Living with chronic fatigue syndrome/ME is probably one of the most challenging and lonely experiences an individual can be faced with in life.
CFS is not a condition that typically has an end in sight or an immediate light at the end of the tunnel, so the suffering can be utterly relentless and to make matters worse there is no accepted medication to even reduce or lessen symptoms.
Allopathic medicine and conventional doctors have virtually nothing of worth to offer an individual with severe CFS/ME and many of the treatments that are prescribed are often neither evidence-based or can actually potentially worsen the condition such as anti-depressants and graded exercise.
There is nothing more lonely, isolating and anxiety-inducing that trying to live with chronic health problems that allopathic medicine either doesn’t properly understand, inadequately treats or trivializes to the point that you begin to question your own mental well-being and sanity.
We have been socially conditioned for years now from allopathic doctors to believe that CFS/ME is this flakey imaginary condition that sufferers exaggerate to feign sympathy, when the scientific research doesn’t support this very dangerous, incorrect and now out-dated belief.
The scientific research at this point is crystal clear that CFS/ME has a complex multi-factorial physiological biochemical origin and virtually no research I have stumbled across even suggests that ME is a psychological disorder or potentially driven by psychosomatic beliefs.
The only individuals still parroting this out-dated, non evidence-based nonsense and incorrect poor understanding when it comes to CFS/ME is of course allopathic trained doctors.
Anyway here are seven of my best tips for managing and living with chronic fatigue syndrome.
As always seek the advice of a qualified healthcare professional before making any significant dietary or lifestyle changes.
1. Pacing & Rest
The most fundamental principle when it comes to managing CFS/ME is balancing your limited energy reserves vs energy expenditure, which is known as “pacing”.
Pacing is about learning how to balance your limited energy pool with your how much energy your daily activities require.
Pacing and learning to stay withing your limited energy confinements is probably one of the most difficult and mentally taxing aspects of managing CFS.
Mitochondrial dysfunction can occur simply due to chronically exceeding your energy reserves.
As a result I believe pacing to be an absolutely vital component to recovery, in fact I will go out on a limb and go as far as saying that recovery is likely impossible whilst one is chronically exceeding their already likely limited energy reserves.
Pacing helps to prevent a worsening of CFS and the development of post-exertional symptoms. However, the fact that individuals with CFS/ME are virtually forced to pace their limited energy pool just re-confirms to me the real biochemical physiology origin of CFS i.e mitochondrial dysfunction.
An individual with CFS/ME is confined to whatever small pool of energy they have, if any, hence why many severe ME sufferers spend the majority of the day virtually bed ridden and even small energy demands such as looking after oneself, preparing meals, cleaning the household and undetaking basic tasks can seem like a huge task and result in worsening of symptoms due to exceeding one’s limited energy reserves and in the process inducing the likes of inflammation, oxidative stress and many other pathological disease processes behind CFS.
Overall, Pacing should be one of the first tips that an individual with CFS/ME tries to incorporate if they haven’t already.
2. Magnesium – The No.1 Nutrient For Individuals With CFS/ME
The most important nutrient in my opinion for an individual with CFS/ME is the mineral Magnesium.
If I was only able to take one supplement for the rest of my life to maintain my health and cfs/me symptoms it would be a high-quality magnesium supplement.
Magnesium is an extremely important mineral for health and individuals with CFS/ME, fibromyalgia and mitochondrial disorders often have disturbed magnesium status and intracellular magnesium deficiency.
Magnesium plays a role in ATP formation, so it is not surprising to me that individuals with CFS/ME can often be vitally depleted in this nutrient, due to cellular energy disorders and mitochondrial dysfunction.
It is worth noting that serum magnesium tests are not reliable for assessing magnesium status and research has found that serum magnesium only accounts for less than <1% of total-body magnesium stores. Hence serum magnesium tests shouldn’t be relied upon to exclude magnesium deficiency states. Supplementation with magnesium can be life-saving for many chronic diseases and low magnesium levels has been shown to play a role in many of these conditions.
The mitochondria are stores of intracellular magnesium and mitochondrial Mg2+ homeostasis decides cellular energy metabolism.
It was around ten or so years ago that I finally realised that many of my adverse symptoms that I was experiencing such as heart palpitations, anxiety/panic disorder, hypoglycemia/insulin resistance, muscle spasms, weak muscles and generally feeling like I could die were largely due to low magnesium levels and were massively relieved upon taking a few magnesium tablets.
I have experimented with many different types of magnesium supplements from magnesium malate to magnesium citrate. My favorite form of magnesium and the one I have had the most success with to date is magnesium citrate. Magnesium malate is another good choice for individuals with CFS as both magnesium and malic acid aid in the formation of ATP.
3. Mitochondrial Support Supplements (Co-Enzyme Q10, B-Complex Vitamins, Acetylcarnitine, Alpha Lipoic Acid…)
Which brings me to my next favorite tip which is mitochondrial support supplements such as Co-Enzyme Q10, Acetyl-Carnitine, B-Complex Vitamins/NADH, Alpha Lipoic Acid, Creatine, D-Ribose, PQQ and many others.
