Sunday, May 22, 2016

Chronic Fatigue and Diabetes

Chronic Fatigue Syndrome, or CFS, is a debilitating condition that involves ongoing fatigue and tiredness. CFS is generally defined by persistent fatigue unrelated to exertion, not substantially relieved by rest and accompanied by the presence of other specific symptoms for a minimum of six months.

CFS is characterized by fatigue, extremely low stamina, weakness, muscle pain, lymph node swelling, depression and hypersensitivity.

Other symptoms of CFS include post-exertional malaise; unrefreshing sleep; widespread muscle and joint pain; sore throat; headaches of a type not previously experienced; cognitive difficulties; chronic, often severe, mental and physical exhaustion; and other characteristic symptoms in a previously healthy and active person. 

Persons with CFS may report additional symptoms including muscle weakness, increased sensitivity to light, sounds and smells, orthostatic intolerance, digestive disturbances, depression, and cardiac and respiratory problems. It is unclear if these symptoms represent co-morbid conditions or are produced by an underlying etiology of CFS. CFS symptoms vary from person to person in number, type, and severity.

Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness. 

CFS often occurs in conjunction with two other related illnesses: fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS), all of which are part of an overlapping spectrum of disabling syndromes. It is estimated that FMS alone affects 3 to 6 million Americans, causing more disability than rheumatoid arthritis. MPS affects many millions more. CFS/FMS/MPS represents a syndrome, a spectrum of processes with a common end point. As CFS often coexists with FMS and MPS, the three are often referred to together. 

Possible Causes of CFS
  • Despite an intensive, nearly 20-year search, the cause of CFS remains unknown. Many different infectious agents and physiologic and psychological causes have been considered, and the search continues.

  • Much of the ongoing research into a cause has centered on the roles of the immune, endocrine and nervous systems may play in CFS. For example, fatigue is a common symptom for people with an autoimmune disease* such a lupus or celiac disease.

  • Genetic and environmental factors may play a role in developing and/or prolonging the illness, although more research is needed to confirm this. CDC is applying cutting-edge genomic and proteomic tools to understand the origins and pathogenesis of CFS.

  • CFS is not caused by depression, although the two illnesses often coexist, and many patients with CFS have no psychiatric disorder.

  • Note: People with diabetes tend to be more tired than the rest of us because the insulin resistance reduces the uptake of glucose into the cells. Consequently, the cells produce less energy.
    *Note: If you have an autoimmune disease, PCOS, or thyroid issues, get the How to Treat Autoimmune Diseases, PCOS & Thyroid Issues Naturally ebook. 

    Alternative Therapies
    There are alternative therapies that have helped relieve anxiety and promote a sense of well-being among those who suffer from CFS. One of the following may work for you:
    • Physical therapy
    • Superior nutritional therapy
    • Vitamin/mineral/herbal supplementation
    • Muscle relaxation techniques and deep breathing
    • Stretching exercises
    • Periodic cleansing/detox
    • Yoga
    • Tai-chi
    • Cognitive behavioral therapy
    Fortunately there are steps you can take to treat Chronic Fatigue Syndrome symptoms. Review the following protocol to learn how you can relieve the effects of this disorder.

    1. Follow a superior nutritional program. Along with regular exercise it is always important to maintain a healthy diet, with natural, balanced foods - vegetables,  some whole fruits, some organic whole grains, beans, fish, plant oils, filtered water. Avoid processed and fast foods, refined sugars and excessive alcohol. You want to make sure your body has essential nutrients it needs for proper function, while at the same time avoiding toxins are harmful substances.

    2. Supplement important nutrients. Unfortunately, most of us do not eat properly. Also, most foods are depleted of essential nutrients due to over-processing. So in most cases it makes sense to supplement important nutrients. There are many natural herbs, vitamins and minerals that can help specifically with Chronic Fatigue Syndrome Symptoms.
    • There are natural energy boosting herbs such as Siberian ginseng, gotu kola and maitake.
    • There are natural energy boosting vitamins such as the B-Complex, particularly B12, Biotin and Folic Acid. B vitamins help fight fatigue by helping our body use the sugar glucose (fuel) and aiding in the formation of red blood cells (energy transport).
    • There are natural energy boosting minerals and nutrients such as NADH, CoQ-10, d-ribose, l-carnitine, and magnesium, all of which can treat chronic fatigue syndrome symptoms by increasing energy production in cells.
    3. Make sure you exercise. Although you might feel too tired to do so, lack of exercise is worse for CFS as muscles will weaken. Any form of exercise will improve your body's health by facilitating blood flow and metabolism. It will also help you build andstrengthen muscle tissue.
      Vitamins and Minerals for Chronic Fatigue
      Many vitamins and minerals are useful in the treatment and prevention of fatigue. However, we recommend a plant-based macronutrient-dense diet as the foundation to combating fatigue (and other illnesses). Then, consider adding specific supplements to complement your nutritional dietary program (based on a nutritional gap analysis). However, before taking any supplements, consult your physician or a nutritionist with specific questions about their use or possible side effects.

