Now we have come to the bad side of things, unfortunately, there is no imaging method or a blood test to reveal chronic fatigue syndrome, and many complaints seen in this syndrome can be seen in other diseases as well. Therefore, it is the best way to review the individual’s symptoms along with the factors that cause these symptoms and the pathophysiology, and to focus on the underlying cause.
I will give you some more information here, chronic fatigue syndrome is recorded as a disorder in the records. Although this word is translated as disease when translated into Turkish, this is not directly correct. Because the definition of disease is slightly different from the definition of disorder. Disorder, disease has both diagnosis and treatment (which the literature admits). However, there is no clear diagnosis or clear treatment accepted in the literature for the disorder.
When diagnosing this syndrome, most complaints are also due to fibromyalgia, and patients are usually diagnosed with fibromyalgia, but we can say that chronic fatigue syndrome is actually the whole of many systematic diseases rather than a single disease. In addition, although it is put on the same scale with the diagnosis of lyme in our age, it actually has many differences.
Pathophysiologically, mitochondrial problems, especially amino acid and nitrogen metabolism, lipid mechanism and carbohydrate metabolism problems have been revealed by studies, intestinal flora problems have been revealed by studies.
-Complaints of the person
-Medications used
-Lifestyle sleep, stress, nutrition
-Mental state is of great importance in the diagnosis of the person.
If you think that you have chronic fatigue syndrome from the above-mentioned symptoms, it would be beneficial to see a competent doctor in this regard, because the earlier the treatment is started, the better the results will be, and the recovery rate decreases as it progresses.
SOME OPINIONS DIVIDE CHRONIC FATIGUE SYNDROME INTO 4 SUB-BRANCHES;
1-Chronic fatigue and immune dysfunction (CFIDS) In this group, together with other complaints, a clear decrease in blood white blood cells and a decrease in NK cells were detected from the laboratory.
2- Neurological problems predominate in myalgic encephalamyelitis (ME) complaints. Many people see chronic fatigue syndrome and myalgic encephalomyelitis as the same disease, as I have mentioned above, but many people distinguish them as such.
3-Adrenal fatigue (decreased or dysfunctional) can be revealed by cortisol laboratory tests. Many reasons, such as sleep disorders and stress, can cause adrenal fatigue. It will be a detailed article on this subject only.
4-Postural tachycardic syndrome (POTS) is cardiovascular problems with low blood pressure and low heart rate, which eventually leads to postural hypotension. Postural hypotension is normal when lying down, but when you stand up, blood pressure drops.
***Many opinions consider mitochondrial dysfunction as the main cause of chronic fatigue and try to develop diagnostic methods accordingly.
BOTTOM FLORA AND CHRONIC FATIGUE SYNDROME
In a study, most of the people with chronic fatigue syndrome had irritable bowel syndrome, and chronic fatigue syndrome patients with and without both of them were examined separately in the study. And the link between the two diseases has also been examined.
Stool samples and blood values of 50 patients with chronic fatigue syndrome and 50 healthy individuals were compared.
When stool analyzes were performed, some flora bacteria were shown to be associated with chronic fatigue syndrome. These;
1- Faecalibacterium
2- Roseburria
3- Dorea
4- Coprococcus
5- Clostridium
6- Ruminococcus
7- Coprobacillus.
Variability was observed in other species as well, depending on whether they were accompanied by IBS. In patients with IBS and chronic fatigue syndrome, alitipes levels increased and faecalibacterium levels decreased in the intestinal flora.
In chronic fatigue syndrome without IBS, an increase in some bacteriodes levels and a decrease in bacteriodes and vulgatus levels were observed.
A similar stool analysis study showed a decrease in anti-inflammatory bacterial strains and an increase in proinflammatory bacterial strains. In other words, there is a serious connection between intestinal flora and these diseases.
According to some opinions, it is possible to give an idea about whether the person will have chronic fatigue syndrome in the future by looking at stool analyzes. Laboratory tests related to these have been started to be used.
The conclusion we will draw from here is that intestinal flora imbalances may be one of the most important reasons behind possible chronic fatigue. But focusing on why this floral balance is disrupted may be the most important thing. In other words, reasons such as nutritional mistakes, chronic toxicity, stress.
