Articles

Chronic Fatigue Syndrome

Introduction

Chronic fatigue syndrome is the current name for a disease that has been described for three centuries. It is characterized by a debilitating fatigue and a variety of other physical, constitutional, and neuropsychological complaints. Certain individuals, who were labeled in the past with diagnoses such as the vapors, neurasthenia, effort syndrome, hyperventilation syndrome, chronic brucellosis, epidemic neuromyasthenia, myalgic encephalomyelitis, hypoglycemia, multiple chemical sensitivity syndrome, chronic candidiasis, chronic mononucleosis, chronic Epstein-Barr virus infection, and post-viral fatigue syndrome, probably had what we now call chronic fatigue syndrome. (1) The diversity of names is a reflection of the number and controversy of theories of the disease’s etiology. Whatever the cause, there seems to be several common themes that occur. It is often postinfectious, it is associated with immunological disturbances, and it is frequently accompanied by depression.

Currently, the lymphotropic herpes viruses, retroviruses, and enteroviruses are being studied as potential etiologic agents. Multiple factors that have led investigators to believe one or more of these viruses causes chronic fatigue syndrome. Chronic fatigue can be precipitated by a variety of acute infections, and some of these organisms have the ability to persist in humans, causing chronic illness. Also, titers to many infectious agents are elevated in patients with chronic fatigue syndrome (most herpes viruses, measles virus, rubella virus, and coxsackie virus B). Experience suggests that, while viruses may precipitate the syndrome, it is unlikely that they contribute to its long-term features. There have been several immunologic disturbances reported in patients with chronic fatigue syndrome; however, none of them appear in all patients, nor have any been correlated with the severity of the illness. An immune disturbance of some type is in line with a favored theory that at least some of the symptoms result from excessive cytokine release. (2)

An interesting finding that has been observed in controlled studies in recent years is that patients with chronic fatigue syndrome have a reduced production of corticotropin-releasing hormone in the hypothalamus. (3) This causes a mean serum cortisol that is lower than in control patients, and a correspondingly high level of adrenocorticotropic hormone (ACTH). Hypothetically, these endocrine abnormalities could contribute to the mood and impaired energy level of patients. It is unclear what significance this finding may have in determining the cause of this syndrome. It does, however, further indicate the complex nature of the illness.

Some clinicians propose that chronic fatigue syndrome is primarily a psychiatric disorder, and that various immune and neuroendocrine disturbances arise secondarily. This has been proposed because mild to moderate depression is evident in approximately two-thirds of patients. While this may be primarily a reactive depression, the percentage exceeds that of other chronic illnesses.

Cases in childhood and middle age have been described; however, the greatest frequency of cases occurs in people aged 25 to 45, and women develop chronic fatigue syndrome approximately twice as often as men. There has been no infectious or environmental causes identified; however, throughout history, there have been sporadic occurrences of “outbreaks" in specific geographical areas. A few examples are Los Angeles County Hospital in 1934; in Akureyri, Iceland, in 1948; in the Royal Free Hospital in London, in 1955; in Punta Gorda, Florida in 1956; and in Incline Village, Nevada, and surrounding communities in 1985.

The typical case of chronic fatigue syndrome arises suddenly, in a previously active individual. Usually the patient can describe an otherwise unremarkable flu-like illness or stressful occurrence as the triggering event. Patients usually seek medical treatment because they believe that they have a persistent infection. There may be a continued feverishness, sore throat, swollen lymph nodes, headache, joint aches, and unbearable exhaustion. As the syndrome continues, usually there is disturbed sleep, difficulty in concentrating, and depression.

Many patients will make the rounds of allergists, homeopaths, psychiatrists, rheumatologists, and others seeking help, frequently with unsatisfactory results. Patients often complain that times of greatest fatigue also equate with times of greatest pain and difficulty in concentrating. Most patients finally balance their obligations of family, work, and other factors. Some patients actually feel they can no longer engage in gainful employment. Quite often there is isolation, a resignation to the illness, and frustration. Many patients express anger with members of the medical community for not recognizing their illness, or not resolving their plight. Fortunately, chronic fatigue syndrome does not seem to progress, and in fact, over time, most patients gradually improve.

