Chronic Fatigue Syndrome and Functional Nutrition Care
Article by Dr. Margo Gasta, DCN, RDN, CCH
Are you suffering from chronic fatigue syndrome (CFS) and can’t seem to get relief through conventional medicine? Many people with chronic fatigue don’t realize that nutrients can play a powerful role in helping with energy production, achy muscles and joints, cognitive function, and dysregulated sleep patterns.
Nutrients play a key role in the healthy function of all the cells in the body as well as all the biological systems in the body. If you or a loved one are suffering from chronic fatigue syndrome, you may want to explore nutritional care.
Chronic Fatigue Syndrome is a challenging long-term illness that can keep people housebound or bedbound for years. (1) If fatigue has lasted longer than 6 months, it can be defined as chronic fatigue. (1) Chronic Fatigue Syndrome (CFS) is defined as chronic fatigue along with a combination of another 4-8 symptoms. (1) The symptoms of CFS include persistent fatigue, difficulty with memory and concentration, a disturbance in sleep patterns, and severe muscular-skeletal pain. (2) Other symptoms may include tender lymph nodes, sore throat, pain, and signs of encephalomyelitis, chronicity, and disability. (3) The duration of the illness is long and often exceeds 10 years. (1) Currently, the diagnosis is based on physical signs and symptoms because there are no known biomarkers. (1) One requirement to obtain a diagnosis of CFS is the absence of other diseases that can cause fatigue. (1) This is where thorough testing from your physician is important. CFS is thought to possibly be triggered by infections, stress, and exposure to toxins. (1)
The CFS cluster of symptoms was first recognized in the 1950s. (3) In the 1980s two outbreaks occurred in the US and the symptoms resembled mononucleosis and were initially linked to Epstein-Barr virus. (3) New research ruled out causes of the illness including the Epstein-Barr virus. (3) In 1987 the CDC chose the term “Chronic Fatigue Syndrome,” and the first definition of the illness was published in 1988. Chronic Fatigue Syndrome was classified as a neurological disease by the World Health Organization in 1993. (2)
Advocacy organizations for CFS feel the term, “chronic fatigue syndrome,” is stigmatizing and trivializing and makes medical clinicians dismissive of symptoms and question if the illness is real. (3) These organizations feel this term does not convey the multi-organ complexity of the disease or the severe impact this illness can have on a person. (3) CFS can increase the risk of disability, financial instability, and social isolation. (3) The disability of chronic fatigue is recognized as a significant public health concern and economic burden to society. (3) CFS affects 2.5 million people in the United States. (3)
Symptoms can be severe enough to prevent completion of everyday tasks and 25-29% of people with CFS are housebound or bedbound. (3) Most symptoms are so severe that patients are unable to work or attend school full-time and unemployment rates range from 35-69%.(3)
Causes of Chronic Fatigue Syndrome May Be A Complex Network of Alterations in:
Inflammation. (3) Inflammation is important to healing but when it becomes chronic it can lead to achiness, pain, degeneration, as well as diseases such as autoimmune arthritis, cancer, and heart disease. Inflammation can cause flu-like symptoms. People with CFS may feel flu-like often.
Immune System Activation. (3) It is important to have a healthy immune response. When immune system disorders occur, that can mean that your immune system is directed against your body, is excessive, or is lacking. (5) Optimal nutrient status is imperative to a healthy immune response.
Autonomic Dysfunction. (3) Autonomic dysfunction is when nerves of the autonomic nervous system are damaged. (4) This can cause dizziness and fainting upon standing, inability to alter heart rate with exercise, sweating abnormalities, loss of appetite, bloating, diarrhea, constipation or difficulty swallowing, urinary problems like difficulty starting urination, incontinence, incomplete emptying of the bladder, sexual problems, vision problems or inability of the pupils to react to light quickly, tremor, and muscle weakness. (1)
Impaired Functioning of the Hypothalamic-Pituitary-Adrenal (HPA) Axis. (3) The HPA axis is a self-regulated feedback system that maintains homeostasis in the body and is impacted by multiple factors such as physical and psychological factors. (2) Regulating cortisol is one of the duties of the HPA axis and cortisol has an important function in the regulation of the neuroendocrine system, and sympathetic nervous system, modulating inflammation, and balancing hormones. (2)
With a dysregulated HPA axis, relatively minor physical or psychological stress may turn into an inflammatory response by triggering the release of chemicals that lead to inflammation and this in turn may play a role in the severe pain experienced in CFS patients. (2) Fatigue, dizziness and an inability to exercise may also be due to HPA axis dysfunction. (2)
Neuroendocrine Dysregulation. (3) Neuroendocrine cells are like neurons (cells that make up the nervous system) but also make hormones like the cells of the endocrine system. (5) Neuroendocrine cells are found in every organ of the body. (5) They are mainly found in the gastrointestinal system, gallbladder, pancreas, thyroid, lung, and airways. (5) The pituitary gland, parathyroid gland, and inner layer of the adrenal gland are made up almost entirely of neuroendocrine cells. (5)
Neuroendocrine cells make and release hormones and peptides in response to neurological signals. (5) Neuroendocrine cells control how fast food moves through the GI tract, airflow, and blood flow through the lungs, blood pressure, and heart rate, etc. (5) When you understand how abundant and wide-spread neuroendocrine cells are in the body, it makes sense how many systems of the body can be disrupted in CFS due to neuroendocrine dysregulation.
