Solutions for Fatigue and Chronic Fatigue Syndrome There's something in this report for everyone

Epstein-Barr virus screen. This is the cause of glandular fever, a common trigger of CFS. Indeed, it has been estimated that over 20% of people getting glandular fever never fully recover their previous energy levels. No specific treatment for this viral infection.

Helicobacter antibody. The bacteria helicobacter pylori lives in the stomach. The stomach tries to get rid of it by producing extra acid. This extra acid production can cause problems such as duodenal ulcer, gastric ulcer, gastritis and oesophagitis, which present with symptoms of indigestion, acidity and heartburn.

Hepatitis A antibodies (Total)- HAV. This causes a mild, non serious jaundice. No specific treatment for this virus.

Hepatitis B core antibody HBcAB

Hepatitis B e antibody HbeAb. Hepatitis B is a nasty chronic infection which can certainly cause fatigue. No specific treatment for this virus.

Hepatitis B surface antibody (post vaccination check) to see if vaccination has been effective.

Hepatitis C antibody HCV. Hepatitis C is a nasty chronic infection which can certainly cause fatigue. No specific treatment for this virus.

Hepatitis D (Delta) - usually found with the other hepatitis viruses.

Hepatitis E antibody (IgG)

Herpes I and II combined IgG antibody test. HSV I causes cold sores and is very common with over half the population testing positive. HSV II is sexually transmitted and is one cause of genital warts (they can also be caused by papovaviruses). In women warts are risk factor for cervical cancer. Both HSV I and II are sensitive to anti-virals such as acyclovir.

HIV antibodies HIV1 and 2. This website does not offer HIV testing. This has to be done at specialist clinics.

Leishmania antibody. Leishmania is a tropical disease transmitted by sandfly bites.

Leptospira antibody. This causes hepatitis, acquired from rat's urine, treatable with penicillin.

Malaria antibodies. Malaria should be suspected in any person with 'flu like illness recently returning from a malarial area, regardless of whether or not they have taken malaria prophylaxis. I don't know if malaria does cause CFS, but I don't see why it could not be a trigger.

Measles antibodies. A viral infection and trigger of CFS. Vaccination also produces antibodies.

Mumps antibodies. A viral infection and trigger of CFS. Vaccination also produces antibodies.

Mycoplasma antibodies. See chlamydia, above.

Mycoplasma incognito. For information about this infection, see Nancy and Garth Nicholson's website www.immed.org.

Parvovirus antibodies. Causes "slapped cheek" in children. Can cause arthritis in women. No treatment for this viral infection.

Rubella IgG. A viral infection and trigger of CFS. Vaccination also produces antibodies.

Salmonella antibodies. There are many strains of salmonella, one of which is typhoid. They are one cause of food poisoning.

Schistosoma antibodies. Schistosomiasis is a tropical disease acquired through paddling in infected water. Treatable.

Toxoplasma antibodies Total. A protozoal infection acquired from cats. May cause low grade fever and swollen lymph nodes. Difficult to treat.

TPHA & VDRL. This is a test for syphilis, which is now very rare since this spirochete is very sensitive to penicillin. All pregnant women are routinely tested for this disease.

Positive results and treatment

A positive antibody test means that there has been exposure at some time in the past to that particular infection, it does not necessarily mean there is active infection now. For helicobacter pylori, breath testing will indicate active current infection. I would normally treat a positive test for chlamydia since this is resistant to commonly used antibiotics. For other infections ultra sensitive tests looking for DNA from the offending organism can be done (PCR tests) but I very rarely do them. Please e-mail my office if you have a particular query. (See How to contact us) The point about any infection is that the diagnosis is both a clinical and a laboratory one - furthermore, lab tests are fallible!

Furthermore, positive results do not mean a cure is round the corner. The problem with CFS is that the immune system is not working properly. This may be why the infection was picked up in the first place. Any antifungals and antibiotics to treat these conditions only give a percentage kill, furthermore there is likely to be an allergic element with inappropriate immune reactions getting in the way. Again see Inflammation and Antioxidants - poor anti-oxidant status is a disease amplifying problem! This essentially is my approach to treating any of the above problems - ie put the immune system in as fit a state as possible so it can sort things out!

