End Fatigue

From Fatigued to Fantastic!
An All-Natural Approach to Chronic Fatigue

Let’s Live February 2003

Chronic fatigue syndrome (CFS) is a complex condition with no magic bullet. but one doctor who had the disease tells how he and his patients have beat it.

Mary, a workaholic 37-year-old physician and mother of two young children, was dismayed over the growing loss of her usual high energy. She had to reduce her work hours drastically. She had little, if any, energy left to spend time with her children.

She was frustrated, unable to figure out her problem. She consulted eight physicians. But they failed to provide answers or effective relief. One doctor suggested she see a psychiatrist, and then prescribed an antidepressant drug. Mary knew this wasn¹t the problem.

Mary¹s quest for relief eventually brought her to Jacob Teitelbaum, M.D., a board-certified internist in Annapolis, Md., who specializes in chronic fatigue.

Mary, it turned out, suffered from chronic fatigue and immune dysfunction syndrome (abbreviated as CFIDS or CFS), a debilitating illness affecting 2 to 12% of the population. According to Teitelbaum, you probably have CFS if you experience severe, unexplained fatigue that doesn¹t go away with rest, along with any two or more of the following symptoms:

» Brain fog
» Poor sleep
» Scattered achiness
» Increased thirst
» Bowel dysfunction (diarrhea, constipation and bloating) » Recurrent and/or persistent infections or flu-like feelings. ³Mary came into my office, plopped a water bottle on the desk, said she was exhausted, always thirsty, and had tremendous difficulty falling asleep and staying asleep,² recalls Teitelbaum. ³The major signs were there.² Teitelbaum learned Mary had a long history of antibiotic treatments, starting with childhood ear infections, then as a teenager for acne, and later for assorted colds and flu that plagued her during her medical student days. She was always an overachiever, worked 60-hour weeks, and never seemed to catch up on her sleep or be able to balance her practice and parenthood. Mary had developed a craving for sweets, and found herself gaining considerable weight even though she didn¹t overeat. Her metabolism had markedly decreased and she couldn¹t exercise to work off the weight because her energy was too low. She had reams of laboratory tests with normal results, but in CFS cases, Teitelbaum has found normal lab results, particularly for hormone levels, are just not reliable. Mary¹s situation had been caused by some of the major factors that can lead to and exacerbate CFS. They include:

» Many courses of antibiotics that lead to yeast infections in the body.
» Excess consumption of sugar (the favorite food of yeast organisms).
» Viral infections.
» Exposure to toxic substances.
» Childbirth, the early stages of menopause, or any event that disrupts sleep or hormonal balance.
» Chronic stress and overwork.

Teitelbaum¹s patients run the gamut from professionals to stay-at-home moms to postgraduate students to mothers who first experience growing fatigue after giving birth to a child and dealing with a new baby. Many CFS patients are Type-A overachievers, he says.

Whatever the background, Teitelbaum relates personally to his patients. He himself became debilitated with total exhaustion as a third-year medical student in 1975 when the term chronic fatigue syndrome was unknown. ³None of my professors could help,² he says. ³I dropped out of school to rest for a year, did as much research as I could about my symptoms, and was able to improve enough to return to complete my studies. The symptoms that persisted‹fatigue, achiness, poor sleep and bowel problems‹served as the arena in which I learned how to help other people overcome these illnesses. ³It took me 15 years to learn about the hormonal, immune, nutritional and psychological factors involved to restore myself to full health,² he says. ³Today, at 50, my health and energy are great.² Teitelbaum has treated more than 2,000 CFS patients. He also teaches doctors to treat the condition with a self-designed approach involving a combination of diet, lifestyle modification, nutritional supplements and medical drugs (e.g., Diflucan and Nystatin). ³The two studies we have published to date show that the program achieves an average of 75% improvement of symptoms, including a huge rise in energy in 91% of patients within three months,² says Teitelbaum. ³This is dramatic. After two years, our follow-up research indicates an average improvement of 90%, and most patients no longer need treatment other than certain maintenance supplements.² To help patients outside of his own practice, Teitelbaum wrote From Fatigued to Fantastic (Avery Penguin Putnam, 2001) and also constructed a Web site (www.endfatigue.com) that includes up-to-date research, a sophisticated computer program that tailors treatment programs for individuals, and provides referrals to physicians and support groups. Teitelbaum has recently developed a program for an all-natural approach to chronic fatigue. He long ago found that vitamins, herbs and natural remedies are powerful tools in the treatment and recovery process. (See sidebar below.)