      Note: For a list of the food sources for most vitamins and minerals, refer to theNutritional Supplementation web page.
      Vitamin A. This nutrient helps protect the body against invasion by pathogens such as viruses (which might trigger chronic fatigue syndrome) and by bacteria, fungi, and allergies. It does this in several ways. Vitamin A supports the production and maintenance of healthy skin, as well as the mucous membranes that line the mouth, lungs, digestive tract, bladder, and cervix. When these tissues are healthy, invaders have difficulty penetrating the mem-branes, the body's first line of defense. Vitamin A also enhances the immune system by increasing T-cell activity (these are important cells that help to fight infectious disease). Vitamin A also contributes to the health of the thymus, a gland located in the chest that plays an important role in maintaining healthy immune function.
      Because Vitamin A is needed for normal production of red blood cells, it helps prevent fatigue caused by anemia. It also helps control the tiredness caused by anemia that occurs with heavy menstrual bleeding.
      But, Vitamin A should be used carefully. It is a fat-soluble vitamin that is stored in the body. You should not take more than 20,000 I.U. (international units) per day without being monitored by a physician. An overdose of vitamin A can cause headaches and stress the liver.
      Beta carotene, called provitamin A, is a precursor of vitamin A found in fruits and vegetables. Beta carotene is water soluble and, unlike vitamin A, does not accumulate in the body. As a result, it can be used safely in high doses. Certain foods, such as sweet potatoes and carrots, contain large amounts of beta carotene. A single sweet potato or a cup of fresh carrot juice contains 25,000 I.U. of beta carotene.
      Provitamin A also enhances immune function. It stimulates immune cells called macrophages and helps trigger increased immune activity against certain bacteria as well as candida. Beta carotene is also a powerful antioxidant that helps to protect the body from damage by free radicals. Free radicals are chemicals that occur as by-products of oxygen use in the body, exposure to ultraviolet light, and other natural processes; they can damage the cell membranes as well as other parts of the cell. Antioxidants like beta carotene neutralize free radicals.
      Vitamin B-Complex. This complex consists of 11 vitamin B factors. The whole complex works together to perform important metabolic functions, including glucose metabolism, stabilization of brain chemistry, and inactivation of estrogen. These processes regulate the body's level of energy and vitality. Because B vitamins are water soluble and are not stored in the body, they are easily lost especially when a woman is under stress or is eating unhealthy food, including coffee, cola drinks, and other caffeine containing beverages. Fatigue and depression can result from the depletion of B vitamins.
      Many women with anemia are deficient in three B-complex vitamins: folic acid, pyridoxine (vitamin B6), and vitamin B12. All three are needed for normal growth and maturation of red blood cells. Their deficiency leads to anemia and fatigue. Supplemental vitamin B12 is necessary for women on a vegetarian diet. It is usually given by injection.
      Vitamin B6 is extremely important in relieving and preventing fatigue. In women who are prone to fatigue caused by bacteria, viruses, candida, or allergies, B6 supports a healthy immune response. Vitamin B6 is needed for both the production of antibodies by white blood cells and the production of T-cell lymphocytes by the thymus. This vitamin also appears to help enhance the activity of the T-cells, making them more effective in destroying infectious agents.
      Vitamin B6 helps reduce PMS related mood swings, fatigue, food cravings, and fluid retention through its effect on glucose metabolism and its participation in prostaglandin synthesis. Prostaglandins hormones that regulate many important physiological functions are formed in the body from certain essential vegetable and fish oils. The essential fats can only be converted to prostaglandins in the presence of B6 and other essential nutrients. Prostaglandin deficiency adversely affects brain chemistry and mood and can worsen fatigue.
      Women using birth control pills and menopausal women on hormonal replacement therapy can be prone to fatigue because the use of hormones causes vitamin B6 deficiency. Finally, B6 deficiency has been found in fatigued women who suffer from depression. Vitamin B6 can be taken safely by most women in doses up to 250 milligrams. Doses above this level should be avoided because B6 can cause toxic symptoms in the nervous system in susceptible women.
      The B-complex vitamins are usually found together in beans and whole grains. These foods should be part of the diet of women with chronic fatigue, who would also probably benefit from the use of supplemental vitamin B.
      Vitamin C. This an extremely important nutrient for fatigue. In one research study done on 411 dentists and their spouses, scientists found a clear relationship between the presence of fatigue and lack of vitamin C. By supporting the immune func-tion, vitamin C helps prevent fatigue caused by infections. It stimulates the production of interferon, a chemical found to prevent the spread of viruses in the body. Necessary for healthy white blood cells and their antibody production, vitamin C also helps the body fight bacterial and fungal infections. Women with low vitamin-C intake tend to have elevated levels of histamine, a chemical that triggers allergy symptoms. Vitamin C is an important antistress vitamin, needed for the production of sufficient adrenal gland hormones. Healthy adrenal function helps prevent fatigue and exhaustion in women who are under physical or emotional stress.
      In women with iron deficiency anemia, vitamin C increases the absorption of iron from the digestive tract. Vitamin C has also been tested, along with bioflavonoids, as a treatment for anemia caused by heavy menstrual bleeding a common cause of fatigue in teenagers and premenopausal women in their forties. Vitamin C reduces bleeding by helping to strengthen capillaries and prevent capillary fragility. One clinical study of vitamin C showed a reduction in bleeding in 87 percent of women taking supplemental amounts of this essential nutrient. The best sources of vitamin C in nature are fruits and vegeta-bles. It is a water soluble vitamin, so it is not stored in the body. Thus, women with chronic fatigue should replenish their vitamin C supply daily through a healthy diet and the use of supplements.
      Bioflavonoids. These nutrients are found abundantly in flowers and in fruits, particularly oranges, grapefruits, cherries, huckleberries, blackberries, and grape skins. Besides giving pigmentation to plants, they have a number of beneficial physiological effects that can help decrease fatigue symptoms. Bioflavonoids are powerful antioxidants that help protect cells against damage by free radicals. They help protect us from fatigue caused by allergic reac-tions, because their anti-inflammatory properties help prevent the production and release of compounds such as histamine and leukotrienes that promote inflammation. Bioflavonoids such as quercetin have powerful antiviral properties that protect us from infections. Quercetin also inhibits the release of allergic compounds from mast cells the cells in the digestive and respiratory tract that release histamine.
      Bioflavonoids are among the most important nutrients for mid-life women suffering from menopausal symptoms. Bioflavonoids produce chemical activity similar to estrogen and can be used as an estrogen substitute. Clinical studies have shown that bioflavonoids can help control hot flashes and the psychological symptoms of menopause, including fatigue, irritability, and mood swings. Interestingly, bioflavonoids contain a very low potency of estrogen, much lower than that used in hormonal replacement therapy. As a result, no harmful side effects have been noted with bioflavonoid therapy.
      Because of their ability to strengthen capillary walls, bioflavonoids have also shown dramatic results in reducing the anemia caused by heavy menstrual bleeding. They have been used in women with bleeding caused by hormonal imbalance and have even been tested in women who have lost multiple pregnancies because of bleeding. They were used in conjunction with vitamin C In these studies. Bioflavonoids are often found with vitamin C in fruits and vegetables.

