Positive Health Online

Patients who suffer from chronic fatigue syndrome (CFS) are often so exhausted that they are unable to undertake half of their daily normal activities.

To date, we still do know what the true causes and cures for CFS are. However, there are a number of practical nutrition steps that may help speed up recovery including changes in diet, nutritional supplements and laboratory tests. 

What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is a group of symptoms associated with severe unrelenting fatigue [1]. The most common symptoms associated with chronic fatigue include poor sleep, achiness, brain fog, bowel and digestive disorders [1].

What are the Causes of Chronic Fatigue?

There are a number of causes of CFS. These include viruses and bacteria. In the case of viruses, the flu can be a trigger. Many patients with CFS never fully recover from the flu even if previously they were perfectly healthy.  Dr Myhill has recently written a book[2] and claims that vaccinations may also be linked to CFS. Dr Myhill  speculates that the immune system in CFS sufferers continues to fight the microbes from the vaccine even if they are at very low levels causing a huge energy drain.[2]

In the case of viruses, in some cases the latter may have the ability to suppress the hypothalamus, the body’s master gland. This can then lead to the body being unable to regulate other glands such as the adrenal glands.[1]

What Tests can be Used to Diagnose CFS?

To date there aren’t any specific tests available on the NHS that are able to diagnose CFS. However useful tests available on the NHS include standard blood tests including Ferritin, B12 levels and white blood cell counts [2].

What Tests are Available Outside the NHS?

There are several useful tests that are frequently used by experienced practitioners that have proved useful in understanding the cause some of the underlying symptoms of CFS.

Urine Thyroid Test

The first test to consider for patients who have debilitating fatigue is a urine thyroid test. This tests measure T3 and T4 hormones in the blood. It is a very useful test particularly if the patient is feeling very tired. Many patients who have already had their thyroid checked by their GP are told that their results are normal. The urine test is very sensitive and is useful in cases of subclinical hypothyroidism. If T3 or T4 levels are low, appropriate supplements will be recommended. These may include Tyrosine, Iodine and Selenium to help improve the function of the thyroid gland.

Vitamin B Deficiency

It is also worthwhile determining Vitamin B status as many patients are deficient in vitamin B3 and B12. B3 is an important vitamin needed to make NAD and thus vital for energy.[2]

Magnesium Deficiency

It is also a good idea to check for magnesium deficiency[2] including red cell magnesium as many patients experiencing unrelenting fatigue appear to be deficient.

Adrenal Stress Index

The adrenal stress index is a valuable test that looks at the function of the adrenal glands. For some patients cortisol production may be impaired and this may be one of the causes of their fatigue.[4] For others, cortisol production may be excessive causing sleep disturbances and anxiety.

Patients who push themselves continually, through work or exercise are likely to experience a breaking point. Initially, their adrenal glands may produce adrenaline and cortisol to deal with the stress. Over time the adrenal glands simply become exhausted and are unable to keep up production of cortisol.  If this happens the patient will feel exhausted. The Adrenal stress index test is an excellent test in as much as it can show the patient exactly how serious things are and may encourage them to take the necessary steps to recover.  Meditation, changes in lifestyle as well as dietary changes should all be addressed.

Comprehensive Stool Test

Many patients with CFS complain of digestive disorders including diarrhoea, constipation and pain.[3]

From a nutritional perspective, the cause of digestive disorders may be linked to bacteria, parasites or yeasts. If the patient has digestive symptoms,[2] a stool test would be a good place to start as it will identify all of the above. Low stomach acid may be implicated in digestive disorders and should be investigated.

SIBO - Small Intestinal Bacterial Overgrowth

Many patients experience upper gut fermentation[2] - this is caused by bacteria in the small intestine and can result in digestive problems. If a patient tests positive for SIBO, foods will be fermented in the small intestine instead of being digested. This is problematic as alcohols will be produced as a result of the fermentation process and may cause fatigue such as brain fog.[2] If the patient tests positive, they will need to follow a strict low carbohydrate diet with the hope of starving the bacteria and reducing the overgrowth.

Diet and CFS

There are two common diets used in CFS.[1] One is an anti-candida diet[5] and the other is the Stone Age diet.[2] I tend to use a combination of both as every patient is different, and some have food allergies and intolerances.

The anti-candida diet is a sugar free and yeast free diet. Sucrose, glucose, maltose, dextrose, honey and fructose should be removed from the CFS patient.[5] Foods containing yeast such as marmite, mushrooms, vinegar, bread alcohol, and soya sauce also need to be avoided for 2-3 months. This type of diet does certainly seem to help with brain fog and foggy thinking.

The Stone Age diet

In her new book, Dr Myhill[2] is a huge advocate of the Stone age diet. She recommends avoiding carbohydrates (that may drain energy) chemicals and common allergens. The Stone Age diet however is quite limited and is only based on vegetables, fat and protein and fibre. Allowed foods include:

• Protein: meat including lamb, beef, chicken, turkey, eggs, fish (not smoked);
• Vegetables: All green vegetables are allowed including asparagus, green beans, salads, and avocado;
• Fats: olive-oil, sunflower oil, sesame oil are all permitted.

Many patients find this diet extremely hard to follow; in some it causes constipation and some have lost too much weight. For those who do manage to follow it, the benefits do outweigh the difficulties, particularly for those with SIBO.

Supplements for Chronic Fatigue

There are a number of supplements that may be used to help CFS sufferers and supplement companies are increasingly providing a huge array of over-the counter vitamins, minerals and herbs. However, before taking any supplements, it is always best to be targeted in one’s approach. For example if a patient does test positive for SIBO, a good practitioner should be wary of feeding the bacteria in the upper gut and would be better off not recommending any supplements.

If an adrenal stress profile does indicate low cortisol, then B vitamins, Magnesium and liquorice may be beneficial supplements;

• If the Comprehensive Stool test comes back with signs of a yeast over-growth anti-fungals may be necessary including oregano oil, grapefruit seed extract and caprylic acid;
• Other important supplements[3] include Magnesium as this may help reduce fatigue. In some patients Magnesium may cause loose stools or diarrhoea so the dose may need to be reduced;
• NADH-and L-Carnitine may help increase energy;
• Vitamin B12- Some patients benefit greatly in terms of energy from injections of B12;
• Vitamin D is also very important for the immune system. Patients with CFS should take between 1000 IU per day.

Conclusion

The question that I get asked by most patients is whether it is possible to recover from CFS. My answer is always the same. If one can identify the trigger and the underlying imbalances recovery is more likely.

From my experience it is the patients who pace themselves and indulge in meditation and rest and relaxation who do recover faster. Diet is also fundamental and strict avoidance of sugars and yeast as well as food allergens can certainly help with a good outcome.

References

1. Teitelbaum J.  From Fatigued to Fantastic. Avery. NY. ISBN 1-58333-097-6. 2001.

2 Myhill S.  Diagnosis and Treatment of Chronic Fatigue Syndrome. It’s mitochondria, not hypochondria. Hammersmith Health Books. London ISBN 978-1-78161-034-3. 2014.

3.  Murray, M. and Pizzorno, J. Encyclopedia of Natural Medicine, Three Rivers Press NY. ISBN 0-7615-1157-1. 1998.

4.Wilson JL. Adrenal Fatigue The 21st Century Stress Hormone. Smart Publications. USA. ISBN 1-890572-15-2 2007.

5. Crook W. The Yeast Connection. Professional Books. Jackson. Tennessee. ISBN 0-933478-24-0. 1983.