in turn, is required for the formation of serotonin. 5 HTP (5 Hydroxytryptophan) 100 to 400mg at night naturally stimulates serotonin.

15.  Cortef:  The outer part of the adrenal gland, the cortex, makes many important hormones like Cortisol, DHEA, aldosterone, and sexual hormones. About two-thirds of chronic fatigue patients appear to have an underactive adrenal gland. If the Cortisol level is low, the person has fatigue, low blood pressure, hypoglycemia, poor immune function, an increased tendency to allergies and environmental sensitivity, and an inability to deal with stress. Treating low or borderline adrenal function with cortef is very important. Giving Cortef (hydrocortisone) in physiological doses are very safe. 5mg tablets ½ to 2½ tablets at breakfast, ½ to 1 ½  tablets at lunch and 0 to ½ tablets at 4 PM. Take it with food if it causes an acid stomach. Do not take over 4 tablets a day without discussing the risks with your physician.

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