Related Tests

Helicobacter Pylori breath test

Comprehensive Digestive Stool Analysis with parasitology

Related Articles

Chronic infection – Life is an arms race – how to tackle with natural remedies

Urine analysis

External Links

The Doctors' Laboratory offer a range of testing for STD. You can see a list of their profile tests here

References Nancy and Garth Nicholson, Sarah Myhill Limited :: Registered in England and Wales :: Registration No. 4545198 Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK. Tel [phone] | Fax [phone]

I) Pleomorphic Microbes

The Hidden Cause of Cancer and Autoimmune Diseases, Walter Last

For nearly a century we had increasingly strong evidence for a common microbial cause of cancer and autoimmune diseases but now we also have visual proof. A newly developed research microscope can show us in great detail what happens in the blood of individuals who develop these diseases. What it shows is that the key for understanding their cause and cure is the rise, or perhaps better the uprising, of an endogenous microbe in the blood.

Based on the work of Louis Pasteur in the late 19th century the scientific community adopted the concept of monomorphism. This means that microbes always maintain their basic shape as virus, bacterium or fungus. The term pleomorphism, on the other hand, as coined by the French chemist and biologist Antoine Béchamp (1816–1908), refers to the ability of microbes to change from one form into another, similar to a caterpillar changing into a butterfly.

Historical Evidence

While a causal correlation between cancer and microbes has been shown only in a few rare or animal tumours, several independent researchers have reported the proliferation of certain microbes in all cancer patients. One of the first was the German professor of zoology and microbiology Günther Enderlein who described in 1925 the different stages of a microbe that is normally present in the blood as tiny colloidal protein units.

These protein units appear to originate from the natural breakdown of cellular components and may be essential for healthy blood. In degenerative diseases, especially cancer and autoimmune diseases, but also Chronic Fatigue Syndrome and Fibromyalgia, these protein units grow into increasingly higher bacterial forms and finally into fungi. Conventionally these forms are called Enderlein structures and are the basis of Live Blood Analysis as presently used in natural therapy.

Independently, mostly without knowing of each other's work, several other researchers - including Royal Raymond Rife, Wilhelm Reich, Virginia Livingston-Wheeler, Alan Cantwell and Gaston Naessens - have described the same phenomenon. Orthodoxy, however, has a dogma that says microbes always have the same form and cannot change from viruses into bacteria and fungi. This is because orthodox microbiologists commonly observe dead stained microbes in dead tissue, or live ones for short periods, instead of live microbes in live tissue at very high magnification over long periods.

Of special interest are experiments of Dr Livingston-Wheeler who injected cultures of pleomorphic organisms into mice. When small amounts were injected then an autoimmune disease developed but higher doses produced tumours or cancer. Accordingly these cancer-forming microbes have often been called cancer viruses or cancer microbes.

notes on Lymes testing that may be relevant

Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach

Abstract

Background and Aims: The aetiology for chronic fatigue syndrome (CFS) remains elusive although enteroviruses have been implicated as one of the causes by a number of studies. Since most CFS patients have persistent or intermittent gastrointestinal (GI) symptoms, the presence of viral capsid protein 1 (VP1), enterovirus (EV) RNA and culturable virus in the stomach biopsy specimens of patients with CFS was evaluated.

Methods: 165 consecutive patients with CFS underwent upper GI endoscopies and antrum biopsies. Immunoperoxidase staining was performed using EV-specific monoclonal antibody (mAb) or a control mAb specific for cytomegalovirus (CMV). RT-PCR ELISA was performed on RNA extracted from paraffin sections or samples preserved in RNA later. Biopsies from normal stomach and other gastric diseases served as controls. 75 samples were cultured for EV.

Results: 135/165 (82%) biopsies stained positive for VP1 within parietal cells, whereas 7/34 (20%) of the controls stained positive (p≤0.001). CMV mAb failed to stain any of the biopsy specimens. Biopsies taken from six patients at the onset of the CFS/abdominal symptoms, and 2–8 years later showed positive staining in the paired specimens. EV RNA was detected in 9/24 (37%) paraffin-embedded biopsy samples; 1/21 controls had detectable EV RNA (p<0.01); 1/3 patients had detectable EV RNA from two samples taken 4 years apart; 5 patient samples showed transient growth of non-cytopathic enteroviruses.

