Chronic Fatigue Syndrome

Chronic fatigue syndrome is a vague condition sometimes referred to as Yuppie Flu, M.E. (myalgic encephalitis), burnout, or adrenal fatigue and the cause is as yet not fully understood. Rather, CFS is defined as a set of symptoms that include prolonged, overwhelming fatigue that begins upon awakening and lasts throughout the day. The fatigue may worsen with exercise or physical activity. Other symptoms associated with CFS include mood swings, muscle spasms, pain, headache, sleep disturbances, and loss of appetite.

It appears to be a combination of factors and there is no definitive medical test available to diagnose it specifically.

• Infectious disease. To date, there is no specific correlation between any infectious agent and CFS. Anecdotally, many CFS sufferers believe that their condition began with a flu-like illness, although for others the disease arises spontaneously.
• Immune disorders. Many patients with CFS have impaired immune function.
• Dental amalgam toxicity. Some research shows a possible correlation between dental amalgam, metal toxicity, and CFS symptoms. In one study, 83 patients (76 percent) reported long-term health improvement following the removal of dental metal.
• Oxidative stress. Studies suggest that oxidative stress may play a role in the development of CFS.
• Endocrine system disorders. Stress, both physical and emotional, can lead to increased levels of cortisol and other hormones. CFS may be associated with low cortisol levels and increased serotonin function. Aluminium is increased in CFS, while DHEA and iron are reduced in female patients.
• Low blood pressure. Low blood pressure is a common finding in CFS.
• Orthostatic hypotension (low blood pressure that occurs when going from a lying to a standing position) is also a common symptom in chronic fatigue patients.

Most patients present with symptoms of continued tiredness, depression, headaches and difficulty in concentrating. The symptoms are vague and mimic many other medical conditions. A CFS diagnosis can be made only when the patient has suffered from persistent, unexplained fatigue for at least six months. Memory, sleep and appetite are often also affected. In addition to fatigue, four of the following symptoms must be present:

• Cognitive impairment, especially short-term memory or concentration
• Sore throat
• Tender lymph nodes
• Aching or stiff muscles
• Multi-joint pain without swelling or redness
• Headaches of a new type, pattern, or severity
• Post-exertion malaise lasting more than 24 hours
• Persistent feeling of illness for at least 24 hours after exercise

Chronic fatigue syndrome tends to arise suddenly in otherwise active individuals. In a typical disease course, an otherwise ordinary flu-like illness or some other stressor will leave behind unbearable exhaustion and symptoms of CFS. This condition is frequently mistaken for a recurrence of the infection, sending the patient back to the doctor for more tests. Repeated tests will reveal no characteristic abnormalities, yet symptoms worsen, eventually resulting in sleep disturbances and depression. Many patients with CFS feel their concerns are initially dismissed by physicians, friends, and family, which may contribute to a sense of isolation. Once diagnosed, the symptoms may fluctuate, but CFS is not a progressive disease. Instead, most patients tend to get better by degrees, and some will fully recover.

There is no standard, approved treatment for CFS. Your Doctor at Health Renewal will perform a physical examination and request a comprehensive blood analysis at your local pathology laboratory or do in house saliva tests. These results will be analysed by your Doctor who will determine whether a definite deficiency exists and advise you on your treatment options, such as correcting any deficiencies.

Your Doctor will also exclude other medical causes for your symptoms, such as anaemia, depression, viral infections, toxic heavy metals and metabolic disorders. This condition is a diagnosis by exclusion and it may take some time before recovery can begin.

Depression and loss of functionality are the greatest risks of untreated chronic fatigue syndrome. Patients experience social, work and relationship problems and require a multi-faceted approach for recovery.

Depending on which form of supplementation you and your Health Renewal Doctor have decided on, one could expect to follow up with your physician from anything between every 3 months to once every 6 months.

A multi-gene DNA test can routinely be added to assessment of:

• blood cholesterol and
• glucose levels,
• blood pressure and
• body mass index (BMI) as part of Wellness Programs offered by healthcare practitioners.

It includes analysis of variation in clinically useful genes that may contribute to:

• abnormal cholesterol levels,
• homocysteine accumulation,
• blood clotting,
• iron overload and
• inflammation.

