CHRONIC FATIGUE SYNDROME:
A Discussion

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diagnosis and treatment by a qualified, licensed professional.

MICHELE GALANTE, MD: People will go for diagnoses. They'll go for tremendous studies and tests. And what happens is they'll come back. They'll come into my office saying, I went to the greatest clinics in the entire world and paid a tremendous amount of money. And they come in with a big package of papers saying that I've got this, this, this and this but they say that they can't help me. It's really the dilemma of modern medicine. 

NEENYAH OSTROM: Because of this terrible lack of definition muddle that the government has created around this illness, it's very hard for physicians and for patients to figure out how to proceed.

GERALD GOLDBERG, MD: How does a patient decide whether or not, who, which doctor, what source of information does he rely on? How do they establish trust in a system that is becoming too complex for them ultimately to understand?

MAJID ALI, MD: I have two prophecies, Gary. First, chronic fatigue is going to be the dominant chronic problem of the twenty-first century. I make a second prophesy. Chronic fatigue, more than any other infectious disease, more than any other viral disease, is going to push the present model of disease doctors practicing drug medicine to holistic doctors.

GARY NULL, PHD: Hi. I'm Gary Null. Chronic fatigue and fatigue is a major problem in the United States. Millions of Americans just don't have the energy they once had. You can go from having just a little bit of energy to maximum depletion in bed, unable to function.

This program will explore the different causes and natural therapies to help people, both nutritional and psychological. Join us now as we take a look at chronic fatigue, a natural approach.

 

CHRONIC FATIGUE SYNDROME: A NATURAL APPROACH

Neenyah Ostrom: Chronic fatigue syndrome is very difficult for your average doctor to diagnose because the government agency that is charged with defining chronic fatigue syndrome has created such a misleading definition that nobody can figure out what this illness is supposed to be. And, in fact, in late November, there was a meeting at the Centers for Disease Control to discuss changing the definition of chronic fatigue syndrome. What the CDC researchers want to do is basically to define chronic fatigue syndrome out of existence. What they want to do is broaden the definition so that anyone who is tired is said to have chronic fatigue.

In fact, if you speak to any clinician who sees a lot of chronic fatigue syndrome patients, they will tell you that it is very easy to diagnose. They can usually tell within moments of talking to a patient whether that patient actually has chronic fatigue syndrome or not because the symptom complex is so unique.

ANDREW GENTILE, PHD: Chronic fatigue syndrome is a non-degenerative, debilitating disorder which causes fatigue and has flu-like symptoms. The fatigue is just not a normal tiredness. This is an exhaustion which is accompanied by a feeling of unwellness. And often patients are bedridden for months on end.

The other symptoms that accompany this syndrome--and we are talking about a collection of symptoms when we talk about a syndrome, not necessarily a disease entity--have to do with sleep disturbance. So, patients often complain of not being able to fall asleep. If they fall asleep they can't stay asleep. Almost always patients complain of not being able to feel refreshed or restored after much sleep.

The other symptoms which are highly debilitating have to do with cognitive symptoms and intellectual functioning. Patients will walk from one room to another and not be able to remember why they were there. They will feel they can't remember the name of a colleague they've worked with for years so there are memory difficulties. There are difficulties in concentration. Patients often complain of high distractibility and the inability to read complex material. So there are cognitive symptoms. There are sleep disorders and there are flu-like experiences that the patients feel so that they have frequent sore throats, tender lymph nodes and often fevers and chills.

 

GARY NULL, PHD: Why is it that for almost ten years Americans suffering from debilitating fatigue were not recognized as having legitimate illnesses? They simply said chronic fatigue syndrome doesn't exit. And then suddenly it does exit.

 

DEAN BLACK, PHD: Well, you know, I believe that you have to go back to the fact that this has been going on longer than just the past decade. It may be true that ten years ago people suffering from fatigue were sort of set aside as being victims of a psychological disorder. But the fact of the matter is you can go back into the late part of the nineteenth century and you'll discover, women especially, suffering then from nervous disorders, nervous weaknesses and so on and so forth. There were clinics set up to try to heal them and cure them and so on and so forth. And all was the search for the cause. But the cause was never able to be discovered. Without a cause you have to say this disease has no cause. Whatever has no cause is in the patient's mind. So, the idea that chronic fatigue is in the patient's mind is not a new idea.

