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NUTRI NEWS NO. 13
FOR PROFESSIONAL USE ONLY
Unravelling the Mystery of Chronic Fatigue
Syndrome

Fatigue is an incredibly common symptom of ill health; up to 30% of patients complain to their doctors of symptoms of fatigue, with a
wide variety of possible causes. Chronic Fatigue Syndrome (CFS), formerly known as Myalgic Encephalomyelitis (ME) is a much
rarer condition and describes a health problem where levels of fatigue are often so debilitating that they prevent sufferers from
continuing with their normal daily life. CFS sufferers often have to take a significant period of time off work, since ‘rest and
recuperation’ are the main ‘treatment’ recommendations given by medical doctors. Whilst it is still a relatively rare health problem,
the worrying news is that the incidence of chronic fatigue syndrome is very much on the increase.


What is CFS?
based on high rates of co-occurrence and overlapping Symptoms of CFS include fatigue for 6 months or more and experiencing other problems such as muscle pain, memory problems, headaches, pain in multiple joints, sleep problems, A preliminary study published in The Medical Journal of sore throat and tender lymph nodes. CFS is most common in Australia found higher levels of environmental pollutants in women in their 40s and 50s, but anyone can develop CFS and the blood of chronic fatigue patients than in control subjects.2 it can last for years. Since other illnesses can cause similar symptoms, CFS is typically very hard to diagnose. Studies have also shown that some forms of chronic fatigue syndrome are most definitely responsive to a comprehensive So what causes CFS?
nutritional treatment program focused on supporting optimal Unfortunately, there is no single definitive answer to this question; from a conventional medical standpoint the aetiology of CFS is unknown, which makes treatment options Dr Jeffrey Bland & the CFS - Detoxification Link
very limited. The Centre for Disease Control & Prevention Dr Jeffrey Bland and his colleagues at the Institute of commented, “It now seems clear that CFS is not caused Functional Medicine (IFM) have done much to study the link exclusively by any single recognised infectious disease agent”. between CFS and metabolic detoxification. In one study, 30 patients with CFS were tested for abnormalities in liver Prevailing medical opinion today is that CFS may be a detoxification and were then advised to follow a tailored common endpoint of disease resulting from multiple causes nutritional strategy. Results showed that both liver function such as viral infection, traumatic conditions, stress and toxins tests and symptom score sheets showed significant among other causes. Medication is often prescribed to treat improvement following nutritional intervention.3 symptoms of pain, sleep disorders and other problems, but does not address an underlying cause(s). Later research, again carried out by Dr Jeffrey Bland and his colleagues at the IFM, showed that a significant proportion of From a functional medicine standpoint, we do know that there patients with CFS had imbalances in liver detoxification, are likely to be a wide range of underlying causes, and that as where phase I was faster than normal, thereby generating high a health care practitioner, there is a vast amount you can do to volumes of toxins, yet phase II was sluggish and unable to help uncover the root causes in any given individual and support these with tailored nutritional interventions. Functional liver detoxification profile
Does toxic overload contribute to CFS?
Liver function testing may be useful as an initial investigation With regard to toxic overload and CFS, it is interesting to note in patients presenting with chronic fatigue syndrome, followed that the symptoms reported by CFS sufferers are similar to the by individually targeted dietary advice and tailored nutritional hallmarks of Gulf War Syndrome, which is now widely supplementation to support optimal detoxification processes. believed to be the result of massive exposure to organophosphate pesticides, coupled with the effects of nerve Alkalising powder formula to support balanced
detoxification in CFS
A complete balanced powder formula made with a base of low Studies have found that chronic fatigue syndrome (CFS), allergy potential rice protein that can be mixed up into a drink multiple chemical sensitivity (MCS), and fibromyalgia (FM) is ideal for patients with CFS since it avoids the need for commonly co-occur. In fact, some experts have suggested patients with low energy levels to take lots of different that CFS, MCS and FM are manifestations of the same illness supplements. A balanced powder formula needs to target Nutri (Imports & Exports) Ltd, Meridian House, Botany Business Park, Whaley Bridge, High Peak, Derbyshire, SK23 7DQ Tel: 0800 212742 Fax: 0800 371731 www.nutri.co.uk [email protected] nutrient support for phase I with additional nutrient support for phase II liver detoxification processes. Key nutrients Can sub-optimal digestive function contribute towards
include a full complement of essential vitamins and minerals for phase I processes, in addition to amino acids, N-Acetyl-L- There are many different underlying causes of CFS and Cysteine, L-Glutathione, L-Cysteine, L-Glycine, Taurine, L- digestion is a key part of this complex picture. An insufficient Lysine, L-Theanine for phase II conjugation. Potassium intake of nutrients can be a significant contributing factor, yet citrate & sesame powder may help to alkalise otherwise acidic so can poor digestion. It is key to remember that you are not what you eat, but rather what you digest and absorb. Eating a wide variety of nutrient dense foods may not be much use if Higher incidence of allergies in people with CFS
digestion and absorption are not functioning optimally. Studies have shown that people with CFS are more likely to Internationally renowned nutrition expert, Dr Jeffrey Bland have a history of allergies than healthy controls. An has always maintained the importance of investigating and oligoantigenic (low allergen) diet is therefore recommended as supporting optimal digestive function in patients with CFS. part of a hepatic detoxification support programme in The tried and tested 4R protocol is an effective way of imbalances in patients with CFS. See Nutri News No 113 for Is CFS a result of adrenal overload?
more detailed guidance on the 4R protocol. In a review article published in the Nov 2008 edition of the journal Integrative Medicine, author David Anderson wrote, Where does energy come from?
