Can you cure chronic fatigue syndrome?

We often hear people say that there is no cure for CFS/ME but what does the word cure really mean?

In medical terms a cure is the complete eradication of a disease. This means that there are no traces of the disease remaining and that the person is completely healthy. For many diseases, such as cancer, this is not possible and so we often talk in terms of remission instead – this is when the disease is inactive and the person has no symptoms. Many diseases are incurable as there is always a chance of relapsing if the conditions in which you initially got sick occur again. As an example, people with high cholesterol can improve their diet and lifestyle and eventually bring their cholesterol levels back into the normal range, but if they return to their previous poor lifestyle habits then their cholesterol levels are guaranteed to increase again. This is because this group of people are susceptible to having high cholesterol levels.

The word cure is probably not the most appropriate term when talking about people overcoming CFS/ME, but restoration of health and the absence of symptoms is possible and that's why I prefer to use the word recovery instead.

Recovery from CFS/ME means that your body can once again cope with the physical and mental demands placed on it. People are able to think clearly, have enough energy to carry out all their usual activities and no longer feel unwell. People who recover from CFS/ME are able to work a full-time job, do reasonable amounts of exercise and enjoy normal social activities.

How do you recover from CFS/ME?

In order to recover from CFS/ME it's important to have an in depth understanding of how this condition occurs in the first place. It all comes down to stress. Physical, mental and emotional stress. Everything that taxes the body in some way results in the same physiological response regardless of where it comes from. This means that the body cannot tell the difference between physical stress, such as chronic infection, mental stress, such as a stressful job, and emotional stress, such as a death from a loved one. It's all just stress as far as the body is concerned. It is particularly important to understand that the body can be stressed even if you don't feel stressed.

Cell Danger Response

For people with CFS/ME another important concept to be aware of is the cell danger response. This is a process whereby the body perceives some kind of threat and responds by increasing inflammation and making it harder for cells to produce energy. Triggers for the cell danger response are any stressors that exceeds the cell's capacity to stay in homeostasis, which essentially means to remain in balance. So, if we experience a stressor which is so challenging that the cell is no longer able to cope, then the body will begin the cell danger response. This is a protective mechanism designed to keep us safe and healthy but for people with CFS/ME they often get stuck in this mode, which ultimately leads to fatigue and a decline in health.

Most people have heard of our energy producing organelles, our mitochondria. Their most well known role is to produce energy, but they also have another role which is to sense danger. Once they sense danger from a toxin, microbe or excessive stress hormones, they go into protective mode and can stay in that mode until they feel safe again. One of the by-products of the cell danger response is oxidative stress, which damages mitochondrial membranes, reduces their energy producing capabilities and makes them less efficient.

So in order to recover from CFS/ME we first must remove the trigger, if this is still active, but we also need to fix the secondary dysfunctions that results from the nervous system dysfunction.

Secondary dysfunctions

During times of stress two hormones are released, cortisol and adrenaline. Cortisol is the stress hormone that helps to mobilise energy stores in the body so that we can deal with the stressful situation. Adrenaline is the hormone that gives us the well-known fight or flight response. In small doses these hormones are actually good for us and help us to cope with stress in the short-term. The problem is that when we are under chronic stress, these hormones are constantly being released and this can lead to lots of unwanted symptoms.

Cortisol

Cortisol is a catabolic hormone, which means that it breaks down tissue in the body in order to release energy. In small doses this is not a problem, but when cortisol levels are constantly high it can lead to a suppressed immune system, hormone imbalances, digestive dysfunction.

Adrenaline

Adrenaline, our other stress hormone, gives us the energy and strength to deal with a stressful situation. In small doses adrenaline can be beneficial, but when it's constantly pumping through our bodies it can lead to anxiety, insomnia and irritability.

Digestive symptoms

Digestive symptoms are really common in CFS/ME and this is because our stress hormones can reduce digestive function, such as the amount of stomach acid produced and the amount of enzymes released. This can cause symptoms like bloating, indigestion, constipation or diarrhoea. Stress can speed up motility leading to diarrhea and decreased nutrient absorption or slow down motility leading to constipation and the resorption of toxins. Stress also leads to leaky gut syndrome, which is where the tight junctions in our intestines become damaged and toxins and bacteria can 'leak' into the bloodstream. This is one of the big drivers of systemic inflammation which can lead to brain fog, reduced capacity to detoxify and joint pain.

Poor immune function 

One of the side effects of chronic stress is that it can also suppress the immune system. This means that you become more susceptible to infections, have infections that linger and can also result in reactivation of latent infections.

