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Chronic Fatigue Syndrome and Fibromyalgia are REAL!
Chronic Fatigue Syndrome and Fibromyalgia are REAL! They are steadily becoming a recognized disorder after having historically been down played or ignored.

Chronic fatigue and its painful counterpart fibromyalgia are real disorders that cause physiologic changes in the body that can be effectively helped by an integrated approach to treatment. They are steadily becoming a recognized disorder after having historically been down played or ignored by many doctors. The difficulty in gaining this recognition is the result of an inability to objectively identify a reproducible cause of all the varied symptoms associated with it.

Fibromyalgia is defined as widespread pain lasting at least three months, significant pain located in at least eleven of eighteen defined tender points on the body, constant exhaustion, constant or intermittent flu like symptoms, and cognitive impairment often called “brain fog”.

Evidence is growing that supports a central brain dysfunction that upsets the communication process with the rest of the body, resulting in disorders or malfunction in several key areas. These areas include sleep, the immune system, the gastrointestinal system, the energy producing mitochondrial cells, and hormone balance. Nutritional insufficiencies and testing along with symptoms indicating potential chronic infections are frequently found as a result. This central dysfunction can be triggered by a particular event such as a severe infection, accident, head trauma, pregnancy, or a severe stressor in life. It can also be triggered by multiple events occurring over time to overcome an individual’s ability to keep all the complex systems of the body in correct balance.

Western medicine demands a test that proves the existence of any particular disease or disorder. Despite this barrier to recognition, the Center for Disease Control did formally recognize Chronic Fatigue Syndrome (CFS) in November of 2006. It is defined as—persistent or relapsing fatigue lasting six months or longer that is not alleviated by rest and has no other discovered cause. The fatigue results in substantial reduction of prior levels of activity professionally or personally. CFS usually presents with four or more of the following symptoms:
  • Sore throat
  • Tender lymph nodes
  • Muscle pain
  • Multi-joint pain without swelling or redness
  • Headaches
  • Un-refreshing sleep
  • Pain and/or fatigue lasting more than 24 hours after exertion
  • Impaired memory or cognition that results in substantial reduction of activity
The role of nutrition
An approach addressing the major areas of dysfunction can result in dramatic improvement. Nutritional issues occur often due to both long-term diet choices and gastrointestinal absorption problems. Comprehensive vitamin and essential fatty acid replacement is the cornerstone of treatment. Vitamin choices must provide for replacing key nutrients the body uses and needs in times of increased stress and pain in a form that will be the most easily absorbed. Essential fatty acids often in the form of fish oil provide building blocks for cells we cannot make ourselves and act as important anti-inflammatories. IV vitamins have been used for many years to rapidly treat nutrient insufficiencies having the advantage of avoiding absorption issues while using doses that can be very helpful clinically but impossible if taken by mouth.

Another critical dysfunction is found within the mitochondrial cells. These cells are found by the hundreds inside virtually every cell in the body. Their sole purpose is to be an assembly line for the molecule that supplies the energy to run all the functions that cell has. If this function is compromised, the cell becomes tired and does not function effectively, and eventually the tissue or organ cannot function as well. D-Ribose is a sugar that has recently been discovered to be a very important part of this production line. It is also used in large quantities in our DNA. Other key elements have been found and are continued to be discovered as insufficient in this process. Replacing these elements can provide a very significant benefit for both chronic fatigue and fibromyalgia.

Sleep’s role
Sleep is one of the most rapidly advancing aspect of medical research and clinical knowledge occurring at this time. It is often seen as the initial dysfunction in the brain that can lead the cascade of other problems and becomes a critical area to correct. While doctors have several tools to help people with consistent sleep problems, the understanding of the serious medical conditions that can result from chronic lack of quality sleep and the training in the use of these tools is inadequate. Using prescription medication, herbal, and nutrient approaches has proven very helpful in overcoming this complex disorder. Sleep is often also integrally involved in dysfunctions in the nutrient and hormone system making corrections here necessary early in the treatment.

Evidence is growing that supports a central brain dysfunction that upsets the communication process with the rest of the body, resulting in disorders or malfunction in several key areas. These areas include sleep, the immune system, the gastrointestinal system, the energy producing mitochondrial cells, and hormone balance.
Hormones’ role
Hormone problems often seen include the thyroid, adrenal, and reproductive systems as well as more specific hormones including pregnenolone, DHEA, and growth hormone. These hormones address such issues as energy, reproductive problems, cognitive issues often known as “brain fog,” sleep, and high cholesterol. Growing understanding of how each contributes to helping the symptoms associated with both fatigue and fibromyalgia has provided guidance in evaluation of levels and efforts needed to help balance them correctly. The use of bio-identical compounds has further improved the ability of knowledgeable physicians to replace and balance especially those hormones that require tight dosing and those unavailable by regular prescription.

Exercise with caution
Exercise is an often-misunderstood aspect of fatigue. Typically, the body’s response to exercise will be an improvement in sleep quality, daytime alertness, strength, and stamina. When the body’s systems are not prepared to respond to the stress of activity or exercise as is the case in chronic fatigue and fibromyalgia, the inability to recover from the stress is heightened. Taxing the muscle and organ systems by just “pushing through it” as is often recommended only digs the hole deeper making it more difficult to recover. The worsening of symptoms is called post-exertion fatigue, which often lasts several days. Attempting activity for the day that approaches only 75-80% of what you think you could do, will avoid this worsened fatigue and the pain it produces.

Chronic infections
The potential for chronic infections becoming intermittently more active may contribute to the daily symptoms of fatigue and pain. This issue is more controversial because there is a lack of specific testing that can prove who has a lingering viral or bacterial infection that could be helped by proper treatment. There are reliable clinical findings and clues in a detailed history that help predict who may benefit from an approach to treatment that will focus on these possible infections.

Chronic fatigue and fibromyalgia are real, debilitating, difficult conditions. An approach integrating nutrients, hormones, sleep management, appropriate activity, and possibly treatment for chronic infections can provide a way to address the debilitating results the condition can cause.

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"Chronic Fatigue Syndrome and Fibromyalgia are REAL!"
   authored by:
OSTEOPATHY
Dr. Pitcher earned her bachelor degree from Colorado State University in Ft. Collins, CO. and Doctor of Osteopathy at Western University of Health Sciences in Pomona, CA. Shortly thereafter she completed her internship and residency in osteopathic fa...



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