Chronic Fatigue, Adrenal Fatigue, Fibromyalgia



Chronic Fatigue and Immune Dysfunction Syndromes (abbreviated CFIDS or CFS) and Fibromyalgia (FMS) represent a group of symptoms associated with severe fatigue, insomnia, "brain fog," and, in those with Fibromyalgia, widespread pain. Many other problems are often also present, including sinusitis, spastic colon, weight gain (by an average of 32 pounds!), loss of libido, and a host of other symptoms. These symptoms can all improve or go away with proper treatment! These illnesses are caused by an energy crisis in your body. Most people can improve and often recover by using our individualized protocols that address sleep, hormonal support, infections, nutrition, and exercise.

Our Integrative Approach
At the Center, we know the fatigue, pain, and other symptoms you are experiencing are not all in your head. They are real, and they have a cause. More important, we can help. Our physicians don’t just treat the symptoms of chronic fatigue and fibromyalgia—we prescribe a nutritional approach and targeted therapies that have the potential to alleviate pain and  increase energy. Diet can make a huge difference in how you feel. First, we look for undetected food allergies, which are an overlooked but frequent cause of fatigue and pain. Omega-3 fatty acids help alleviate pain, slow-burning carbohydrates increase energy, and a full array of antioxidants, B-complex vitamins, and other essential nutrients provide energy..

There is no specific lab test needed to confirm that you have CFS or Fibromyalgia. Instead, thorough testing is done to look for the underlying problems causing your CFS/FMS and to eliminate other causes of your fatigue and pain. That a test result is in the "normal range" does NOT mean it is OK.

Some of you have had your illness caused by any of a number of infections. In this situation, you can often give the time that your illness began almost to the day. This is also the case in those of you who had an injury (sometimes very mild) that was enough to disrupt your sleep and trigger this process. In others the illness had a more gradual onset. This may have been associated with hormonal deficiencies (e.g., low thyroid, estrogen, testosterone, cortisone, etc.) despite normal blood tests. In others, it may be associated with chronic stress, antibiotic use with secondary yeast overgrowth, and/or nutritional deficiencies. Indeed, we have found well over 100 common causes of, and factors that contribute to, these syndromes. Understanding this helps us understand the symptom complex seen in CFS/fibromyalgia. Restoring energy production and balancing your hormones and endocrine system gives us a way to effectively treat you!

These are the four key areas that need to be treated for Chronic Fatigue syndrome, fibromyalgia and muscle pain to resolve:
1. Disordered Sleep.
 For patients to get well, it is critical that they take enough of the correct sleep medications to get 8 to 9 hours of sleep at night!  Our approach is to offer natural safe treatments, but in some cases, the use of prescription muscle relaxants and sleep aids may be needed. Valerian, passion flower, theanine, 5 HTP melatonin and calcium magnesium can be helpful.
2. Hormonal Deficiencies. 
It may be necessary, albeit controversial, to treat with thyroid, adrenal (very low dose cortef; DHEA), and ovarian and testicular hormones—despite normal blood tests! These hormones have been found to be reasonably safe when used in low doses. Growth hormone has also been shown to be helpful in fibromyalgia. Most growth hormone is made during deep sleep. This may be another reason why getting eight to nine hours of deep sleep a night can be critical!
3. Unusual Infections
 Many studies have shown immune system dysfunction in FMS/CFS. Although there are many causes of this, I suspect that poor sleep is a major contributor. The immune dysfunction can result in many unusual infections. These include viral infections (e.g., HHV-6, CMV, and EBV), parasites and other bowel infections, infections sensitive to long-term treatment with the antibiotics Cipro and Doxycycline (e.g., mycoplasma, Chlamydia, Lyme) and, most importantly, fungal/Candida infections. Although the latter is controversial, we have found treating with an antifungal to be very helpful with the symptoms seen in these syndromes. Avoiding sweets (stevia is OK) and taking probiotics can be very helpful. We often also add prescription antifungals as well.
4. Nutritional Supplementation.
Because the western diet has been highly processed, nutritional deficiencies are a common problem. In addition, bowel infections can cause poor absorption, and the illness itself can cause increased nutritional needs. The most important nutrients include:
Vitamins—especially the B vitamins and, antioxidants such as vitamin C and E.
Minerals—especially magnesium, zinc, and selenium.
Amino acids (proteins).

