Every person with chronic fatigue syndrome (CFS) also known as myalgic encephalomyelitis (ME) and/or fibromyalgia syndrome (FMS) has a unique presentation of these conditions with various complications and sets of symptoms. There is no one treatment that can “cure” these syndromes or that is helpful to everyone however a combined approach of therapies can lead to an improved quality of life. Listed below are strategies and therapies that have been beneficial for others and myself.
1. Diet and Chemical Exposure
Impaired detoxification is common to chronic fatigue and fibromyalgia sufferers. Avoidance of stimulants, depressants, pharmaceutical drugs and toxic chemicals can make a big difference in feeling better. This includes alcohol, caffeine, sugar, pain relievers and additives in processed food. Unfortunately many physicians prescribe drugs for pain, depression and sleep, which become less effective with time and in the long run make a patient worse. The optimal diet is one that is high in protein and minimally processed: organic meats, fish, eggs and full fat dairy products, vegetables, nuts, whole grains and fruit. It is also important to consume salt and to drink plenty of water.
2. Breathing and Oral Balance
Breathing is the underlying force of life and many people with chronic fatigue and fibromyalgia have impaired or restricted breathing contributing to poor health and pain. People with CFS/FMS are often unaware that they are surviving on less air, which does not show up in an oxygen saturation test because their bodies compensate for this with low blood pressure. This is the cause of neurally mediated hypotension and other cardiovascular irregularities common in many Chronic Fatigue patients. Oral Systemic Balance is a treatment developed by a TMJ dentist named Farrand Robson that employs oral appliances to help patients breathe better and restore balance to the autonomic nervous system. It resulted in significant improvement in my own health and provided the foundation for my recovery which I discuss in my post “Oral Systemic Balance” fibrofriends.typepad.com/fibro_friends/2010/02/oral-systemic-b.html and "Oral Systemic Balance - the Second Chapter" http://fibrofriends.typepad.com/fibro_friends/2014/01/oral-systemic-balance-the-second-chapter.html.The treatment is time consuming and expensive however I believe that it addresses a key source of stress for those suffering from Chronic Fatigue and Fibromyalgia Syndromes. For more information go to: http://www.oralsystembiology.com/default.html.
The website www.breathing.com has information on holistic breathing development research, education and self-help programs developed by “The Optimal Breathing Coach” Mike White. I recommend ordering the Fundamentals of Breathing Development Video and Breathing Kit, which offers an effective program of breathing exercises.
3. Gastrointestinal Problems
Many people with CFS/FMS suffer from gastrointestinal problems including constipation, loose stools, bloating, and flatulence. There are multiple causes of these symptoms including low production of stomach acid and pancreatic enzymes, intestinal parasites and small intestine bacterial overgrowth. Low production of stomach acid can improve by taking apple cider vinegar or hydrochloric acid capsules with meals; low production of pancreatic enzymes can be treated by taking digestive enzymes; and parasites and bacterial overgrowth can be treated with appropriate antibiotics or herbs. An excellent laboratory used primarily by naturopathic or holistic physicians for diagnosing digestive problems is Diagnos-Techs, Inc in Tukwila, WA. Small Intestinal Bacterial Overgrowth (SIBO) is diagnosed with a breath test that measures hydrogen and methane gas. SIBO is common in persons with Irritable Bowel Syndrome and fibromyalgia. For more information on this disorder go to: http://www.siboinfo.com. Agiatations of the autonomic nervous system may also be responsible for many gastrointestinal issues and can resolve with Oral Systemic Balance.
Chronic Fatigue and Fibromyalgia Syndromes are conditions of neurological exhaustion and physical stress that result in dysregulation of the Central Nervous System. Dr. Len Ochs, a pioneer in the biofeedback field developed a unique form of EEG feedback or neurofeedback called Low Energy Neurofeedback System (LENS) that has helped many people with CFS/FMS. The system operates entirely different from traditional EEG or neurofeedback training. Treatment involves very short (a few seconds per session) feedback of the dominant frequency the brain is producing at an offset. This results in the brain jumping out of its existing patterns and breaking up dysfunction. The therapy works best for those who have resolved underlying physical stressors that led to their condition i.e. obstructive breathing and infections. For more information read the book "The Healing Power of Neurofeedback" by Stephen Larsen and go to www.ochslabs.com/. For more information on LENS and my experience with this go to: fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html.
