Understanding Chronic Fatigue Syndrome

In the 1980s patients and doctors alike faced a completely new problem. All of a sudden and without any explanation young people who in other times would have been considered strong, healthy and very productive became ill. The new illness did not follow a specific pattern but rather was a number of symptoms that altogether did not seem to make much sense --at least to the eyes of physicians at that time. Patients were also disoriented. Young professionals at the top of their careers fell ill and became tired, depressed, lost interest in all activity and gradually lost their jobs, social status and even family lives. Worse, medical professionals failed to diagnose the problem and usual laboratory tests came back consistently normal. All this, along with a wide variety of neurological signs, caused physicians to take the easy way out: "The problem is in your mind, you will get over it; you need a vacation and if all this fails look for psychological help and take Prozac”, they said. What nobody seemed to understand at the time was that we were facing a new entity, a number of illnesses somehow connected with the failure of the immune system -- a new dysregulation of this very important defense mechanism.

With the first cases at our hospital, doctors immediately noticed that young, supposedly active people were undergoing months if not years of partial disabilities, had lost their goals in life and evinced a group of signs and symptoms never before seen together in this population group.

The medical team decided that we were facing a new syndrome of great significance to which laboratory tests were oblivious.

The AIDS epidemic at the same time had brought about significant interest in viral diseases and AIDS itself and herpes became important diagnoses at the time. At the same time, this “new kid on the block” seemed to be related to a widespread new and apparently unimportant virus: Epstein Barr. One of the clinical advantages about this new virus was the fact that we already had available sophisticated tests to discover its present level of activity and to determine whether we were facing a new or old problem.

The new interest in viral testing rapidly brought to light for our physicians the fact that the new syndrome consistently included an elevation of EBV titers. By then the term Chronic Fatigue Syndrome had been coined and has remained in place probably because it so accurately describes one of the most important factors of this illness: periods of extreme fatigue.

Chronic Fatigue Syndrome (CFS) is the official name given by the United States Centers for Disease Control and Prevention (CDC) for a multifactorial disorder that in the USA was not recognized until 1988.

CFS has had several names: Epstein Barr Virus, Yuppie Flu, Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) and in many places Myalgic Encephalomyelitis.

Its signs and symptoms can be confused with such related conditions as mononucleosis, thyroid dysfunction, chemical sensitivities, autoimmune diseases and other viral conditions.

This dysfunction seems to be mainly associated with several viruses. Among the more common are those within the herpes family (EBV and HHV-6) and less commonly the Enteroviruses and Retroviruses, but there may be other infectious agents at work as well, including mycoplasmas.

CLINICAL SYMPTOMS
The most important complaint of the CFS sufferer is energy loss, translated into a fatigue that does not improve with rest, vacation, or entertainment. This fatigue lingers for long periods of time, and worsens with time.

Along with the fatigue other symptoms -- mostly from the neurological sphere-- occur: insomnia, depression, mood shifts, emotional instability and personality changes are frequent symptoms; unexplained sadness or guilt or feelings of worthlessness and suicidal thoughts are not uncommon.

Other symptoms reflecting a chronic, viral condition are frequently present such as weakness, malaise, joint pains, recurrent headaches, stomaches, sore throat, low-grade fever, swollen glands, night sweats, cough and cold symptoms.

These symptoms, and others, can occur in any combination and at any intensity. For physicians the world over, the protean span of signs and symptoms seen in apparently healthy young people and with no apparent cause made it frustratingly difficult to come up with a single diagnosis.

Physicians were often faced with such a myriad of disturbances -- digestive problems ranging from belching to flatulence to diarrhea or constipation, together with loss of appetite, and allergy/sensitivity reactions which might involve the skin, eyes, or other organs and tissues -- that they could not grasp the idea that they were dealing with a single syndrome.

The easy way out was often —as noted— to blame it all on the patient's mental state, write him a prescription for an antidepressant or sedative, and recommend psychological counseling.