TREATMENT OF CHRONIC FAILURE
We will talk about what we can do in the treatment of chronic fatigue step by step.
The basic logic in the treatment of people is to focus on the underlying causes, as in every chronic disease. These reasons may differ from person to person, and the reason that should be focused on in one person may be in the back row in another. But basically, let’s talk about it step by step, what should we do? In fact, you can see this order in all my other articles, because in my opinion, the approach to all chronic diseases should be in this order. And while making these changes, I consider many systems pathophysiologically and systematically.
1-Diet regulation
2-Getting rid of toxins
3-Chronic stress management
4-Lifestyle changes
5-Focusing on inflammation
6-Focusing on germs
7-Missing completing vitamins and minerals
8- Focusing on the spiritual system, resolving mental and physical traumas
9- Getting rid of emotional and mental toxins
Healing may take time and this is a difficult path, but it is possible to achieve good results if you put effort into it. .
1-DIET REGULATION
Proper nutrition is one of the most important steps in all chronic diseases. The right diet is one that provides you with the enzymes, minerals, phytochemicals and vitamins necessary for your recovery and is free from foods that harm you and cause inflammation. For a healthy life, we should eat in a way that supports our intestinal flora and does not cause digestive problems.
The thing that I get the most results in defeating chronic diseases in my patients and myself is a plant-based diet. Many studies have shown that a plant-based diet is essential for a healthy gut microbiota. Vegetables and greens should make up almost half of your plate in your diet.
Nutrition in chronic fatigue syndrome
It will be on a graph:
Isn’t the title a daily diet, how should it be?
• 40% Vegetables
• 15% Fruits
• 15% Animal foods
• 10% Legumes
• 10% Gluten-free grains
• 10% Oilseeds
These rates may vary from person to person, I must specifically mention that these percentages are roughly given rates and vary in terms of distribution in most patients, but if you focus on the largest majority, the “plant-based The proportions in nutrition are like this. And this is how I have been getting miraculous results in my patients for years.
Our animal food preferences may be free-range organic eggs, fish and meat from animals that graze on pasture, but this should not be the basis of our diet, but only a maximum of 20%.
Fruits, legumes, gluten-free grains, and oilseeds should be ahead of animal foods in your diet.
Food intolerances may be one of the most important points to be considered here, because almost all chronic diseases have an intolerance table.
I recommend that you remove gluten and dairy products from your life for a while and do an elimination diet. I will share a detailed article about the elimination diet.
It is especially stated that long-term fasting is not suitable for this type of patient. Because of the disorders in energy metabolism, therefore, intermittent fasting and starvation are never recommended in these patients without correcting the metabolism of the patients.
Adequate water consumption is essential for healthy cellular function and detoxification. Some of the diseases in the society can be significantly reduced when adequate water consumption is provided. There is an issue that I want to pay attention to here. The water in vegetables and fruits is more active and energetic inside the cell than normal water. In cases of chronic thirst, I usually tell them to drink vegetable juices and eat it directly, not in the form of fruit juice.
2-PURIFYING FROM TOXINS
We will have a detailed article about detoxification, but let’s talk about it briefly here. The body normally makes its own detoxification every day, but if our chronic toxin load increases and some systematic situations occur that prevent the detoxification systems from working (infection, vitamin mineral deficiencies, stress, etc.), we will not be able to remove the toxins sufficiently and the toxins accumulated in our body go to the tissues and cause damage to many diseases and symptoms. they will cause.
The first rule of detoxification is to reduce environmental toxins. It is to eliminate all kinds of chemicals that we are exposed to. Toxins come to our body through mouth, breathing or skin contact. The first step should be to get away from toxins and to get away from all toxic factors in our lives. In advanced cases, it is important to support the detoxification systems of the person by starting the necessary vitamins and minerals in the form of medical detox and to support the 3 phases of the detox.
3-CHRONIC STRESS MANAGEMENT
Stress is like a paradox for diseases. Stress causes diseases, diseases cause stress. In the end, it’s up to you. Body HPA hypothalamus, pituitary adrenal axis deteriorates, adrenal fatigue occurs. We will have a detailed article on this subject, and the first thing to do here is to eliminate the factors that cause stress. It could be a problem at your workplace, it could be a problem at home, or it could be many external factors. I know this is not easy, but as long as the stress continues, recovery is unlikely to happen.