5. Thyroid Function
Most chronic fatigue and fibromyalgia patients suffer from symptoms of hypothyroidism, which include low body temperature (below 98 degrees), fatigue and constipation, even though their thyroid blood tests are normal and/or they are taking thyroid replacement. Dr. Denis Wilson discovered that this condition which is called “Wilson’s Thyroid Syndrome”, "Wilson's Low Body Temperature Syndrome" or “Wilson’s Syndrome” can be reversed by taking for a period of time the active thyroid hormone T3. Returning my body’s temperature and thyroid function to normal was one of the big breakthroughs of my healing and I think it is an issue for many CFS/FMS patients. You can read more about this at www.wilsonssyndrome.com and in my post “Thyroid Function" fibrofriends.typepad.com/fibro_friends/2009/03/thyroid-function.html.
6. Biofeedback Self-Regulation Skills
Biofeedback is the process of becoming aware of various physiological functions using instruments that provide information on these systems and through practice learning to manipulate them at will. I have found two biofeedback modalities: Surface EMG and Hand-Warming to be particularly beneficial in reducing the symptoms of an agitated sympathetic nervous system. Although I have personally not been successful in using HeartMath as a biofeedback tool it has helped many other people. All modalities use instruments that are inexpensive and can be practiced on one's own.
An electromyograph (EMG) is an instrument that uses surface electrodes to detect muscle contraction. EMG biofeedback employs this instrument to measure the surface electromyogram (SEMG) using one or more active electrodes that are placed over a target muscle and actively record the muscle tone in micro volts. Paying attention to this feedback one can manipulate and decrease agitated muscle contractions. The therapy is particular helpful for fibromyalgia, which often manifests itself as a condition of hypertoned muscles that over contract. By placing electrodes on the tender or trigger points one can learn to retrain the muscles to relax. Surface EMG is also helpful for tension headaches, repetitive strain injuries and general calming of the nervous system. An inexpensive home unit can be purchased from Win Health www.win-health.com/neurotrac_simplex.html.
Hand-Warming or temperature biofeedback is a self-regulation skill that employs a feedback thermometer that detects skin temperature with a sensor that is attached to a finger. Paying attention to this feedback one can manipulate circulation to the extremities of the body which is often shunted in response to stress. The skill is helpful for preventing migraine headaches, arresting night sweats and general calming of the nervous system. An inexpensive Indoor/Outdoor thermometer can be purchased at a hardware or electronics store such as Radio Shack for this purpose using First Aid tape to affix the "outdoor" temperature sensor to one's finger.
HeartMath is a company that has developed a heart rate variability (HRV) biofeedback technology called emWave which analyzes the beat to beat changes in the time intervals between heart beats, a measure of physiological stress. The program teaches the user to create positive heart rhythms that have a calming and balancing effect on the brain and entire body. Mastering this "coherence" technique through a three step process and the visual and auditory feedback from the emWave can improve health, energy, mental clarity and emotional balance and is particularly helpful for improving sleep. The emWave Coherence System is available as a computer application or a hand held device. For more information go to: www.heartmath.com.
To read more about biofeedback treatments for CFS and my personal experience exploring them go to: fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html.
7. Mind Body Therapies
The physical symptoms of chronic fatigue and fibromyaliga may be compounded or even rooted in emotional stress and past traumas. A number of "mind body" therapies have proven to be helpful for many suffering from these conditions.
