Conquer Fatigue With A Comprehensive Approach
By Terry Grossman, MD, And Karen Kurtak, Lac
CHRONIC FATIGUE
Beyond ordinary or even “above normal” fatigue, chronic fatigue syndrome or CFS can be so severe that it’s actually disabling. No specific laboratory test is available for CFS, and no clinical sign can verify its presence, which means no one knows exactly how many people are affected by this illness. The Centers for Disease Control and Prevention, however, estimates that as many as 500,000 people in the United States have CFS or a CFS-like condition. In a recent study CFS was found in 235 out of every 100,000 people, with the prevalence four times higher in women than men.
A difficult diagnosis
Although CFS has been present for many years and affects millions of people, the existence and diagnosis of the disease remains controversial. Much of the reason for this controversy is confusion over how to make an accurate diagnosis of CFS. Other diseases closely associated with CFS include fibromyalgia, a condition in
which pain in the soft tissues of the body predominates; and multiple chemical sensitivity (MCS), in which patients are unable to tolerate environmental toxins such as auto exhausts, paint fumes, or tobacco smoke. These conditions often have overlapping symptoms, further adding to the confusion.
To help physicians, an international panel of experts met in 1994 and recommended a list of diagnostic standards for chronic fatigue syndrome. The panel determined that, to be diagnosed with CFS, an individual must have chronic fatigue lasting more than six months unexplained by another illness and have at least four symptoms from the following list:
• Impaired short-term memory and/or concentration
• Sore throat
• Tender lymph nodes
• Muscle pain
• Joint pain without swelling or redness
• Headaches different than ones experienced in the past
• Fatigue not improved by sleep
• Tiredness after exercise that lasts at least 24 hours
What causes CFS?
Multiple hypotheses have been proposed to explain what causes CFS. The most widely accepted theories include infectious agents, such as viruses or bacteria; abnormalities of the immune system; improper regulation of the master hormone control system of the body; abnormal detoxification of environmental toxins; and nutritional deficiencies. Although each of these theories seems to explain part of the symptoms of CFS, none offers a satisfactory explanation for all the associated symptoms.
Lifestyle and nutritional treatments can help CFS affects many organs and requires a multifaceted approach
for successful treatment. Fortunately, lifestyle and dietary choices as well as nutritional supplements can be very helpful in relieving symptoms.
EXERCISE:
Although many people with CFS become even more exhausted after physical exertion, a graded exercise program has been proven to have long-term benefits. Patients who participate in regular exercise over time are able to do more physical work before becoming exhausted and note an improvement in mental attitude. To begin a graded exercise routine, patients should exercise only up to the point at which they begin to feel tired. They should increase exercise time very gradually, by a minute or so every few days.
STRESS REDUCTION:
Most experts agree that stress is a major factor in CFS, and stress reduction can play an important role in CFS recovery. Stress reduction through meditation, visualization, yoga, and massage can be helpful.
ACUPUNCTURE:
A form of Traditional Chinese Medicine (TCM), acupuncture works by rebalancing the energy system of the body, known as “chi.” Adjustments are made by gently inserting very fine needles along specific points in the body to stimulate and balance the flow of energy. After the body is balanced on physical, mental, and emotional levels, healing can take place. Many people have found relief with acupuncture in treating chronic diseases such as CFS.
DIET:
People often discover that modifying their diets can greatly improve their CFS symptoms.
RECOMMENDED FOODS:
• Green vegetables
• Low-glycemic fruits such as apples, berries, and kiwi
• Legumes
• Whole grains
• Nuts and seeds
• Healthy protein such as chicken without skin, fish, and tofu
LIMIT:
• Sugary foods
• Dairy products
• Red meat and pork
• Alcohol
• Caffeine
CFS affects many organs and requires a multifaceted approach for successful treatment.
Nutritional supplements
On a cellular level, the common denominator for CFS appears to be a lack of adenosine triphosphate (ATP), the body’s main source of energy. Cells convert food and water into ATP to use as energy. Studies have shown that ATP concentrations are much lower after exercise in patients with CFS. This suggests that individuals suffering from CFS have a defect in their cells’ ability to produce ATP. Fortunately, an array of nutritional supplements improve ATP production and increase energy.
N-ACETYLCYSTEINE (NAC) increases production of glutathione, one of the most powerful antioxidants produced in the body. Glutathione is used in the final phase of the body’s elimination of toxins. It is vital for proper functioning of the nervous system, muscles, and immune system. Since glutathione is necessary for ATP production as well as detoxification and immune function, supplementation with NAC may be helpful.
NADH (NICOTINAMIDE ADENINE DINUCLEOTIDE) is another chemical that is necessary for the production of energy inside all our cells. Studies suggest supplementation with NADH is effective in reducing many symptoms of CFS.
ALPHA LIPOIC ACID is a powerful antioxidant in its own right, but it has the added benefit of helping the body use other antioxidants such as vitamins C and E. Alpha lipoic acid also helps the cells maximize their production of energy by working with NADH to produce ATP. It has also been shown to help remove certain toxic heavy metals such as lead and cadmium from the body and prevent the damage that occurs to cells from exposure to these metals.