“stress has become the leading health problem in Western Energy happens as a result of a series of chemical reactions in society. We are more ravaged by the consequences of stress the body; food is broken down into its component parts, and today than at any time in previous history”.5 As a society we these are combusted with oxygen, to make a unit of cellular are suffering from an epidemic of stress-related health energy called ATP. This process happens inside the energy- problems; significant physical or emotional stress is making powerhouse, the mitochondria in every single cell in commonly reported as a pre-onset condition in patients with the body and there are nutrient co-factors required at every Multiple laboratory studies have suggested that the Central Restoring baseline nutrient deficiency
Nervous System (CNS) may have an important role in CFS. One of the biggest overlooked factors in CFS is broad- Physical or emotional stress alters the activity of the spectrum nutritional deficiency. Many people mistakenly Hypothalamus-Pituitary Axis (HPA), leading to altered release assume that if you eat a well-balanced diet, you will get all the of corticotrophin-releasing hormone (CRH), cortisol and other nutrients that you need, yet scientific studies have shown hormones. CRH influences the immune system and many other body systems, and may also affect several aspects of recommending nutritional supplementation. In an expert review of vitamins for disease prevention published in the highly prestigious Journal of the American Medical Recent studies have shown that CFS patients often produce Association it was concluded that; “Most people do not lower levels of cortisol than do healthy controls.7 Cortisol consume an optimal amount of all vitamins by diet alone. suppresses inflammation and cellular immune activation, thus Pending strong evidence of effectiveness from randomised reduced levels may relax constraints on inflammatory trials, it appears prudent for all adults to take vitamin processes and immune cell activation. Hypoactivation of the supplements”.14 Experts agree that supplementing with a high stress system is a common feature of patients with CFS;8 quality, one-a-day multivitamin/mineral supplement can help supporting the adrenal glands through targeted nutritional to correct widespread underlying nutrient deficiency. An intervention is therefore a key part of any CFS treatment effective multivitamin & mineral supplement should contain all essential vitamins and minerals; and in particular and what is so often missed from multivitamin & mineral supplements, Synergistic herbal support for adrenal balance
1000IU vitamin D, vitamin K, 200IU vitamin E and optimum Herbal adaptogens, Rhodiola rosea, Asian ginseng & levels of B complex vitamins all in a highly bioavailable form. Cordyceps mycelium have all been shown to help support A one-a-day formula is particularly important for CFS patients adrenal balance and can be particularly useful for patients as it avoids the need for patients to take multiple numbers of presenting with adrenal hypofunction, such as is typical of supplements, which may be a struggle when dealing with low Rhodiola rosea is a particularly useful plant adaptogen with The Energy Nutrients
over 180 scientific studies supporting its use. Studies have shown that Rhodiola rosea can help to balance activity of the NADH – Nicotinamide adenine dinucleotide (NADH) is
hypothalamic pituitary axis, an effective target for patients essential for the production of the body’s energy currency, ATP. NADH is the active coenzyme form of niacin (vitamin B3) and plays an essential role in energy production, carrying Asian ginseng & Cordyceps mycelium have shown similar electrons from the citric acid cycle to the electron transport efficacy as adaptogenic plant compounds; and may be a useful chain, ultimately producing ATP, the body’s energy currency. adjunct in any treatment strategy to support adrenal balance.11- Nutri (Imports & Exports) Ltd, Meridian House, Botany Business Park, Whaley Bridge, High Peak, Derbyshire, SK23 7DQ Tel: 0800 212742 Fax: 0800 371731 www.nutri.co.uk [email protected] medicine model aims to uncover and address the underlying Coenzyme Q10 – The body’s energy-making process, the
causes, which have collectively overloaded the body. At the electron transport chain, converts the energy stored in root cause of CFS may be endotoxins, xenobiotics, radiation carbohydrates into ATP, the energy currency of the body. exposure, specific food and environmental allergens, Coenzyme Q10 is a critical component of this process, being a over exertion, structural imbalances, imbalanced diets, and the direct carrier of electrons in the mitochondria; inadequate presence or absence of specific nutrients. From a functional amounts of this vitamin-like nutrient can cause free radical medicine perspective, the most effective treatment to date damage to the mitochondria, which then causes a greatly involves investigation of root cause(s) in each individual coupled with a specifically tailored diet and supplement programme with the sole aim of restoring and supporting CoQ10 is therefore strongly recommended in patients with N-Acetyl-L-Carnitine – is an essential co-factor for helping
References:
to transport long chain fatty acids into the mitochondria for 1. Brown MM et al. Functioning in individuals with conversion into energy and may be a useful adjunct in a chronic fatigue syndrome: increased impairment with co-occurring multiple chemical sensitivity and fibromyalgia. Dyn Med. 2007 May 31; 6:6 Thiamin (B1) & Riboflavin (B2) – these important B
2. Dunstan RH et al. A preliminary investigation of vitamins support the catabolism of carbohydrates, fats and chlorinated hydrocarbons and chronic fatigue protein into energy; essential nutrients for anyone suffering syndrome. Med J Aust. 1995 Sep 18; 163 (6): 294-7 3. Rigden S. et al. Management of chronic fatigue symptoms by tailored nutritional intervention using a Antioxidant protection
program designed to support hepatic detoxification. Antioxidant protection is an essential part of any supplement programme in patients with CFS. Key antioxidant nutrients 4. Rigden S. et al. Evaluation of the effect of a include vitamins C & E, glutathione, NAC, alpha lipoic acid, modified enterohepatic resuscitation program in CoQ10 & polyphenols from grape seed extract. chronic fatigue syndrome patients, Functional Medicine Research Center (March 1997) Is severe magnesium deficiency at the heart of CFS?