Ashok Gupta thinks that CFS and FMS are conditioned syndromes where the brain is stuck in a state of hyper arousal. He developed a program that retrains the amygdala, the part of the brain responsible for the "fight or flight" or stress response. His program called Amygdal Retraining Programme is available in workshops, webinars and home study DVD. http://www.guptaprogramme.com
Dr. Howard Schubiner has developed a 4-week educational course for treating chronic pain in persons with "Mind Body Syndrome" that has helped many persons diagnosed with FMS. www.unlearnyourpain.com
Emotional Freedom Technique (EFT) is a technique that combines Chinese acupressure and modern psychology by tapping on various meridian points while speaking phrases that target physical and emotional stress. This simple technique has helped many individuals process and resolve these problems. http://www.thetappingsolution.com
8. Oxidative Therapies
Dr. Majid Ali, a leader in the field of Integrative Medicine believes that all the symptoms of fibromyalgia and chronic fatigue syndromes are caused by cellular oxygen deprivation and dysfunctional oxygen metabolism. His website that discusses this theory is: www.majidali.com/oygenand.htm.
Oxidative therapies that have helped persons with CFS and FMS include ozone therapy, hyperbaric oxygen, and Exercise with Oxygen Therapy. The therapies are thought to increase oxygen levels in the mitochondria, tissues and cells; stimulate the production of white blood cells necessary to fight infections; and eliminate toxins. Ozone therapy is administered from a generator through rectal or vaginal insufflation, intervenous injections or through autohemotherapy which involves removing about one half pint of blood from the patient, adding ozone and oxygen to the blood and infusing the blood back to the patient. Hyperbaric oxygen therapy (HBOT) involves breathing pure or 100% oxygen in a sealed chamber that is pressurized at 1 & 1/2 to 3 times normal atmospheric pressure. Exercise with Oxygen Therapy (EWOT) involves exercising for 15-30 minutes a day while breathing high flow oxygen produced by an oxygen generator.
NanoVi is an innovative biophysics technology that produces a bio-identical signal known as reactive oxygen species (ROS) that initiates an oxidative response without introducing extra oxygen to the body. The therapy reverses free radical damage and increases cellular activities including energy production detoxification and healing. http://www.eng3corp.com
9. Whole Body Cryotherapy
CryoTherapy is a cold therapy that effectively reduces inflammation, muscle soreness, and pain. Treatments consist of standing in a cold chamber for 2 and a half to 3 minutes where liquid nitrogen lowers the surrounding air to minus 260 degrees F. It is used by athletes to recover faster and to heal from injuries. It is also effective in treating chronic inflammatory and degenerative conditions including fibromyalgia and chronic fatigue syndromes. Not only does the therapy decrease the pain associated with these conditions but it also can provide the catalyst for the body to reset its physiology and heal. For more information read my post fibrofriends.typepad.com/fibro_friends/2012/08/whole-body-cryotherapy.html and go to: http://lifeofmillennium.com
10. Frequency Specific Microcurrent
Frequency Specific Microcurrent is a system of treatment using microamperage current and the resonance effects of frequencies on tissues and conditions to create beneficial changes in symptoms and health. FSM is effective at treating nerve and muscle pain, inflammation and scar tissue. There is one frequency combination that has been observed to eliminate pain in fibromyalgia associated with spine trauma. Another frequency combination eliminates pain that manifests itself as chronic Delayed Onset Muscle Soreness. For more information go to: www.frequencyspecific.com and read the post "Frequency Specific Microcurent" http://fibrofriends.typepad.com/fibro_friends/2012/01/freq.html.
11. Hormone Replacement Therapy
Hormone replacement therapy or HRT involves the supplementation of the female hormones estrogen and progesterone for the relief of menopausal symptoms. Fibromyalgia Syndrome occurs most often in women who are perimenopausal or postmenopausal which suggests that decreasing female reproductive hormone levels may be involved in the development of this condition. HRT is helpful as an adjunct therapy for many women suffering from fibromyalgia. For more on this go to: http://fibrofriends.typepad.com/fibro_friends/2012/02/hormone-replacement-therapy-an-effective-adjunct-treatment-for-fibromyalgia-and-chronic-fatigue-synd.html Women as well as men may also benefit from taking testosterone which declines with age in both sexes.