Conclusion: Enterovirus VP1, RNA and non-cytopathic viruses were detected in the stomach biopsy specimens of CFS patients with chronic abdominal complaints. A significant subset of CFS patients may have a chronic, disseminated, non-cytolytic form of enteroviral infection, which could be diagnosed by stomach biopsy.

www.enterovirusfoundation.org/immuneboosters.shtml

( Alternative Treatment for Enterovirus

Due to the lack of pharmaceutical medicines or antiviral treatments, it is important for an infected patient to boost their immune system to help fight disease. Below are a select group of alternative treatments that may help some individuals. These treatments have not been FDA approved and are not endorsed by the Enterovirus Foundation. These are listed for information only.

The Enterovirus Foundation advises individuals to consult a physician before talking any medication, supplement or alternative treatment.

Immune Boosters

ProBoost - Thymic Protein A - This is a synthetic version of the protein made in the thymus that helps CD4 cells mature and differentiate. It was developed by Terry Beardsley, PhD, from Baylor College in Texas, and is sold as a nutraceutical. It has been tested in two small uncontrolled trials of chronic viral illness patients and AIDS patients, and was shown to increase CD4 count and normalize other immune markers such as elevated antiviral pathways. http://www.proboostmed.com/research.html

ImmunoPro - This product is reported to have antiviral properties in addition to immune modulating effects. It is a combination of denatured whey, lactoferrin, active peptides, transfer factors, and immunoglobulins, and is said to be a potent stimulant of glutathione. The product contains high levels of cysteine and other amino acids that are precursors to glutathione. The compound is also supposed to shift cytokines toward a th1 profile. http://www.allergyresearchgroup.com/proddesc/products/immunopro.htm

Imunovir - Immunomodulator. This is a prescription drug that is not approved in the US but is used extensively in Eastern Europe and Russia as an antiviral treatment. It is also used in the US with special permission, on a case-by-case basis, for SSPE (chronic measles encephalitis) because nothing else works for it. It can be legally imported to the US from pharmacies overseas with a prescription. http://www.rivexpharma.com/products_imunovir.html

Zadaxin - This is an immune stimulant made by SciCline Pharmaceuticals in California, and marketed in 30 countries. It is not yet approved in the US; however, it is in Phase III trials. Zadaxin is a synthetic version of thymosin alpha, a substance produced by the body's thymus to stimulate T cells and NK cells. It can be legally imported to the US from pharmacies overseas with a prescription. It involves injection with an insulin needle twice per week. http://www.scicloneinternational.com/zadaxin.shtml

Equilibrant is an all-natural dietary supplement that supports a healthy immune system. Its unique nutrient rich formula is composed of vitamins, selenium, and a proprietary blend of herbal extracts. Unlike other immune "stimulants" or "modulators", Equiliabrant works by balancing the immune response to the appropriate direction. Made in the United States under GMP standards. Coming soon. http://www.equilibranthealth.com.

D-ribose - D-Ribofuranose (D-ribose) is a five-carbon monosaccharide that is made in cells and stimulates the metabolic pathway used to make a class of compounds called purines and pyrimidines. These compounds are essential for the body's production of adenosine triphosphate (ATP). It is reported to have direct antiviral effects. D-ribose is widely used to boost energy and treat heart disease. http://www.corvalen.com/Dietary_Supps.html

High dose EPA - Eicosapentaenoic acid (EPA) is one of the active ingredients of omega-3 fish oil. An Israeli study of 20 patients with major depression found that EPA resulted in "highly significant benefits" compared to a placebo by week three. Virally ill patients may be benefit from this as well.

Vitamin D - Vitamin D produces a peptide that is important for cell mediated immunity and antiviral defenses. Patients with Multiple Sclerosis and Parkinson Disease tend to have low Vitamin D levels, and viruses have long been suspected in both conditions. Depending on the condition, physicians may recmmend 3000-5000 IUs daily.