Oxidative Stress. (3) This is an imbalance between free radicals and antioxidants. (6) Free radicals are produced naturally through exercise and inflammation, can be beneficial to healing, and help to fight infection. When free radicals are not kept in check by antioxidants, they can damage fatty tissue, DNA, and proteins in your body. (6) This can include damaging the membranes of cells that we need to form healthy tissues and a healthy neurological system. Oxidative stress contributes to several health conditions including inflammation, neurodegenerative diseases, cancer, heart disease, and aging. (6)
If you are suffering from CFS your medical provider may run a battery of tests, which is necessary to rule out other causes. With CFS these tests often show no underlying explanation or biomarkers for the symptoms. This is where more in-depth nutritional testing may be helpful.
Functional nutrition dietitians can work with your doctor and provide more in-depth nutritional testing and nutritional intervention to support the health of the body.
Improving Nutritional Status May Improve The Following:
Mitochondrial energy production
Malabsorption and impaired intestinal barrier function
Antioxidant status to balance oxidative stress and enhance the integrity of cell membrane linings
Nutrient deficiencies that can impact neurological health
Sleep Quality
Inflammation
Thyroid function
Adrenal function
Blood sugar regulation
Blood pressure levels
Lifestyle education around decreasing your everyday toxin exposure and optimizing your nutrient status may support your body’s natural ability for detoxification.
One more factor to consider with chronic fatigue symptoms is hormone imbalance.
A few supplements have been researched that show a significant reduction in chronic fatigue symptoms, and improved mitochondrial function. (7) Typically, a combination of nutrients is used to help combat CFS. (8) The use of supplements should be individualized and based on nutritional testing.
If you or someone you know is suffering from chronic fatigue syndrome and are interested in optimizing your nutritional status, please reach out for a free 15-minute discovery call HERE.
References
Klimas NG, Broderick G, Fletcher MA. Biomarkers for chronic fatigue. Brain Behav Immun. 2012 Nov;26(8):1202-10. doi: 10.1016/j.bbi.2012.06.006. Epub 2012 Jun 23. PMID: 22732129; PMCID: PMC5373648.
Retrieved on 2/26/22 from: https://pubmed.ncbi.nlm.nih.gov/22732129/
Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neurosci. 2013;2013:784520. Published 2013 Sep 30. doi:10.1155/2013/784520.
Retrieved on 4/6/22 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045534/
Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome; Board on the Health of Select Populations; Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington (DC): National Academies Press (US); 2015 Feb 10. 2, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK284897/
Retrieved on 2/26/2022 from: https://www.ncbi.nlm.nih.gov/books/NBK284897/
Case, C. March 8, 2019. Autonomic Dysfunction. Retrieved from https://www.healthline.com/health/autonomic-dysfunction
Canadian Cancer Society. The Neuroendocrine System. Retrieved on 4/6/22 from: https://cancer.ca/en/cancer-information/cancer-types/neuroendocrine-tumours/what-are-neuroendocrine-tumours/the-neuroendocrine-system.
Healthline. Retrieved on 3/6/22 from: https://www.healthline.com/health/oxidative-stress
Castro-Marrero J, Cordero MD, Segundo MJ, et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome?. Antioxid Redox Signal. 2015;22(8):679-685. doi:10.1089/ars.2014.6181. Retrieved on 4/6/22 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346380/
Nicolson GL. Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements. Integr Med (Encinitas). 2014;13(4):35-43. Retrieved on 4/6/22 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566449/