      Vitamin D. Vitamin D helps to regulate immunity functions of monocytes and neutrophils, and plays an important role in affecting the immune system and maintaining organ systems, such as bone formation and mineralization. While Vitamin D is largely found in sunlight, it can also be found in such foods as milk and cereals, fish and related oils such as salmon, catfish, and tuna, eggs, yogurt and bread.

      Note: While Vitamin D is an important necessity for the body, too much can be as problematic as too little exposure. Excess amounts of vitamin D can cause dangerously elevated levels of calcium in the blood, high blood pressure, and can cause Vitamin D toxicity, resulting in increased thirst, nausea, vomiting, and renal failure. Once Vitamin D levels have risen in a person's body, it can take weeks or even months to return to their original levels. It is for this reason that there are restrictions on allowed dosages for Vitamin D. The recommended allowable limit for adults and children is 2,000 units a day and 1,000 units a day for infants. If an individual chooses to exceed these limits, they should consult with a physician to have their blood calcium levels checked.
      Vitamin E. This vitamin can enhance immune antibody response at high levels and has a significant immune stimulation effect. Vitamin E has antihistamine properties and should be used by women who suffer from allergies. One group of volunteers who were injected with histamine showed far less allergic swelling around the injection site when they were pretreated with vitamin E.
      Like vitamin C and beta carotene, vitamin E is an important antioxidant. It protects the cells from the destructive effects of environmental pollutants that can react with the cell membrane. Because it has been found to increase red blood cell survival, it is an important nutrient for the prevention of anemia.
      Vitamin E can act as an estrogen substitute. Like bioflavonoids, it has been studied as a treatment for hot flashes and for the psychological symptoms of menopause, including depression and fatigue. It can even relieve vaginal dryness in those women who either can't take or can't tolerate estrogen. According to one study, vitamin E helped skew the progesterone/estrogen ratio in the body toward progesterone. This could be very helpful for women who have heavy menstrual bleeding caused by excess estrogen. Vitamin E is also needed for healthy thyroid function.
      Vitamin E occurs in abundance in wheat germ, nuts, seeds, and some fruits and vegetables.
      IronAn essential component of red blood cells, iron combines with protein and copper to make hemoglobin, the pigment of the red blood cells. Studies have shown that women with iron deficiency have decreased physical stamina and endurance. Iron deficiency, the main cause of anemia, is common during all phases of a woman's life, because of both poor nutritional habits and regular blood loss through menstruation. Iron deficiency frequently causes fatigue and low energy states.
      Women who suffer from heavy menstrual bleeding are more likely to be iron deficient than woman with normal menstrual flow. In fact, some medical studies have found that inadequate iron intake may be a cause of excessive bleeding as well as an effect of the problem. Women who suffer from heavy menstrual bleeding should have their red blood count checked to see if supplemental iron and a high iron diet are necessary.
      Good sources of iron include liver, blackstrap molasses, beans and peas, seeds and nuts, and certain fruits and vegetables. The body absorbs and assimilates the heme iron from meat sources, such as liver, much better than the nonheme iron from vegetarian sources. To absorb non-heme iron properly, you must take it with at least 75 milligrams of vitamin C.
      Zinc. This mineral plays an important role in combating fatigue. Supplementation with zinc improves muscle strength and endurance. It reduces fatigue by enhancing immune function, acting as an immune stimulant and triggering the reproduction of lymphocytes when incubated with these cells in a test tube. Zinc is a constituent of many enzymes involved in both metabolism and digestion. It is needed for the proper growth and development of female reproductive organs and for the normal functioning of the male prostate gland. Good food sources of zinc include wheat germ, pumpkin seeds, whole grain wheat bran, and high protein foods.
      Magnesium and Malic AcidCombinations of these two supplements are very important for the maintenance of energy and vitality. Magnesium is required for the production of ATP, the end product of the conversion of food to usable energy by the body's cells. ATP is the universal energy currency that the body uses to run hundreds of thousands of chemical reactions. Malic acid is extracted from apples and is also an important component in the production of ATP. Another form of magnesium has been researched for the treatment of fatigue called magnesium aspartate, formed by combining magnesium with aspartic acid. Aspartic acid also plays an important role in the production of energy in the body and helps transport magnesium and potassium into the cells. Magnesium aspartate, along with potassium aspartate, has been tested in a number of clinical studies and has been shown to dramatically improve energy levels after five to six weeks of constant use. Many volunteers began to feel better even within ten days. This beneficial effect was seen in 90 percent of the people tested, a very high success rate.
      Magnesium is an important nutrient for women with chronic candida infections. A magnesium deficiency can develop from the diarrhea, vomiting, and other digestive problems associated with intestinal candida infections. Magnesium deficiency can worsen fatigue, weakness, confusion, and muscle tremor in women with candida infections. Women with these symptoms must replace the magnesium through appropriate supplementation. Magnesium deficiency has also been seen in women suffering from PMS; medical studies have found a reduction in red blood cell magnesium during the second half of the menstrual cycle in affected women. Magnesium, like vitamin B6, is needed for the production of the beneficial prostaglandin hormones as well as for glucose metabolism. Magnesium supplements can also benefit women with severe emotional stress, anxiety, and insomnia. When taken before bedtime, magnesium helps to calm the mood and induce restful sleep. Good food sources of magnesium include green leafy vegetables, beans and peas, raw nuts and seeds, tofu, avocado, raisins, dried figs, millet and other grains.
      PotassiumLike magnesium, potassium has a powerful enhancing effect on energy and vitality. Potassium deficiency has been associated with fatigue and muscular weakness. One study showed that older people who were deficient in potassium had weaker grip strength. Potassium aspartate has been used with magnesium aspartate in a number of studies on chronic fatigue; this combination significantly restored energy levels.