12. Adrenal Exhaustion
Adrenal exhaustion is common to all CFS/FMS due to the enormous stress of living with these conditions. Mainstream endocrinologists do not diagnose or treat adrenal fatigue because there is nothing fundamentally wrong with the adrenal glands i.e. cancer or autoimmune disease. Holistic and naturopathic physicians diagnose this condition through saliva tests and treat with small amount of hydrocortisol, adrenal cortical extracts or live cell therapy for a few months to give the adrenal glands a chance to recover. Taking hydrocortisol has been helpful for those suffering from severe gastrointestinal issues as well. I have benefited from this treatment for short periods of time however my symptoms of adrenal exhaustion both experientially and as measured by cortisol levels did not resolve as a result of this. My adrenal exhaustion resolved permanentely after doing a year of LENS neurofeedback. To read more on this go to my post "Adrenal Exhaustion" fibrofriends.typepad.com/fibro_friends/2008/10/adrenal-fatigue.html
Identifying "hidden" food and chemical allergens and eliminating them can make a significant difference in the health of persons with chronic illness including chronic fatigue and fibromyalgia. The enzyme-linked immunosorbant assay/activated lymphocyte cytotoxicity test or ELISA/ACT is a valuable diagnostic test as well as the exclusion diet. Some persons have reported a relief from fibromyalgia-like symptoms by avoiding night shade vegetables.
14. Low Dose Naltrexone (LDN)
The drug Naltrexone was originally approved in a high dose for the purpose of helping heroin or opium addicts by blocking opioid receptors. When taken at a much smaller dose it has the effect of boosting a body's immune system by causing an increase in endorphin and enkephalin production. LDN is helpful for a variety of conditions that are triggered by a deficiency of endorphins including cancer, HIV/AIDS and autoimmune diseases as well as persons with CFS and FMS. LDN is safe, inexpensive and has no reported side effects. For more information go to: http://lowdosenaltrexone.org/ and read my post http://fibrofriends.typepad.com/fibro_friends/2011/10/low-dose-naltrexone.html
Earthing is the practice of connecting with the energy emanating from the surface of the earth by standing or walking barefoot on the ground; or through the use of floor pads and conductive bed sheets linked by a wire to a ground rod outside or plugged into a wall outlet with a ground system. Reported benefits of Earthing on a regular basis include improved sleep, increased energy, improvement or elimination of symptoms of auto immune and inflammatory disorders, accelerated recovery from intense physical activity, normalization of the body's biological rhythms, reduction of jet lag, relief from hormonal and menstrual symptoms, and protection against environmental electromagnetic fields (EMFs). Some persons with CFS and FMS have reported dramatic improvements in their conditions especially in the area of sleep from Earthing. Others including myself appear to be hyper sensitive to Earthing products, which aggravate symptoms. To learn more about this read my post on Earthing at: fibrofriends.typepad.com/fibro_friends/2011/01/earthing-healing-from-the-ground-up.html . For more information and to order Earthing products go to: www.earthing.com.
16. Electromagnetic Pollution
Many chronically ill persons including those with CFS & FSM are sensitive to environmental stresses from man-made radio frequencies (RFs) and electromagnetic fields (EMFs). They may be sick due to living in close proximity to a cellular tower; and may be particularly sensitive to the radiation coming from wireless devices, computers and microwave transmissions including microwave ovens and cell phones. Safe Living Technologies Inc. is a company that provides a lot of good information on the subject as well as technology and products to evaluate and protect your home from electromagnetic radiation. http://safelivingtechnologies.ca/ There are a number of other companies that sell products that claim to provide protection from the adverse effects of "electrosmog" including www.earthing.com (see strategy #6), http://earthcalm.com/ and http://mystressblocker.com however their effectiveness varies with each individual and the science behind them is controversial. The MRS2000 is a pulsed electromagnetic field therapy (PEMF) device designed for personal use that simulates earth based frequencies using more sophisticated and expensive technology. A good site for information on this is: http://gaiaresonance.com. I discuss electromagnetic pollution and PEMF therapies in my post: http://fibrofriends.typepad.com/fibro_friends/2011/03/energy-medicine-of-the-future.html .
