Guest guest Posted May 5, 2004 Report Share Posted May 5, 2004 Chronic Fatigue Syndrome (EBV) Researchers are only beginning to target possible causes of CFS. Many suspect that it is caused by thyroid, adrenal, liver, or immune system dysfunction. It is a poorly understood disease involving many body systems. No single cause for chronic fatigue syndrome (CFS) has been identified. Therefore, it is defined by symptoms and by ruling out other known causes of fatigue. Suggested causes include chronic viral infections, food allergy, adrenal gland dysfunction, and many others. None of these have been convincingly documented in more than a minority of sufferers. Another theory is that CFS is caused by a virus similar to the herpes virus, i.e. Epstein-Barr virus. The current definition is disabling fatigue lasting more than six months that reduces activity by more than half. In some people there is also difficulty sleeping, swollen lymph nodes, and/or mild fever. When there is muscle soreness, fibromyalgia may be the actual problem. Although CFS is considered a modern diagnosis, it may have existed for centuries under other names, such as “the vapors,” neurasthenia, “effort syndrome” (diagnosed in World War I veterans), hypoglycemia, and chronic mononucleosis. What are the symptoms of chronic fatigue syndrome? In addition to fatigue, there may also be muscle pain, joint pain not associated with redness or swelling, short-term memory loss, and an inability to concentrate. Some people with chronic fatigue syndrome also experience difficulty sleeping, swollen lymph nodes, and/or mild fever. How is it treated? Since there is no definitive conventional therapy for CFS, doctors use a combination of lifestyle changes, including aerobic exercise, healthful diet, stress reduction, phototherapy, and psychological counseling. Dietary changes that may be helpful: Some believe that people with CFS who have low blood pressure should not restrict their salt intake. Among CFS sufferers who have a form of low blood pressure triggered by changes in position (orthostatic hypotension), some have been reported in a preliminary study to be helped by dietary intervention and the addition of sea salt to their regimen. People with CFS considering increasing salt intake should have their blood pressure monitored before making such a change. Lifestyle changes that may be helpful: Many people report feeling better after undertaking a moderate exercise plan. However, most people with CFS are sensitive to overexertion, and excessive exercise may lead to consistently worsening fatigue and mental functioning. Exercise should be attempted gradually, starting with very small efforts. One small study found that intermittent exercise, in which patients walked for three minutes followed by three minutes of rest for a total of 30 minutes, did not exacerbate their CFS symptoms. Nutritional supplements that may be helpful: The combination of potassium aspartate and magnesium aspartate has shown benefits for chronically fatigued people in double-blind trials. Usually 1 gram of aspartates is taken twice per day, and results have been reported within one to two weeks. Vitamin B12 deficiency may cause fatigue. However, some reports even double-blind ones, have shown that people who are not deficient in B12 have increased energy following a series of vitamin B12 injections. Some sources in conventional medicine have discouraged such people from taking B12 shots despite this evidence. Nonetheless, some doctors have continued to take the limited scientific support for B12 seriously. In one preliminary trial, 2,500 to 5,000 mcg of vitamin B12 given by injection every two to three days led to improvement in 50 to 80% of a group of people with CFS; most improvement appeared after several weeks of B12 shots. While the research in this area remains preliminary, people with CFS considering a trial of vitamin B12 injections should consult their health professional. Oral or sublingual B12 supplements are unlikely to obtain the same results as injectable B12, because the body’s ability to absorb large amounts is relatively poor. A preliminary trial has shown that people with CFS have reduced functional B-vitamin status when compared to people without the condition. The functional vitamin deficiency seen in this study was most pronounced for vitamin B6. Double-blind trials are needed to establish whether B-vitamin supplementation is effective in people with chronic fatigue syndrome. L-carnitine is required for energy production in the powerhouses of cells (the mitochondria). There may be a problem in the mitochondria in people with CFS. Deficiency of L-carnitine has been