Some of these abnormalities contribute to the development of type II diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.

This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression if left untreated.

For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasised that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, an aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.

Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he/she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.

The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non-loyalty programme members) you will have to complete an in-depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.

Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.

In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Renewal Institute Diet may be recommended. All these recommendations will be summarised on a sheet or print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavour, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.

1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in this and take it into account when prescribing a treatment plan for you.

2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually, your ID number is sufficient.

Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.

You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.

It is important to never self-medicate, your Health Renewal Doctor will prescribe which supplements, in what amounts, you should be taking for your body`s needs.

Fighting Fatigue:

Free radicals and other potent oxidants may contribute to the development of CFS. One study showed that protein oxidation was significantly elevated in the blood of CFS patients.

Hormonal therapies:

DHEA has also been singled out for its ability to help CFS 15-25 mg daily for women (depending on blood test results). 25-75 mg daily for men (depending on blood test results).

Melatonin: before bed (sometimes up to 10 mg)

Bio-identical Hormone Replacement (if indicated, usually based on symptoms & blood results)

Coenzyme Q10(CoQ10), is a potent antioxidant that aids in metabolic reactions, including the process of forming adenosine triphosphate (ATP), the molecule used by the body for energy.CoQ10 is leading therapy for CFS, with 69 percent of patients reporting it was helpful.

Nutritional Therapies/deficiencies

B-Complex vitamin: A prescribed combination of Thiamine(B1), Riboflavin(B2), Niacin(B3), Folate (preferably as L-methylfolate), Vitamin B6 (pyridoxine) & Vitamin B12.

Other nutrients include Biotin, Pantothenic acid, Vitamin C, Omega 3 Fatty acids (with olive polyphenols, Phosphatidylserine, L-Theanine, Calcium, Magnesium, Zinc, Chromium, Selenium, Manganese.

Vitamin B6. Some data provide evidence of reduced functional B vitamin status, particularly of pyridoxine (vitamin B6) in CFS patients.

Folate. Researchers found that 50 percent of patients had values below 3.0 mcg/L.

Glutathione has been shown to help prevent damage to DNA and RNA, detoxify heavy metals, boost immune function and assist the liver in detoxification. Levels of intracellular glutathione decrease with age and may be depleted in CFS patients. Glutathione/Cysteine depletion may also cause the muscular fatigue and myalgia associated with CFS. Supplements used to raise cellular glutathione levels include N-acetylcysteine(NAC) (with vitamin C), lipoic acid, whey protein, L-cysteine and glutathione.

Essential fatty acids. Essential fatty acids are the fatty acids that cannot be made by the body. Essential fatty acids are crucial for rebuilding and producing new cells, and required for normal brain development. Studies concluded that essential fatty acids provide a rational, safe, and effective treatment for patients with post-viral CFS.

Energy Boosters

A number of nutrients have been studied for their ability to boost cellular energy- a possibly important concern among CFS patients. These include the following:

NADH. Reduced B-nicotinamide dinucleotide(NADH), along with CoQ10, is essential for the production of cellular energy.

L-carnitine. Although the research is somewhat inconsistent, several studies have found deficiencies of the amino acid L-carnitine among CFS patients. L-carnitine is known to boost energy levels. Acetyl-L-carnitine relieved mental fatigue and propionyl-L-carnitine alleviated general fatigue in a study comparing the two in CFS patients.

Magnesium. Magnesium participates in energy metabolism and protein synthesis.

Glutamine is a conditionally essential amino acid needed during periods of excessive stress. Glutamine is the preferred energy.

Adaptogens-Rhodiola rosea (in a standardised extract), Ashwagandha(in a standardised extract), Red Korean/ Asian Ginseng (Panax)

Herbal Therapies- Lemon Balm extract, Valerian root, or Licorice Root.

The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.

The obvious recommendation of avoiding stressful situations and occurrences goes without saying.

• Commuter stress, for example, cans affect your body. Try moving to a home closer to your workplace or finding a job closer to home is an obvious solution.
• If working a third-shift causes disruption in your cortisol levels or circadian rhythm resulting in disease, then change your work schedule to eliminate this stressor.
• Smoking and extremely vigorous or protracted bouts of exhaustive exercise impact the adrenals in a negative way.