      Potassium has many important roles in the body. It regulates the transfer of nutrients into the cells and works with sodium to maintain the body's water balance. Its role in water balance is important in preventing PMS bloating symptoms. Potassium aids proper muscle contraction and transmission of electrochemical impulses. It helps maintain nervous system function and a healthy heart rate. Potassium is found in abundance in fruits, vegetables, beans and peas, seeds and nuts, starches, and whole grains.
      Calcium. This mineral helps combat stress, nervous tension, and anxiety. An upset emotional state can dramatically worsen fatigue in susceptible women. A calcium deficiency worsens not only emotional irritability but also muscular irritability and cramps. Calcium can be taken at night along with magnesium to calm the mood and induce a restful sleep. Women with menopause related anxiety, mood swings, and fatigue may also find calcium supplementation useful. It has the added benefit of helping prevent bone loss, or osteoporosis, because calcium is a major structural component of bone.
      Like magnesium and potassium, calcium is essential in the maintenance of regular heartbeat and the healthy transmission of impulses through the nerves. It may also help reduce blood pressure and regulate cholesterol levels; it is essential for blood clotting. Good sources of calcium include green leafy vegetables, salmon (with bones), nuts and seeds, tofu, and blackstrap molasses.
      IodineThis mineral is necessary to prevent fatigue caused by low thyroid function. Iodine, along with the amino acid tyrosine, is necessary for the production of the thyroid hormone thyroxin. Without adequate thyroid hormone women may suffer from excessive fatigue, excess weight, constipation, and other symptoms of a slowed metabolism. Iodine deficiency has also been linked to breast disease. Only trace amounts of iodine are needed to maintain its important metabolic effects. Good food sources include fish and shellfish, sea vegetables such as kelp and dulse, and garlic.
      Tyrosine. This amino acid combines with iodine within the thyroid gland to form the thyroid hormone thyroxine. Thyroxine has many important functions in the body, including control of metabolic rate, promotion of growth (particularly crucial in children), and carbohydrate and fat metabolism.
      Women whose protein intake is low (which can be a problem for vegans who get their protein exclusively from plant sources) and women who can't absorb and assimilate protein due to severe digestive problems, may lack sufficient tyrosine in their diets and require manufactured thyroxine. These women may have border-line low thyroid levels which can be remedied by increasing their intake of thyroid hormone precursor nutrients. Besides increasing protein, tyrosine may be taken as a dietary supplement. Generally, 500 to 1500 milligrams of pure tyrosine per day may be used. It is best to take tyrosine with a meal high in carbohydrates.
      Tyrosine has been reported to help relieve depression, another cause of chronic fatigue. It has also been shown to relieve some symptoms in patients with Parkinson's disease. Women using monoamine oxidase (MAO) inhibitor drugs for the treatment of depression should avoid taking tyrosine as should those diagnosed with melanoma. Otherwise, tyrosine is safe for use by most people.
      Phenylalanine. Tyrosine, the amino acid needed by the body to produce the thyroid hormone thyroxine, is actually manufactured from another amino acid called phenylalanine. This essential amino acid must be acquired through diet since the body cannot make phenylalanine from other amino acids. Good food sources of phenylalanine include fish, poultry, red meat, soybeans, almonds, lentils, lima beans, chickpeas, and sesame seeds. It can also be taken in purified form as a dietary supplement. Five hundred to 2,000 milligrams per day is the usual theraputic dosage. Be sure to start at the lower end of the range, increasing gradually.
      Phenylalanine is a natural antidepressant and pain killer, but can also cause jitteriness and nervousness when used in too high a dose. As with tyrosine, it should be avoided by women using monoamine oxidase inhibitor drugs for depression. Patients on phenylalanine may notice a greater alertness, an increased sense of well-being, and an enhancement of sexual interest.
      Essential Fatty Acids (EFAs). Essential fatty acids are very important nutrients for women with fatigue and play an important role in maintaining optimal health. Essential fatty acids consist of two types of special fats or oils, called linoleic acid (Omega-6 family) and linolenic acid (Omega-3 family). Because your body cannot make these fats, you must sup-ply them daily via foods or supplements. Though these essential fatty acids supply stored energy in the form of calories, they also perform many other important functions in the body.
      Essential fatty acids are important components of the membrane structure of all the body's cells. They are also required for normal development and function of the brain, eyes, inner ear, adrenal glands, and reproductive tract. The essential oils are also necessary for the synthesis of prostaglandins type I and III, which are hormonelike chemicals that help decrease the risk of heart disease by regulating blood pressure and platelet stickiness. Prostaglandins type I and II help reduce fatigue through their role in preventing a number of healthcare problems: they decrease inflammation, boost immune function, decrease menstrual cramps, and help to reduce PMS symptoms. One essential fat evening primrose oil has been tested in the United States and England for its beneficial effects on PMS and menstrual cramps.
      Essential oils are particularly important to menopausal women because deficiency of these oils is responsible in part for the drying of skin, hair, vaginal tissues, and other mucous membranes that occurs with menopause. Along with vitamin E, which also benefits the skin and vaginal tissues, I have used essential oils extensively in my nutritional program for women. Essential fatty acids are important in treating immune problems such as candida infections, allergies, and CFS, which worsen fatigue in millions of women.
      The best sources of linoleic and linolenic acids are flax seeds and pumpkin seeds. Both the seeds and their pressed oils should be used absolutely fresh and unspoiled. Because these oils become rancid very easily when exposed to light and air (oxygen), they need to be packed in special opaque containers and kept in the refrigerator. Essential oils should never be heated or used in cooking because heat affects their special chemical properties. Instead, add these oils as a flavoring to foods that are already cooked. Fresh flax seed oil is my special favorite. Good quality flax seed oil is available in health food stores. Flax seed oil is golden, rich, and delicious. It is extremely high in linoleic and linolenic acids, which comprise approximately 80 percent of its total content. Pumpkin seed oil has a deep green color and spicy flavor. It is probably more difficult to find than flax seed oil. Fresh raw pumpkin seeds are a good source of this oil. They can be purchased from many health food stores. Both flax seed oil and pumpkin seed oil can also be taken in capsule form.