 

NEENYAH OSTROM: Because chronic fatigue syndrome is so poorly defined and because there are still debates within certain sectors of the government, in particular, about whether it exists or it is simply a type of depression, very few therapies have even been tested for chronic fatigue syndrome patients.

 

ANDREW GENTILE, PHD: It's very important to make a differential diagnosis between chronic fatigue syndrome and other disorders. Since chronic fatigue disorder has no known cause it's very important that you rule out any other disorder that might explain the fatigue. In fact, the case working definition that's used by the Center for Disease Control to diagnose chronic fatigue requires, as a major criteria, that you exclude all other possible illnesses of which there are many since fatigue is so ubiquitous across illnesses. Anemia, low thyroid, hypoglycemia, quite a variety of illnesses have to be ruled out clearly.

 

DIAGNOSIS OF CHRONIC FATIGUE SYNDROME

MARTIN FELDMAN, MD: The first step in the analysis of any patient who comes with fatigue, whether it be mild, moderate or severe is to profile their, in my view, five major categories or five major possibilities for the fatigue.

Number one is the immune thyroid breakdown leading to low adrenal function. Almost all fatigue people have a low adrenal function once you learn how to test the adrenals properly. We'll get to that in a moment. Number two, a large proportion, perhaps less than half, have also thyroid imbalance in the bargain. That's two major issues. Number three, you have to test for B vitamin deficiency. Number four, you have to test for hypoglycemia. Number five, cerebral allergy. But in those five is maybe 85 percent of all people who have fatigue.

The next phase is the testing of the thymus, the spleen and the lymphatic system. This is very simple and yet it's very hard because you have to use electrical energies. You could test the thymus by T and B cell counts in the laboratory. That's easy to do but it's very expensive. And that would be another way to do this. But in daily practice it's very simple to test the thymus' electrical energy. And also you can do the spleen's electrical energy and the lymphatic electrical energy. Beyond the electrical energy, when we have a circuit, let's say a weak thymus circuit, we can then try any aspect of therapy in the weak circuit for resonance so that an herb could be tested, a homeopathic could be tested, a thymus glandular could be tested, in a weakened thymus circuit to obtain a resonance which will support or help the circuit to come up.

 

ANDREW GENTILE, PHD: I would suggest, in short, that if you feel you have chronic fatigue disorder you should ask yourself the following simple questions. Firstly, are you not just tired but are you debilitated and exhausted for more than six months and there's no known reason for it? Secondly, you've seen a physician and he can't find any physiological cause or other illness that causes this. Thirdly is pronounced sleep disorder. You can't get a good night's rest and feel restored upon waking up and this persists over time. Fourthly, that your stress tolerances are very low. That is, if you take a short walk, if you look at physical stress, or if you go back to any sport, and you feel, anywhere within moments to 72 hours after doing that, vaguely ill, tired again, and you seem to revert back to these flu-like symptoms of exhaustion, that you may want to then consider yourself for a more thorough assessment with a physician.

 

MAJID ALI, MD: I think most physicians, Gary, have a tendency to focus very narrowly on just one or two aspects of the clinical problem. And if I had to characterize the basic principle of my work, that is that I don't think in chronic immune problems or chronic degenerative problems the diagnosis is terribly important. I think that what is important is, how does the patient describe the suffering and how many different things can we do at the molecular energetic level to relieve the suffering and restore health?

I've seen people who have had their lives devastated from chronic fatigue. We've gone through more drugs--steroids, antiviral drugs. With each drug, even Nystatin, they get better usually and then they nosedive.

So what we do is basically... do you play chess? Wonderful. You know, in chess, the queen is the most powerful piece. And pawn is the weakest piece. Yet, you and I know and all the chess players know that in any given board the weakest piece, the lowly pawn, can take the most powerful piece, which is the queen. So it is reading the board. I think a holistic physician, first and foremost what he needs to do with people who have severe illness, is read the board. I call it the oxidative board. And then decide, shall I first work on choices in the kitchen? Shall I first work on meditations, self regulation, slow breathing, create some hope, let them talk to other patients, come in and take a workshop?