5. Anderson D.C. Assessment and Nutraceutical Fatigue is a classic deficiency sign of many nutrients, Management of Stress-induced Adrenal Dysfunction. including B vitamins and vitamin C in particular. Of all the Integrative Medicine. Vol. 7; 5. Oct/Nov 2008 nutrients tested so far, the most consistently beneficial for 6. http://www.cdc.gov/cfs/general/causes/ CFS sufferers is the mineral magnesium.15-18 Magnesium has 7. The potential role of hypocortisolism in the many important functions for optimal health and is commonly pathophysiology of stress-related bodily disorders. found to be deficient in a typical Western diet. Many Psychoneuroendocrinology 25 (2000) 1 – 35 symptoms of CFS are consistent with typical signs of 8. Tanriverdi, Karaca et al. The hypothalamus-pituitary- magnesium deficiency such as low energy, sleep problems, adrenal axis in chronic fatigue syndrome and muscle cramps and spasms, muscular aches and pains and fibromyalgia syndrome. Stress, March 2007; 10(1): imbalanced adrenal function. Supplementing with GI- friendly, high-strength magnesium and additional necessary 9. Brown R. et al. Rhodiola rosea, a phytomedicinal co-factors such as malic acid, taurine, glutamine, l-carnitine, calcium, molybdenum, B6, B12 and folic acid can help to support optimal levels of magnesium and correct any 10. Olsson EM et al. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract SHR-5 of the roots of Rhodiola Magnesium is:
rosea in the treatment of subjects with stress-related A vital mineral for supporting energy production fatigue. Planta Med. 2009 Feb; 75(2):105-12 An essential cofactor in glycolysis and the citric acid 11. Tachikawa E et al. Proof of the mysterious efficacy of ginseng: basic and clinical trials: suppression of Involved in the production of adrenal hormones and adrenal medullary function in vitro by ginseng. J helps to keep the adrenal glands functioning Pharmacol Sci. 2004 Jun; 95(2): 140-4 12. Tode T et al. Effect of Korean red ginseng on Essential for maintaining the proper function of psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet. 1999 Chronic Fatigue Syndrome – From uncovering root causes
13. Zhu et al. J Altern Complement Med. 1998 Fall; 4(3): to restoring optimal health
Chronic Fatigue Syndrome is a very real condition where a 14. Fletcher RH, Fairfield KM. Vitamins for chronic range of underlying causes may co-exist and manifest as a disease prevention in adults: clinical applications. debilitating illness which conventional medicine has very few JAMA. 2002 Jun 19;287(23):3127-9. answers for. Fortunately, for sufferers of CFS, the functional Nutri (Imports & Exports) Ltd, Meridian House, Botany Business Park, Whaley Bridge, High Peak, Derbyshire, SK23 7DQ Tel: 0800 212742 Fax: 0800 371731 www.nutri.co.uk [email protected] 15. Cox, I.M. et al., Red blood cell magnesium and 17. Hicks J.T. Treatment of chronic fatigue in general chronic fatigue syndrome. Lancet 337: 757-60 practice: a double blind study. Clin Med 85-90 16. Ahlborg L.G. et al., Effect of potassium-magnesium 18. Shaw D.L., Management of fatigue: a physiologic aspartate on the capacity for prolonged exercise in approach. Am J Med Sci 43: 758-69 (1962) man. Acta Physiologica Scandinavia, 74: 238-45 (1969) Nutri (Imports & Exports) Ltd, Meridian House, Botany Business Park, Whaley Bridge, High Peak, Derbyshire, SK23 7DQ Tel: 0800 212742 Fax: 0800 371731 www.nutri.co.uk [email protected]

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