17. Low Intensity Laser Therapy
Low Intensity Laser Therapy also known as Cold Laser Therapy and Phototherapy is a noninvasive therapy that utilizes light emissions from a laser diode or super luminous diodes to help facilitate healing and relieve pain in injured or damaged tissues. It has proven to be effective in a variety of conditions including tendonitis, musculoskeletal injuries, wounds, rheumatoid arthritis and diabetic neuropathy. I used a system facilitated by a chiropractor called BioFlex Professional System manufactured by Meditech International Inc. www.bioflexlaser.com which was moderately helpful for my fibromyalgia muscle pain and plantar fasciitis. To read more about laser therapy go to: fibrofriends.typepad.com/fibro_friends/2010/07/phototherapy-healing-with-light.html
Glutathione is the master antioxidant found in every cell of the body. It is responsible for transporting proteins between cells, detoxifying chemicals and environmental pollutants, activating the immune system and regenerating a variety of other antioxidants. Chronic Fatigue and Fibromyalgia patients have low levels of glutathione and this causes some of the symptoms associated with the disorder including brain fog. Taking glutathione orally is ineffective because it is destroyed by stomach acid. Some physicians treat chronically ill patients with glutathione injections or include glutathione in a intravenous solution with vitamins and minerals. These therapies are expensive and their effects immediate and short term. There are supplements that can increase the production of glutathione including vitamin C, alpha lipoic acid, milk thistle and N-acetyl cysteine. Dr. Robert Keller, a doctor who treated many chronic fatigue and fibromyalgia patients developed after 10 years of research a glutathione optimizer, which is a patented formula of supplements called MAXGXL. To order his original formula go to: http://robkellermd.com/link.php?go=glutathione.html&affid=67246. A more recently developed product produced by Max International Corporation called MaxONE contains RiboCeine, a patented combination of D-Ribose and L-Cysteine developed after 25 years of research by the Japanese scientist Dr. Nagasawa. RiboCeine has also shown to be effective in raising glutathione levels. For more information go to: www.maxgxl.com.
Another nutritional product sold through network marketing that can boost glutathione is Immunocal. This patented natural protein derived from whey helps the immune system and supplies the body with amino acids. http://www.immunotec.com/IRL/Public/en/USA/ShowItemDetails.wcp?&Item=00010000
An alternative method is using a nonotechnology homeopathic patch that stimulates acupuncture points to increase the production of glutathione. For more information go to: www.lifewave.com.
To learn about my experience exploring the detoxification issue go to fibrofriends.typepad.com/fibro_friends/2009/05/detoxification.html.
To download interesting articles written by Rich Van Konynenburg, Ph.D.,an independent researcher about the role of glutathione depletion in Chronic Fatigue Syndrome" go to: www.aboutmecfs.org/Trt/TrtGSHIntro.aspxaboutmecfs.org/Trt/TrtGSHIntro.aspx.
19. Protein Deficiency
Fibromyalgia patients have chronically low levels of amino acids and are deficient in systemic protein, which provide the materials to maintain, protect and repair body functions. This is most likely due to low production of stomach acid and digestive enzymes, and inflammation in the gastrointestinal tract, which makes it difficult to completely digest protein, carbohydrates and fats. Increasing stomach acid by taking hydrochloric acid capusules or apple cider vinegar with or before meals and taking digestive enzymes after meals can improve the body's digestion and its production of amino acids. Alternatively one can purchase amino acids in the form of dietary supplements. A chiropractor named Dr. Brice Vickery has developed a patented formula of amino acids called “Platinum Plus Essential Amino Acids” that is beneficial in addressing protein deficiency and improves many of the symptoms of fibromyalgia. To learn more about this read my post “Protein Deficiency” fibrofriends.typepad.com/fibro_friends/2009/01/protein-deficiency-fibromyalgia.html.You can order the amino acids at: www.supernutrient.com. Some persons with fibromyalgia have reported an improvement in sleep and pain by taking collagen hydrolysat, a food supplement made from an animal collagen protein formula, manufactured by Nutr-Diem, Inc. under the brand name "Colorad".