Statistic

The Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) Association of America, 2000.

    800,000 American adults suffer from CFS. CFS is three times as common in women (522/100,000) as in men. CFS is over four times more common than HIV infection in women. 90% of patients have not been diagnosed and are not receiving proper medical care for their illness. CFS has been shown to affect persons of all races, ages, and socioeconomic groups. A significant improvement in CFS patients was 31.4% during the first five years of illness and 48.1% during the first 10 years. CFS cases for Latinos are 726 per 100,000. 95% of CFS patients have neurally mediated hypotension.

Signs and Symptoms

[span class=alert]The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.[/span]

The CDC was developed in 1988 and more recently, revised guidelines for criteria for chronic fatigue syndrome. (4)

A case of chronic fatigue syndrome is defined by the presence of:

  1. Clinically evaluated, unexplained, persistent or relapsing fatigue that is of new or definite onset; is not the result of ongoing exertion; is not alleviated by rest; and results in substantial reduction of previous levels of occupational, educational, social, or personal activities; and
  2. Four or more of the following symptoms persist or recur during six or more consecutive months of illness and that do not predate the fatigue:
    • Self-reported impairment in short term memory or concentration
    • Sore throat
    • Tender cervical or axillary nodes
    • Muscle pain
    • Multijoint pain without redness or swelling
    • Headaches of a new pattern or severity
    • Unrefreshing sleep
    • Postexertional malaise lasting more than 24 hours
The symptoms of Chronic Fatigue Syndrome and their reported percentages of occurrence: (5)
Fatigue 100%
Difficulty concentrating 90%
Headache 90%
Sore throat 85%
Tender lymph nodes 80%
Muscle aches 80%
Joint aches 75%
Feverishness 75%
Difficulty sleeping 70%
Psychiatric problems 65%
Allergies 55%
Abdominal cramps 40%
Weight loss 20%
Rash 10%
Rapid pulse 10%
Weight gain 5%
Chest pain 5%
Night sweats 5%

Treatment Options

Conventional

Once the possibility of other illness is ruled out, the patient must be informed of the syndrome, its prognosis, and its potential impact on the patient’s life. Patients are often relieved when their complaints are taken seriously. Periodic assessment is appropriate to assure the patient, assess status, and make sure another underlying cause has not surfaced.

Many symptoms of chronic fatigue syndrome may respond to treatment. Nonsteroidal anti-inflammatory medications relieve headache, diffuse pain, and relieve feverishness. Antihistamines and decongestants are helpful for allergic rhinitis and sinusitis.

Although many patients are averse to psychiatric diagnoses, depression is a prominent symptom that may be alleviated with nonsedating antidepressants. Frequently, they not only improve mood, they also help with sleep disturbances, thereby relieving the fatigue somewhat. Many times, even modest improvement can make a vast difference in a patient’s degree of self- sufficiency and ability to enjoy life.

Consumption of heavy meals, caffeine, and alcohol in the evening can make it harder to sleep, compounding fatigue. Also, total rest is not good as it leads to further de-conditioning and contributes to the feeling of being an invalid. Strenuous exercise only leads to greater fatigue, so a well-planned, moderate exercise regimen should be a part of the treatment plan.

Nutritional Supplementation


Nicotinamide Adenine Dinucleotide (NADH)

NADH is the reduced form of coenzyme 1, which is one of the most important substances necessary to catalyze and stimulate the production of cellular energy. NADH was studied in a randomized, double-blind, placebo-controlled crossover study in patients with chronic fatigue syndrome. 26 subjects were randomly assigned to receive either 10 mg of NADH or placebo for a 4-week period. After a 4-week washout period, subjects were crossed to the alternate regimen for a final 4-week period. In this study, 8 of 26 patients (31%) responded favorably to NADH while only 2 of 26 (8%) subjects taking the placebo improved. Although longer term follow-up studies are needed, the favorable results in this preliminary study indicate that NADH may be a valuable adjunctive therapy in the management of the chronic fatigue syndrome. (6)


