Chronic fatigue (CFS) is an interesting concept as a condition that brings as much frustration as relief to many. It really makes you evaluate your existence. Typical sufferers are over-achiever’s, carers, trauma victims and others who work hold the hard play hard philosophy. However, as Hippocrates said, “Healing is a matter of time, but it is sometimes a matter of opportunity”. Prevalence rates vary between 2 and 2,800 per 100,000 with no social class, group or race distinction. Women are said to predominate but we are seeing more men than ever at this moment in time. Auto-immunity is more common in women so this may account for the numbers.
We like to think of chronic conditions as being part of an onion. You have to peel away each layer in the correct order for health to be regained. If you remove the wrong layer at the wrong time you can have a set-back. An example of this is when you try a “detox” without first opening your channels of elimination (kidneys, liver, lungs, colon). Chronic fatigue lends itself beautifully to functional medicine as every organ appears to be affected. In fact Myhill[i] calls it a disease of the mitochondria, the mitochondria being the energy systems of cells. Not only this but a complete reshape of lifestyle choice is necessary to ensure a return to health. There are a number of causes that may underpin mitochondrial dysfunction, which we are about to explain.
Genetics: CFS does run strongly down the female bloodline in families. We see many mother-daughter and mother-son pairs where the each has CFS. Now we have access to 23andme for genetic data we can see specific gene polymorphisms that may affect the person with CFS. These are different for everyone and we are just learning this aspect of CFS but we think in the next few years the whole area will evolve.
Could it be Environmental?
Viral or Toxic stress: direct damage from pesticides, carbon monoxide, heavy metals, Volatile organic compounds, hair dyes, silicones, burnt hydrocarbons etc. These compounds can block translocators (these transport cholesterol into the mitochondria to help with stabilisation of membranes). Medications such as the contraceptive pill, HRT, Statins and beta-blockers can also disrupt this process. Numerous viruses have been identified such as Epstein Barr[ii], Human Herpes virus[iii], Human Retrovirus[iv], Enterovirus[v][vi]. Bacterial overload has also been identified with Mycoplasma[vii], Rickettsia[viii], Mold[ix] [x] and Mold in relation to B12 deficiency[xi]
Nutritional Deficiencies: inability to fight off viral or toxic stress may be the result of poor nutritional and anti-oxidant status. Eating disorders, alcohol excess, western diets may all have an impact on body biochemistry as it slows down to accommodate the environmental load.
The Natural Ageing Process: as we age our natural ability to repair mitochondrial DNA diminishes. Our batteries flatten as our metabolism slows down. This would be a natural process for an eighty year old but not for a seventeen year old.
Sleep Disturbances: Chronically insufficient sleep such as shift work and being “tired but wired” means your body has no time for healing and repair.
Poor Methylation: According to Rich van Konynenburg, poor methylation is a major cause of fatigue. Methylation is essential for
- To produce vital molecules such as Co Q-10 and carnitine.
- To switch on DNA and switch off DNA. When viruses attack our bodies, they take over our own DNA in order to replicate themselves. If we can’t switch DNA/RNA replication off then we will become more susceptible to viral infection.
- To produce myelin for the brain and nervous system.
- To determine the rate of synthesis of glutathione which is essential for detoxification.
- To determine the rate of synthesis of glutathione which is an essential anti-oxidant as glutathione-peroxidase. Furthermore oxidative stress blocks glutathione synthesis – yet another vicious cycle!
- To control sulphur metabolism of the body, not just glutathione but also cysteine, taurine and sulphate. This is an important process for detoxification.
- As part of folic acid metabolism. This also switches on synthesis of new DNA and RNA.
- For normal immune function. The methylation cycle is essential for cell mediated immune function and blockages here will mean that infections will not be adequately dealt with. I know this clinically because many patients tell me that once they get on to their B12 injections (an essential co-factor for methylation) this seems to protect them from getting infections.
The overall effect here is that if the methylation cycle doesn’t work, the immune system malfunctions, the detoxification system malfunctions, our ability to heal and repair is reduced and the anti-oxidant system malfunctions.
Later theories are now considering Limbic Kindling[xii] and Vagus nerve inflammation[xiii] [xiv]. If you would like to see which ones may be affecting you please book a free 15 minute chat to find out if we can help you.
[i] Myhill S. (2014) Diagnosis and Treatment of Chronic Fatigue Syndrome its mitochondria not hypochondria. London Hammersmith Health.[ii] Cheney & Peterson www.CheneyResearch.com
[iii] Komaroff A.L. (2006) Is human herpes virus a trigger for chronic fatigue syndrome? Journal of Clinical Virology. Dec;37; Suppl 1:s39-46
[iv] Lombardi, F,, Ruscetti, W., Das Gupta, J. et al, (2009) Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Science New York, 326:585–589.
[v] Chia, J., Chia, A., Voeller, M., et al, (2010) Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence. Journal of clinical pathology, 63 (2):165–8. Available from: <http://www.ncbi.nlm.nih.gov/pubmed/19828908> [Accessed 4 April 2015].
[vi] Behan W.M,, More I.A,, Behan PO. (1991) Mitochondrial abnormalities postviral fatigue syndrome. Acta Neuropathol; 83: 61–5.
[vii] Nicolson G., Gan, R., Hair J. (2003) Multiple co-infections (mycoplasma, chlamydia, human herpes virus -6) in blood of chronic fatigue patients: association with signs and symptoms. APMIS May;111(5): 557-66
[viii] Hickie, I., Davenport, T., Wakefield, D., et al, (2006). Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. Bmj, 333(7568), 575.
[ix] Brewer, J.H., Thrasher, J.D. & Hooper, D. (2013) Chronic illness associated with mold and mycotoxins: Is naso-sinus fungal biofilm the culprit? Toxins, 6: 66–80.
[x] Anyanwu `E.C,, Morad M,, Campell A.W. (2004) Metabolism of mycotoxins, intracellular functions of vitamin B12 and neurological manifestations in patients with toxogenic mold exposures, A review. Scientific World Journal Aug 26(4):736-45
[xi] Van Konynenburg R.A. (2007) Glutathione depletion-methylation cycle block, a hypothesis for the pathogenesis of chronic fatigue syndrome; Poster presented at the 8th International Conference on in International Association of CFS; Fort Lauderdale, Fl. Jan
[xii] Gratrix, N. (2015) Limbic Kindling: hard-wiring the brain for hypersensitivities, CAM, Feb;13-16
[xiii] Sircus M. (2014) Vagus Nerve – inflammation – Heart Rate Variability. Available from www.drsircus.com/medicine/vagus-nerve-inflammation-heart-rate-variability
[xiv] Rochlitz, S. (2013) Hiatal Hernia Syndrome/Vagus Nerve Imbalance: The Most Common Health Syndrome in Mankind, With Illustrated Self-Help Corrections, The Syndrome That Can Cause or Exacerbate: Reflux, Asthma, Anxiety