Friday February 1, 2013

By DR. ALEXIS CHESNEY

In the United States, 24 percent of adults report having experienced fatigue lasting two weeks or longer. It can be debilitating. In extreme cases, where the severe fatigue has lasted more than six months, a physician may diagnose Chronic Fatigue Syndrome. In addition to severe fatigue, a person experiencing CFS may also exhibit some of the following: sore throat, muscle pain, joint pain, headaches, cognitive impairment, tender lymph nodes, sleep disturbances, long-lasting malaise after exertion. The cause of CFS is unknown and a diagnosis is made by excluding other medical causes. There is mixed evidence of association with the Epstein-Barr virus (which causes mononucleosis), other systemic viral load, Candidiasis and poor immune function. More recently, the central nervous system is seen as playing a role in CFS. One study showed that 96 percewnt of adults with CFS had a specific type of low blood pressure provoked by a tilt table test. Risk factors include stress, toxins, infection, allergies, nutritional deficiencies and immune dysfunction.

There are two conditions associated with long-term fatigue that, although rarely the sole cause of the condition, need to be diagnosed and treated to get effective results. Hypoglycemia (low blood sugar) can cause fatigue, dizziness, cognitive impairment, nausea, shakiness, and palpitations. Diabetes and alcohol abuse are risk factors for hypoglycemia. It is important to eat small frequent meals that are high in protein and contain some fat throughout the day in order to stabilize blood sugar.


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Hypocortisolemia, or low cortisol, can also cause fatigue. Blood and saliva studies are used to diagnose this condition. Naturopathic treatment may involve adaptogenic herbs that help our adrenal gland respond to stress such as Ashwaganda, Holy Basil, Siberian Ginseng and Rhodiola. Stress plays an important role in adrenal health and is a risk factor for CFS. Having healthy stress relieving tools are essential: having someone to talk to that you trust, being in nature, yoga, meditation, gardening, hobbies, social connection.

Magnesium, B12 (cobalamin), B6 (pyridoxine), B1 (thiamine), and B2 (riboflavin) deficiencies are seen in studies on CFS patients. Dr. John Myers pioneered the use of intravenous vitamins and minerals in Maryland. Since then, intravenous nutrient therapy has been shown to be far more effective in treating CFS than taking oral supplementation. Vitamin D3 deficiency may cause fatigue, weakness and pain, and is common in Vermont due to our latitude. Amino acid deficiencies have also been found. Eating at least 50 grams of protein per day and supplementing with Vitamin D3 is recommended for most people.

Post-infective fatigue has been documented with various illnesses and may actually be a root cause of Chronic Fatigue Syndrome. Ensuring that the microbial infection has been thoroughly treated is important. For example, Candida albicans may present on its own or secondary to the use of medications like antibiotics, birth control pills or Prednisone. It has been found that candidiasis can decrease immune function in the same way as in CFS. An anti-Candida diet focused on removing sugar, grains, yeast, dried fruit and fruit juices from the diet for a period of time may be recommended.

Food sensitivities (which cause gut inflammation) are also associated with fatigue. The most commonly associated sensitivities are to sugar, wheat, refined grains, corn and rice. It is useful to remove these, and/or other foods that one suspects themselves to be reactive to, from the diet for four weeks. Upon careful reintroduction, one can assess which food may be the culprit. Eating a clean diet high in vegetables, protein and good fats, as well as low in pesticides, food additives, hormones, and processed foods, decreases the inflammation in the gut. Healing the gastro-intestinal mucosal lining using glutamine, slippery elm or marshmallow, and creating healthy gut flora using probiotics is also important. Research shows that 80 percent of our immune system is in our gut. Therefore, decreasing inflammation, optimizing gut flora and healing the gut are essential to creating a healthy immune system.

Ultimately, Chronic Fatigue Syndrome is a description of symptoms. Getting to the cause behind the severe fatigue is the key.

Dr. Alexis Chesney is a naturopathic physician and acupuncturist at Sojourns Community Health Clinic. For more information please contact Sojourns Community Health Clinic, at (802) 722-4023, 4923 US Route 5, Westminster, VT, www.sojourns.org, find us on facebook and check out our blog: http://www.reformer802.com/journey2wellness.