seen in some CFS sufferers. One gram of carnitine taken three times daily for eight weeks led to improvement in CFS symptoms in one preliminary trial. NADH (nicotinamide adenine dinucleotide) helps make ATP, the energy source the body runs on. In a double-blind trial, people with CFS received 10 mg of NADH or a placebo each day for four weeks. Of those receiving NADH, 31% reported improvements in fatigue, decreases in other symptoms, and improved overall quality of life, compared with only 8% of those in the placebo group. Further double-blind research is needed to confirm these findings. Magnesium levels have been reported to be low in CFS sufferers. In a double-blind trial, injections with magnesium improved symptoms for most people. Oral magnesium supplementation has improved symptoms in those people with CFS who previously had low magnesium levels, according to a preliminary report, although magnesium injections were sometimes necessary. These researchers report that magnesium deficiency appears to be very common in people with CFS. Nonetheless, several other researchers report no evidence of magnesium deficiency in people with CFS. The reason for this discrepancy remains unclear. Dehydroepiandrosterone, more commonly known as DHEA, is a hormone now available as a supplement. In one report, DHEA levels were found to be low in people with CFS.26 Another research group reported that, while DHEA levels were normal in a group of CFS patients, the ability of these people to increase their DHEA level in response to hormonal stimulation was impaired. Whether supplementation with DHEA might help CFS patients remains unknown due to the lack of controlled research. DHEA should not be used without the supervision of a healthcare professional. Herbs that may be helpful: Some research suggests that CFS may be partially due to low adrenal function resulting from different stressors (e.g., mental stress, physical stress, and even viral illness) and impacting the normal communication between the hypothalamus, pituitary gland, and the adrenal glands. Licorice root is known to stimulate the adrenal glands and to block the breakdown of active " cortisol " in the body. One case report described a man with CFS whose symptoms improved after taking 2.5 grams of licorice root daily. While there have been no controlled trials to test licorice in patients with CFS, it may be worth a trial of six to eight weeks using 2 to 3 grams of licorice root daily. Other integrative approaches that may be helpful: Prescription drugs, such as anti-hypertensives(blood-pressure meds), birth control pills, or sedatives may 'trigger' chronic fatigue. Diet can play an important role in CFS treatment. Patients often discover that simply by modifying their diet, they can greatly improve their CFS symptoms. By choosing organically grown nutrient-rich foods which are easily digested, CFS patients can begin to take control. Good dietary choices include: Organic vegetables, fresh organic fruits, Legumes, Beans, lentils, Whole grains, Seeds, Raw Nuts and cold-water fish such as Alaskan Salmon. CFS patients may also find that certain foods " intensify " their symptoms. Processed foods and foods that require more 'energy' to digest may increase fatigue symptoms in CFS patients. Some foods that CFS patients may want to avoid include: Dairy products, Red meats and poultry, Alcohol, Refined Sugar,aspartame and other artificial sweeteners,refined oils and Processed foods containing hydrogenated fats, Caffeinated beverages including sodas, coffee (both caffeinated and decaf), and chocolates may be problematic as well. The most debilitating symptom of CFS is a complete lack of energy. Some herbs used for energy enhancement include: Ginger Licorice Root Dandelion Root & Leaf Alfalfa Organic Blackstrap Molasses Stinging Nettle tea (for iron) Garlic Chives In a study at the University of California Department of Medicine, Echinacea and Astragalus extracts enhanced cellular immune function in both healthy individuals and patients with depressed immune systems. Other herbs that are recognized for immune system enhancement include: Shitake Mushrooms Fresh Garlic Leeks, Onions, & Scallions Reishi Mushroom Olive leaf extract IMPORTANT SUPPLEMENTS: Dietary supplements can provide great relief to individuals suffering from CFS. In a study of fibromyalgia and CFS, patients reported a significant improvement in symptoms after taking nutritional supplements. Experts recommend the following nutritional supplements for CFS patients. Magnesium- is important for energy production, protein formation, and cellular replication. Most Americans are deficient in this mineral. Iron