Dealing with chronic fatigue syndrome
Chronic fatigue syndrome (CFS) is the subject of much debate between healthcare professionals the world over. The complexity of the condition makes it difficult to pinpoint an exact cause, and as the illness is often categorised by different criteria, even diagnosis can prove problematic. Because of this, estimates for the number of sufferers vary wildly, but to put things in a bit of a perspective, in the United States there are approximately one million to four million cases – of which only 20% are thought to be diagnosed.
Regardless of the official numbers, what is clear is that CFS can be absolutely debilitating to sufferers, limiting a person’s ability to go about their daily activities, and actually taking a devastating toll on quality of life.
As for a definition of it: We are talking about much more than feeling a bit sluggish at times. The condition is most commonly characterised by long-term (more than six months) unexplained fatigue, with sufferers displaying symptoms including memory loss, flu-like symptoms, muscle and joint pain, unrefreshing sleep, headaches, and enlarged lymph nodes in the neck and armpits.
Symptoms usually develop quickly, and they can affect different people in very different way. What’s more, sufferers will have periods where they suddenly feel much better, only to be followed by bouts of extreme exhaustion. This is what often makes diagnosis rather tricky.
At its most mild, those CFS sufferers can usually go about their lives relatively normally, though additional rest periods may be required. At its most extreme, CFS is a severe disability, often leaving sufferers bedbound for long periods, unable to perform the simplest of tasks.
CFS and hormone imbalance
Of the array of potential causes of CFS, hormones is a big one. It’s worth mentioning here that CFS affects four times as many women as men – and particularly around the time of menopause.
So let’s start with that topic: Women undergo several changes during menopause, as the body naturally begins to produce less of the vital hormones oestrogen, progesterone, DHEA, pregnenolone, and testosterone. These hormones are vital for everything from memory function, weight control and immune system regulation, to libido and organ health. Hormone imbalance of this type can impact sleep and the ability to handle stress, as well as impact physical strength, motivation level and mood. What we find is that those with low levels of these hormones (again, what is often see during menopause) are more naturally prone to developing CFS.
At its most extreme, CFS is a severe disability, often leaving sufferers bedbound for long periods, unable to perform the simplest of tasks.
Men, too, experience hormone depletion as they get older. In fact, many of the symptoms of ageing come about as a result of hormone decline. From the age of around 30, certain hormone levels in the body start to decline by a few percentage points each year, and by the time a male hits 40, significant effects of low or imbalanced hormones can start to show.
Low levels of testosterone, for example, can have a massive impact on our ability to grow and maintain muscle mass, as well as on our energy levels and our ability to handle stress – all of which may be contributors to CFS. Cortisol levels are another example. Otherwise known as the “stress hormone”, when imbalanced, cortisol levels can diminish our muscle strength and recovery speed, which may lead to CFS or exacerbate the symptoms where the condition is already present.
And as is so often the case when it comes to our health, our body can find itself in a vicious circle of sorts. What I am referring to here is that CFS not only is a result of low or imbalanced hormones, but it also contributes to the further depletion of hormone levels.
CFS and stress
According to the American Center for Disease Control, over 100 million people around the world are thought to die as a result of stress-related illnesses every year. That’s around seven people every two seconds. The issue is a hot discussion point in the UAE, where 60% of the workforce told a recent YouGov poll that they were suffering from stress-related concerns.
The line from stress to CFS is very clear. In the initial stages of stress, our body is hyper-alert, ready to respond to and ward off stressful situations – known as the “fight or flight” response. When this period of stress goes on for days or even weeks, we remain in this hyper-vigilant state, overworking the adrenal glands and pumping out excessive levels of stress hormones.
After a sustained period of stress, the body can no longer cope in its heightened state, and excessive levels of the stress hormone cortisol (mentioned above) – which, among other things is responsible for regulating our immune system, cardiovascular system, metabolism and blood pressure – begins to sap our strength and energy levels.
It is at this stage where people are most likely to experience aches and pains, muscle tension and drowsiness. Eventually the body can no longer respond to stress in the appropriate manner, with our hormone stocks too depleted, leaving us utterly exhausted and open to a whole host of serious ailments, including, potentially, CFS.
CFS and diet
As with most matters of health, our diet has a large part to play with CFS as well. All of those foods that are part of the Western diet – sugar, starch, grains, dairy, processed – are weakening our immune systems and depleting our energy levels, thus potentially putting us at higher risk for developing CFS. To reduce the risk of developing CFS – and for reducing symptoms in those with the condition – the Paleo Diet has once again proven to be the right one.
A recent study by the American National Center for Biotechnology Information took a group of subjects with symptoms of CFS and placed them on a strict Paleo Diet. They were then instructed to go about their daily lives, manage stress levels, get plenty of sleep – and stick firmly to the Paleo way of eating.
At the end of the study, all patients who had complied with the protocols reported an improvement in their symptoms. The findings suggest that the Paleo Diet’s high levels of important nutrients such as magnesium, CoQ10, and Vitamin D – as well as its avoidance of foods that lead to leaky gut and silent inflammation in our bodies – are effective in treating CFS.
First and foremost, if you think you are displaying any signs or symptoms of CFS, visit your doctor, explain the situation and ask to be tested. Among other things you will likely be tested for hormone imbalance. Should your levels be low or imbalanced, you may be required to start a hormone therapy program (bioidentical – never synthetic). This treatment can take many forms – including injections, gels and patches.
Also look at how you are managing stress. This is for many of us the main energy-drainer. Where possible reduce the stress in your life (I know, so much easier said than done), and of course learn some coping techniques for managing stress. Few of us actually incorporate techniques such as meditation into our daily routine, but it is something I absolutely swear by, and given the demands put on us in this 21st century, it is almost a survival tool.
And of course there is diet and exercise. We’ve covered Paleo above. As for the fitness, not only is it a necessary stress-buster and energy-booster, it has also been shown to activate adrenal function and regulate our cortisol levels, which can help CFS sufferers in particular. Just to note: You may have to go real slow initially and then increase the exercise length and intensity after a few months.
On a final note, there is in fact no cure for CFS, and no prescription drugs have been developed for this disease. It is therefore rather about properly managing the condition, and so it is extremely important that those with CFS are closely monitored by a trusted physician. Any worsening of symptoms should be addressed immediately, and in general an overall strategic approach should be adopted that is constantly seeking to find the best balance in order to reduce and, in some fortunate cases, eliminate the symptoms.
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Graham Simpson, MD is Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai. He graduated from the University of the Witwatersrand Medical School in Johannesburg, South Africa, and is board certified in Internal Medicine and Emergency Medicine. As a founding member of the American Holistic Medical Association (AHMA) Dr Simpson is also a licensed homeopath.