With regard to the diurnal biorhythms of cortisol release, a few things increase cortisol at the inappropriate time.

• The consumption of alcohol and caffeinated beverages such as tea and coffee before bedtime is not recommended as caffeine can increase serum cortisol levels, which is counterproductive during the evening hours when the normal trough is expected. Additionally, caffeine and alcohol affect the release of melatonin (melatonin counters some of the negative effects of cortisol), causing a relative reduction in melatonin secretion during the night when a spike is usually seen.
• Other therapies such as acupuncture, Traditional Chinese Ping, Ayurvedic medicine, massage therapy, relaxation, yoga and even music therapy have shown success in stress management.
• Owning a pet is associated with improved physical and psychological health. Adopting a dog or cat may help ameliorate some of the symptoms and effects of chronic stress.

Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives: Health and intellect are the two blessings of life.

• “After joyfully working each morning, I would leave off around midday to challenge myself to a footrace. Speeding along the sunny paths of the Jardin du Luxembourg, ideas would breed like aphids in my head—for the  creative invention is easy and sublime when air cycles quickly through the lungs and the body is busy at noble tasks.” ― Roman Payne, Rooftop Soliloquy
• “When you got a condition, it's bad to forget your medicine.” ― Frank Miller, Sin City, Vol. 1: The Hard Goodbye
• “Sorry, there´s no magic bullet. You gotta eat healthy and live healthy to be healthy and look healthy. End of story.” ― Morgan Spurlock, Don't Eat This Book: Fast Food and the Supersizing of America
• “[G]rowing into your future with health and grace and beauty doesn’t have to take all your time. It rather requires a dedication to caring for yourself as if you were rare and precious, which you are, and regarding all life around you as equally so, which it is." ― Victoria Moran, Younger by the Day: 365 Ways to Rejuvenate Your Body and Revitalise Your Spirit
• “You will know if you are too acidic if you get sick often, get urinary tract infections, suffer from headaches, and have bad breath and body odour (when you do not use antiperspirant). Acidosis is the medical term for a blood alkalinity of less than 7.35. A normal reading is called homeostases. It is not considered a disease; although in and of itself it is recognised as an indicator of disease. Your blood feeds your organs and tissues; so if your blood is acidic, your organs will suffer and your body will have to compensate for this imbalance somehow. We need to do all we can to keep our blood alkalinity high. The way to do this is to dramatically increase our intake of alkaline-rich elements like fresh, clean air; fresh, clean water; raw vegetables (particularly their juices); and sunlight, while drastically reducing our intake of and exposure to acid-forming substances: pollution, cigarettes, hard alcohol, white flour, white sugar, red meat, and coffee. By tipping the scales in the direction of alkalinity through alkaline diet and removal of acid waste through cleansing, and acidic body can become an alkaline one. Natalia Rose, Detox for Women: An All New Approach for a Sleek Body and Radiant Health in 4 Weeks
• "Bear in mind that some substances that are alkaline outside the body, like milk, are acidic to the body; meaning that they leave and acid reside in the tissues, just as many substances that are acidic outside the body, like lemons and ripe tomatoes, are alkaline and healing in the body and contribute to the body's critical alkaline reserve.” ― Natalia Rose, Detox for Women: An All New Approach for a Sleek Body and Radiant Health in 4 Weeks
• “In a massive, long-term study of 17,000 civil servants, an almost unbelievable conclusion emerged: the status of a person's job was more likely to predict their likelihood of a heart attack than obesity, smoking or high blood pressure.” ― Matt Ridley, Genome: the Autobiography of a Species in 23 Chapters
• “If one’s life is so unsatisfying that an unhealthy activity brings a shred of happiness, it is nigh impossible to give it up unless something that brings greater happiness can be enjoyed in its stead. (28)” ― Prem Prakash, The Yoga of Spiritual Devotion A Modern Translation of the Narada Bhakti Sutras
• “May you be ordinary, as the poet once wished the new-born baby.” ― Julian Barnes, The Sense of an Ending
• “It is in the balancing of your spirituality with your humanity that you will find immeasurable happiness, success, good health, and love.” ― Steve Maraboli, Unapologetically You: Reflections on Life and the Human Experience