ACETYL-L-CARNITINE (ALC) and L-CARNITINE. Several studies have confirmed that individuals with CFS have lower cellular levels of both ALC and L-carnitine and that supplementation with these nutrients improves symptoms. ALC is primarily found in the brain and is used for energy production and synthesis of neurotransmitters. L-carnitine is primarily found in muscle cells and has been shown to produce significant improvements in energy levels in patients with CFS.
MAGNESIUM is necessary for energy production and utilization of B vitamins and helps to activate over 350 enzymes in the body. A study in Lancet showed that CFS sufferers had lower levels of magnesium in their red blood cells compared to healthy individuals. When these patients were treated with magnesium, they were found to have improved energy levels, a better emotional state, and less pain.
B VITAMINS are a complex of 11 vitamins. Many of the B vitamins such as folic acid, B6, and B12 have been shown to be lower in people with CFS. These three B vitamins in particular play an important role in detoxification, as well as helping with energy production, adrenal function, red blood cell production, and nervous system health.
VITAMIN C is an important antioxidant known to enhance immune function. Under stressful conditions such as CFS, the body needs additional vitamin C to help the immune system function normally. A clear correlation has been found between low levels of vitamin C and fatigue. Vitamin C is particularly helpful in CFS when there is evidence of an ongoing viral infection, such as a lingering sore throat.
ESSENTIAL FATTY ACIDS (EFAs) play an important role in maintaining immune function and reducing inflammation throughout the body. They also assist in maintaining normal brain and nervous system function. Research has demonstrated that many CFS patients showed an improvement in symptoms after three months of supplementation with EFAs. One study found a combination of 1000-2000 mg of EPA (eicosapentaneoic acid), 300-600 mg of DHA (docosahexenoic acid), and 100-200 mg of GLA (gamma linolenic acid) to be of value.
S-ADENOSYLMETHIONINE (SAMe) can be helpful in reducing the depression and muscle pain that often accompany CFS. SAMe is naturally made in the body from certain amino acids when our cells have proper levels of folic acid and vitamins B6 and B12. SAMe is an important cofactor in the metabolism of many neurotransmitters in the nervous system that help balance emotions and reduce fatigue and depression.
HELPFUL HERBS FOR CFS
WINTER CHERRY (Withania somnifera) Also known as ashwagandha, winter cherry is an adaptogenic herb traditionally used in Ayurvedic medicine. It has been shown to reduce oxidative damage to tissues including the brain, spinal cord, and liver. It improves memory and adrenal function, stimulates thyroid activity, and increases the body’s ability to fight viruses by increasing white blood cell count.
CORDYCEPS This herb has several beneficial effects and may be helpful for reducing fatigue, stimulating the immune system, and reducing inflammation.
GINKGO (Ginkgo biloba) Ginkgo provides diverse benefits, including the ability to protect cell membranes, neutralize free radicals, improve circulation, and enhance blood supply to the brain—all functions that boost immunity and overall health.
ASTRAGALUS (Astragalus membranaceus) This herb stimulates the immune system and improves energy. It may have powerful effects on the reduction of CFS symptoms, particularly if there is evidence of immune dysfunction or viral activity.
Final thoughts
The lack of energy associated with chronic fatigue syndrome can dramatically affect a person’s quality of life. Studies show that proper nutrition, lifestyle modification, and certain supplements and herbs can help ease symptoms of this illness. Anyone who is experiencing extreme fatigue on an ongoing basis should see a healthcare professional knowledgeable about diagnosing and treating CFS.
Terry Grossman, MD, and Karen Kurtak, LAc, are a husband and wife team at Frontier Medical Institute in Lakewood, Colo. Their clinic specializes in treating patients with illnesses that do not respond well to conventional medical treatment. Dr. Grossman lectures nationally and internationally and is the author of The Baby Boomers’ Guide to Living Forever (2000) and the coauthor, along with Ray Kurzweil, of Fantastic Voyage: Live Long Enough to Live Forever (2004). Karen Kurtak is an acupuncturist and environmental biologist working to bridge the gap between Eastern and Western medicine. Last year she was accepted to the scientific advisory board of The Scientist Journal.
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Randomised controlled trial of graded exercise in chronic fatigue syndrome. Med J Aust, 2004;180(9):444-8.; Wong R, et al.
Skeletal muscle metabolism in the chronic fatigue syndrome. Chest,1992;102(6):1716-22. Bounous G, Molson J.
Competition for glutathione precursors between the immune system and the skeletal muscle: pathogenesis of chronic fatigue syndrome. Med Hypotheses, 1999;53(4):347-9. Forsyth LM, et al.
Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome. Ann Allergy Asthma Immunol, 1999 Feb;82(2):185-91. Jones W, et al.
Uptake, recycling, and antioxidant actions of alphalipoic acid in endothelial cells. Free Radic Biol Med, 2002;33(1):83-93. Vermeulen RC, Scholte HR.
Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome. Psychosom Med, 2004;66(2):276-82. Cox IM, Campbell MJ, Dowson D.
Red blood cell magnesium and chronic fatigue syndrome. Lancet,1991;337(8744):757-60. Puri PK.
The use of eicosapentaenoic acid in the treatment of chronic fatigue syndrome. Prostaglandins Leukot Essent Fatty Acids, 2004;70(4):399- 401.Papakostas GI, Alpert JE, Fava M. S-adenosyl-methionine in depression: a comprehensive review of the literature. Curr Psychiatry Rep, 2003(6):460-6.
From: alternativemedicine.com
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