Chronic Fatigue Syndrome and Fibromyalgia
There is no one, sure-fire, effective treatment
either complementary or conventional for ME or Fibromyalgia. Much
can be done usually to meaningfully improve symptoms, sometimes to
radically improve and sometimes almost to ‘cure’ the situation.
However, be very cautious about promises of an instant magical ‘cure
- It simply does not exist. Also be careful on the internet if you
are tempted to buy products which promise miracles.
My Advice on Tackling Fibromyalgia
-
Do not self-diagnose. Get a proper diagnosis
from your GP and/ or specialist before diagnosing Chronic Fatigue
Immune Disorder or Chronic Fatigue Syndrome. Part of this process
is to have appropriate medical testing to rule out
life-threatening medical disorders needing urgent treatment.
-
If you do not consider yourself to be depressed
then maybe you are not depressed! Although you may be told "You're
just depressed" if your condition is not responding well to
appropriate antidepressant therapy then perhaps other causes for
your fatigue or pain need to be sought.
MY ‘Toolkit’ for investigating Chronic Fatigue
and Fibromyalgia
A Proper Medical History: The most
important and useful investigative and diagnostic tool is an
in-depth medical history and to obtain that I usually quite a
while taking a full, expanded, medical history.
The Investigations which I use:
I am selective about investigations and only
use those which are necessary to guide treatment for a particular
patient.
Comprehensive Digestive Stool Analysis and
Comprehensive Parasitology (Doctors Data Laboratories):
Untreated low-grade persistent bowel infections whether bacterial or
fungal are frequently a part of the problem. Sometimes treatment
yields an excellent response. This test also enables us to look at
the adequacy of digestive enzymes, hydrochloric acid in patient’s
digestive tract since some patients have problems absorbing and
until this is fixed there will be very little progress.
Other Important Biochemical and Hormonal
Investigations
-
ATP Profile: ATP is the currency of the energy
in patients cell. If you cannot produce enough ATP and are unable
to recharge it in an efficient manner then the cells have no
energy. More information below at HELPING CELLS PRODUCE ENERGY
-
CoQ10 Level, NAD, SODase STUDIES: these are
also important in basic energy production
-
Cell-free DNA: Gives an estimate of how damaged
the patients biochemical system is.
-
Sweat Test for Minerals (BioLab): Without the
correct minerals we cannot function properly. Some individuals
take tons of supplements but do not absorb. This helps clarify
issues such as these.
-
Essential Fatty Acids: Omega 3 and Omega 6
essential fatty acids are important for everything from skin to
brain and lots of other things in between.
-
White blood cell Zinc, Red Blood cell
Magnesium, Vitamin Profile including various B Vitamins and also
fat-soluble vitamins.
-
Kelmer test for Body Mercury Load: I consider
Mercury is a toxic metal. Occasionally it may be important to
advise mercury removal. I try not to do this often because it is
expensive and not without its hazards.
-
Hormonal Profiles: Free thyroid hormone levels
including free T3 and free T4, salivary cortisols, Testosterone
levels, estrogen and Progesterone levels,
-
Neurotransmitter Profiles (occasionally):
Serotonin, Dopamine, Nor-Adrenaline, Adrenaline levels etc
-
More ‘run-of the-mill’ hospital laboratory
testing: B12, Folic Acid, Ferritin, Full Blood Count. Occasionally
we will pick up an undiagnosed pernicious anemia or low thyroid.
Other investigations as appropriate.
Treatments
At the risk of sounding simplistic; Fix what
seem to be wrong having taken a proper history and performed
appropriate investigations, is the basic methodology:
In a nutshell my most useful interventions are:
Ultraviolet blood therapy,
diagnosing and treating undiagnosed bowel infections, helping people
to stop eating junk food all the time, recognizing and treating
vitamin and mineral deficiencies, realizing that some individuals
are not absorbing properly and helping them to do so, recognizing
and treating multiple chemical sensitivity and organizing resources
to help people deal with any longstanding emotional issues whether
from their home environment, relationships or form their past.
My medical credo is that people usually need a
‘blend’ of several treatment approaches rather than ‘lots’ of one
particular approach.
Very occasionally there may be an undiagnosed
straightforward medical illness which has not shown itself despite
previous investigation.
-
If there is a persistent low-grade bowel
infection then treat it. This may dramatically help fatigue,
brain fog or irritable bowel syndrome. It is most important to get
rid of any unwanted gut bacteria and re-inoculate the bowel with
‘good’ bacteria. Also people may need digestive enzymes etc to
help them to absorb properly.
-
If there is a
vitamin or mineral deficiency particularly Magnesium
Chromium or Zinc or the B Vitamins then treat it. Subtle B vitamin
deficiencies may de diagnosed. Important to treat via
supplementation. B Vitamins (despite being water-soluble) are best
absorbed with a fatty meal.