Coenzyme Q10 (CO-Q10)

Chronic fatigue syndrome has been identified as a symptom or condition that frequently precedes by years the development of congestive heart failure. In one study, administration of coenzyme Q10 resulted in improvement of cardiovascular function and fatigue. (7)


Magnesium

One group of researchers reported that individuals with chronic fatigue syndrome were found to have lower red cell magnesium concentrations compared to matched controls. In a double-blind study, 32 patients with chronic fatigue syndrome were either given 50% magnesium sulfate in a 1 gm/2 ml I.M. weekly injections or a placebo of 2 ml of injectable water. Patients treated with magnesium claimed to have improved energy levels, better emotional states and less pain. Twelve of 15 patients reported benefiting from the therapy and 7 patients reported significant energy improvement. In the placebo group only 3 of 17 patients said they felt better and one patient had improved energy. Red cell magnesium normalized in all patients receiving the injection, but only 1 patient returned to normal in the placebo group. The authors conclude that chronic fatigue syndrome patients have slightly lower magnesium levels than healthy controls and that magnesium therapy appeared to be of benefit. They cautioned that their trial was small and only had a follow-up of 6 weeks. (8)


Folic Acid

Researchers assayed the serum folic acid levels of 60 patients with chronic fatigue syndrome (CFS) and found that 50% had values below 3.0 micrograms/l. The results of this study indicate that a substantial percentage of patients with chronic fatigue syndrome may be deficient in folic acid. (9)


Omega-3, Omega-6

Essential Fatty Acids: Sixty-three adults with postviral chronic fatigue syndrome were studied in a double-blind, placebo-controlled study of essential fatty acid therapy. The patients had been ill for from one to three years, suffering from severe fatigue, myalgia and a variety of psychiatric symptoms. Patients were given capsules containing linoleic, gamma-linolenic, eicosapentaenoic and docosahexaenoic acids (8 x 500 mg capsules per day over a 3-month period) or a placebo. After 3 months, 85% of patients on active treatment assessed themselves as improved over the baseline compared to 17% of placebo patients reporting improvement. The essential fatty acid levels were abnormal at the baseline and corrected by active treatment. These results suggest that essential fatty acids may provide a rational, safe and effective treatment for patients with post-viral chronic fatigue syndrome. (10)


L-Carnitine

Investigation of 35 patients with chronic fatigue syndrome (27 females and 8 males) revealed that CFS patients have statistically significantly lower serum total carnitine, free carnitine and acylcarnitine levels. These investigators also reported a statistically significant correlation between serum levels of total and free carnitine and clinical symptomatology. Higher serum carnitine levels correlated with better functional capacity. These findings suggest that carnitine deficiency may cause mitochondrial dysfunction, which may contribute to or cause symptoms of fatigue in CFS patients. (11)

Herbal Supplementation


Ashwagandha

Ashwagandha root, also known as winter cherry or Indian ginseng, is an important herb from the Ayurvedic or Indian system of medicine. Ashwagandha has been traditionally used for the treatment of debility, emaciation, impotence, and premature aging. (12) This dietary supplement is used to enhance mental and physical performance, improve learning ability and decrease stress and fatigue. Ashwagandha is a general tonic to be used in stressful situations, especially insomnia, overwork, nervousness, restlessness and chronic fatigue syndrome. (13)

Ashwaghanda is an adaptogen, or substance that helps protect the body against various emotional, physical and environmental stresses. Ashwagandha is reported to have tonic or adaptogenic effects similar to panax ginseng. (14) Ashwagandha reportedly prevented myelosuppression in mice treated with three immunosuppressive drugs with a significant increase in hemoglobin concentration. (15) Ashwagandha was also reported to have immunostimulatory activity, because treatment was accompanied by significant increases in hemolytic antibody responses towards human erythrocytes.