20. Infections & Complicating Conditions
CFS/FMS patients are prone to a variety of infections and conditions including yeast overgrowth or candida, intestinal parasites, heavy metal toxicity and mercury poisoning, viral, retroviral and mycoplasma infections, and Lyme disease and its co-infections. This is due to lack of oxygen, inflammation in the gastrointestinal tract, low levels of stomach acid, depletion of glutathione and stress. These conditions can be treated by a good holistic physician using herbs, courses of antibiotics and probiotics. An interesting website that discusses research on chronic infections is www.immed.org. Fry Laboratories is an idependent clinical diagnostic and research laboratory dedicated to the study of chronic disease that provides testing for pathogens associated with these conditions. http://www.frylabs.com To read about other approaches to improving the immune system read the post "Unconventional Approaches for Improving the Immune System" http://fibrofriends.typepad.com/fibro_friends/2013/05/unconventional-approaches-to-improving-the-immune-system.html
21. Atlas Profilax
Atlas Profilax is a physical therapy developed in Switzerland by Rene-Claudius Shumperli, which employs a vibrating instrument that massages the sub-occipital muscles of the neck. This results in a freeing and relocating the first cervical vertebra or atlas. The treatment is gentle, safe and usually permanent typically requiring only one session. Cost for the treatment and follow-ups is $250. Although the treatment was not helpful for me, I know of a few people who got significant improvement in fibromyalgia symptoms from it. To read about their experiences check out the post "Atlas Profilax" fibrofriends.typepad.com/fibro_friends/// . For more information on the procedure and to find a practitioner go to: www.atlasprofilax.ch/.
22. Lymphatic Dysfunction
The lymphatic system is a specialized component of the circulatory system which functions to remove excess fluids from body tissues, absorb fatty acids and produce immune cells. FMS patients have a sluggish or restricted flow of lymph resulting in mild edema. Some people have experienced a decrease of symptoms by taking decongestants and expectorants such as guaifenesin. An alternative treatment is using an electronic vibrational massage instrument called Lymph Star Pro that facilitates lymph drainage. The device is manufactured by Arcturus Star Products www.arcturusstar.com. Low Intensity Laser Therapy (see strategy #6) and EMG biofeedback (strategy #5) are also therapeutic for lymph function.
23. Physical Therapies
I have explored a variety of physical modalities extensively in my search for better health including many kinds of acupuncture, massage, Rolfing, cranial sacral work, Tragger, chiropractic, Reiki, etc. I have found two forms of physical therapy to be particularly beneficial: Feldenkrais and Bowen Work. Both these therapies are very gentle and noninvasive which is important for CFS/FMS patients who can overreact to more aggressive treatments. Feldenkrais addresses patterns of movement and posture that can cause pain. Its practitioners are well educated and can help individuals attain the most efficient and stress free way to move, stand and sit as well as an overall awareness of one’s body. For more information and to locate a practitioner go to: www.feldenkrais.com. Bowen Work stimulates healing through subtle moves that release tension in specific areas of the body and restore physical balance. For more information and to locate a practitioner go to: [email protected]. Both therapies activate the sympathetic nervous system and are excellent adjuncts to healing. Many people including myself also benefit from regular chiropractic adjustments. I also highly recommend The Miracle Ball Method, a program of "unexercises" developed by Elaine Petrone to heal chronic pain. www.elainepetrone.com
Exercise is a tricky and sometimes impossible activity for persons with CFS/FMS depending on the severity of the condition. Overdoing it can result in a flare-up of symptoms and compound the exhaustive state. Mild exercise and movement such as walking, yoga and Tai Chi well within the limits of one's capacity for exertion however are beneficial.
24. Stress Management
The challenge of living with conditions that cause ongoing fatigue, pain and insomnia is huge. Persons with CFS/FMS are under incredible stress physically and therefore have a low tolerance for additional stress in their personal lives. They need to learn to pace their activities and to make good decisions whenever possible about relationships, work and lifestyle that minimize personal stress. I have been very fortunate to have people in my life who are supportive and understanding and to not have to solely support myself financially. I have benefited from learning meditation, relaxation and biofeedback self regulation skills. I also have built into my schedule a half hour “nap” after lunch that is a lifesaver.