D-Ribose is an outstanding nutrient (a special sugar—even OK for those who need to avoid sugar) for those of you who want a powerful energy boost.
We rule out heavy metal toxicity, which can sap energy and cause aches and pains. Ridding the body of these toxins via a course of EDTA chelation is an important step on the road back to health.  

We also work to improve immune function with intravenous vitamin C and other nutrients. Your physician may also prescribe low-dose naltrexone (LDN), a safe, nontoxic drug and powerful immune booster that is making inroads as a therapy for fibromyalgia and chronic fatigue.

So Can I Make My Pain Go Away?
Fibromyalgia and myofascial pain and associated nerve entrapments are now very responsive to treatment! In many cases, they usually will improve dramatically and often even go away if you simply get the eight hours of sleep a night, take vitamins, take thyroid hormone, and treat the underlying yeast infections. Other patients require more thorough evaluation and treatment. Localized myofascial pain also requires an evaluation for structural causes.

There are many other medications and other effective ways to treat pain as well. These can be used to help keep you comfortable while we go after the pain's underlying causes. For pain relief, we offer a number of effective alternative therapies. Microcurrent therapy delivers very low-frequency electrical currents to areas of pain and tenderness with often-remarkable results. Patients with fibromyalgia and chronic fatigue also respond well to, acupuncture,  massage, hyperbaric oxygen therapy, and reflexology.


The Adrenal Fight-Flight Response
Above our kidneys sit a pair of glands called the adrenal glands, which secrete many hormones that help us cope with stress. They accomplish this through communications with the hypothalamus and the pituitary gland, both located in the brain, in a feedback system called the hypothalamic-pituitary-adrenal axis. It is the signaling between the adrenal glands and the brain that regulate a variety of bodily processes during threatening situations to help us react and escape if necessary. During this "fight-or-flight" response, some blood vessels are dilated while others are constricted, redirecting blood flow to the muscles. Nutrients that had been stored for energy may be released and burned so that the body can respond quickly. The heart rate increases and the reflexes become faster.


Symptoms of Adrenal Fatigue

In addition to the "stress hormones" mentioned above, the adrenal glands produce a number of other hormones involved in other physiological functions. The glucocorticoids, for example, help direct metabolism and regulate blood sugar levels, which may become imbalanced if there is insufficient adrenal activity. Those with adrenal fatigue might find themselves more easily prone to "sugar crashes" or find themselves with intense salt or sugar cravings. Glucocorticoids also help control the immune response, modulating inflammation responses, so those with adrenal fatigue might also become more sensitive to infections, causing them to have to endure illnesses longer than usual. Low levels of mineralcorticoid hormones, which help balance the body's sodium and potassium levels, blood volume, and blood pressure, may also cause pronounced changes in dietary habits and overall energy levels. In women, the adrenal gland also produces testosterone, a reduction of which can cause lowered sex drive.

Secretion of cortisol, another adrenal hormone, normally fluctuates following a day/night cycle, stimulated by light/dark patterns noted by the brain. Cortisol levels are normally highest in the morning, decrease throughout the day, and reach their lowest point several hours into sleep. Cortisol helps the body bounce back from stress by returning it to a more normal, "resting physiological state, and plays a wide variety of functions in metabolism, immunity, memory, and also plays roles in making the body sensitive to other hormones, like epinephrine. Lowered levels of cortisol can cause a person to become dehydrated, fatigued, run down, and have difficulties thinking. A person will have significant difficulty getting out of bed in the mornings and feel their energy continue to decline throughout the day.


Risk Factors of Adrenal Fatigue

The lowered adrenal hormone secretion keeps a person's body in a perpetual state of stress, since it reduces the body's capacity to deal with any kind of stress. The fluctuations in blood sugar and metabolism, combined with becoming less active due to exhaustion, can lead to weight gain. Because of the reduced immunity, adrenal fatigue may also open the door for chronic infections, which can cause further medical complications related to the infections themselves. The high blood pressure associated with adrenal fatigue may also lead to numerous complications, including stroke, heart attack, and heart failure.


Causes of Adrenal Fatigue

In cases of adrenal fatigue, the adrenal glands produce hormones, but not enough to help the body cope with the stresses that it faces. A balance of adrenal hormones is necessary to help maintain a state of positive well-being. If the adrenal glands are chronically overworked, they may not be able to catch up with the body's need for their activities, resulting in adrenal fatigue.