 

DEAN BLACK, PHD: We need to go back to the origins of medicine's power base which is its scientific model. This actually began back in the days of Renee Descartes who, in essence, proposed the doctrine of universal doubt which was that we can know nothing at all without a particular scientific method. Descartes would have people explain ideas to him and he would say but I can explain that away by this and this and this. And when he could explain things away there was some doubt remaining. So what Descartes said was, we can only know if we have a scientific method that will define the truth in a rational cause and effect fashion.

Now that scientific method had certain rules one of which was it had to be a straight line cause and effect between a single cause and a single effect. If you deviate from that you introduce so much complexity that the idea of certainty is lost.

Medicine's power base is the idea that its certainty depends upon the idea of a single linear cause and effect relationship. And this is why whenever medicine puts its theories to work it's always looking for a single cause--this is called the theory of specific etiology. In the case of Epstein Barr they discovered this was a marvelous discovery because it seemed to justify their theory of a single cause. And yet, as you pointed out, everyone can have Epstein Barr. Epstein Barr is not the cause. The fact of the matter is, chronic fatigue is caused by many, many factors operating together.

That very idea is excluded by the scientific method that really is unable to come to grips with multifactorial diseases. So, medicine's reluctance to accept multifactorial explanation comes from its claim to absolute truth which can only be sustained with utter simplicity. Simplicity requires one cause, one effect.

 

CAUSES OF CHRONIC FATIGUE SYNDROME

ANDREW GENTILE, PHD: Most practitioners now have a much more holistic multi-causal approach and model for this disorder. There's a feeling that the single cause is probably not explanatory enough and that in the world of treatment it really is, at this point, important to begin to manage the symptoms rather than to continue to search for the single cause which is really the charge of scientific medical research.

 

MARTIN FELDMAN, MD: Chronic fatigue syndrome, which is an entity of severe, severe fatigue defined as 50% reduction in capacity, is

part of a spectrum of low energy; it's at the very severe end. In my experience, from a clinical perspective, it always has two factors. Number one, there is a viral infection, either reactivated or new, and often a history of a flu-like episode, but not necessarily, and there are many viruses involved, not just one. This mixed viral syndrome diminishes or impairs immune function. And then somehow this immune imbalance pulls down hormonal function such that almost all patients with severe fatigue states have low adrenal function and many have low thyroid function. So we have here a hormonal mixup which is the root of an energy lack. But behind the scenes is this mixed viral immune problem which is pulling down the hormonal system.

 

NEENYAH OSTROM: What is probably the most likely cause of chronic fatigue syndrome is a virus that was first found in AIDS patients, a virus that was called human herpes virus 6. This is a very interesting virus because there are two types of the virus, one of which is found very widespread in the population, the other which is found in people who have cancer and chronic fatigue syndrome and AIDS and other immunological problems. That virus appears to be able to attack the immune system very, very successfully. I believe that it is going to be found to be instrumental in causing not only chronic fatigue syndrome but also AIDS and probably some forms of cancer.

 

ANDREW GENTILE, PHD: There has been a plethora of studies on viruses and much work continues to look at viral agents. One theory is that there is a single viral agent. You may have heard about chronic fatigue being called a number of other things. One of those things was Epstein Barr or mononucleosis which is caused by Epstein Barr or chronic mononucleosis.

Epstein Barr was first believed to be a cause of this. An interesting turn of events in which a laboratory in Philadelphia that exclusively studies Epstein Barr was doing a study in which one of the lab assistants was negative for current and acute Epstein Barr virus. In the course of the study, this particular technician developed symptoms that were strikingly similar to the CDC list of symptoms coinciding with chronic fatigue syndrome. This person was tested at that time and at that point showed positive for Epstein Barr virus. So, we had the first case in which a person went from an EBV negative to an EBV positive viral titre and at the same time had all the clinical symptomatology. That began the flurry of studies investigating Epstein Barr. We now know that since we don't get very high correlations between the symptoms of chronic fatigue and Epstein Barr seratological titres that Epstein Barr is probably not the cause. We also know that Epstein Barr is widely distributed in the normal population and most people have Epstein Barr by the age of eight. So, it's not a clear discriminator between those who have chronic fatigue and those who would not. We would expect many more people to be ill with chronic fatigue if in truth it was their Epstein Barr's virus that was causing it. As a result, this particular single viral agent, Epstein Barr, as the cause of chronic fatigue, has fallen into disfavor.