deficiency can lead to chronic fatigue and anemia. Spinach, kale, dandelion, beets, asparagus and organic eggs are important food sources. Vitamin B-complex consists of 11 B vitamins, including folic acid, vitamin B6, and vitamin B12. Vitamin B6 deficiency has been implicated in fatigue and anemia. Vitamin B12 deficiency is implicated in elevated *homocysteine* levels. High levels of homocysteine are believed to contribute to heart disease, the number one killer in the U.S. elevated levels of *homocysteine* are characteristic of CFS patients. Researchers have discovered that CFS patients have lower levels of B vitamins than healthy patients as well. Vitamin E--an important antioxidant, protects cells against damage from toxins. It can enhance imune function and has antihistamine properties. Potassium-- deficiency has been linked to fatigue and muscle weakness. Potassium may help restore energy levels in CFS patients. Pantothenic Acid helps your body make its own *thyroid glandular*. Blackstrap molasses, Brewers Yeast, Coconut milk and fresh Pineapple are all rich in Pantothenic Acid. Vitamin C is an important antioxidant known to support immune function. Under stressful conditions, the body needs additional vitamin C to help the immune system function normally. Vitamin C promotes healthy adrenal function, which is especially helpful for women who suffer from stress. In one study of 411 married couples, researchers found a clear correlation between fatigue and low levels of vitamin C. Stress Reduction: Most experts agree that *stress* plays a part in CFS. Meditation induces relaxation. Try thinking affirmative thoughts. Visualization may be combined with calming music to reduce stress Focus on positive imagery. Yoga can improve circulation and may increase energy Massage can also improve circulation and reduce stress as well. How CFS Begins and Its Symptoms For many people, CFS begins after a bout with a cold, bronchitis, hepatitis, or an intestinal bug. For some, it follows a bout of infectious mononucleosis, or mono, which temporarily saps the energy of many teenagers and young adults. Often, people say that their illnesses started during a period of high stress. In others, CFS develops more gradually, with no clear illness or other event starting it. Unlike flu symptoms, which usually go away in a few days or weeks, CFS symptoms either hang on or come and go frequently for more than six months. CFS symptoms include: Intense Headache Tender lymph nodes Fatigue and weakness Muscle and joint aches Inability to concentrate What Causes CFS? While no one knows what causes CFS, for more than a century, doctors have reported seeing illnesses similar to it. In the l860s, Dr. George Beard named the syndrome neurasthenia because he thought it was a nervous disorder with weakness and fatigue. Since then, health experts have suggested other explanations for this baffling illness. Iron-poor blood (anemia) Low blood sugar (hypoglycemia) Environmental allergy A body wide yeast infection (candidiasis) In the mid-1980s, the illness became labeled " chronic EBV " when laboratory clues led scientists to wonder whether the Epstein-Barr virus (EBV) might be causing this group of symptoms. New evidence soon cast doubt on the theory that EBV could be the only thing causing CFS. High levels of EBV antibodies (disease-fighting proteins) have now been found in some healthy people as well as in some people with CFS. Likewise, some people who don’t have EBV antibodies, and who thus have never been infected with the virus, can show CFS symptoms. How is CFS Diagnosed? Doctors find it difficult to diagnose CFS because it has the same symptoms as many other diseases. When talking with and examining you, your doctor must first rule out diseases that look similar, such as multiple sclerosis and systemic lupus erythematosus in which symptoms can take years to develop. In follow-up visits, you and your doctor need to be alert to any new cues or symptoms that might show that the problem is something other than CFS. When other diseases are ruled out and if your illness meets other criteria as well, your doctor can diagnose you with CFS (see The CFS Case Definition). The CFS Case Definition The EBV work sparked new interest in the syndrome among a small group of medical researchers. They realized they needed a standard way to describe CFS so that they could more easily compare research results. In the late 1980s, CDC brought together a group of CFS experts to tackle this problem. Based on the best information available at the time, this group published in the March 1988 issue of the scientific journal, Annals of Internal Medicine, strict symptom and