Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is classified as fatigue lasting more than 6 months, which is accompanied by other symptoms. These include muscle and joint pain, sore throat, post-exertion fatigue lasting longer than 24 hours, and cognitive difficulties. It is generally not relieved by rest, and has substantial effects on the person’s activity levels.
Diagnosis can sometimes be difficult due to the varying symptom criteria (Fukuda, ICC, or CCC), and because there is no objective blood or bio-marker available. Often people are labelled with chronic fatigue after no other cause of illness can be found, or else no diagnosis is given due to doctors not believing that it exists. This is frustrating for individuals who are suffering.
Causes of Chronic Fatigue
The mitochondria are ancient bacteria that are responsible for creating energy in the form of ATP. These mitochondria are quite unique. They have 2 membranes made from phospholipids, and contain an electron transport chain on the inner membrane. This is an important chain that contains 5 channels that pass electrons from one to the other, with the end goal being the creation of ATP.
Mitochondria need many nutrients to function. For example, carnitine and vitamin B2 are needed to move nutrients through the membranes. They also need vitamin B3, CoQ10, oxygen, alpha-lipoic acid, ribose, metabolites created in the citric acid cycle, and other nutrients. The Organic Acid Test includes many of these nutrients, which provides good insight into energy production and possible causes for chronic fatigue.
There are other options for increasing mitochondrial function in the body. Using a rebounder for 10 minutes per day, specific breathing exercises, and even putting your feet in the ocean can help improve the transport of electrons.
Methylation and Genetics
Methylation is needed to make various compounds, one being the body’s master antioxidant Glutathione. Glutathione regulates the immune system, detoxes harmful toxins and heavy metals, and also helps to reduce free radicals within the mitochondria. It does this in collaboration with the SOD (superoxide dismutase) enzyme. There are many other genes that code for important enzymes needed to create glutathione, as well as increasing serotonin, lowering inflammation, and optimizing energy production.
Glutathione is also needed for the proper functioning of vitamin B12, which is hugely involved in energy production, making red blood cells for oxygen delivery, and reducing oxidative stress in itself.
Oxidative Stress and Inflammation
Oxidative stress is defined as an “imbalance between the production of free radicals (oxidising molecules) and the ability to reduce them with antioxidants”. This oxidative stress will damage various parts of our biology, but in the case of chronic fatigue patients, it will damage their mitochondria. This causes a poor ability to make energy.
High oxidative stress will deplete antioxidants further, which makes people more susceptible to other issues that relate to their immune system, food and chemical sensitivities, mood issues, digestive concerns, and can greatly affect pain sensitivity.
Increasing antioxidant capabilities provides a good foundation to build from. There are specific nutrients that can be utilised according to the person’s case to help with this.
The gut is the foundation of our health. The bacteria that reside there exist in a delicate balance which, when disrupted, can cause noticeable symptoms. These may be gastrointestinal bloating, irregular bowel movements, pain and nausea, but it can also cause severe fatigue.
Parasitic infections such as Blastocystis, Dientamoeba, or Giardia are associated with chronic fatigue. An overgrowth of beneficial bacteria such as Entereococcus, Streptococcus, and other lactic acid producing bacteria are also likely candidates, and of course, so is Candida Albicans and SIBO (Small Intestinal Bacterial Overgrowth).
Hypoxia occurs when the body receives poor delivery of oxygen to the cells. Following exercise, those with CFS have a significantly lower oxygen delivery to their muscles, which results in pain and a longer time period to recover. It may also be the cause for impaired concentration, memory loss, inability to focus vision, and poor motor coordination.
CFS patients are often shallow chest breathers. This reduces oxygen delivery to the blood due to insufficient oxygenation of the lower parts of the lungs. (Shallow breathing also stimulates the sympathetic nervous system). Other causes of poor oxygen delivery may include sleep apnoea, poor air quality in general, stress, or pulmonary conditions.
The autonomic nervous system has 2 branches; the sympathetic nervous system, and the parasympathetic nervous system.
The sympathetic nervous system is the fight or fight branch. When under threat, the SNS releases stress hormones such as cortisol and adrenaline to help deal with the occasion. The body can release these hormones at moments such as long-term stress, periods of very poor sleep, infections, trauma, vaccinations, or environmental toxins etc. If the person becomes more sensitive to being triggered, the brain rewires in such a way that it becomes hyper vigilant to any small thing that may pose danger to the system. Continual activation of the SNS is like having the gas pedal down flat, all the time. It’s exhausting!
The parasympathetic nervous system is the other side of the dial. Often referred to as the rest and digest branch, it is also called “flood” or “freeze”. The PNS is activated to help protect the body. For example, when a lion chases a deer, the deer releases adrenaline to help it flee (SNS). Once the lion catches the deer, the nervous system becomes flooded with adrenaline, and then the PNS becomes activated. This releases other hormones, such as prolactin, oxytocin, and acetylcholine, which cause the deer to disassociate and to not feel the pain.
People with CFS can have trouble regulating the ebb and flow between the sympathetic and parasympathetic branches of the nervous system.
Evidence exists that suggests serotonin plays a role on the pathogenesis of CFS. Research shows that CFS sufferers have a lower amount of serotonin receptors in the brain. This leads to depression, and fatigue of varying severity.
There is an association between serotonin protein polymorphisms (5-HTT/SLC6A4), and the occurrence of low serotonin, depression and also chronic fatigue. This is often the link between chronic fatigue and fibromyalgia, because serotonin acts as a pain mediator. The more serotonin you have, the less pain you experience. For this reason, antidepressants are often the first treatment approach for Fibromyalgia sufferers, and often CFS as well.
There are dedicated nutrients that can be used to increase serotonin production naturally. Methylation and gut optimisation are also an important players in serotonin production.
Treatment is multi-layered according to what is necessary for each person. Organic Acid testing is a good strategy for gaining information on mitochondrial function. It also includes gut markers, serotonin, antioxidant capabilities, and other specific nutrients.