Several other candidates have been carefully studied, including HHV6, by the National Institutes of Health. This is Human Herpes Virus 6, formerly called HBLT, a B-lymphotrophic virus. The same fate followed this virus. Basically, the studies showed that this is a very widely distributed virus and therefore couldn't be considered a clear distinguishing single viral agent for the disorder.

There are many others. The (unintelligible) virus is now being studied in California. Wistar, a very renown laboratory research institute in Philadelphia, is studying a retrovirus HTLV2. And the studies for viruses continue.

 

NEIL BLOCK, MD: Some of the viruses that have been implicated in types of fatigue syndromes have been cytomegalovirus, Epstein Barr virus, herpes virus in addition to several of the other lesser commonly known viruses such as chronic adenovirus, cocsackivirus, enterovirus and probably another half a dozen. The one that has received the most attention, the Epstein Barr virus, has not panned out to be the total answer here. Indeed, in some people it only plays a minor role or even no role at all. But it can't be dismissed and most cases deserve an Epstein Barr or viral titre to determine the antibody status, susceptibility and resistance, current or past infection to the Epstein Barr virus.

In addition, the other viruses that have been implicated are long lasting sequela or aftermath of hepatitis viruses, mononucleosis viruses. In addition, influenza virus has been known to cause chronic fatigue syndrome for two, three, four or five months subsequent to the body supposedly healing.

 

MAJID ALI, MD: The fundamental difference that I think exists between those of us who are very holistic in our thinking is that... listen, it's very enlightening just to look at Epstein Barr. I came from Pakistan and, you know, in Pakistan nobody had a kissing disease. Because of the poor sanitation all of us got exposed to Epstein Barr when we were children. We had strong, intact immune systems. So our immune systems fought off the Epstein Barr and we acquired a certain resistance.

Now, in this country people used to get infectious mono or Epstein Barr; it's the same thing. They would get it in college or high school. They would have so-called kissing disease. They would be sick for four or five weeks. They would lose some weight and be tired for a couple of months. And then they snap back.

We did not have the pandemic that people in their thirties and forties... they have good jobs, they're under a lot of stress, their nutrition is awful, they are physically not fit... and now comes Epstein Barr. And it floors them.

The problem is not that the virulence of Epstein Barr virus has changed. The problem is that their molecular defenses are shattered. Their body ecosystems are battered. They have no ability to fight back. So now the virus replicates and replicates. So whether the Epstein Barr virus for a given person is a devastating terminal injury to their immune system or whether it is just an ordinary garden variety depends upon the defenses. You give Epstein Barr to little children, they generally survive very well. In fact, most people don't even know when they have Epstein Barr. So, the issue is not so much the virulence of the virus but our own defenses.

 

ANDREW GENTILE, PHD: The current feeling among practitioners, however, is that probably a single virus doesn't cause this illness. I'm going to use my words carefully to distinguish between cause and trigger. Many of the practitioners feel that, in truth, a virus may trigger a cascading set of events in various systems in the body that we've mentioned: neuroendocrine, cognitive, hormonal. And we have many studies showing that there are a variety of abnormalities in these areas. But it's as though if there are viral agents causing this or triggering it, they then quickly hide within the normal cell as is the case of viruses and produce such havoc in other systems. Namely the abnormal immune system of chronic fatigue suffers is an area that cannot really be unaddressed by most researchers and even by most disbelievers.

There are so many abnormalities in the immune system. Recently there have been studies with two thousand patients showing something called circulating immune complex is abnormal. In Japan they have found low natural killer cell and they call this an almost link because of that. There are many studies in Australia showing problems in the immune system.

