CFS (Chronic fatigue syndrome) also known as ME (myalgic encephalomyelitis) is a disabling and complex long-term illness. It is characterised by a range of symptoms including muscle pain with intense physical or mental exhaustion, relapses, and specific cognitive disabilities. One of the hallmark symptoms of ME/CFS is post-exertional malaise, which is an abnormal and extreme upswing in symptoms after exertion. The amount of exertion it takes varies by person, but it leaves them unable to do the same amount of activity the following day, (delayed fatigue response) which is unusual and unique to this disease. Generally symptoms last at least six months and cannot be attributed to any other condition.
What causes CFS/ME?
Research has shown that there are two main triggers of CFS/ME. The first being a significantly depleted immune system as a result of having contracted a viral/bacterial infection at some point in the past.
The second trigger can be when the sufferer, quite often someone considered a ‘high achiever’, pushes themselves to a point beyond the limits of their body’s capacity to function. They simply run out of energy.
Who gets CFS/ME
Whilst anyone can be affected at any age, it is more common in women. A combination of factors, both physical and psychological, can lead to a predisposition to CFS/ME. Those factors can be characterised as types:
- Adrenal Type – long term stress – manifesting in physical conditions over time
- Immune Type – past virus still in system
- Digestive Type – IBS Mal absorbtion of nutrients
- Toxicity overload Type – genetic predisposition
- Structural Type – physical imbalance/posture
- Anxiety Type – constantly worrying/fearful but may present as ‘all is well’
- Achiever Type – perfectionist – pushing themselves
- Trauma Type – may have experience traumatic event or had troubled upbringing
- Helper Type – people pleaser
The body and it’s systems
The body is made up of a series of systems which need to work in harmony for optimum health.
- Immune/Lymphatic system – People with CFS/ME are prone to a range of immune related issues, food/chemical intolerances and sensitivities. CFS/ME is often preceded by a viral infection and “flu-like” illness. For example, infectious mononucleosis has been shown to be a risk factor for developing CFS/ME.
- Digestive/Excretory system – Many CFS/ME patients complain of gut dysfunction – may have had previous diagnosis of irritable bowel syndrome (IBS). There is recent evidence showing that interactions between the intestinal microbiota, mucosal barrier function, and the immune system play a role in the disorder’s pathogenesis. Gut pathogens can influence emotional behaviours such as anxiety and depression.
- Endocrine system – The endocrine system uses a combination of glands and hormones to send signals to the nervous system and control functions in the body. It is a central regulator of stress response. Its dysfunction has been associated with CFS/ME. As has hypo-thyroidism and adrenal fatique.
- Integumentary system / Exocrine system – consists of the skin, hair, nails, glands, and nerves. Its main function is to act as a barrier to protect the body from the outside world.
- Circulatory system- It is common for CFS/ME patients to have low blood pressure.
- Muscular system- One of the primary symptoms of CFS/ME is generalised abnormal muscle fatigue that occurs after relatively mild activity. Evidence suggest that muscular biochemical abnormality may play a major role in fatigue associated with CFS/ME.
- Nervous system- Even when asleep, the stress-responsive neural systems of people with CFS/ME are on high alert, signalling that it is not safe to relax. Hence feeling exhausted whilst unable to rest. This is known as “tired and wired”.
Other systems of the body include Renal/Urinary system, Reproductive system, Respiratory system, Skeletal system and Energy system.
The Biochemistry of CFS/ME
The most fundamental system involved in CFS/ME is the chemical process which takes place at a cellular level to produce the body’s energy.
Mitochondria are small structures inside our cells that generate energy and are often referred to as ‘the powerhouse of the cells’. They are responsible for converting chemical energy from food into a form that’s readily available for use by the cell, called ATP (adenosine triphosphate).
The energy released by hydrolysis (breakdown) of ATP is used to power many energy-requiring cellular reactions. ATP then becomes ADP (adenosine di-phosphate)
Like most chemical reactions, the hydrolysis of ATP to ADP is reversible. The reverse reaction, which regenerates ATP from ADP requires energy. Regeneration of ATP is important because cells tend to use up ATP molecules very quickly and rely on replacement ATP being constantly produced. You can think of ATP and ADP as being like the charged and uncharged forms of a rechargeable battery. ATP, the charged battery, has energy that can be used to power cellular reactions. Once the energy has been used up, the uncharged battery (ADP) must be recharged before it can again be used as a power source. When the building blocks of ATP aren’t available to your body or something interferes with the recycling process, ATP levels can become low and result in energy deficiency. There is considerable evidence that mitochondrial dysfunction is present in some CFS /ME patients, which is a primary factor in delayed fatigue response.
A blood sample is required for the ATP profile test which is a powerful diagnostic tool and can differentiate patients who have fatigue and other symptoms as a result of energy wastage by stress and psychological factors from those who have insufficient energy due to cellular respiration dysfunction. The individual factors indicate which remedial actions, in the form of dietary supplements, therapies and detoxification, are most likely to be of benefit, and what further tests should be carried out.
Treatment and Recovery
As CFS/ME is known to affect multiple systems a combination of factors must be taken into account when developing a strategy for recovery. The order in which the different systems are strengthened is vital to the healing processes. The approach taken by BioMed is firstly to work on boosting the immune systems, as it is involved in many of the body’s processes.
This is a link to a podcast about Epstein-Barr virus (EBV) which may be of help https://youtu.be/J2_YiKePAAM