One of the first private tests that I had done to prove my chronic fatigue had a real physiological and biochemical origin was the plasma Co-Enzyme Q10 blood test.
Not surprisingly my plasma Co-Enzyme Q10 levels came back severely deficient and from there I became hooked on reading all the medical literature I could find on the now proven role that Co-Enzyme Q10 deficiency plays in the pathophysiology of CFS/ME and all things mitochondrial dysfunction.
Co-Enzyme Q10 deficiency has now been shown to be related to the chronic fatigue, autonomic dysfunction and neurocognitive symptoms, not to mention Coq10 deficiency is also an independent risk factor explaining the early mortality from cardiovascular disorder typically seen in individuals with CFS/ME. [1]
Which is why it greatly worries me that allopathic medicine and doctors do not seem to be taking this serious, especially regarding the literature on Co-Enzyme Q10 deficiency and the now proven inflammatory, oxidative and nitrosative stress component of chronic fatigue syndrome, which if left unaddressed may ultimately result in early mortality from the likes of cardiovascular disease. This to me is not what I believe to be acceptable…..
There were times I would bring my plasma Co-Enzyme Q10 tests and the supporting medical literature to many of the general practitioners I had seen over the years and of course nine times out of ten I was met with the usual passive-aggression, dismissive, trivializing attitude and often not willing to entertain even looking at the tests I had not only spend hundreds of pounds my own money doing, but also what appeared to be clinically relevant findings.
It didn’t take me long to realize that the reason why these conventional physicians were acting in such an aggressive manner was because they weren’t competent or knowledgable enough about the human physiology and were clearly intimidated that their patients had a better understanding of their health problems than they do, especially when presenting solid biochemical evidence in the form of blood tests. Blood test’s fortuanately don’t lie and aren’t prone to bias or being influenced by psychosomatic beliefs and any other weak excuses commonly used to fob off CFS patients.
Often many doctors would ask me why I was doing these tests or trying to find out what the cause of my health problems were. This to me was the straw that broke the camels back and I decided as far as CFS/ME was concerned I would never return to a conventional trained GP for health. If you cannot understand why someone who is chronically bed ridden wants to find out the root causes of their health problems, then in my opinion you shouldn’t be a doctor in the first place. These doctors are simply there to push medications to poorly mask some isolated symptoms often at the expense of addressing now proven easily addressable pathophysiology such as restoring Co-Enzyme Q10 levels.
Anyway back to the mitochondrial support supplements. If you have read any of my past articles you will likely already know I am a massive fan of mitochondrial support supplements such as Ubiquinol, Magnesium, D-Ribose, Alpha Lipoic Acid, Acetylcarnitine etc and have had excellent improvements in my health from increases in energy to functional capacity to reducing post-exertional symptoms and adverse symptoms such as shortness of breath on exertion.
The main downside to the mitochondrial support supplements is the expense, especially when you are often having to take several different supplements at the same time. Unfortunately you cannot even get these nutrients prescribed on the NHS, even when you can prove you are severely deficient and that there is adequate supporting science to support the role the likes of Coq10 deficiency can play in these common health problems.
There is no care or desire to treat the underlying complex multi-factorial pathophysiology that drives conditions such as CFS/ME because it is far more profitable for allopathic medicine to just prescribe multiple different medications to poorly “mask” the myriad of general non-specific symptoms that can accompany the likes of CFS, autoimmune diseases, fibromyalgia, autism spectrum disorders or virtually any health problem in which there is a proven genetic/biochemical and physiological influence and component, which to be fair is virtually all chronic diseases at this point.
4. Diet & Nutritional Therapy
Diet and nutritional therapy particularly in the form of an optimized predominantly plant-based diet can be a very powerful strategy for attenuating and modifying many of the speculated disease processes behind CFS such as reduced methylation capacity, micro-nutrient deficiencies, inflammatory, oxidative/nitrosative stress, lowered antioxidant status/redox imbalance, supporting optimal mitochondrial function, gut microbiome abnormalities/dysbiosis and so on and so forth.
For any diet to be healthy I believe it must be predominantly plant-based rich in high intake of a variety of plant-foods including fruits, vegetables, whole grains, nuts, seeds, legumes, herbs, mushrooms, healthy oils such as olive oil and many others.
These plant-based foods provide substantial quantities of potent anti-inflammatory and antioxidant phyto-nutrients such as polyphenols, flavonoids, not to mention various vitamins such as ascorbic acid, carotenoids and so on. All of these potent antioxidant phyto-chemicals help to combat oxidative stress and inflammation, both of which play key roles in the pathophysiology of CFS/ME according to the latest research.
Individuals with cellular energy disorders such as CFS/ME often have increased nutritional demands such as magnesium, B-complex vitamins, vitamin C and so on, which makes eating a healthy diet vital.
I am a huge believer in using evidence-based nutritional strategies and making your diet do as much as physically possible for strengthening and improving health, especially in the case of individuals with conditions such as CFS/ME, autoimmune diseases and serious mental health disorders such as major depression, which often come with an increased risk of cardiovascular disease and/or early mortality.