physical criteria -- the first case definition -- by which scientists could evaluate CFS study patients. Not knowing the cause or a specific sign for the disease, the group agreed to call the illness " chronic fatigue syndrome " after its primary symptom. " Syndrome " means a group of symptoms that occur together but can result from different causes. (Today, CFS also is known as myalgic encephalomyelitis, postviral fatigue syndrome, and chronic fatigue and immune dysfunction syndrome.) How Can I Cope With and Manage the Illness? There is no effective treatment allopathic treatment for CFS. Even though there is no specific treatment for CFS itself, you may find it quite helpful to treat your own symptoms. Learning how to manage your fatigue may help you improve the level at which you can function and your quality of life despite your symptoms. A qualified naturopath can evaluate and teach you how to plan activities to take advantage of times when you usually feel better. Conclusion CFS seems to involve interactions between the immune and central nervous systems, interactions about which scientists know relatively little. Scientists' concerted efforts to penetrate the complex nervous system and immune system events in CFS have created a challenging new concept of the pathology of this and other illnesses. ________________ References: 1. De Lorenzo F, Hargreaves J, Kakkar VV. Pathogenesis and management of delayed orthostatic hypotension in patients with chronic fatigue syndrome. Clin Auton Res 1997;7:185–90. 2. Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. Br Med J 1997;314:1647–52. 3. McCully KK, Sisto SA, Natelson BH. Use of exercise for treatment of chronic fatigue syndrome. Sports Med 1996;21:35–48 [review]. 4. Blackwood SK, MacHale SM, Power MJ, et al. Effects of exercise on cognitive and motor function in chronic fatigue syndrome and depression. J Neurol Neurosurg Psychiatry 1998;65:541–6. 5. LaManca JJ, Sisto SA, DeLuca J, et al. Influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome. Am J Med 1998;105:59S–65S. 6. Paul L, Wood L, Behan WM, et al. Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome. Eur J Neurol 1999;6:63–9. 7. Clapp LL, Richardson MT, Smith JF, et al. Acute effects of thirty minutes of light-intensity, intermittent exercise on patients with chronic fatigue syndrome. Phys Ther 1999;79:749–56. 8. Shaw DL, Chesney MA, Tullis IF, Agersborg HPK. Management of fatigue: a physiologic approach. Am J Med Sci 1962;243:758–69. 9. Crescente FJ. 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Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome. Ann Clin Biochem 1994;31(Pt. 5):459–61. 26. Kuratsune H, Yamaguti K, Sawada M, et al. Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Int J Mol Med 1998;1:143–6. 27. De Becker P, De Meirleir K, Joos E, et al. Dehydroepiandorsterone (DHEA) response to i.v. ACTH in patients with chronic fatigue syndrome. Horm Metab Res 1999;31:18–21. 28. Bou-Holaigah I, Rowe PC, Kan J, Calkins H. The relationship between neurally mediated hypotension and the chronic fatigue syndrome. JAMA 1995;274:961–7. 29. Whorwood CB, Shepard MC, Stewart PM. Licorice inhibits 11ß-hydroxysteroid dehydrogenase messenger ribonucleic acid levels and potentiates glucocorticoid hormone action. Endocrinology 1993;132:2287–92. 30. Baschetti R. Chronic fatigue syndrome and liquorice. New Z Med J 1995;108:156–7 [letter]. 31. Brown D. Licorice root—potential early intervention for chronic fatigue syndrome. Quart Rev Natural Med 1996;Summer:95–7. 32. Price JR, Couper J. Cognitive behaviour therapy for adults with chronic fatigue syndrome. Cochrane Database Syst Rev 2000;(2):CD001027 [review]. ----- 2002 Healthnotes, Inc. All rights reserved. www.healthnotes.com Learn more about Healthnotes, the company. Learn more about the authors of Healthnotes. The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. _________________ JoAnn Guest mrsjoguest DietaryTipsForHBP http://www.geocities.com/mrsjoguest The complete " Whole Body " Health line consists of the " AIM GARDEN TRIO " Ask About Health Professional Support Series: AIM Barleygreen " Wisdom of the Past, Food of the Future " http://www.geocities.com/mrsjoguest/AIM.html PLEASE READ THIS IMPORTANT DISCLAIMER We have made every effort to ensure that the information included in these pages is accurate. However, we make no guarantees nor can we assume any responsibility for the accuracy, completeness, or usefulness of any information, product, or process discussed. Win a $20,000 Career Makeover at HotJobs Quote Link to comment Share on other sites More sharing options...
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