Tag: fatigue

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Be aware of allergies as the root cause of many problems including fatigue

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Blog written by Sarah Myhill, author of Diagnosis and Treatment of Chronic Fatigue Syndrome, Ecological Medicine, and The PK Cookbook

Allergy is the inflammation which results from response to substances (called antigens) from outside the body. Some of these present no threat to the body. Examples include pollen, house dust mites, animal dander and foods. Some antigens do pose a threat in high doses, such as metals (lead, mercury, arsenic, nickel), toxic chemicals (pesticides, solvents) or electromagnetic radiation (wi-fi, mobile phones, cordless phones etc).

Allergy has been known about for centuries. For example, 5-10 per cent of people with asthma are also allergic to sulphites. Pliny the Elder wrote of this when he reported the case of an asthmatic patient (rare for his times) who died from a bronchospasm in 79 AD after the eruption of Mount Vesuvius. The patient had lived a ‘normal life’ but for this ‘one incident’.

Allergy is the great mimic and can produce almost any symptom. Furthermore, one can be allergic to anything under the sun, including the sun! Allergy is also common – at least 30 per cent of the population are allergic to some foods. However, by the time allergy has produced fatigue (the major focus of my work as a doctor) it has usually caused other problems beforehand. Suspect an allergy problem if any, or a combination, of the following are present:

* The onset of fatigue is pre-dated by, and/or there is a long history of:

* asthma, sinusitis, rhinitis, eczema or urticaria

* irritable bowel syndrome with wind, gas, bloating, abdominal pain, alternating constipation and diarrhoea

* migraine or headaches

* joint (arthritis) and muscle pain

* mood swings, depression, anxiety, PMT

* almost any unexplained, recurring, episodic symptom.

  • Childhood problems – This would include being a sickly child with recurrent ‘infections’, such as tonsillitis (actually probably allergy). Indeed, a colleague who is a consultant paediatrician considers it medical negligence to surgically remove tonsils without first doing a dairy-free diet. Rhinitis, sinusitis, catarrh and colic are typical dairy allergy symptoms.
  • Symptoms change with time – Often the allergen is the same, but the symptom changes through life. Allergy to dairy products typically starts with colic and projectile vomiting as a baby, followed by toddler diarrhoea, catarrh and glue ear, recurrent infections (tonsillitis, croup, middle ear infections) and ‘growing pains’. Teenagers develop headaches, depression, irritable bowel syndrome, PMT and asthma. In adult life, muscle, tendon and joint pain (arthritis). Any of the above may be accompanied by fatigue.
  • There is a positive family history – I have yet to find a patient who is dairy allergic who does not have a first-degree relative (parent, sibling, child) who also has symptoms suggestive of allergy to dairy products. Allergy to gluten grains also runs in families.
  • There is a tendency to go for a particular food – One of the interesting aspects of allergy is that sufferers often crave the very food to which they are allergic. This was illustrated by one patient who told me that when he died he wished to take a cow to heaven with him. It was dairy which was his main problem! If wheat appears with every meal, then allergy to such is likely.
  • There are symptoms of fermenting gut – Microbes from the gut are minuscule and easily spill over into the bloodstream. This is called ‘bacterial translocation’. These bacteria do not cause septicaemia (blood poisoning), but they may cause allergy reactions at distal sites. I suspect many clinical pictures can be explained by this, including irritable bladder, interstitial cystitis, intrinsic asthma, chronic urticaria, chronic venous ulcers, polymyalgia rheumatica and arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and so on).

How to identify your personal food allergies

I never do tests for food allergy because they are unreliable. False negatives are common – so, for example, many people who are intolerant of gluten will test negative for coeliac disease. Often, when the test is negative, they are told by their doctor that it is safe to eat that food – not so! There are many tests for food allergy on the market, but again I find positive results can be misleading, not least because the patient believes absolutely in the accuracy of tests and ends up avoiding foods unnecessarily or eating foods which are causing them symptoms.

The only reliable way to diagnose food allergy is by an elimination diet. The key is to cut out those foods that one is consuming daily. The reason that reactions may be prolonged or delayed is that daily consumption masks the link between exposure and symptom. Western diets include daily consumption of grains, dairy products and often yeast. If in addition one is eating other foods, such as potato, soya or tomato, or drinking regular tea, coffee or whatever on a daily basis then this too should be excluded. One should stay on this diet for at least one month before reintroducing foods to the diet – this should be done cautiously since reactions can be severe. Dr John Mansfield developed a practical, easy-to-follow elimination diet that is described in his last book, Six Secrets of Successful Weight Loss.

The Stone-Age or Paleo diet is a ‘best guess’ diet and a useful starting place, hence my recommendation of the PK (Paleo-Ketogenic) diet as explained in our book Paleo-Ketogenic: the Why and the How. If it transpires that there are multiple allergies, then these days I do not put people on a more restricted diet – that is because some people get completely stuck on two or three foods and are unable to bring in new foods because of the above severe reactions. Instead, I put in place the interventions I recommend for a general approach to inflammation together with specific desensitisation techniques to switch off allergy (see our book Ecological Medicine).

Increasingly I am finding that one does not have to be perfect to reduce allergy and allergy symptoms. Simply reducing the total load is helpful – attention to the general approach is as important as specific desensitisation. However, the key steps are:

  • The PK diet
  • Extinguishing the inflammatory fire with my Groundhog Chronic regime (see any of our books) including antioxidants, especially vitamin C
  • Identifying possible causes, not forgetting micro-organims in the upper gut that should not be there, and eliminating or avoiding them
  • Detoxing to reduce the factors that cause inflammation
  • Reprogramming the immune system with probiotics, micro-immunotherapy, enzyme potentiated desensitisation (EPD) and neutralisation – all explained in detail in Ecological Medicine.
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CFS/ME – Vicious circles and multitasking

As co-admin of Dr Myhill’s Facebook groups, I often see members asking what the single most important intervention in a person’s recovery from CFS/ME has been. I totally understand the reasoning behind this question – having limited funds where should attention be directed first to achieve the best results? Where does one find the most bang for one’s buck!