Today, Teitelbaum says CFS ³is a very treatable condition.² In fact, he adds, the major problem is misdiagnosis. Physicians are not taught about chronic fatigue in medical school, and most remain unfamiliar with the growing scientific research and treatment options. They often misdiagnose it as depression, or tell patients that they just don¹t know what the problem is.

Such was Mary¹s experience for several years. Once properly diagnosed and on Teitelbaum¹s program, she was able to turn her life around. That included striking a good balance with her work and home schedule and, more important, finding quality personal time to pursue her own health and happiness. ³Mary, like many of my patients, was able to use the disease as a teacher to get her life back,² says Teitelbaum.

Martin Zucker is a health writer who has been writing for Let¹s Live since 1978. His latest book is Preventing Arthritis (Penguin, 2001).

The Fatigued-to-Fantastic Program

CFS is a problem with multiple issues requiring a multifaceted treatment approach. There is no magic bullet. Following are three key elements of the comprehensive natural program for eliminating CFS developed by Jacob Teitelbaum, M.D. The supplements mentioned here are available in health-food stores. Other important recommendations, such as for hormonal support and yeast and other infections, are available under ³treatments² at www.endfatigue.com.

Element no. 1.- Sleep

CFS usually involves severe sleep disturbances. Getting a solid eight hours of good sleep a night is essential for recovery.

A hot bath before bedtime is helpful.

Taking the following supplements at bedtime is also helpful. Some people need all of them, others, a few or just one.

» Calcium (chewable or liquid form), 500 to 1,000 mg » Magnesium glycinate, 100 mg » Valerian (Valeriana officinalis), 200 to 600 mg » Hops (Humulus lupulus), 30 to 120 mg » Passionflower (Passiflora incarnata), 90 to 360 mg » L-theanine (an extract from green tea), 50 to 200 mg » Wild lettuce extract (Lactuca virosa), 30 to 100 mg » Jamaica dogwood (Piscidia piscipula), 30 to 50 mg » 5-HTP, 300 mg (limit intake to 200 mg if on prescription antidepressant)

Element no. 2- Nutritional Support

CFS patients have numerous nutritional deficiencies and absorption problems. Supplements in powder or capsule form are generally best absorbed, says Teitelbaum, and should provide, among other factors, these key nutrients:

» B-complex vitamin, 50 to 100 mg of major vitamins
» Folic acid, 800 mcg
» Vitamin B12, 500 mcg
» Vitamin A, 3,000 to 5,000 IU
» Vitamin C, 500 to 1,000 mg
» Vitamin D, 400 IU
» Vitamin E, 200 IU
» Magnesium glycinate, 200 mg (in addition to magnesium at bedtime).
» Zinc, 15 mg
» Selenium, 200 mcg
» Malic acid, 900 to 1,200 mg
» Acetyl-L-carnitine, 500 to 1,000 mg
» CoQ10, 200 mg at mealtime with some fat
» Essential fatty acids (such as flaxseed or fish oil, 5 gm, or a ½ tablespoon of cod-liver oil)

» Digestive enzymes (derived from plants), follow label instructions Note: Drink plenty of water with supplements.

Element no. 3. - The Mind/Body Connection

Take care of yourself. As you start to feel better from treatment, do what feels good to you rather than doing what you feel obligated to do. ³This is an important lesson for you to learn and to continue, even when you get well,² says Teitelbaum.

Selected References

Jason, LA, et al ³A community-based study of chronic fatigue syndrome² Archives of Internal Medicine (1999) 159: 2129-2137 Teitelbaum, J, et al ³Effective treatment of chronic fatigue syndrome and fibromyalgia‹A randomized, double-blind, placebo-controlled, intent-to-treat study² Journal of Chronic Fatigue Syndrome (2001) 8: 3-28 Teitelbaum, J From Fatigued to Fantastic. (Avery Penguin Putnam, 2001)