      Linolenic acid (Omega-3 family) is also found in abundance in fish oils. The best sources are cold water, high fat fish such as salmon, tuna, rainbow trout, mackerel, and eel. Linoleic acid (Omega-6 family) is found in seeds and seed oils. Good sources include safflower oil, sunflower oil, corn oil, sesame seed oil, and wheat germ oil. Many women prefer to use raw fresh sesame seeds, sunflower seeds, and wheat germ to obtain the oils. The average healthy adult requires only four teaspoons per day of essential oils. However, women with chronic fatigue, who may have a real deficiency of these oils, need up to two or three tablespoons per day until their symptoms improve. Occasionally, these oils may cause diarrhea; if this occurs, use only one teaspoon per day. Women with acne and very oily skin should use them cautiously. For optimal results, be sure to use these oils along with vitamin E.
      Herbs. Many herbs can help relieve the symptoms and treat the causes of chronic fatigue, by using them as a form of extended nutrition. They can balance and expand the diet while optimizing nutritional intake. Some herbs provide an additional source of essential nutrients that help relax tension and ease anxiety. Other herbs have mild anti-infective and hormonal properties in addition to their nutritional content; these help to combat fatigue causing viruses and fungi, as well as provide support for the endocrine system with a minimum of side effects.

      In the following section, many specific herbs are identified that are useful for relief of chronic fatigue and related problems.
      Chronic Fatigue and Depression
      For women with fatigue and depression, herbs such as oat straw, ginger, ginkgo biloba, licorice root, dandelion root, and Siberian ginseng (eleutherococcus)may have a stimulatory effect, improving energy and vitality. Women who use these herbs may note an increased ability to handle stress, as well as improved physical and mental capabilities.
      Some of the salutary effects may be due to the high levels of essential nutrients captured in herbs. For example, dandelion root contains magnesium, potassium, and vitamin E, while ginkgo contains high levels of bioflavonoids. These essential nutrients help relieve fatigue, depression, PMS, and hot flashes, and they increase resistance to infections.
      Siberian ginseng, ginger, and licorice root have been important traditional medicines in China and other countries for thousands of years. They have been reputed to increase longevity and decrease fatigue and weakness. These herbs have been found to boost immunity and to strengthen the cardiovascular system.