Dr Myhill instinctively takes this approach too, preferring her patients to do the ‘easy’ cheaper things first because these interventions are often enough on their own to elicit recovery. So, correcting sleep, doing the right diet and taking nutritional supplements are right at the top of the list. This is laid out in her CFS/ME checklist.

However, for some this is not enough and it is then that we must face the complexity of our intricate biological system with its many feedback loops and synergistic effects.

I am a mathematician and so the assumption is that I like linear arguments progressing from one irrefutable logic step to another, and so on, until we arrive at the ‘answer’! In my case, nothing could be further from the truth. For example, when first introduced to James Watt’s centrifugal governor, I was fascinated. This governor is essentially a continuous feedback system that controls the rate of a steam engine so as to maintain a near-constant speed, irrespective of the load or fuel-supply conditions. The constant speed of the engine achieved in this way is the mechanical equivalent of a well-functioning biological system. I enjoyed learning about these feedback systems but never had a chance to study the many biological examples because aged 12, I chose Latin and Ancient Greek over Biology for my school options.

However, life, and more specifically CFS, has forced me to become more acquainted with these biological systems because I am one of those for whom the ‘easy’ cheaper things have not fully worked.

As laid out in much more detail in Dr Myhill’s upcoming and fully revised book, Diagnosing and Treating CFS/ME – It’s mitochondria, not hypochondria and in Sustainable Medicine, there are many vicious circles in CFS/ME and these make the recovery process so much harder.

For example, if mitochondria go slow then the heart, being a muscle and so dependent on good mitochondrial function, will also go slow. The heart delivers fuel and oxygen to all cells in the body and so, if fuel and oxygen delivery is impaired then this too further impairs mitochondrial function. This can be seen below:

cfs-myhill-mitonchondria-vicious-circle

As further illustration, magnesium is of central importance for mitochondria. Having low levels of magnesium inside cells and mitochondria is a symptom of CFS but also a cause of it. This is because 40 per cent of resting energy simply powers the ion pumps for sodium/ potassium (Na/K) and calcium/magnesium (Ca/Mg) across cell membranes. When energy supply is diminished, as in mitochondrial dysfunction, there is insufficient energy to fire these pumps, and so magnesium cannot be drawn into the cells for oxidative phosphorylation to work. If there is insufficient energy to drag magnesium into cells, then there is a further diminishing of energy delivery, because of the lack of magnesium, and hence we have another vicious circle.

But all is not lost! We have at least two things in our favour – we now understand these vicious circles, and so can ‘break’ them, and many of the nutritional interventions we use can ‘multi-task’.

So, considering the two examples above, we can ‘break’ those vicious circles and so restore mitochondrial function by using Dr Myhill’s standard mitochondrial package of supplements, and by supplementing with magnesium we can further support the ion pump:

  • Coenzyme Q10 as ubiquinol – 200 milligrams
  • Vitamin B3 as niacinamide – 500-1500 milligrams – slow release
  • Acetyl-L-carnitine – 1-2 grams
  • D-ribose – up to15 grams
  • Vitamin B12 – 5 milligrams sublingually or ideally B12 by injection
  • Magnesium – ½ ml 50% magnesium sulphate, ideally, or 300mg orally

So, what of this multi-tasking then? Many interventions multi-task. High-dose vitamin B12 may be used to improve mitochondrial function, for detoxing via the methylation cycle, as an antioxidant and for its anti-inflammatory properties by damping down the pro-inflammatory fire of the NO/ON/OO cycle. This makes correcting multiple co-existent problems that much ‘easier’!

And then we have a ‘lovely’ example which I came to learn through both my own experience and also very many questions on Dr Myhill’s Facebook groups, essentially asking the same thing:

Why is it that when I have a sudden energy dip, I also feel weepy and emotionally fragile, weepy beyond what I would expect to feel?

Well, here is one way of looking at it – ATP is not only the energy molecule but also a neurotransmitter – to be precise, a co-transmitter. Other neurotransmitters, such as serotonin, dopamine, GABA and acetylcholine, will not work unless they are accompanied by a molecule of ATP. So, if ATP levels fall precipitously low, then one feels dreadfully fatigued [ATP as the energy molecule] and simultaneously one feels very low emotionally [ATP as co-transmitter]. To mitigate this ‘double whammy’ effect, I carry a bottle of water with D-Ribose dissolved in it and this works as a great ‘rescue remedy’ for when I experience these sudden ATP dips.

So, I suppose what I am saying is that CFS/ME sufferers should try the ‘easy’ things first but that if these don’t work out for you, then don’t despair. We know the circles that must be broken and we have some great helpers, like Vitamin B12 and D-Ribose, which can multi-task and solve more than one problem at once! Never ever give up!

Craig Robinson first met Sarah in 2001, as a patient for the treatment of his CFS, and since then they have developed a professional working relationship, where he helps with the maintenance of www.drmyhill.co.uk, the moderating of Dr Myhill’s Facebook groups and other ad hoc projects, as well as with the editing and writing of her books.

A fully revised and expanded 2nd Edition of Dr Myhill’s book Diagnosis and Treatment of Chronic Fatigue Syndrome: it’s mitochondria, not hypochondria will be published in January 2017.