Probably one of the best diagnostic clues for the physician is that CFS patients feel like they are not themselves. They feel disoriented, do not understand what is going on and desperately seek an answer.

ORIGIN
Our research suggests that CFS has multiple causes and that either new or old reactivated viruses or mycoplasmas may be playing roles as catalysts to a preexisting condition of general immune impairment, elements of which are often related to prior or ongoing abuse of steroids, prior or ongoing abuse of antibiotics (from medications or food), prior or ongoing abuse of recreational drugs, elevated numbers of mercury amalgam fillings and/or root canals in the mouth, continual overexposure to industrial chemicals and/or herbicides/pesticides, fluoridated water, immunizations/ vaccinations, continual exposure to low-level electromagnetic emissions, poor responses to anesthesia or incompatible prosthetics, elements of the standard Western diet, prior or ongoing unresolved bacterial or viral infections, prior or ongoing parasitical infestation and possible genetic predispositions.

One critically important fact is that immune impairment can frequently crossreact with common viruses. In many cases an antibody intended to attack a foreign protein may in turn react against a normal component of the body, hence creating an autoimmune-like response.

For this reason autoimmune symptoms and abnormal allergic reactions are frequently present. The former explain many of the neurological, muscular and degenerative symptomata; the later explain the multiple allergies, even the universal reactor syndrome, and many of the digestive problems our doctors encounter.

LABORATORY
Early in the history of this syndrome it was discovered that standard laboratory tests did not provide any diagnostic evidence. This was a major setback that caused physicians to be unaware of an abnormal process going on. Due to the experience of alternative physicians in dealing with viral, fungal and yeast infections, it became clear that one of the major parameters observable in CFS was the level of Epstein Barr virus (EBV) titers that became reactivated. Epstein Barr virus is a relatively widespread virus that is acquired early in life and, due to the immune system, becomes dormant for the rest of a healthy individual’s life.

When the immune system undergoes dysfunctional conditions, the normally dormant Epstein Barr virus can be reactivated, elevating the amount of antibodies the body produces against it. The same reactivation occurs with other viruses such as human herpes-6 virus (HHV-6). It is unclear whether these are actual causative agents or simply the effects of an immune dysfunction.

Whatever, the laboratory assessment of antibodies to them reflects the ongoing immune dysfunction, are factors suggestive of diagnosis, and may be used to monitor progression or improvement.

Another important tool that is not only consistent with the syndrome and for the same reason an important diagnostic tool, but also is probably the most important piece of evidence that convinced orthodox medicine that CFS is a real disease, is the Single Photon Emission Computerized Tomography (SPECT) of the brain. This technologically advanced test conclusively demonstrates dysfunctional brain activity that improves as treatment is provided. For this reason it is a major monitoring test for the CFS patient.

TREATMENT CONSIDERATIONS
Because of International Bio Care Hospital's prior history in the development of individualized, integrative metabolic protocols, its approach to Chronic Fatigue Syndrome was not long in coming and it is based on the following concepts: The illness probably has an immunological imbalance in which some of the following can play a role, in no particular category of importance: Overadministration of antibiotics, steroids, immunizations, mercury amalgam fillings; overconsumption of refined carbohydrates, chemical additives; environmental chemicals including cigarette smoke; fluoridated water; agricultural chemicals; hormonal manipulation; exposure to low level electromagnetic frequencies; and, of considerable importance, mental stress.

With these considerations in mind, the treatment is based on the following concepts:

Detoxification is a primary feature of any therapy and in the case of CFS the previous history of exposure to chemicals, antibiotics, steroids etc. makes detoxification one of the key factors in its successful treatment. For the same reason avoidance of toxins becomes a major issue. Tobacco smoke, alcohol, prescription and recreational drugs should be a major target of the life-style manipulation elements in CFS management.