Rhodiola

Rhodiola has long been used in traditional folk medicine in China, Serbia and the Carpathian Mountains of the Ukraine. In the former Soviet Union, it has long been used as an adaptogen, decreasing fatigue and increasing the body’s natural resistance to various stresses. In Siberia it is said that "those who drink rhodiola tea regularly will live more than 100 years." Rhodiola also has been traditionally used in sexual disorders in men and women.

Rhodiola seems to enhance the body's physical and mental work capacity and productivity, working to strengthen the nervous system, fight depression, enhance immunity, elevate the capacity for exercise, enhance memorization, improve energy levels and possibly prolong the life span. (16) In Siberia it was taken regularly especially during the cold and wet winters to prevent sickness. In Mongolia it was used for the treatment of tuberculosis and cancer.

The effect of alcohol-aqueous extract from rhodiola roots on the processes of learning and memory was studied in rats. (17) Several methods of active avoidance with negative and positive reinforcements are used, as well as of passive avoidance. Rhodiola extract was reported to improve learning and retention after 24 hours. Significant improvement of the long-term memory was also established in memory tests after 10-day treatment with the same dose of the extract (0.1ml of a 1:1w/v). Like Siberian ginseng, rhodiola is routinely used by athletes in the former Soviet Union to improve performance. While the mechanism is not completely understood, rhodiola seems to improve the ratio of muscle-fat and increases hemoglovin and erythrocytes levels in the blood.

For the treatment of depression extracts of rhodiola, namely rosavin and salidroside, in animal studies seem to enhance the transport of serotonin precursors, tryptophan, and 5-hydroxytryptophan into the brain and decrease the action of COMT (catechol-O-methyltransferase), an enzyme that degrades serotonin. (18) Rhodiola has been used by Russian scientists alone or in combination with antidepressants to enhance mental state and decrease the symptoms of SAD or Seasonal Affective Disorder common to Northern European countries.

In animal experiments, rhodiola extract increased blood insulin and decreased glucagon levels, resulting in a 50 to 80% increase in liver glycogen where excess sugar is stored. This information suggests that rhodiola extracts may help normalize blood sugar levels. (19) Rhodiola is also reported to be a potent antioxidant in vitro, most likely due to the cinnamic alcohol content.


Eleuthero, Siberian Ginseng

Eleuthero is a different genus than other popular ginsengs such as the American and Panax or Asian varieties. The use of eleuthero root dates back 2,000 years in the records of Chinese medicine. It was used for respiratory tract infections, as well as colds and influenza. (20) The Chinese also believed that eleuthero provided energy and vitality. In Russia, it was originally used by the Siberian people to increase physical performance and to increase the quality of life and decrease infections. Eleuthero has been studied extensively since the 1940s. The root has been found to have many adaptogenic benefits. (21) , (22) Eleuthero has been reported to increase stamina and endurance and protect the body systems against stress-induced illness. (23) , (24) It is rumored that Soviet Olympic athletes have used eleuthero successfully to enhance sports performance and concentration.

Eleuthero root is frequently prescribed in Europe and Russia as an herbal “tonic," improving immune function and general well-being. It has been classified as an “adaptogen," meaning a substance that increases nonspecific resistance of the body to a wide range of chemical, physical, psychological and biological factors (stressors). Adaptogens have the unique ability to switch from stimulating to sedating effects based on the body's needs. According to tradition and the literature, eleuthero possesses this kind of balancing, tonic, antistress action on the body. The chief component in eleuthero that has the adaptogenic ability and adrenal tonic properties has been found to be the eleutheroside content, and high quality preparations are standardized or guaranteed to have a certain amount of this compound. (25) Also, polysaccharides in eleuthero play a role in its support of immune function. (26)

The adaptogenic properties of eleuthero have been extensively investigated in Russia. Both animal and human studies have reported the benefits of eleuthero in different conditions. Eleuthero extract has been administered in Russia to more than 4300 human subjects in studies involving either healthy or unhealthy individuals. Some of the benefits claimed for eleuthero are listed below:

    Increases physical endurance under stress (27) Increases mental alertness (28) Increases work output and quality of work; decreases sick days (29) Increases athletic performance (30) Protects against reduced cellular oxygen (31) Cardioprotective (32) Protects against excessive heat and cold conditions (33) Protects against radiation exposure and other toxins such as chemotherapeutic agents and alcohol (34) , (35) Protects against viral and microbial infections; enhances immunity (36) , (37) Aids general health of patients with chronic illnesses such as atherosclerosis, (38) acute pyelonephritis, (39) diabetes mellitus, (40) hypertension and hypotension, (41) acute craniocerebral trauma, neuroses, (42) and rheumatic heart disease (43) Promotes normal endocrine function (44) , (45) Improves visual acuity, color perception, and hearing acuity (46)


Astragalus

Astragalus has been valued by the Chinese for centuries for its immune-enhancing and adaptogenic properties. As an adaptogen, it may modify and improve the body’s response to stress through action on the adrenal cortex. (47) , (48) Experiments have reported that astragalus promotes regeneration of cells in the bronchi after viral infection. The polysaccharides contained in astragalus relate to the improvement in natural killer (NK) cells and T-cell function, as well as interferon production by the immune system. (49) Studies have reported that administration of astragalus for 1 month increased phagocytosis by spleen cells, decreased T-suppressor cell function and improved T-killer cell function. (50) Astragalus enhances the effects of interferon and may act not only to improve resistance to colds but decrease the duration of a cold. (51) Due to a belief that it inhibits bone marrow depression, astragalus has been studied in patients with AIDS and cancer. (52) , (53) Astragalus is claimed to protect against cellular damage in the liver, (54) , (55) help with oxygenation of the heart and cerebrovascular tissue and improve stamina and endurance. (56) , (57)


Cordyceps

Cordyceps is a unique black mushroom that extracts nutrients from and grows only on a caterpillar found in the high altitudes of Tibet and China. Cordyceps is one of the most valued medicinal agents in the Chinese Materia Medica. Cordyceps has been used in traditional Chinese medicine as the herb of choice in lung and kidney problems, and as a general tonic for promoting longevity, vitality and endurance. (58) Cordyceps is beneficial in helping individuals with decreased energy restore their capacity to function at a greater level of activity.Cordyceps has traditionally been used for its improvement in respiration and in individuals with decreased lung function, such as asthma and bronchitis, by increasing oxygenation (improving VO2 max by 9-15%). (59) Cordyceps has been reported to have anticancer effects by decreasing proliferation and differentiation of cancerous cells and has immunomodulatory effects. (60) , (61) , (62) Cordyceps has been used for decreasing the renal toxicity of aminoglycosides and cyclosporine (63) , (64) and in individuals with chronic renal failure. (65) Kidney protection is claimed to be due to: protecting tubular cell sodium pump activity; attenuating tubular cell lysosome overfunction stimulated by phagocytosis of aminoglycoside; and decreasing tubular cell lipoperoxidation in response to toxic injury. (66) Cordyceps was also reported to protect stem cells and red blood cells during chemotherapy and radiation. (67)


Evening Primrose

Evening primrose oil (EPO) is rich in gamma-linolenic acid which is an omega-6 fatty acid. (68) , (69) Omega-6 fatty acids reportedly reduce the arachidonic acid cascade and decrease inflammation through inhibiting the formation of inflammatory mediators in this process. Supplementation with essential fatty acids such as EPO has been shown to prevent zinc deficiency, thereby potentially improving immunity. (70) Fatty acids are an important part of normal homeostasis. The human body can produce all but two fatty acids - omega-3 and omega-6 fatty acids. Both must be obtained through the diet or by the use of supplements. Obtaining a balance of these two fatty acids is essential. Essential fatty acids are needed for building cell membranes and are precursors for production of hormones and prostaglandins. Modern diets tend to be lacking in quality sources of fatty acids.