It is as though a virus triggers the immune system and the immune system can't find its way back to homeostasis. It fails to self-regulate. And then, each time a toxic load from the environment, from food allergies, from reactivated viruses in the patients' history, of which most patients have one to three herpes or herpetic viruses that get reactivated, the flare-up and the relapse, reproducing all the symptoms reoccurs and reoccurs frequently.

These relapses then compound themselves. If a person is not sleeping every night, then symptoms like exhaustion, like deranged immune system, which we now know seems to dovetail nicely with ninety minute circadians. When we're sleeping we have a REM cycle that's every ninety minutes. It's the time our body is synthesizing proteins. The immune system works lock and key with this timing. And if you have a sleep disturbance caused perhaps by a virus or set of viruses in this disorder, then also your sleep will be off and in turn your immune system will be off.

So, most practitioners now have a much more holistic, multi-causal approach and model for this disorder. There's a feeling that the single cause is probably not explanatory enough and that in the world of treatment it's really, at this point, important to begin to manage the symptoms rather than to continue to search for the single cause which is really the charge of scientific medical research.

 

MAJID ALI, MD: The immune system gets injured primarily by four different mechanisms. Either there are some environmental agents--mold allergy, for example, chemical sensitivities, formaldehyde--or it gets injured by nutritional aspects, not in the narrow sense of nutritional deficiencies. Or the third possibility is the stress element and the fourth is the problems of lack of physical fitness. In my clinical management I emphasize all four areas with equal emphasis.

 

MICHELE GALANTE, MD: It has been my experience that most of the patients that I have seen have been very allergic. They are allergic to not only pollens and airborne agents, such as trees and grasses and so on, but mostly for foods. Also, tremendous chemical sensitivities. People are so sensitive to chemicals, some of them, that they cannot be exposed to perfume or to nail polish or paint thinner or even a freshly painted room or, gas fumes, carbon monoxide fumes. Some people are so weak that an exposure to these items for a short time can throw them into a headache or a very weakened conditioned or even emotional states. Chronic fatigue is very much connected with allergy and chemical sensitivities.

 

NEENYAH OSTROM: People who have chronic fatigue syndrome, like people who have AIDS, often develop allergies when they have never had allergies in their lives before. They will develop very severe sensitivities to medications, for instance. They will develop food sensitivities they never had before. And what happens in both AIDS and chronic fatigue syndrome is that while one portion of the immune system shuts down, another portion of the immune system, the portion that causes allergic reactions, is revved up almost 100 percent of the time. These people respond immunologically to things that before they got sick their immune systems wouldn't even have recognized.

 

MICHELE GALANTE: Chemicals are pervasive in our environment. Aside from the preservatives in our foods and colorings and so on, it's everywhere. In the water we have chlorine. In the air we have all types of pollutants. These are items that were not in our systems, say fifty, sixty years ago. It's been a recent phenomenon from technical advances. And chemical influences from dental work. Amalgam fillings are tremendously influential in weakening the system.

Any one of these items taken alone wouldn't necessarily have as much of an influence as when you take them in on a daily basis for years and years. Add them up and you find that the body is becoming overloaded. The liver is becoming overloaded. The immune system is becoming overloaded. And they take their toll. Electromagnetic influences aren't talked about very much. I know that many people believe, as I do, that cathode ray tubes, CRTs, computers, on a daily basis, watching these things all day long in the office and so on, have the potential of influencing the electromagnetic fields of the body. These are influences which aren't talked about that much. More and more they are being talked about: Cellular phones, not to mention radio waves which are transmitted, TV waves, things which didn't exist in the environment.

 

MAJID ALI, MD: My most important lessons come from children. I'll see a child with fatigue, with allergies, attention deficit problems, Dr. Jekyll/Mr. Hyde state in the classroom, they are in special schools. You do the test. They are allergic to eggs, they are allergic to dairy, they are allergic to wheat, they are allergic to peanut. What do you feed them? Their moms are ready to collapse.