      The bioflavonoids contained in ginkgo are extremely powerful antioxidants and help to combat fatigue by improving circulation to the brain. They also appear to have a strong affinity for the adrenal and thyroid gland and may help to boost function in these essential glands. 

      Oat straw
       has been used to relieve fatigue and weakness, especially when there is an emotional component.

      One note of caution: Licorice root should be used carefully and only in small amounts because, over time, it can cause potassium loss.
      In modern China, Japan, and other countries, there has been much interest in the pharmacological effects of these traditional herbs. Scientific studies are corroborating the medicinal effects of these plants.
      Anxiety, Irritability, and Insomnia
      Women suffering from anxiety, irritability and insomnia often have a worsening of their fatigue symptoms because of emotional stress and sleep deprivation. Luckily, a number of herbal remedies relieve such symptoms. Herbs such as passionflower (passiflora)and valerian root have a calming and restful effect on the central nervous system.
      Passionflower has been found to elevate levels of the neurotransmitter serotonin. Serotonin is synthesized from tryptophan, an essential amino acid that has been found in numerous medical studies to initiate sleep and decrease awakening.

      Valerian root has been used extensively in traditional herbology as a sleep inducer. It is used widely in Europe as an effective treatment for insomnia. Research studies have confirmed both the sedative effect of valerian root and its effectiveness as a treatment for insomnia. For women with insomnia, valerian root can be a real blessing.

      Other effective herbal treatments include chamomile, hops, catnip, and peppermint teas.
      Candida Infections, and Allergies
      Women with fatigue symptoms caused by severe immune dysfunction may initially have difficulty using any herbs at all because their bodies are too weak. In cases of severe fatigue, some patients are started on aloe vera and peppermint -- because most women can tolerate these two supportive and soothing herbs. You can take aloe vera internally as a juice. Buy the cold pressed, nonpasteurized brands. You can take peppermint as a tea or, even better, as an oil in capsules or an herbal tincture in water.
      Once you are stronger and less fatigued, you may be able to tolerate herbs that can boost your energy and vitality (see information earlier in this section), as well as herbs that help suppress infections from viruses, candida, and other pathogens. One of the best herbs for this purpose is garlic. Garlic contains a chemical called allicin that is a powerful broad spectrum antibiotic. Studies have shown garlic to be effective against fungi such as candida, as well as the fungus that causes athlete's foot and the dangerous fungus that causes serious cryptococcal meningitis. Garlic also kills bacteria and viruses. In addition, garlic protects the cells through its powerful antioxidant effects. If you can't stand garlic, try the aged garlic supplement (i.e. Kyolic).
      Two other herbs have strong anti-infective properties and can be used to treat pathogens that cause fatigue. The first is echinacea, a powerful immune stimulant herb.Echinacea helps fight infections by promoting interferon production, as well as activation of the T-lymphocytes (natural killer cells) and neutrophils (the cells that kill bacteria). Native Americans traditionally used this plant as a medicinal agent. The second herb, goldenseal, is also an excellent immune stimulant. Goldenseal contains a high level of chemical called berberine. Berberine activates macrophages (cells that engulf and destroy bacteria, fungi, and viruses). When used in combination with garlic and echinacea, goldenseal is an effective tool for suppressing infections.
      Menopause, PMS, and Hypothyroidism
      Many plants are good sources of estrogen, the hormone that helps control hot flashes in menopausal women. Blueberries, blackberries, huckleberries, and citrus fruitcontain bioflavonoids. Bioflavonoids have weak estrogenic activity (1/50,000 the strength of estrogen), but are very effective in controlling such common menopausal symptoms as hot flashes, anxiety, irritability, and fatigue. Plants containing bioflavonoids may be particularly useful for women who cannot take normal supplements because of their concern about the possible strong side effects of the prescription hormones (increased risk of stroke, cancer, etc.).