Research has also found that small and large artery endothelial dysfunction to occur in individuals with chronic fatigue syndrome/ME. Nutritional therapy is a very powerful strategy for addressing endothelial dysfunction. Many plant-based foods are now proven to reverse endothelial dysfunction and improve endothelial function such as apples, green/black tea, walnuts, dark chocolate, nitrite-rich spinach/leafy greens and many others.
Some of my other favorite foods in particular for reducing cfs symptoms include pomegranate, oily fish in the form of sardines, rosehip/hibiscus tea, high-flavanol raw cacao powder and oatbran for its prebiotic gut supportive properties.
A traditional Greek Mediterranean plant-based diet is a great basic template of a heart healthy, longevity promoting and evidence-based diet pattern.
Deficiencies in any of the B-complex vitamins can contribute to mitochondrial dysfunction. There is the compounding issue that many individuals have genetic mutations/SNP’s/MTHFR/MTRR and errors processing and uptaking certain B-vitamins, which can significantly negatively impact B-vitamin status and the likes of methylation, oxidative stress and consequently mitochondrial function as a result.
Severe Vitamin D deficiency states can result in muscle mitochondrial myopathy. My whole life I struggled to maintain a healthy Vitamin D status, despite often getting hours of sunshine daily prior to developing CFS. I would later find out from my own genetic tests that I had various genetic mutations relating to VDR(vitamin D receptor) that can potentially negatively impact Vitamin D status, often making supplementation essential.
I am also a huge believer in higher dietary vitamin C intake from natural foods such as berries, kiwis, amla, bell peppers, acerola cherry, rosehip etc. Vitamin C is a cofactor required both in catecholamine biosynthesis and in adrenal steroidogenesis. The adrenal glands also hold some of the largest stores of Vitamin C in the body. Stress can deplete Vitamin C levels in the body and lets be honest living with CFS is extremely stressful both physically and mentally on the body.
I have noticed a significant improvement from focusing on higher dietary vitamin C intake from the above natural foods. I am not a great fan of synthetic ascorbic acid supplements and prefer to utilize natural food-source as they are more stable and contain the supporting bioflavonoids to aid absorption.
5. Meditation & Mind-Body Techniques(Deep Breathing Exercises, Emotional Freedom Techniques(EFT), Qi Gong, Reflexology etc)
For years I neglected the mental and emotional component to well-being and as a result it kept me firmly stuck in a chronic “fight or flight” sympathetic stress state.
Part of the reason for this was not really understanding how meditation worked and incorrectly writing it off as being pseudo-spiritual and not worth bothering with.
I couldn’t have been further from the truth and for the past decade I have been experimenting with all sorts of different meditation and mind-body techniques such as deep diaphragmatic breathing, emotional freedom techniques aka EFT/tapping, tai chi, reflexology, qi gong and many other techniques to calm and balance the autonomic nervous system.
I try to meditate for at least 10-30 minutes 1-2x a day and have experienced profound improvements to both my mental/emotional well-being, and also many improvements to my physical health and a reduction of CFS symptoms.
EFT aka Emotional Freedom Technique aka the “tapping solution” is another favorite free technique that I have been using for a couple of years now with significant benefits for reducing stress, anxiety and PTSD symptoms, balancing the autonomic nervous system and aiding sleep. Many individuals with CFS often have difficulty sleeping due to cortisol reversal and personally I find a minute or two of EFT can often really help aid falling to sleep.
Reflexology is another great technique that is not only free but can be administered by onself or a friend and again I have experienced many great benefits. I tend to use reflexology when I am really struggling from a crash, I will just naturally play about and apply some pressure to my feet and often I will notice afterwards my autonomic nervous system is more balanced, I’m more calm, increased energy and an general increased feeling of well-being. Not bad for a technique which is free and can be done at home.
6. Adaptogenic Herbs
Out of all the different medicinal herbs, the group I believe to be the most beneficial for individuals with chronic fatigue syndrome is the adaptogen herbs.
Adaptogenic herbs or “adaptogens ” are botanicals which increase the bodies resistance to mental and physical stress, whilst having a normalizing effect on the body as a whole, helping to maintain optimal homeostasis.
The adaptogen herbs are very helpful for reversing the negative physiological consequences and metabolic changes that chronic stress has on the body.
Adaptogen herbs can help to balance endocrine stress hormones such as cortisol and modulate the hypothalamic-pituitary-adrenal axis, which is often dysfunctional in CFS patients and is a suspected part of the pathophysiology of CFS/ME.
Adaptogen herbs increase energy naturally and functional work capacity, which of course can be very helpful for those with CFS who often have a very poor and limited exercise capacity.
Some examples of my favorite adaptogen herbs include astragalus, jiaogulan, rhodiola rosea, schizandra berry, maca, panax ginseng, cordyceps, holy basil(tulsi), suma root and many others.
Other herbs which I find beneficial for CFS are the “nervine” herbs such as oat straw(avena sativa), skullcap, passionflower, chamomile, valerian root etc. These medicinal herbs are excellent choices for calming the mind and for supporting, toning and strengthening the nervous system overall.
The information in this article has not been evaluated by the FDA and should not be used to diagnose, cure or treat any disease, implied or otherwise.
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