You talk to the same mother six or nine months later. She now knows all the other wonderful options in foods that we have. The child resisted in the beginning, fought hard. Then began to clear up. Somebody's birthday came; he nose dived. Then he began to clear up. Halloween came; he nose dived. How many times does a child have to be hit on his head to know that foods are making him sick? So, it's a process of enlightenment.

 

MICHELE GALANTE, MD: The diets which we have today, with the processing of our foods, are contributing tremendously to the problems. Let me elaborate. For example, processed foods, such as white sugar, white flour, hydrogenated products, chemical products, chemicalized foods, manufactured foods, lack vitality. Most people are eating these things in far too great a quantity for convenience or whatever reason because of our society and its fast pace.

Many of the cases that I've had, the less extremely severe cases, respond often very favorably, very quickly, to the removal of certain foods from their diets such as sugar, processed cane and beet sugar. Even fructose sold in the health food stores in the processed form is not too good. Or even boiled honey is going to cause hypoglycemic type reactions and cause this moodiness, swings of energy, swings of emotionality.

 

NEENYAH OSTROM: I think that doctors should advise their patients to be healthy in every way that they can and that of course includes diet. I think that we're going to discover even more than we know already about chronic fatigue syndrome patients developing yeast infections like candida infections, exactly like those that are developed by AIDS patients. I think that because their immune systems are damaged in virtually identical ways they are going to develop these opportunistic infections that cause them exactly the same kinds of problems.

 

NEIL BLOCK, MD: Another main problem for chronic fatigue syndrome, but again very rarely found alone, would be candidiasis. And whether it's the more external form of candidiasis on the surface of the body or going towards the mucal membrane candidiasis found in the mouth and sinuses, the anal and vaginal areas, or whether its more of the internal candidiasis, which in some cases can actually turn a special serum candida antibody test positive and indicates the chance of it being related to a fungemia. A fungemia is fungus in the blood stream which is a very, very serious state.

 

MAJID ALI, MD: Don't go looking for doctors who will cure your yeast. Yeast is with us. The good lord put it in us for good reasons. So, number one, don't look for people who will cure it. You want to go for gut balance. You want to restore the gut ecosystem.

Candida is just one. When I test my patients I test them for nine different types of yeast. Candida is just one of the nine. You know something? We just did a study. Candida is not the number one yeast in the intestine in terms of antibodies to it. It happens to be aspergillus and after aspergillus is ultimaria. But candida is number one in terms of total population.

 

MARTIN FELDMAN, MD: The overlooked area of nutrition, even among the nutritional community, is the testing for absorption and digestion. And it's a shame because many, many persons, even people who have no obvious illness or even a hint of illness are not absorbing efficiently. It's very simple. There is the stomach acid phase, the first phase of digestion, commonly, especially in persons over the age of 40, commonly suboptimal. The second phase is the duodenal pancreatic enzyme production which is also commonly faulty or suboptimal but less so than the stomach acid. And the third real major phase is the small intestine itself which has to absorb the nutrients efficiently. It's occasionally off as well. These three can be tested in many ways but the simplest way is via muscle testing to determine the energy of the muscle of the stomach acid circuitry or the pancreatic enzyme circuitry.

 

PAVEL YUTSIS, MD: How can one understand the theory of metabolic immunodepression and what it has to do with chronic fatigue immunodysfunction syndrome? First, level of glucose will go up that bring upon a phenomenon called hyperglycemia or high level of glucose in the blood that will cause, subsequently, increased level of insulin, so-called hyperinsulinemia or increased level of insulin in the blood. And because of the poor utilization of glucose, fatty acids come to the scene and their level in the body will be increased in order to provide sufficient energy. So level of fatty acids will be increased and subsequently, level of triglycerides, or so-called hypertriglyceridemia, or increased level of triglycerides, will occur. At this point, the immune system will be depressed because the immune system needs a new army of t-lymphocytes which will not be produced due to the derangement in the carbohydrate and lipid metabolism.