Dietary manipulation, together with detoxification, is the foundation of any treatment intended to restore and balance immune function. The proper use of diet can never be overlooked. Food is not only the basis of energy and building materials but is also the source of detoxification elements, immune substances and balanced intestinal flora -- all of which becomes the foundation of immune performance and equilibrium. A healthy body and immune competent system are unobtainable under poor nutritional conditions.

Since opportunistic infections seem to be the most apparent triggers in many of the symptoms, the treatment of these conditions becomes a priority: EBV, HHV-6, mycoplamas, yeasts, and candida are the most frequent and visible infectious elements in this syndrome. Oxidative therapies are the best choice for the treatment of these conditions. BI-OX, a powerful oxidative agent, has become the treatment of choice for them. BI-OX is a broad-spectrum antimicrobial oxidative agent which attacks all cell wall-deficient structures -- virtually all viruses, yeast/fungal species, various bacteria and mycoplasma.

Ozone therapy has also been very powerful in the treatment of these problems, together with the irradiation of blood with ultraviolet (UV) light. Ultraviolet irradiation has a well-documented antimicrobial effect.

An integrative approach utilizes all forms of attack against a broad spectrum of microbes, yeasts and viral infestations so strongly present in immune disturbances in general and CFS in particular.

Integrative physicians stress that the origin of the illness is within the immune dysfunction of the host, or patient -- and that whatever relief that may result from an attack on opportunistic infections will be lost if the patient's immunological integrity is not restored.

Hence, immune restoration is the major long-term objective for the CFS patient. The attempt to regulate immune function without detoxification, dietary management and relief from pathogenic infestations will fail. Since mental stress is increasingly and demonstrably seen to be playing an important role in immune regulation it must also be addressed if the patient is to have lasting results and full recovery.

Recent research reveals that most immunologically disturbed patients are neither classically immune depressed nor autoimmune-stimulated; rather, they are suffering the highs and lows of dysregulation of the various elements of what is called the immune system.

Modern biochemical research also has made it clear that a vast range of nutriments and supplements -- vitamins, minerals, enzymes, amino acids, essential and nonessential fatty acids, phytochemicals, herbs-- are of positive benefit in either specific or nonspecific immune regulation. Many nutritional elements classed as antioxidants or free-radical scavengers also exert a balancing effect on immunity. Fetal cell extracts (live cell therapy) or their derivatives have been widely used to balance the immune system. Beginning in the 1930’s the late Paul Niehans MD in Switzerland began using animal fetal tissue to produce overall health benefits in chronically ill and older patients.

Modern cell-extraction and preservation techniques have helped make live cell treatments highly successful in immune system augmentation. The availability of such tissue-specific extracts such as those from the thymus gland is also of great help in the long-term management of CFS. Research continues in these areas and underscores the importance of integrative and individualized treatments -- an approach which continues to lengthen our list of successfully managed cases.

EXPECTED OUTCOME
A multifactorial program containing elements of the above -- tailored for the individual case -- can expect to achieve dramatic decreases in pathological symptoms in a short period of time.

However, reduction in symptoms is not the cure of a multifaceted syndrome of so many parts. Restoration of immune and endocrine balance is a long-term challenge and can only be achieved through adherence to a program of proper diet, nutrition, supplementation and proper lifestyle.

Our experience with CFS and related disorders is that the great majority of patients show immediate short-term improvement; smaller numbers improve, relapse and improve again. CFS remains the most unpredictable and highly individualized of chronic conditions.

The successful treatment of this condition demands from the patient a commitment to intensive treatments, many hospital stays followed by an at-home program accompanied by discipline and a commitment to create a new lifestyle and improved health. The do-it-yourself approach is usually wasteful, expensive, frustrating and unsuccessful.

At the present time, the innovative, integrative, individualized program synthesized here is securing the best results, and is optimistically aimed at greater success in the future against an awesome foe which has mostly baffled standard medicine.

The final determination of the value of this form of treatment in any particular case will be the interaction of doctor and patient and correct evaluation of patient clinical and laboratory findings.