      Other plant sources of estrogen and progesterone used in traditional herbology includeDong Quai, black cohosh, blue cohosh, unicorn root, false unicorn root, fennel, anise, sarsaparilla, and wild yam root. The hormonal activities of these plants have been validated in a number of interesting research studies.
      Women with PMS also benefit from herbs that relieve mood swings and anxiety, such as valerian root or passionflower, and those that directly reduce fatigue and depression, such as ginger root, ginkgo biloba, and dandelion. Ginger also helps relieve the bloating and fluid retention symptoms of PMS, as do dandelion and burdock root, which act as mild diuretics. Iodine containing plants, including dulse and kelp, help correct low thyroid function. These sea vegetables are also high in trace minerals, so are excellent for general health and well being. Iodine is used for the production of thyroxin, the thyroid hormone that helps boost metabolism and maintain energy level.
      Anemia and Heavy, Irregular Menstrual Bleeding
      Plants that contain bioflavonoids help strengthen capillaries and prevent heavy, irregular menstrual bleeding (menorrhagia), a common bleeding pattern in women approaching menopause. Besides controlling hot flashes, bioflavonoids also help to reduce heavy bleeding. Bioflavonoids are found in many fruits and flowers; excellent sources arecitrus fruits, cherries, grapes, and hawthorn berries.
      According to research studies, they have also been found in red clover and in some clover strains in Australia. Many medical studies have demonstrated the usefulness of citrus bioflavonoids in treating a variety of bleeding problems in addition to those related to menopause, including habitual spontaneous abortion and tuberculosis. Herbs such asyellow dock and pan d'arco are useful for anemia because of their high iron content.
      Please Note: Anyone with chronic fatigue should follow a plant-based diet in combination with other healthy lifestyle choices such as consistent exercise, quality sleep, wholefood/herbal supplementation, and less stress. However, always consult with your physician.
      More about CFS and Nutrition
      Virtually any disease can be caused or made worse if the diet is inadequate to support health. The majority of CFS can be attributed to a dietary imbalance.
      Sodium is an essential nutrient for fluid balance. The actual amount of sodiumrequired per day is unknown, but the recommended amount for adults varies from a minimum of 200 milligrams to an upper limit of 3,000 milligrams; approximately the amount of sodium in 1¼ teaspoon (7.6 grams) of salt .1,3
      The mean daily intake of salt for Americans is around 10 grams per day; approximately 3 grams occurring naturally in foods, another 3 grams from processed foods and 4 grams added during meals.1, 2 Using one-fourth to one-half teaspoon of added salt per day is generally regarded as reasonable and safe.
      The highest sources of sodium in the diet are salt, animal protein, processed foods and chemically softened water. A diet chronically high in water and potassium, and low in animal protein, processed foods or added salt can potentially lead to sodium depletion. 1, 4
      Symptoms of low blood sodium (hyponatremia) include extreme debilitating fatigue, aching skeletal muscles, abnormally high blood pH, chronic low blood pressure, orthostatic tachycardia, cardiac arrythmias and profuse sweating upon minimal exertion.1, 4 Hyponatremia in competitive sports is a growing concern, and in noncompetitive sports such as desert hiking, cases have skyrocketed in the last decade.6Mild to moderate hyponatremia can often be corrected by simply increasing dietarysodium.6 More severe cases may require a restriction of water, and/or the administration of corticosteroids to support adrenal function4
      The volume and composition of body fluids are controlled by water ingestion and excretion, acid-base reactions and electrolytes (salts). These mechanisms are closely interrelated and imbalances are typically multiple disturbances.4 Electrolytes such assodium play essential roles in maintaining proper fluid pH, ionic balance (osmolarity), and fluid pressure. If you disrupt the electrolytic balance, then the body's physiology in general can become disturbed.
      Adrenal hormones, "aldosterone" and "cortisone", regulate fluid balance and nutrient levels. Aldosterone controls blood sodium and potassium levels. If potassiumlevels become too high, aldosterone is secreted causing the kidneys to excrete morepotassium and retain more sodium. Low sodium can also stimulate the secretion ofaldosterone.1, 2, 3, 4
      A diet chronically high in potassium or low in sodium can stress the adrenals.1 Excesspotassium is also a natural diuretic and causes some loss of sodium. Foods highest inpotassium include whole fruits and vegetables and their juices.1
      Cortisol stimulates the breakdown of proteins and fats, and provides for the conversion of some amino acids into glucose as needed (gluconeogenesis). If the diet is deficient in protein, or if digestion of protein is inadequate, extra cortisol must be produced to break down muscle tissue for needed amino acids. This extra demand on the adrenals could conceivably lead to adrenal fatigue and cortisol deficiency with impaired gluconeogenesis, decreased glycogen production, hypoglycemia and a decrease in metabolism.2, 3, 4
      Neuromuscular functions might also decrease, as well as resistance to infections, inflammations and/or stress.3, 4 The decreased resistance to stress and disease could increase susceptibility to infections of Epstein Barr or other viruses. In this respect, Epstein Barr, common in people with CFS, may be more an opportunistic infection and a symptom of immune system weakness rather than a direct cause of CFS. Insufficient dietary protein or impaired protein digestion, coupled with an excess of cortisolproduction and breakdown of muscle tissue, could be a factor in the cause ofFibromyalgia, a soft tissue condition often seen in people with CFS.
      When the adrenals become fatigued and unable to release adequate amounts ofaldosterone or cortisolpotassium levels rise, sodium and blood sugar levels fall, body fluid volume decreases and hypotension and dehydration can result.3, 4 Aerobic exercise or caffeine consumption can add more stress to the adrenals. Massive water ingestion can also aggravate the condition and lead to a high-water/low-sodium state called "dilutional hyponatremia". 3, 4
