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Chronic Fatigue Syndrome & Fibromyalgia Are Real
By Dr. Jill Pitcher
Do you:
have trouble sleeping 3 or more nights a week?
ever feel achy?
have frequent headaches?
frequently forget or lose things?
feel depressed or like something’s wrong?
wake up feeling more tired than when you went to bed?
You could be one of more than 25 million Americans suffering from Fibromyalgia,
Chronic Fatigue and Immune Dysfunction Syndrome or Unrelenting Fatigue
Chronic fatigue, and its painful counterpart fibromyalgia, are real disorders
that cause physiologic changes in the body and can be effectively helped by an
integrated approach to treatment. They are steadily becoming a recognized
disorder after having historically been down played or ignored by many doctors.
The difficulty in gaining this recognition is due to the lack of ability to
objectively identify a reproducible cause of all the varied symptoms associated
with it. Western medicine has a need for a test that proves the existence of any
particular disease or disorder to validate it. Despite this barrier to
recognition, the Center for Disease Control did formally recognize Chronic
Fatigue Syndrome in November of 2006. They defined it as:
Persistent or relapsing fatigue lasting six months or longer and not alleviated
by rest that has no other discovered cause.
The fatigue results in substantial reduction of prior levels of activity
professionally or personally.
Four or more of the following symptoms:
• Sore throat
• Tender lymph nodes
• Muscle pain
• Multi-joint pain without swelling
or redness
• Headaches
• Un-refreshing sleep
• Pain and/or fatigue lasting more
than 24 hours after exertion
• Impaired memory or cognition that
results in substantial reduction of
activity
Fibromyalgia is defined as wide spread pain lasting at least three months,
significant pain located in at least 11 of 18 defined tender points on the body,
constant exhaustion, constant or intermittent flu like symptoms, cognitive
impairment often called “brain fog”.
Evidence is growing that supports a central brain dysfunction that upsets the
communication process with the rest of the body resulting in disorders or
malfunction in several key areas. These areas include sleep, the immune system,
the gastrointestinal system, the energy producing mitochondrial cells and
hormone balance. Nutritional insufficiencies and testing, along with symptoms
indicating potential chronic infections, are frequently found as a result. This
central dysfunction can be triggered by a particular event such as a severe
infection, accident, head trauma, pregnancy, or a severe stressor in life. It
can also be triggered by a length of time with multiple events essentially
adding up to overcome an individual’s ability to keep all the complex systems of
the body in correct balance.
An approach addressing the major areas of dysfunction can result in dramatic
improvement. Nutritional issues occur often due to both long term diet choices
and gastrointestinal absorption problems. Comprehensive vitamin and essential
fatty acid replacement is the cornerstone of treatment. Vitamin choices must
provide for replacing key nutrients the body uses and needs in times of
increased stress and pain in a form that will be the most easily absorbed.
Essential fatty acids often in the form of fish oil provide building blocks for
cells we cannot make ourselves and act as important anti-inflammatories. IV
vitamins have been used for many years to rapidly treat nutrient insufficiencies
having the advantage of avoiding absorption issues and the ability to use doses
that can be very helpful clinically but impossible if taken by mouth.
Another critical dysfunction is found within the mitochondrial cells. These
cells are found often by the hundreds inside virtually every cell in the body.
Their sole purpose is to be an assembly line for the molecule that supplies the
energy to run all the functions that cell has. If this function is compromised,
the cell becomes tired and does not function effectively, and eventually the
tissue or organ cannot as well.
D-Ribose is a sugar that has recently been discovered to be a very im-portant
part of this production line. It is also used in large quantities in our DNA.
Other key elements have been found and are continuing to be discovered as
insufficient in this process. Replacing these elements can provide a very
significant benefit for both chronic fatigue and fibromyalgia.
Sleep is one of the most rapidly advancing aspects of medical research and
clinical knowledge occurring at this time. It is often seen as the initial
dysfunction in the brain that can lead the cascade of other problems and becomes
a critical area to correct. While doctors have several tools to help people with
consistent sleep problems, the understanding of the serious medical conditions
that can result from chronic lack of quality sleep and the training of the use
of these tools is inadequate. Using prescription medication, herbal and nutrient
approaches has proven very helpful in overcoming this complex disorder. Sleep is
often also integrally involved in dysfunctions in the nutrient and hormone
system making corrections here necessary early in the treatment.
Hormone problems often seen include the thyroid, adrenal and reproductive
systems as well as more specific hormones including pregnenolone, DHEA and
growth hormone. Issues these hormones help with include energy, reproductive
problems, cognitive issues often known as “brain fog”, sleep and high
cholesterol. Growing understanding of how each contributes to helping the
symptoms associated with both fatigue and fibromyalgia have provided guidance in
evaluation of levels and efforts needed to help balance them correctly. The use
of bio-identical compounds has further improved the ability of knowledgeable
physicians to replace and balance especially those hormones that require tight
dosing and those unavailable by regular prescription at all.
Exercise is an often misunderstood aspect of fatigue. Typically, the body’s
response to exercise will be an improvement in sleep quality, daytime alertness,
strength and stamina.
When the body’s systems are not prepared to respond to the stress of activity or
exercise as is the case in chronic fatigue and fibromyalgia, it only further
drains its ability to recover from the stress at all. Taxing the muscle and
organ systems by just “pushing through it” as is often recommended only digs the
hole deeper making it more difficult and longer to recover at all. The worsening
of symptoms associated with this is called post-exertional fatigue and can often
last several days. Aiming at only attempting activity for the day that
approaches 75-80% of what you think you could do will avoid this worsened
fatigue and pain it produces.
An area of great importance is the potential for chronic infections becoming
intermittently more active but which may contribute to the daily symptoms of
fatigue and pain. This is a more controversial issue due to the lack of specific
testing that can prove who has a lingering viral or bacterial infection that
could be helped by proper treatment.
There are reliable clinical findings and clues in a detailed history that help
predict who may benefit from an approach to treatment that will focus on these
possible infections.
Chronic fatigue and fibromyalgia are real, debilitating, difficult conditions.
An approach integrating nutrients, hormones, sleep management, appropriate
activity and possibly treatment for chronic infections can provide a way to
navigate out of the debilitating results it can cause.
Dr. Pitcher has spent several years in private practice and practices focused on
Osteopathic Manipulative Medicine, Natural Hormone use and Nutrient Therapy. |
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