Reishi Mushroom

Reishi mushroom is called the “mushroom of immortality" in China and has been used as a tonic and strengthening medicine for thousands of years. Uses in traditional healing include increasing intellectual capacity and memory, promoting agility and lengthening the life span. (71) Reishi is reported to have some of the most active polysaccharides in the plant kingdom. Polysaccharides are claimed to have immunomodulating activity. Reishi is also reported beneficial as an antioxidant, antihypertensive, hypoglycemic, antiviral and hepatoprotective agent.

Reishi extracts have been reported to significantly increase the life-span of fruit flies by significant amounts (16-17 percent) in several studies, and also enhancing endurance and cellular oxygenation. (72) Reishi has been reported to inhibit superoxide activity and hydroxyl radical activity in vitro, supporting its role as an antioxidant. (73) The constituents with antioxidant activity have been reported to include the triterpenes. (74)

Reishi extracts have been reported to inhibit tumor growth in laboratory animals. (75) , (76) In one study, an isolated polysaccharide from reishi (b-1, 3-glucan) was administered to laboratory mice and was reported to produce tumor inhibiting rates of greater than 90 percent, with complete tumor regression of over 75 percent of the mice. (77) A study of 48 patients with advanced stage carcinomas (including renal, gastric and breast cancers) were administered an extract of reishi mushroom (1:10w/v) before chemotherapy. (78) Immunocompromised patients showed increased levels of CD4/CD8 ratio and T-cell counts and lowered levels of T-suppresor cell counts. Radio- and chemotherapy intolerance reportedly was reduced in the cancer patients on the reishi extract and leukopenia from the treatments improved. The patients also showed improved vigor and appetite. Reishi also decreased the immunosuppression seen in whole body ¡-irradiated mice, showing a greater degree of recovery vs. the control group. (79)

Reishi extracts have also reported hypoglycemic activity both in laboratory animals and in human subjects. (80) A small 2-month open label trial of eight diabetic patients reported that an extract of reishi produced hypoglycemic effects comparable to that of insulin and oral hypoglycemic agents. (81)

Polysaccharides in reishi have been reported several clinical studies to have antiherpetic properties, and has been used in treating herpes (82) and postherpetic neuralgia, decreased pain dramatically in two patients with postherpetic neuralgia recalcitrant to standard therapy and two other patients with severe pain due to herpes zoster infection. (83) The triterpenoid constituents in reishi have reported anti-HIV-1 and anti-HIV-1-protease activity in vitro. (84)


Schisandra

Schisandra has been used in Chinese medicine for centuries as a kidney tonifying agent and sedative. It has historically been used to treat cough and wheezing, spontaneous sweating, chronic diarrhea, insomnia and forgetfulness. (85) In Russia, schisandra has been used as an adaptogen, increasing the body’s natural ability to fight off disease and stresses from chemical, physical, mental and environmental sources. (86) Schisandra has been reported to increase human endurance and mental and physical performance. (87)

Recent literature has focused on schisandra’s ability to protect the liver from damaging toxins. (88) Liver regeneration was reported in laboratory animals following partial hepatectomy. (89) Other uses include as an expectorant and cough suppressant and as an antioxidant. Schisandra was reported to have a cardioprotective action during administration of Adriamycin (doxorubicin). (90) Schisandra and its lignans have been reported to prevent liver damage, stimulate liver repair and stimulate normal liver function. (91) , (92) These properties are thought to be related to the antioxidant ability of the schisandrins, stimulation of liver glycogen synthesis, protein synthesis, protection of hepatocyte cell membranes and elevation of liver microsomal drug-metabolizing enzyme activities. (93) , (94)

In clinical studies, schisandra reportedly reduced elevated serum glutamic-pyruvic transaminase (SGPT) levels in various types of hepatitis. However, SGPT levels rebounded after stopping the herb, especially in chronic persistent hepatitis. (95)

Homeopathic

Arsenicum album

Typical Dosage: 6X or 6C, 30X or 30CWeak; Pale; Sensitive to cold; Burning sensations; Restless, worse at night between 1:00-3:00AM; Better from heat

Gelsemium sempervirens

Typical Dosage: 6X or 6C, 30X or 30CGeneral weakness; Lethargy; Sleepiness; Stiffness in body; Limbs feel heavy