What I’m going to tell you now are tips for coping with stress;
-Healthy sleep is important for coping with stress, but it also takes one of the most important places in the treatment of chronic fatigue syndrome. Quality and adequate sleep can reduce many symptoms and is essential for a healthy functioning immune system. A dark but completely pitch-dark, quiet room away from technological devices – at a suitable temperature is important for falling asleep and ensuring the continuity of sleep.
Sometimes, melatonin supplementation for a certain period of time may be considered
-When you encounter a situation that bothers you or stresses you, get away from the environment and take a walk in the open air for at least 15 minutes. When you return, you are likely to realize that the problem that will cause stress is not that big of a problem or that you can cope with this stress.
– 10-15 minutes of meditation and breathing exercises, yoga breaks that you do during the day are very useful
-Stop doing many things at the same time. This will stress you out a lot. It will be healthier to move forward by doing one job at a time.
-I think one of the biggest problems in our lives may be the suffix “must have”. In other words, the sentences that we must constantly present to ourselves, I must do this, this must be this way, it must be this way, are actually quite unhealthy. We can have goals and work hard for them, but putting ourselves into certain patterns and focusing madly on them perhaps affects us more than environmental stressors.
4-LIFE STYLE CHANGES
While we were creatures created to act, over time we were all condemned to work behind closed walls, unfortunately including me. That’s why increasing our movement is not a luxury but a necessity for us. Even while working at the workplace, it is very important that you get up and move from time to time, and move outdoors if possible. Movement increases blood flow and proper detoxification is very important for oxygenation of cells. Movement releases endorphins that will make you feel happier in your body, raises your immunity.
But there is something very important to be aware of here. In chronic fatigue syndrome, challenging movements and excessive exercise can greatly increase your complaints. Therefore, it is very important to start with simple movements, even to try yoga pilates and very light-paced walks as sports, and to start with short periods of time and gradually increase them.
Keeping your sleep hours at regular intervals is perhaps the most important of the lifestyle changes. As I said to my patients, it is recommended to sleep between 22:00 and 24:00.
It is very important that you keep screen and computer times short. The frequency and interference field emitted by technological devices will greatly affect your diseases.
It is important to get out into nature as much as possible. Being in areas such as the seaside, waterfalls and forests will expose you to lots of negative ions. These negative ions are very important for your health. We will talk about this in detail in another article.
FOCUS ON 5-INFLAMMAATION
It is worth mentioning here that chronic inflammation is one of the main causes of almost all diseases. This will be a very detailed post on the subject. But I want to talk to you in particular here, briefly, under this inflammation, there are other substances we have mentioned, in fact, nutrition, stress, sleep, toxins, etc.
6-FOCUSING ON MICROBES
Microbe theories have been one of the most confusing and almost researched subjects in the history of medicine, both in acute and chronic diseases. Although it is immediately accepted that there is a microbe, virus, bacteria parasite in acute diseases, it has always been kept in the background in the approach to chronic diseases for years. I have been researching and reading a lot on this subject for years, because I have worked and researched to cure my own chronic disease lupus, and I have been a close follower of this subject since the first time it came to the fore.
First of all, let me state that the theory that microbes underlie chronic diseases is still being discussed and studies are increasing day by day. But the latest studies show us clearly that microbes in our body no longer attack us directly and cause disease, as is thought, that is, due to other reasons that multiply in tissues and cells and affect immunity, stress, deficiencies, nutrition, etc. ) attack when immunity is low and multiply to produce symptoms. Even when most of the immune system is working adequately, it can cause problems in the cell and cause mitochondrial dysfunctions. Most of them, such as EBV and HHV6, directly suppress the immune system themselves. Our most studied viruses are the EBV (EBSTEIN BARR) virus. Apart from that, studies on other herpetic family viruses are increasing day by day. Apart from that, the studies of bacteria such as streptococcus and parasites such as Bartonella babesisa and many microbes are increasing day by day. It is very difficult to detect these microbes in people with chronic diseases, and I think this is the most challenging part of the studies. But with each passing day, the view that microbes are the biggest problems under the name of microbes that can no longer be detected, is becoming widespread. Not all antibiotics and antiviral, antiparasitic agents can act on these microbes because the adaptation of these species is highly developed. I leave many studies in the scientific literature to the bibliography link section below. The treatment of these microbes will be to eliminate these microbes by recovering the immune system, but this can be a long way. It seems like the wise way to cleanse them from the body gradually over time rather than an aggressive battle against them. Suspected microbes in chronic fatigue syndrome are EBV Iyme bacteria-q fever bacteria, CMV HHV6, enterovirus, parvovirus B19
-The agents frequently preferred by naturopaths in eliminating these microbes, using phytotherapeutic agents is my favorite method against microbes.
