You may have heard about chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS); two syndrome with overlapping symptoms. Both conditions have contributed to significant mental and physical frustration in our communities. CFS has been a subject of controversy for many years but now it is officially recognized by Centers of Disease Control (CDC). CFS affects 3 out of every 1000 Americans; most patients are caucasian women between the ages of 20-50 years. FMS affects more than 3 to 6 million people in the United States, and it is responsible for more disability than rheumatoid arthritis (RA).
Although they can present alone, CFS and FMS can be triggered as a result of an infection or stressful event, underlying autoimmune diseases, chronic inflammation and hormonal imbalances. It is quite challenging but surely an astute physician will investigate underlying causes. FMS is characterized by widespread pain, tenderness on light touch, non-restoring sleep, brain fog, poor metabolism resulting from hormonal imbalances and depression. CFS is a state of energy crisis, there is lack of energy production which cannot match body demands. Subjects suffer from persistent fatigue, even after rest or vacation, notice extreme exhaustion after workouts. Irritable bowel syndrome and recurrent sinus infections are also common.
To make it easier to understand; think of your body as a house; so having a chronic autoimmune disease or inflammation is like having house on fire, if ignored this fire will setoff fire alarms; which is like developing fibromyalgia (FMS). If alarms remain unattended the house will eventually collapse; this is like having chronic fatigue (CFS) settling in your body. Most of my patients appear depressed, they are frustrated due to energy crisis, they are depressed but depression is not the cause but one of the complications.
Several research studies have pointed out specific area of the brain known as hypothalamus to be affected, it is like energy crisis of your body "!s control center. Hypothalamus regulates our sleep, hormonal balance, body temperature and blood pressure. As a result, patients suffer for months, if not years of disordered sleep, poor body temperature and low blood pressure regulation, irritability and exhaustion.
Unfortunately modern medicine and pharmacologic prescriptions have come short in solving these challenges of such complex and chronic disorders.
Currently, there is no FDA approved treatment for CFS and current FDA approved therapies for FMS include Cymbalta, Savella and Lyrica. It "!s about time we think out sided the box and fortunately over last decade, integrative and functional medicine research has led thought leaders to make design treatment protocols for FMS and CFS. One of the integrative physicians, Dr. Teitelbaum has developed S.H.I.N.E. approach which has been successful in majority of patients. S.H.I.N.E. focuses on the five key areas related to the body that, when addressed in combination can provide a roadmap for optimal energy production.
I have modified to meet unique needs of my patients with autoimmunity and inflammation. Our approach is called RISE and SHINE, which has functional medicine basis; RISE is for Reducing Inflammation, Stress and Exhaustion. SHINE address issues of Sleep, H for hormonal balance; I for immunity and infections, N for nutritional deficiency and E for exercise (as able) and energy.
Relaxed and uninterrupted sleep can be achieved by educating patients about maintaining sleep hygiene and if needed using non-addicting natural therapies. Customizable combination of valerian root, passion flower, lavender oil, 5HTP and melatonin can help meet individual needs. Magnesium at night can help relax muscles and reduce spasms. Early recognition of poor function of thyroid and adrenal gland is crucial and when indicated natural supplements to support hormones help significantly. Literature supports use of of licorice extract, vitamin B6, C and DHEA for adrenal support.
To address inflammation and misdirected immunity seen in patients with rheumatologic diseases and chronic infections, I pay very close attention on anti-inflammatory diet rich in omega fatty acids such as fatty fish (salmon, mackerel, sardines), avocados, raw nuts, seeds (walnuts, flax seeds) and extra virgin olive oil. Increasing use of dietary fibers in whole fruits and vegetables along seasoning with garlic, ginger and turmeric add anti inflammatory properties to your diet. Probiotics help intestinal inflammation along elimination of trans fats, animal fat and protein can reduce inflammatory chemicals.
To boost immunity, antioxidants like B-complex, vitamin C, eluthero, coenzyme Q10, raw garlic are helpful. Daily vitamin D is essential for stabilizing immune cells. Supplements like carnitine, D-Ribose with exercise help mitochondrial function and promote energy production. I assure patients that as it took them several months and years to develop CFS and FMS, it may take months to get better and for realistic recovery expect 10% improvement every month, eventually you will be ready to embrace life and SHINE like a star.