Phosphoricum acidum

Typical Dosage: 6X or 6C, 30X or 30CProstration and severe fatigue; Nervous exhaustion; Better from heat and rest; Worse from any physical or mental effort

Acupuncture & Acupressure

Acupuncture and moxibustion therapy

Zeng et al. treated 38 cases of chronic fatigue syndrome with acupuncture and moxibustion. Based on syndrome differentiation, acupoints were selected to receive treatment as follows: for deficiency of spleen-kidney yang, acupoints Bai Hui (GV20), Guan Yuan (CV4), Zu San Li (ST36), Shen Shu (BL23), and Fu Liu (KI7) were treated, 3-5 points at a time, and after acupuncture, moxibustion (5-7 moxa cones) was applied to Bai Hui (GV20), Guan Yuan (CV4), Zu San Li (ST36); for deficiency in heart and spleen, acupoints Nei Guan (PC6), Xin Shu (BL15), San Yin Jiao (SP6), Qi Hai (CV6) were treated, 3-5 points at a time, and after acupuncture, moxibustion (3-5 moxa-cones) was applied at Xin Shu (BL15) and Qi Hai (CV6). The acupuncture treatment used weak stimulation and the needles were retained for 15 minutes after insertion. The results: 9 cases greatly improve, 21 improved, and the remaining 8 did not respond to the treatment. (96)

Gao treated 21 cases of chronic fatigue syndrome with acupuncture. One point was selected alternatively each time from the following 3 groups: (1) the upper region: Bai Hui (GV20) and Yin Tang (EX-HN3); (2) the middle region: Qi Hai (CV6) and Guan Yuan (CV4); (3) the lower region: Zu San Li (ST36) and San Yin Jiao (SP6). The needles were maneuvered using either the reinforcing method or the uniform reinforcing-reducing method. All the patients received the treatment once a day, and once course of treatment consisted ten sessions. The results: after 2-3 courses of treatment, 17 cases were resolved, and the remaining 4 improved, with a total effective rate of 100%. (97)

Traditional Chinese Medicine

Chronic Fatigue Syndrome

Extensive information regarding the treatment of this health condition using Traditional Chinese Medicine is available through the link above.

Clinical Lab Assessment

Some of the following laboratory testing can provide information necessary for the diagnosis and treatment of chronic fatigue syndrome. In addition, the tests listed may also give insight to functional metabolism and functional nutrient status in the body.

Adrenal Function Profiles

Stress activates the HPA axis and has impact on the immune system, particularly through the adrenal hormones. Adrenal functional abnormalities (specifically the production of DHEA and cortisol) are relatively simple to identify and address (e.g. when compared to hypothalamic dysregulation or pituitary imbalance).

Thyroid Profile

Hypothyroidism or autoimmune thyroiditis is diagnosed in a significant number of CFS patients.

Organic Acids

Organic acids analysis is a useful method for measurement of biochemical intermediates in urine. Serotonin and its contribution to central nervous system (CNS) function have been studied in relationship to CFS. (98) 5-hydroxyindolacetate (5-HIA) is a metabolite measured in urine that reflects CNS levels of this product of tryptophan. Low levels of 5-HIA are associated with depression, fatigue, insomnia, suicide, attention deficit and behavioral disorders as well as CFS. B-12 and folic acid status may also play a role in fatigue and are best assessed for functional adequacy in an organic acids panel. A subset of organic acids, the dysbiosis markers, can be used to identify the presence of bacterial infection or imbalance in the gastrointestinal tract. This data can be useful in assessment and monitoring of abnormalities implicated in symptoms of CFS such as an irritable bowel.

Mineral Analysis

Toxic elements, especially lead, mercury, and cadmium, have been implicated in syndromes with fatigue as a primary symptom. Magnesium has been shown to have particular importance in alleviating symptoms of CFS.

Allergy and Food Sensitivity Response Assessment

Allergies have a significant correlation with CFS. (99) Allergy screening may provide useful information regarding potential therapeutic interventions.

References

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