7-COMPLEMENTING THE MISSING VITAMINS AND MINERALS
One of the most important points here is to approach a person’s deficiencies by dominating the symptoms as well as by laboratory tests, because in cases of vitamin and mineral deficiencies, blood and other laboratory tests are often incapable of showing us functional deficiencies. Treatment should be planned considering both laboratory tests and the symptoms of the person, and the necessary deficiencies should be supported with nutrition first, and the necessary supplements should be started where the nutrition is deficient.
-Our next chapter will give you information about deficiencies and supplements in chronic fatigue syndrome.
There will be a detailed section about Items 8 and 9, but it should be noted that unless a person focuses on the spiritual system and gets rid of the emotional and mental toxins that tire and wear out his body, he cannot fully get rid of his illness. In some patients, these 2 items are more important than all the reasons we have mentioned before.
When you approach the person from a holistic perspective in chronic fatigue
There are also complementary medicine methods and some other methods that we can use to touch these systems.
-Acupuncture
-Homeopathy
-Neural therapy
-Ozone therapy
-Breathing exercises
-Yoga
-Reiki
-Massage
-Ham sauna
-Aromatherapy
-PEMF treatments (pulsed, electomagnetic field machines)
Adding these according to the needs of the person is very beneficial for the treatment.
-The effectiveness of psychotherapy cognitive behavior therapy in the treatment of chronic fatigue has been demonstrated by many studies.
However, it is necessary to focus on the underlying problems of the person, to turn to whichever path is broken, and to make changes in the lifestyle. This differs from person to person, but what are the supplements and phytotherapeutic agents that we can use in chronic fatigue syndrome
?
1-Valerian (VALERIAN)
600-900 mg of valerian extract standardized as 0.4% valeric acid can be used 1 hour before bedtime. It allows you to sleep better and reduces fatigue, you need to use it for at least 2 months.
2-LICORD ROOT EXTRACT
It can be used to increase your energy in cases of low blood pressure and to support the adrenal system. The anti-inflammatory compounds in it raise the sodium level in the blood and cause an increase in blood pressure. 500 mg can be used 2-3 times a day.
3-SIBERIAN GINSENG
It can help with fatigue It can support the adrenal system In a study, it was observed that among people with moderate fatigue, those who used Siberian ginseng regularly for 4 months experienced less fatigue compared to placebo. However, its effectiveness has not been seen in advanced fatigue, unfortunately 400 500 mg standardized extra can be used. Caution should be exercised in patients with diabetes and high blood pressure. It is not recommended to be used in the evening hours as it may affect sleep.
PANAX GINSENG (AMERICAN GINSENG)
100 -200 mg can be taken twice a day. It may be necessary to use with caution in diabetes and high blood pressure. It has been shown from several studies to be highly supportive of the immune system.
4-GINKO
May increase concentration and awareness Increases blood flow in the brain, thanks to its antioxidant effect, it protects the muscles from oxidative damage and can reduce muscle pain 80-120 mg can be used twice a day standardized 24% flavonoids and 6%-7% must be tincture containing terpene, lactone.
5-COENZYME Q10
In chronic fatigue syndrome, there may be a problem in adequate ATP production. Although ATP production is troubled, you feel quite tired and coenzyme q10 supports you to produce more ATP. Coq10 is also involved in ATP production. It is also an antioxidant and supports immunity and muscles. In a study, 155 patients used coenzyme q10 and it was seen that these patients’ ability and power to exercise increased
. As we mentioned above, exercise can be a nightmare for patients with chronic fatigue syndrome, there are other studies on coenzyme q 10 on this subject, and the basis of all of them is energy production, namely ATP, my dear. It can be started as 100 mg daily, and if necessary, you can increase the dose with your doctor.