-
Address any omega-3 and omega-6 essential
fatty acid deficiencies.
-
I may advise some amino acid therapies
to help normalize brain neurotransmitter chemistry particularly
where there is sleep problems or anxiety. It is my belief that
viral infections may be associated with seeming deficiency of
brain chemical such as serotonin, dopamine etc. B vitamins also
have an important role to play here. Neurotransmitters also
control the immune system.
-
Persistent Viral
Illnesses and Ultraviolet B Blood Therapy (UVB): Sometimes
a patient will complain of symptoms which are akin to a recurrent
flu-like illness: Swollen Glands, sore throat, muscle aches and
pains, fuzzy head. Or, sometimes, a patient will have improved a
lot with the nutritional biochemical approach but not be truly
better. Sometimes I meet an adult or teenager who had a ‘terrible
infection’ of some kind whether bacterial, viral or mixed. In
cases such as these UVB may be very useful. For more extensive
information please follow this link to the Ultraviolet Blood
Therapy information section.
-
Detailed Help with Food Choices, Eating
Plans: Some groups, particularly teens, may need help in this
area.
Brain Chemistry in Pain and Fatigue
Depression, Fatigue, Fibromyalgia, Chronic Pain
and Mood problems are closely related to brain chemistry and
hormonal status.
The brain ‘pulls the strings' in many aspects of
the body’s functioning. Brain chemistry may contribute to chronic
pain problems, anxiety, insomnia, low mood etc.
Consider the analogy of a car:
-
Neurons (the cells in the brain) use some
neurotransmitters as an accelerator (i.e. to produce a signal) and
some as a brake (i.e. to dampen down or block a signal).
-
The accelerator is equivalent to the excitatory
neurotransmitter system which includes the neurotransmitters
glutamate, epinephrine, norepinephrine, and PEA to name a few.
When these chemicals are released, the hypothetical accelerator is
pushed, and the nervous system revs up. The excitatory
neurotransmitter system is responsible for sending a signal.
-
The brake is equivalent to the inhibitory
neurotransmitter system which includes the neurotransmitters GABA
and serotonin. When these chemicals are released, the hypothetical
brake is pushed, and the system slows down. The inhibitory
neurotransmitter system is responsible for ‘blocking’ a signal.
There are also many other transmitters and
modulators that factor into the effectiveness of the two systems and
they include glutamine, glycine, histamine, glutamate, taurine and
various hormones.
Just like in a car, the brakes must be maintained
or the car will not be able to stop. If the inhibitory system isn't
maintained or replenished, then the excitatory system will be
allowed to go out of control, and eventually, it too will become
exhausted.
How do we treat neurotransmitter imbalances?
We use amino acid precursors and Vitamin
supplementation and also sometimes low doses of prescription
medicines to increase levels of specific neurotransmitters. The
amino acids and the vitamins and mineral are to increase the amount
of ingredients available to the body and the medicines, if needed,
are used to slow down the breakdown of the neurotransmitters
Dopamine is a major neurotransmitter and serves
as a precursor to norepinephrine and epinephrine. It plays a
significant role in cognitive function and emotion, as well as roles
in the cardiovascular, renal, hormonal, and central nervous systems.
Long-term excess is often associated with increased blood pressure
whilst long-term deficiency may result in impairment of some
movement, memory problems and mood swings.
Adrenaline (Epinephrine) is a neurotransmitter
and hormone essential to the body's metabolism. Epinephrine raises
the concentration of free fatty acids in blood and releases glucose
from the liver. Long-term excess may result in anxiety,
cardiovascular problems and problems with glucose utilization.
Long-term deficiency can be associated with fatigue, depression and
digestive problems.
GABA is the major inhibitory neurotransmitter of
the brain, occurring in 30 -40% of all synapses. Insufficient GABA
neurotransmission has been associated with increased anxiety and
sleep problems.
Norepinephrine (Nor- Adrenaline) is most active
in the waking state and is important for focus and attention. It
also seems to contribute to anxiety and its turnover is increased
during stress. Patients with depression appear to have lower levels
of norepinephrine.
Serotonin is an amine neurotransmitter
synthesized by enzymes that act on tryptophan and/or 5-HTP.
Serotonin has been extensively studied and is a therapeutic target
for conditions like depression, compulsive disorders, anxiety,
insomnia, and migraines.
Acetylcholine is one of the major
neurotransmitters and has been shown to be essential for brain
development. Learning ability, mental awareness and memory function
tend to decline with lowering levels of acetylcholine whilst
long-term excess may be associated with exhaustion of pancreatic
activity and activation of destructive processes.
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