      If adrenal function is impaired, the physiological balance can become disrupted. High blood potassium (hyperkalemia), low blood sodium, and hypotension, together, suggest adrenal insufficiency.4 Indeed, these are classic symptoms of Addison's disease, a chronic and progressive adrenal disease associated with adrenocortical hypo-function, including insufficient production of cortisol and aldosterone.2
      The early signs of Addison's disease include weakness, fatigue and orthostatichypotension.4 Many who have Addison's disease appear healthy, but they experience acute adrenocortical insufficiency when under stress.4 This is also true in people with CFS. Could CFS be related to Addison's disease?
      If the physiological balance is disrupted, normal adrenal function can become impaired. The classic symptoms of Addison's disease, high blood potassium, low blood sodium, andhypotension, can be induced by improper diet or lifestyle and potentially result in adrenal insufficiency. In such cases, diet and lifestyle patterns should be considered in order to promote normal adrenal health and function.
      However, keeping sodium and potassium in a proper balance may be difficult. If you take a little too much potassium, you could fall back into exhaustion and excessive sweating. Too much salt seems to drive out potassium and could cause problems with muscle cramps.
      In the book Natural Alternatives to Over the Counter and Prescription Drugs, Dr. Murray, ND, discussed the different common forms of calcium supplements, and how calcium carbonate tends to neutralize stomach acid more than calcium citrate. He advised supplementing with calcium citrate and using hydrochloric acid tablets (Betaine HCl) if necessary to better insure complete digestion. Hydrochloric acid is secreted by the stomach and aids in the first stage of protein digestion.
      A client had been taking calcium carbonate with meals for years and, although his diet had ample amounts of protein, we wondered if the calcium carbonate might be inhibitingprotein digestion and whether that could be a factor in his fatigue. He began taking thecalcium carbonate between meals and noticed a definite improvement in energy. When he started taking Betaine HCl with meals, the results were truly remarkable. Within a day, there was a significant increase in energy and stamina. Within weeks, the muscle injury of six months healed. His muscle discomfort substantially improved and areas that were hardened became much more normal. The excess sweating during work ceased and the problems of chronic fatigue vanished.
      Socioeconomic changes may be related to the modern day advent of Chronic Fatigue Syndrome. In the mid 1970s, national food standards for processed foods were revised in order to limit the amount of salt added by food processors to soups, snacks and other foods. People became wary of salt and got in the habit of consciously avoiding it. Processed food manufacturers followed the market by giving the public what they wanted--salt free foods. The general avoidance of dietary salt continues to this day. Twenty-five years ago, Americans were thought to be eating too much salt. Now, some may be getting too little salt and as a result, may be experiencing problems of adrenal exhaustion and chronic fatigue.
      The early and mid 1970s saw the beginning of the modern day "health and nutrition" movement. People became interested in natural foods and nutrition, and aware of the importance of taking dietary supplements. By the early to mid 1980s, people were taking more dietary supplements, using less salt and sometimes experiencing problems of chronic fatigue. "Chronic Fatigue Syndrome" became an officially recognized disease. Maybe a general avoidance of salt, or consumption of calcium supplements with meals could sometimes cause CFS.
      An active lifestyle focused on health and fitness is especially popular with young, upwardly mobile professionals (YUPPIES). In the mid 1980s, Chronic Fatigue Syndrome was sometimes referred to as "YUPPY FLU", which often manifested after a metabolic stress from trauma or an infection like the flu. The inability to fully recover from such trauma or illness is consistent with problems of adrenal exhaustion and a common symptom in people with CFS.
      From the late 1980s to the present, there has been an increased interest in health and fitness with a focus on physical exercise, high consumption of water, juices, fruits and vegetables, and an avoidance of salt and processed foods. In spite of this interest in health and fitness, CFS has persisted as a common ailment of unknown origin. More than 75% of my clients diagnosed with CFS work out regularly, avoid salt and are preoccupied with drinking lots of water or juice. They usually have hypotension as well. Could a lifestyle of health club workouts, increased ingestion of water, juices, fruits and vegetables and avoidance of salt be causing adrenal exhaustion and contributing to the prevalence of CFS?
      The cause of Addison's disease is unknown in 70% of cases.4 Could the classic "symptoms" of Addison's disease -- high blood potassium, low blood sodium andhypotension -- also be the "cause" of CFS, and whether these two diseases could be related in cause and effect.
      An imbalance or insufficiency of virtually any nutrient can potentially cause problems of chronic fatigue. These two models of adrenal insufficiency -- one caused by an imbalance of sodiumpotassium and water osmolarity, the other by an inadequate intake or insufficient digestion of proteins -- suggest specific dietary concerns which may be common in the etiology of Chronic Fatigue Syndrome.
      In cases of CFS where nutritional imbalance or insufficiency may be a factor, dietary assessment and revision may offer the best approach to treatment and cure.

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      More References:
      1. Mahan, L. Kathleen, Escott-Stump, Sylvia, Krause's Food, Nutrition, & Diet Therapy, 9th Edition, W.B. Saunders Company, Division of Harcourt Brace & Co., Philadelphia, PA, 1996
      2. Hole, John W. Jr, Human Anatomy and Physiology, 2nd Edition, Wm. C. Brown Company, Dubuque, Iowa, 1981
      3. Guyton, Arthur C., Hall, John E., Textbook of Medical Physiology, 9th Edition, W.B. Saunders Company, Division of Harcourt Brace & Co., Philadelphia, PA, 1996
      4. Berkow, Robert, Beers, Mark H, Editors, The Merck Manual of Diagnosis and Therapy, 17th Edition, Merck Research Laboratories, Division of Merck & Co., Inc., Whitehouse Station, N.J., 1999
      5. Murray, Michael T, Natural Alternatives to Over-the-Counter and Prescription Drugs, William Morrow and Co. Inc., New York, 1994
      6. Kauder, Carol, Mr. Salty to the Rescue, Outside Magazine, Apr. 2000, Mariah Publications Corp., Santa Fe, NM

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