At Westcoast Integrative Health we take the underlying causes of both Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) very seriously. These complex conditions require proper evaluation to determine there cause, along with proper support options to help people take control of their health. Dr Davies has access to a variety of testing facilities however evaluation will always start with inexpensive lab testing suggestions, along with nutritional and lifestyle support to help get the body back online. Although these complex conditions can be difficult to beat, take time, and require a very active client role, using a functional medicine approach to guide treatment and treatment outcomes has been very helpful in tackling the underlying cause of these complex chronic conditions.
Chronic fatigue syndrome (CFS) and Fibromyalgia (FM) are characterized primarily by the abrupt onset of profound fatigue or pain that does not resolve with bed rest and is severe enough to reduce daily activity by at least 50% for a period of at least 6 months. The fatigue or pain is accompanied by varying combinations of symptoms including sore throat, low-grade fever, lymph node swelling, headache, muscle and joint pain, intestinal discomfort, emotional distress and/or depression, sleep disturbances, and loss of concentration.
Associated symptoms
| Fatigue
Low-grade fever Muscle pain Excessive sleep or insomnia Impaired mental function Depression Headache Allergies |
Anxiety
Muscle weakness After-exercise fatigue Premenstrual syndrome (women) Stiffness Visual blurring Nausea Dizziness |
Joint pain
Dry eyes and mouth Diarrhea/Constipation Cough Decreased appetite Night sweats Painful lymph nodes Sore throat |
Possible or associated causes:
Infection: All Chronic infections should be identified or ruled-out
Epstein–Barr virus (EBV)
Many research studies have attempted to identify an infectious agent as the cause of CFS, and EBV has emerged as the leading, yet controversial, candidate: EBV is a member of the herpes group of viruses, which includes herpes simplex types I and II, varicella zoster virus, cytomegalovirus, and pseudorabies virus. After the initial infection, all of these viruses establish a lifelong latent infection that is usually kept in check by a healthy immune system. When the immune system is compromised, however, these viruses can become active, replicate and spread. This viral reactivation and recurrence of infection can itself compromise and/or disrupt immunity, increasing susceptibility to other diseases.
Elevated EBV antibody levels are observed in a significant number of diseases characterized by disorders in immune function. Elevated antibody levels to not only EBV but to the herpes-group viruses, measles, and other viruses have been observed in patients suspected of having CFS and or fibromyalgia. EBV infection is the rule rather than the exception among humans. By the end of early adulthood, virtually all of us demonstrate detectable antibodies to the Epstein–Barr virus in our blood, indicating past infection. When the initial infection occurs in childhood, it usually produces no symptoms, but when it occurs in adolescence or early adulthood, symptoms of infectious mononucleosis develop in approximately 50% of cases.
Small Intestinal bacterial Overgrowth
SIBO has now been strongly correlated to cases of fibromyalgia and CFS. Check this SIBO Clinic website for more information.
http://sibotesting.com/about-sibo/
Other infectious agents:
A number of other viruses and bacteria have been investigated as possible causes of CFS and/or fibromyalgia, although the underlying issue – the inability of the individual’s immune system to deal with chronic infections effectively – needs to be addressed. The following organisms have been proposed as causative agents in CFS and FM:
- Epstein–Barrvirus
- Human herpes virus 6
- Inoue–Melnichvirus
- Brucella
- Giardia
- Cytomegalovirus
- Enterovirus
- Retrovirus
- Borrelia burgdorferi (Lyme Disease)
Chronic Candida infection: normally, Candida albicans lives harmoniously in the inner warm creases and crevices of the digestive tract and, in women, also in the vaginal tract. However, when conditions, such as antibiotic use, allow this yeast to over-grow, when immune system mechanisms are depleted, or when the normal lining of the intestinal tract is damaged, then yeast cells, particles of yeast cells, and various toxic by-products of yeast metabolism enter the general circulation and significantly disrupt body processes. Fatigue, allergies, immune system malfunction, depression, chemical sensitivities, and digestive disturbances are just some of the symptoms patients with yeast syndrome can experience.
A disturbed immune system plays a central role in both chronic fatigue and fibromyalgia which can lead to the onset and continuation of the symptoms that people may experience. A variety of immune system abnormalities have been reported and include;
Low natural killer (NK) cell activity: the most consistent abnormality is a decrease in number or activity of NK cells, immune cells responsible for destroying cells that have become cancerous or infected with viruses.
