Chronic Fatigue Solutions

by Dennis Gersten, M.D.

Introduction

Almost everyone wants more energy. Many of us are dragging at the end of the day, but recuperate after some rest. Others need to spend their entire weekend recuperating from work. For these "walking wounded," one can think of energy as a sloping line. At one of the line, let's say the left end, the line is high and we have fantastic energy. The right end of that line is much lower, representing a dramatic decrease in energy. Most of us are somewhere on that line. But when fatigue becomes an illness, that line suddenly takes a straight plunge downward. That is one way to begin to understand chronic fatigue syndrome (CFS). These people "fall over the energy cliff," and experience an energy "crash." Interestingly, everyone with CFS uses the same word - "Crash."

The science and treatment of CFS is ever-evolving. This article synthesizes the latest thinking on the problem of fatigue. Is CFS Real? It is all too real. In fact, it has been suggested that people with CFS are functioning at a level equivalent to an AIDS patient with two months to live

CFS Defined

CFS is a debilitating chronic illness characterized by severe fatigue lasting more than six months. The Center for Disease Control's (CDC) definition of CFS includes: the lack of any other medical or psychiatric condition that could explain the fatigue and the presence of four or more of the following symptoms: insomnia, sore throat, non-restorative sleep, memory and concentration problems, muscle pain, multijoint pain without swelling or redness, headaches of a new type, and post-exertional malaise lasting more than 24 hours.

CFS is a "spectrum of illnesses" that includes fibromyalgia and multiple chemical sensitivity. Patients visiting my office for the first time fill out an extensive Health and Wellness Assessment Form that assesses body, mind, and spirit. The form includes a check list of 80 symptoms. People with CFS have anywhere from 20 to 60 active symptoms.

What is CFS?

We know it is real, and we know it is not the same as major depression, although people with CFS usually get depressed by their long battle with this serious illness. The experts disagree on what CFS is and even what to call it. The British call it ME (myalgic encephalomyelopathy). It is much more than the CDC case definition. Each clinician and researcher has his own theory.

In my experience, CFS is a metabolic/nutritional imbalance in the central nervous system, immune system, gastrointestinal tract, and endocrine system. The symptoms of CFS are a final common pathway triggered by many causal factors. Those with fatigue, but not CFS, also have multiple metabolic imbalances. Causes of CFS CFS is a multi-system collapse with many initial causes and many factors that keep it going. These causes include: Infection Parasites Bacteria Candida (yeast) Chronic Viruses, especially Epstein Barr Virus (EBV), Cytomegalovirus (CMV) and Human Herpes Virus 6 (HHV6) Polio Virus.

There is a connection between CFS and post-polio infection. We now know there are at least two kinds of polio. The most common one infects motor neurons and causes muscle weakness and paralysis. The second kind of polio virus (possibly involved in CFS) infects sensory nerves, giving rise to a host of neurological problems, but not paralysis. Coxsackie B Virus Mycoplasma Chemical Exposure Heavy Metal Toxicity including: mercury, nickel, lead, cadmium, aluminum, arsenic

Dental Oral hygiene impacts CFS in several ways:

1. Presence of mercury fillings
2. Poor dental hygiene with overgrowth of abnormal bacteria. High levels of oral bacteria combined with gum disease allows for these bacteria to enter the blood stream, creating low levels of septicemia.
3. Poor digestion of food at the entry point - the mouth. Trauma Nutrition Imbalance in amino acid chemistry.

On average, 36% of amino acid sub-tests are abnormal in

Chronic Sinusitis Researchers at the University of Newcastle, Australia believe that chronic sinusitis creates a breakdown in the normal sinus bacteria, namely staph aureas. The staph mutates, breaks down normal nitric oxide levels in the sinuses . . . and the staph then enters the blood stream as "bacteria without walls." These un-walled bacteria then easily pass into cells throughout the body. Mental/Emotional Long-term effects of child abuse and neglect Unresolved conflict Acute severe stress Chronic stress Cellular Hypoperfusion Lab Testing Conventional lab tests offer little or no help to the person with CFS. After a routine workup, the CFS patient is often told, "There is nothing wrong with you. It's all in your head." Then the patient is put on anti-depressants for mood, energy and sleep. This approach does not work and it leaves the patient feeling profoundly misunderstood.

Scientific nutritional testing is a different story. From the seven or eight initial tests that form the foundation from which we begin to truly understand this illness, there is so much positive data generated that it takes more than one hour to interpret the data for a patient. Here is a brief sketch of those tests:

Amino Acids, Plasma. Amino acids make up 75% of body dry weight. First we are water. Second, we are amino acids. They make up all protein, almost all neurotransmitters and hormones, and are involved in almost every chemical reaction in the human body.

Comprehensive Digestive Stool Analysis analyzes the gastrointestinal tract for infection, inflammation, leaky gut, dysbiosis, absorption of nutrients and ability to keep toxins out
of the body.

Food Antibodies tests for 95 different foods. Food allergies generally arise out of problems in the gastrointestinal tract.

Cellular Energy Profile tests for the Kreb's Cycle, the cellular engine of energy metabolism. The Kreb's Cycle, which takes place in the mitochondria, can be blocked by lack of appropriate nutrients, presence of heavy metals, absence of glutathione and much more. This is the final common pathway for energy. Regardless of the stress, this is where energy stops and starts. If fatigue is a problem, the Kreb's Cycle is impaired.

Oxidative Stress/Glutathione. Most people with chronic illness have accelerated levels of free radical damage (oxidative stress). They may or may not also be deficient in glutathione (GSH), our body's number one detoxifier.

Heavy metals destroy GSH. Heavy Metals directly poison the body and cripple the Kreb's Cycle.

Essential and Metabolic Fatty Acids. Essential fatty acids are one of our key nutrients, important for cell membrane function, nervous system, and hormone metabolism. Their importance is generally overlooked.

This is a partial list of important tests. In addition, we often will test for viruses. From this information, we can create a powerful nutritional program, based on scientific lab work. In addition to handling physical causes of fatigue, the mental/emotional component must be addressed. People with CFS are often reluctant to admit to an emotional component to their illness because doctors have told them for so long that it's all in their head. Now, that we've set the record straight, we can go back and address stress, abuse, and unresolved conflict. When I ask patients what percentage of their illness is caused by mental/emotional factors, the answer is anywhere from 10% to 75%. The answer has never been "zero." Patient can learn powerful, specific mental fitness techniques (meditation, mental imagery and use of the breath) to decrease stress and conflict and work through life-long physical effects of child abuse without spending years in psychotherapy. Once nutritional testing has paved the wave for a scientific approach to nutritional supplementation, and mental fitness techniques have been mapped out and tailored to the individual's personal psycho-spiritual needs, we have one more important thing to do.

We need to review the six keys to successful treatment:
1. Accurate and Productive Diagnosis
2. Patient's Active Participation
3. Commitment to Knowing the Truth
4. Determination
5. Belief in the Healing Process, Self, and Healer
6. Sustained Hope
These six keys are essential to the success of any healing process, whether one is working with an internist, chiropractor, acupuncturist, holistic physician or shaman. This comprehensive mind/body program almost always leads to improvement and can lead to something that people say does not exist for people with CFS - a cure. And for the walking wounded, the working weary, treatment is much easier than for CFS.

Dennis Gersten practices nutritional medicine and psychiatry out of his office in Encinitas, California.
Contact Information: www.aminoacidpower.com e-mail: dgersten@imagerynet.com. Tel: 800-211-5215 or 760-633-3063