Lysine - This is reported to be a natural antiviral, and is used widely for cold sores and ulcerations.

Quercetin - This is found to be the most active of the flavonoids in studies, and many medicinal plants owe much of their activity to their high quercetin content. Quercetin has demonstrated significant anti-inflammatory activity because of direct inhibition of several initial processes of inflammation. For example, it inhibits both the manufacture and release of histamine and other allergic/inflammatory mediators. It also exerts potent antioxidant activity and vitamin C-sparing action. Quercetin has been shown to be a good treatment option for interstitial cystitis.

Zinc, Selenium, Potassium, Glutamine, Calcium & Magnesium - These are important in fighting off viral infections.)

(A reply to the article "High levels of ciguatoxin are found in almost all people diagnosed with CFIDS/ME. This is a slightly different epitope of ciguatoxin that effects the sodium channel membranes. Enterovirus etc do not release ciguatoxin").

Chronic infections in CFS

Whilst there is no doubt that an acute infection is a common trigger for CFS, the question is: to what extent does chronic infection perpetuate the fatigue? I have struggled with this question for years! There is a body of evidence pointing to chronic infections such as Lyme disease, borreliosis, mycoplasma, HHV, Epstein Barr, cytomegalovirus etc. present in CFS patients together with various trials showing benefits from anti-microbials. The trouble is the diagnosis is difficult, the treatments often expensive and all carry potential for harm from toxic drugs.

We are all exposed to infections, but only a few get chronic problems. The difference has to do with individual susceptibility – as Pasteur famously said “The microbe is nothing, the terrain is everything”.

What is central to CFS is mitochondrial function. I believe this will be the most important marker of CFS and testing mitochondrial function often points to nutritional deficiencies or toxic blockages which, when corrected, in many case result in clinical improvement. However, Dr Paul Cheney believes that one’s redox state is also central in the control of mitochondria. See CHENEY ON CFS MECHANISMS, also FERMENTATION IN GUT, FREE RADICALS and CFS.

What is the redox state?

Think of redox state as a fire. For the fire (mitochondria) to burn brightly we need optimum conditions of fuel, oxygen and the molecular machinery to handle this. If the fuel supply is sluggish, the fire burns low. If the oxygen supply is sluggish, the fire burns smokey (free radicals). Getting the right balance between fuel, oxygen and the molecular machine (magnesium, coenzyme Q 10, acetyl L carnitine, magnesium D-ribose, NADH etc) together with adequate antioxidant cover to mop up smoke (superoxide dismutase, co-enzyme Q 10, glutathione peroxidase, vitamins A,E and C etc) is necessary for the efficient use of energy.

The graph below illustrates this. To have adequate supply of energy, the redox state must be central. At this level, the fire is burning brightly; we have a good balance of supply of fuel and oxygen on the one hand, with good antioxidant cover on the other to carry the smoke (free radicals) away.

Graph: Energy REDOX STATE

If one falls to the right side, the fire burns low because we do not have the raw materials to feed it so energy levels are low. One would see this in starvation, or chronic poor oxygen supply from lung disease or anaemia.

If one falls to the left side, there is too much free radical production, which overwhelms the antioxidant mopping up system. The free radials then inhibit mitochondrial function directly and the fire burns low and again we see low levels of energy.

There is a further complication. Mitochondria have to adjust the level of their fire from second to second so that energy supply is coupled to energy demands. Mitochondria need to supply energy at a millisecond’s notice! In the micro-respirometry studies that John McLaren-Howard does, we often see uncoupling of oxidative phosphorylation so this link is lost and energy is wasted.

Why is this important?

Using his methods of assessing heart function (also a measure of mitochondrial function), Dr Cheney has shown that CFS sufferers respond to oxygen very differently from healthy controls. People with normal energy levels who function in the middle of this redox state perform better with additional oxygen. Their fire glows brighter! In contrast, CFS sufferers get worse. Cheney postulates that this is because they are sitting to the left side – with low levels of energy and poor anti-oxidant status. They cannot cope with free radicals which are already making their mitochondria go slow. Give them oxygen and this creates further pro-oxidant stress which worsens the situation by pushing them further to the left. Indeed, this is how he distinguishes experimentally between people with CFS and normals.