 

NEIL BLOCK, MD: More commonly, nutritional causes of fatigue syndrome have to do with deficiencies. Deficiencies can be broken down into several areas. We'll start with the B nutrients which have been shown to be in higher need in people with less than perfect life styles, of course the drinkers, smokers and people who are not breathing the best air. People who have been toxic for other reasons do require more B vitamins than others. Again, even if you're assigned to take one or two or three specific B vitamins in excess of the normal, remember, you still have to be on a multi B or B complex to make sure that none of them begins to get scarce in the body. Not only are they individually important, they're important to be taken concomitantly.

Another more frequent cause of nutritional deficiencies would be relative deficiencies in vitamin C and in some cases I feel E also, especially if we're dealing with immune system dysfunction with regard to defense.

I'd like to include in other deficiency states, being low in vitamin A as well as beta carotene. We must remember that vitamin A tends to be more of an antibody enhancing vitamin than its progenitor betacarotene.

Another cause of nutritional deficiency diseases, either causing or contributing to a fatiguing syndrome, would be lack of minerals. The minerals most important here are both the macrominerals such as calcium, magnesium, potassium and the trace minerals, especially the ones that are necessary for our organs and hormones, such as iodine and chromium, in some cases boron, molybdenum, vanadium, copper, selenium and chromium.

Moving along to the third reason for chronic fatigue syndrome are tendencies toward hormonal imbalance. In my practice, the one I see most would be thyroid imbalances and the most likely one of that is idiopathic hypothyroidism. Idiopathic is the medical term that implies that even the doctors are idiots for not being able to find the cause of it. Indeed, it tends to be found in females 6:1 over males at least and tends to come spontaneously some time between the age and 20 and 50 although it can come at any time for very often unknown causes. Indeed, the rare causes that are known are something like particular super amounts of iodine excess or an under ingestion of iodine which is unlikely in our society that now uses iodinated salt.

Other rare reasons would be a person consuming too much of the cruciferous vegetables such as broccoli, cauliflower, cabbage or brussel sprouts, which tend to bind the active ingredient and inhibit thyroxin production.

Another hormone that's frequently out of normal range when I'm treating people with chronic fatigue is that of the adrenal gland. Indeed there are many tests one can run on the adrenals, no one of which is a perfect test because we have to remember that the adrenal is really two organs in one. The adrenal medulla found on the inside is making relative amounts of adrenalin and its brother noradrenalin. And then the adrenal cortex or the outer coating is making things cortisone-like, related to our immune system and blood sugar control as well as mineral corticoids which include aldosterone and other fluid water retention. And the last thing that the adrenals are very important for, the third zone of the adrenal cortex, is the zone that modulates the male/female hormones that are in conversation between our pituitary gland and our primary sexual organs.

Lastly, indeed, some patients with chronic fatigue have imbalances in their gender hormones. It is not unusual for a female to have estrogen imbalances or other things that govern ovary functioning such as FSH hormone from the pituitary, LH hormone from the pituitary and prolactin from the pituitary.

But there are patients that come with other medical complaints such as lack of having menstrual periods or milky discharge from the breasts, breast tenderness, or infertility, or more menstrual cramps than usual, or worse PMS. Indeed every month I get one or two men that come out very low on the testosterone blood scores. Importantly, one must do the percent of free testosterone to validly interpret that test. And these men can sometimes make great strides when given carefully judicious doses of male androgens, things related to the testosterone family.

 

MICHELE GALANTE, MD: The influence of allopathic drugs or conventional drugs and antibiotics and so on, steroid usage, is a major factor, in my opinion. The use of these drugs in childhood, for example, the abuse of these drugs in childhood can set up a chronic weakened condition which will extend into adulthood and contribute to the overall predisposition to chronic fatigue. These drugs are suppressive in nature. They are really not, in a sense, curative. They impose upon a system an illness in itself. I think that probably of all these factors, this may be one of the largest factors.

 

MAJID ALI, MD: I saw one patient two days ago, a young person with chronic fatigue. He went to one of our medical schools in one of the fatigue clinics. He was given a prescription for steroids. He was given a prescription for Amantadine. He was given a prescription for Psychobel.

We know steroids suppress the immune system. Everybody knows that. So, why would anybody want to use steroids? Do you know why? For a couple of weeks, steroids can create euphoria, a sense of well being. It's a false sense of well being but it is a sense of well being. So, if the patient is not enlightened enough, he will take the steroids. But if you give an enlightened person steroids for fatigue, he will reject it.