Recovering from fatigue is possible

When helping people recover from fatigue I move through a series of stages that are tailored to the patients specific presentation. Treatment plans are different for each patient and will depend on the patient's presentation and lab results.

Stage 1

The first step is removing any active triggers, this is essential to shut off the cell danger response and allow the body to being to heal. Some of these are easier to remove than others and often patients will have more than one of these triggers contributing to their condition.

• Active infection
• Parasites
• Heavy metals
• Chemical exposure
• Present trauma
• Chronic stress

Chronic stress

Addressing chronic stress can often be often the hardest for many individuals as some of these are often out of the patients control or are difficult to resolve such loss of a loved one, marital problems, abuse and violence of any kind, financial pressures, caring for love ones who are sick and of course the stress from dealing with having chronic fatigue. Having a chronic illness such as chronic fatigue can place pressure on relationships as well as other areas in your life such as finances. It is often difficult to solve many of these stressors but when you understand that these are making and keeping you sick then it might give you the push to make some big changes in your life to overcome this problems. We often cannot remove these problems from our lives but we can learn how to deal with them in a better way, or manage them more effectively so they will eventually have less of an impact on our lives.

Many people can benefit from speaking to a trained therapist to help them understand and work through their stressors. Therapists can help to identify the problem and pinpoint any unaddressed feelings or issues that may be contributing to stress levels.

Pacing

During these initial stages I always stress the importance of pacing. Pacing is a self-management strategy for all types of activity including physical, cognitive, social and emotional. Pacing is the concept of learning to use the amount of energy that you have whilst also reducing the risk of post-exertional malaise or worsening of symptoms from stretching yourself beyond your energy capabilities.

It is important to know the signs of when you are ‘overdoing it’ as this will define your particular limits. Whatever level of activity that results in worsening of symptoms is beyond your limit, your limit is not some activity level that you think you should be doing or a level of activity that you used to be able to do.

This will require you to set limits on your work and life and for you to consistently stick to these limits as stretching beyond this is counterproductive and is only going to set back your recovery. As you improve however, you will be able to reset your limits to suit.

Restorative practices

In this stage rest and restoration are key. Some activities that may be beneficial during this stage are time in nature, restorative styles of yoga and sleeping and napping when needed.

Some patients that are really reactive may also benefit from beginning a limbic retraining program at this stage.

Stage 2

In this stage I work on rebuilding reserves, this involves looking at lifestyle factors such as sleep, nutrition and managing stress so that your body can continue to restore its function in a sustainable way. I also look for any nutritional deficiencies and may look to incorporate some gentle movement if the patient has capacity.

Stage 3

Stage three is where we address any secondary dysfunctions that have resulted from having this condition such as digestion, detoxification, mitochondrial function and hormonal imbalances. Addressing these issues is essential for restoring health and wellbeing and recovering your energy. I often do these as modules over a number of sessions as some of these may resolve on their own once we have addressed other dysfunctions such as digestion.

Stage 4

Past trauma can also be a big factor in stress levels and can often be the root cause of chronic fatigue. Trauma can be anything from being in a car accident to growing up in a dysfunctional family. Often trauma is stored in our bodies and can lead to physical symptoms such as pain, fatigue and anxiety. It's important to address any past trauma that may be contributing to your chronic fatigue as it can be a big obstacle in recovery. If your trauma still upsets you when you talk about it in detail, it might mean you have more work to do to deal to overcome this.

In this stage it's also important to consider if any of your personality traits are contributing to your condition such as people pleasing and perfectionism. These personality types often result in higher levels of stress and can be unhelpful in our recovery.

Stage 5

In this stage the body has begun to heal and patients often feel they have energy to challenge themselves. This is the stage where patients can now stretch their capacity by increasing exercise and using some hormetic stress therapy such as sauna, cold water therapy and fasting. Hormetic stress is the concept of using small amounts of something that is stressful to activate our body’s healing mechanisms. It is important that patient only doing these activities if they have some solid reserves, so these should not be conducted at earlier stages of recovery.

Stage 6

Stage 6 is recovery, where you have recovered your energy and health to the point that you can maintain it without too much effort. It is important to remember that recovery from chronic fatigue is a process and it is not going to happen overnight. It takes time, dedication and consistency in order for progress to be made. Be patient with yourself and trust the process, as this will help you get back to being the best version of yourself.

 

If you are looking for help with CFS/ME, please feel free to reach out and discuss your case with a professional such as myself who is experienced in treating this condition. With the right guidance and support, you can reclaim your health and vitality and start living life to its fullest potential again!