6-ESSENTIAL FATTY ACIDS
Essential fatty acids were found to be quite low in patients with chronic fatigue syndrome,
The group 3 that has studies on this subject is fish oil, evening primrose oil and flaxseed oil on supplements. The recommended dose is either 2 grams of fish oil combined with 2 grams of flaxseed oil or 2 grams of fish oil combined with 2 grams of evening primrose oil.
7-MELATONIN
It can improve sleep quality and be very beneficial due to its antioxidant effect. There are no clear studies on its use on chronic fatigue yet. 3 mg per day can be used before going to bed
8-GOLD ROOT (RHODIOLA ROSEA)
In a study, it was shown that doctors working in shifts provide high efficiency in cognitive and thinking abilities.100 -200 mg can be taken 2-3 times a day. It is recommended to use at least 2 months for the effect. It plays a role in balancing the adrenal system and producing energy. It can be used safely because it is an adaptogen like ashwaganda. Unfortunately, another phytotherapeutic agent that I like very much but is difficult to find.
9-SCHISANDRA BERRY
It was antioxidant and anti-inflammatory. It can even be used in the treatment of diabetic patients. It can be especially good for adrenal fatigue. 500-1000 mg extra 2 times a day can be used.
10-CORDYCEPS MUSHROOM (CORDYCEPS SINENSI)
Tablet forms are more common. 80 mg can be drunk once or twice a day, but there is no clear opinion about the dose. It is highly supportive of the adrenal system.
11-NADH
In a study, daily use of 10 mg of nadh significantly reduced complaints against placebo. It is also thought to be beneficial in serotonin balance. 20 mg can be used once a day.
12-MAGNESIUM
Magnesium deficiency may be the cause of most of the symptoms experienced in chronic fatigue syndrome. In studies, the superiority of magnesium over placebo has been demonstrated many times. Also, since fibromyalgia is one of the diseases that most trigger chronic fatigue, one of the magnesium forms is malate form. It’s worth keeping in mind. I especially recommend the malate form
13-L CARNITIN
Its role in muscle metabolism and cellular energy metabolism is important. Deficiency can cause low energy and fatigue, muscle pain. Studies have found that the serum acetyl carnitine levels of chronic fatigue patients are quite low. A serious increase was observed in the ratio of acetyl carnitine to l carnitine. L-carnitine supplementation may be beneficial in patients with chronic fatigue syndrome. 500 mg can be taken 1-3 times a day.
14-L GLUTAMINE
It can be used to restructure the intestinal flora and balance cortisol levels.
15- FOLIC ACID
Serum folate level can actually be an indicator of folate level in cerebrospinal fluid. And low folate levels and folate deficiency can cause problems with brain function. It can affect depression
16-B12
It has an important role in many pathways. Its effectiveness in chronic fatigue has been seen as preventing erythrocyte abnormalities. Hydroxycobalamin or methylcobalamin are suitable for use, do not use cyanocobalamin.
17-OTHER VITAMINS B
Low levels of riboflavin, thiamine, and pyridoxine were found in the blood of patients with chronic fatigue syndrome, and it was suggested that supplementing these could be effective in relieving the complaints of patients.
VITAMIN 18-C
Vitamin C deficiency can cause fatigue and depression. Vitamin C supplements are thought to be beneficial in chronic fatigue syndrome, as it supports the immune system and regulates erythrocyte abnormalities. The doses in the studies are usually 15 g IV doses and 1-3 g daily oral vitamin C doses. Vitamin C also supports the adrenal system.
19-SODIUM (SALT)
Neurological hypotension is seen in some of the patients with chronic fatigue, the main reason of which is the restriction of salt (SODIUM) consumption in the society. It is beneficial for these cases to increase their salt consumption to a certain extent.
20-ZINC
Zinc deficiency can cause low immune system, cause fatigue and muscle aches, and is quite common in society. Zinc supplementation should be considered together with magnesium for muscle coordination and relief of pain.