Lack of lymphocyte response: another consistent finding is a reduced ability of lymphocytes (a type of white blood cell critical in the battle against viruses) to respond to stimuli.
Interferon abnormalities: one of the reasons for the lack of lymphocyte response may be reduced activity or decreased production of interferon, a key compound produced by the body to fight viruses. Both low and high levels of interferon have been reported in CFS and FM, but levels are more often depressed. When interferon levels are low, reactivation of latent viral infection is likely. When interferon levels are high, as is the case when interferon is used as a therapy for cancer and viral hepatitis, the side effects produced are similar to the symptoms of CFS or FM.
Hormonal Imbalances:
CFS and FM suffers typically present with associated hormonal imbalances. Hormonal imbalances may be part of the cause of immune system dysfunction experienced by people coping with these conditions. Hormonal imbalances should be properly evaluated and addressed to help with both symptom management and to support resolution of the underlying causes of FM and CFS.
Sex hormone imbalances: Sex hormones play a major role in how we feel and in-turn how our immune systems function. Testosterone, estrogen and progesterone are important hormones to asses and address in a comprehensive treatment strategy.
Low adrenal function: debilitating fatigue is one of the major symptoms of low adrenal function, also characterized by a stressful event, followed by feverishness, joint pain, muscle ache, swollen lymph glands, fatigue, worsening of allergic responses, and disturbances of mood and sleep. DHEA and cortisol are the major adrenal hormones in the body that may lead to impaired immune function. These hormones may be evaluated using a variety of methods to help determine if low adrenal function needs to be addressed as part of a comprehensive treatment strategy.
Hypothyroidism: since hormones produced by the thyroid gland affect every cell of the body, a deficiency will cause numerous problems. Depression, weakness and fatigue are usually the first symp- toms. Hypothyroidism is often undiagnosed because standard blood measurements of thyroid hormone are not sensitive enough to diagnose the most common, yet milder forms (for more information see the chapter on Hypothyroidism).
Hypoglycemia: blood sugar imbalances induced by a diet too high in refined carbohydrates results in low blood glucose (sugar) levels. Hypoglycemia is associated not only with fatigue, but depression and anxiety, which is the most common cause of chronic fatigue.
Other circustances that can lead to CFS and Fibromylagia
Food allergies: chronic fatigue, muscle and joint aches, drowsiness, difficulty in concentration, nervousness and depression are key features of the toxemia resulting from food allergy. Between 55 and 85% of individuals with CFS have allergies.
Multiple chemical sensitivities (MCS): one group of researchers carefully compared the symptoms of 90 patients who had been diagnosed as having CFS, MCS, or FM (30 in each category). Eighty percent of both the FM and MCS patients met the CFS criteria of fatigue lasting more than 6 months and causing a 50% reduction in activity. More than 50% of the CFS and FM patients reported adverse reactions to various chemicals.
Environmental illness: exposure to food additives, solvents (cleaning materials, formaldehyde, toluene, benzene, etc.), pesticides, herbicides, heavy metals (lead, mercury, cadmium, arsenic, nickel, and aluminum), and other toxins can greatly stress the liver, leading to a reduction in its ability to detoxify. All types of environmental toxicity may be evaluated for to determine in chronic toxicity may be leading to impairment of the immune system and disruption in hormone function.
Anemia and nutritional deficiencies: Many nutritional deficiencies and causes of chronic anemia may be evaluated for and properly treated. Functional testing and conventional blood testing can help to determine underlying deficiencies.
Sleep disturbances: Insomnia can be devistating to the bodies immune and endocrine systems. Chonic sleep disturbance may be a result of breathing obstruction, medication side effects, blood sugar imbalances, nutritional imbalances and unbalanced microflora in the gastrointestinal tract.
Negative or defeatist attitude: many people with CFS are told that it is “something they will have to live with”. This is not true! It is possible to get better. In addition to correcting the underlying physiological causes of CFS, a positive mental attitude is critical to good health and energy levels. Mental states have a direct impact on the production of neurotransmitters that translate our thoughts into physiological changes throughout the body. These neurotransmitters are found, not just in the brain, but also in the immune system, endocrine system, heart, lungs, intestines – everywhere. Proper evaluation may be done to determine neurotransmitter imbalances and should be evaluated in all people with chronic diseases.