Why is this relevant to viral infection?

A paper published in 1991 by Fauci looked at the ability of viruses to replicate according to redox status of the host. What was so fascinating about this paper is that in those individuals with normal redox status viruses were unable to replicate and so their hosts were markedly resistant to viral infection. This explains why when we see an epidemic of infectious disease such as influenza, not all people are equally affected. Some have no symptoms, whereas others are completely flattened. In those people with poor redox state, the virus was able to replicate easily and it is high numbers of viruses in a human host which dictate the severity of the illness. Furthermore, if the immune system moves into “overdrive”, one can get a “cytokine storm” resulting in massive tissue damage and possible death. Indeed, this is what kills people in flu epidemics.

So, if one gets an acute viral infection, and one cannot drag oneself back from the left pro-oxidation side into a normal redox state, one will be stuck with low levels of energy because the mitochondria cannot work. A recent article in the New Scientist (29.8.09) shows that some viruses generate oxygen. If this were the case, it could partly explain how viruses keep one in this pro-oxidant state. The virus has manipulated the host’s biochemistry to suit itself and allow it to multiply!

So how does one get rid of a chronic infection?

The majority of people I see improve without resorting to anti-microbials by putting in place all the interventions to restore mitochondrial function and good anti-oxidant status. These include:

▪ STONEAGE DIET

▪ NUTRITIONAL SUPPLEMENTS

▪ SLEEP

▪ PACING

▪ Correcting MITOCHONDRIAL FUNCTION

▪ Correcting ANTI-OXIDANT status

▪ DETOX regimes

▪ Etc

However, Cheney has seen good results by treating CFS sufferers using artesunate. This is derived from the Chinese herb artemesia. It is of proven benefit in treating malaria. But, interestingly, it is active against a wide range of other infections including schistosomiasis, cytomegalovirus, hepatitis B, Human Herpes Virus simplex type 1, Human Herpes Virus type 6, hepatitis C, Epstein Barr virus, bovine viral diarrhea virus and probably others. Artemesins have also been shown to be effective against bacterial infections, yeast infections and also they have powerful anti-cancer activity. What is most remarkable is that side-effects are minimal and rare.

This begs the question as to how one drug can have such a broad spectrum of activity against so many different pathogens? The answer is that it has an effect on the redox state of the host – it pushes it back to the right. It creates a terrain in which bugs cannot replicate! In a normal redox state mitochondria can work normally, energy levels are restored, the body warms up (many pathogens are markedly heat sensitive- that is why we run a fever to get rid of bugs) and the immune system has the energy to kill infection. BUT THIS WILL ONLY WORK IF ALL OTHER INTERVENTIONS ARE IN PLACE. Without normal mitochondrial function, normal antioxidant status, etc. artemesins cannot work!

Using Artesunate

The dose is 2-4mgs per kg body weight daily given by mouth in two doses. I would suggest 100- 200mgs twice daily for one week, then go to a maintenance dose of 100-200mgs alternate days, gradually tailing off until there is clinical improvement and stability.

Side effects are remarkably few – see below:

Possible side effects: Artemether has been remarkably well-tolerated, and appears less toxic than quinine or chloroquine; adverse effects include bradycardia, electrocardiogram abnormalities, gastrointestinal disturbances (nausea, abdominal pain, diarrhoea - oral therapy only), dizziness, injection site pain, skin reactions, and fever. Transient decreases in neutrophils and reticulocytes have been reported in some patients treated with artemether.

Drug induced fever has been observed with artemether. Mild reactions were seen in patients to whom artemether had been administered intramuscularly. These included nausea, hypotension, dizziness and tinnitus. These side effects were also reported: dark urine, sweating, somnolence, and jaundice. There were no deaths or any other side effects. No irreversible side effects were seen.

Slight rise of SGOT and SGPT may occur in individual cases. Neurological side effects have not yet been observed in clinical use but clinical trials suggest that coma may be prolonged in patients treated with artemether and there was an increased incidence of convulsions in one trial in cerebral malaria. Transient first degree heart block has been documented in three patients receiving artemether.