21-L TRIPTOPHAN
In studies, it was observed that l tryptophan levels in the blood decreased by up to 80% in patients with chronic fatigue syndrome. Decreased tryptophan levels cause decreased brain serotonin levels. Tryptophan is a precursor to serotonin, which can cause mood problems. Low tryptophan levels can cause depression. It is not clear yet whether tryptophan supplementation will be effective in chronic fatigue syndromes, but feeding with sources such as tryptophan-rich spirullina can be very beneficial.
22-DHEA
It is a hormone secreted mainly from the adrenal glands and to a lesser extent from the ovaries and testicles. And more is converted into other steroid hormones in the body like estrogen and progesterone. It also plays a role in your mood and sleep quality. Studies show that dhea levels are abnormal in patients with cornic fatigue syndrome. Dhea supplements are never recommended without a clear diagnosis of deficiency by laboratory tests. And the use of dhea supplements must be followed by a doctor.
23-DIGITAL ENZYMES
It can be used to regulate digestion and support digestion while solving basic problems
24 -BETA CAROTEN
It can be used due to its antioxidant effect
25- ASHWAGANDA
Here we come to my favorite. Obviously, it is not produced in Turkey and it is a supplement that is difficult to obtain, but it is the one that gives the best results because it is an adaptogen, that is, it does not tire the body while repairing the adrenal glands. It is very effective in anxiety and fatigue. In one study, 250 mg of ashwaganda daily increased energy levels by 79% in weeks with chronic fatigue syndrome!
26- D RIBOSE
It can be used for energy metabolism in cells. 5 g can be used 2-3 times a day.
27- 5 HTP
It can be used for anxiety symptoms and for serotonin balance. Uyku kalitesini düzeltir ve ayrıca seratonin seviyesi arttıkça ağrının da azalması olasıdır.100 mg günde 2-3 kez alınabilir.
28- OREGANO OİL (KEKİK YAĞI)
Antimikrobiyal ajan olarak oldukça etkilidir. 1 ay kullanıp ara ara kesilmesinde fayda vardır. 500 mg günde 3-4 kez kullanılabilir.
29- D VİTAMİNİ
Vitamin D eksikliği ciddi yorgunluk ve immün sistem sorunlarına yol açabilir. Kan D vitamini seviyesini 60-80 civarında tutmakta fayda vardır.
30- PROBİYOTİK
Doğru suşlar içeren probiyotikler bağırsak florasına destek verebilir. Bu konudaki araştırmalara hala devam etmektedir.
GELENEKSEL ÇİN TIBBINA GÖRE
Kronik yorgunluk sendromu nedenleri geleneksel Çin tıbbına göre şu şekildedir
-Uyku yin eksikliği
-Böbrek yin eksikliği
-Böbrek yang eksikliği
-Öz eksikliği. Bunlara Çin tıbbı tedavileri şeklinde odaklanmak da hastalara faydalı olabilir. Maalesef henüz bu konuda bir tecrübem bulunmadığı için sizlere daha fazla ayrıntı veremeyeceğim ama denenebilir neden olmasın?
AYUVERDAYA GÖRE
Ayuverdik yaklaşımda sindirim sistemini düzenlemek ve kronik toksinlerden arınmak yatar bu sendromda.
Ayuverdik ajanlar ashwaganda, amla, ,bala ,triphala, lomatium kullanılabilir. Kendileri bazen benim en sevdiğim fitoterapik ajanlar olabilyorlar ve kişiyi toksinlerden temizlemek her zaman ilk yaklaşım açım olmaktadır ayuverdadaki gibi.
Unutulmamalıdır ki kronik yorgunluk sendromu ile alakalı yoğun çalışmalar hala devam etmektedir bu sendroma tam olarak neyin neden olduğu ve tam nasıl tedavi edileceği çoğu zaman büyük bir sis perdesi. Ama bütünsel yaklaşımla kişinin semptomlarına ve patofizyolojiye odaklandığınızda çok güzel sonuçlar görülmektedir, bizzat birçok hastam hayatlarına yeniden kavuşmuştur ama unutmamak gerekir ki kişiye göre semptomlar ve tedaviler değişmektedir, alınan sonuçlarda kişisel farklılık göstermektedir.
Sendromsuz enerjik günleriniz olsun.