 

PSYCHOLOGICAL FACTORS AND REACTIONS TO STRESS

ANDREW GENTILE, PHD: Illness seems to reduce stress tolerance. This is most prominent in patients who report a post exertional fatigue. Any time they exert themselves, they will revert into a relapse again. If they take a walk, if they take a swim. We have patients who are marathoners who contract this illness and they say the same things that other chronic fatigue sufferers say. They say that I was working very hard. I came up with a flu. I had a flu for several days and I had chills and fevers and then after that I never felt better. I never felt right. I simply didn't return to normal. Then my illness waxed and waned and I would feel better at times. When I would go back to my running and quickly relapse into the illness again. Stress, both physical and psychological, is tolerated poorly in this illness and may, in fact, re-exacerbate the illness over and over again.

 

NEIL BLOCK, MD: The last contributor to chronic fatigue syndrome is the usual psychosocial stresses in our life. If a person is going through protracted court hearings or tests or studying or under a huge amount of stress or living conditions, it can contribute to an overall faltering in many body systems, especially the neurotransmitters which are many times the reason that's missed by most doctors who treat chronic fatigue syndrome by not being aware of adrenaline, serotonin, gabba, dopamine and other neurotransmitter levels.

 

DR. PAUL EPSTEIN: Two key components of naturopathic and holistic health care is do no harm and treat the underlying cause. As you treat the cause healing occurs. We want to trace back. This person has chronic fatigue. That's a diagnosis. They have a suppressed immune system. That's also, perhaps, a diagnosis or a reality as we explore it by blood tests and by their symptoms.

We then ask the question, what caused that? It may be a virus. Then we might ask, what's the susceptibility to that virus? It may be improper diet. But what caused them to eat that improper diet? It may be stress and the need to relax and change this. But what caused them to live patterns of stress?

Even as we treat the patient in each of these levels and patterns and layers that are one upon another we eventually come back to the core cell, to the relationship that the person has with themself and they get in touch with their life history and their life story. And then we get into inner child work. There has been a lot of work these days with John Bradshaw's work on recovery and healing the inner child.

There's a connection between the wounds and pains of childhood and immune disorders. Because of the abuse and the shame and the grief of childhood and the wounds that we may have covered up, we often create patterns of life that are addictive that cause us to lead lifestyles that are stressful. So even as I may help the person by devising proper diets and stress management programs, if we're not touching the deeper healing, healing may not occur.

 

 

A HOLISTIC APPROACH TO CHRONIC FATIGUE SYNDROME

DEAN BLACK, PHD: You know, this body was made for one purpose only. And that was to interact with all the things that surround it. To be able to go out into the world, (unintelligible) into it the air, the water, the food, to be able to outwardly act and speak and play and enjoy and so on and so forth.

Now, if we were to cut off all of those things that connect us with out environment, we would die. If we add them back we begin to live. But the quality of life depends upon how we have them back. Even the amount of food we eat. If I have no food I die. I begin adding food I live but not very comfortably. As I add more, suddenly I reach a point where that's the ideal amount of food for me to eat. If I eat more than that I begin to jeopardize my health again. There's a right amount to eat of food.

Likewise, with regard to the particular kinds of foods, the proteins, the vitamins, the minerals, the same thing happens. If I eat none of them I die. If I add them I become healthier and if I go too far I become unhealthy again.

We're made to interact with our environment but only in a particular way. All these natural therapies do is say this: What is right for this body as far as how it behaves in the real and natural world? If we behave wrongly we become sick. If we behave rightly we become better. The concept is as simple as that. Natural health methodologies, natural health treatments do nothing more than sustain the body's operations as they ought to be sustained. And when that happens the body becomes healthy. If it doesn't happen it becomes sick.

 

NEIL BLOCK, MD: When you look at the system from an overall point of view rather than I should say the environmental point of view or from the energetic point of view, then focusing on the bug is not going to be productive because as sophisticated as modern medicine is, and as incredibly technologically advanced as it is, we can actually visualize, tell you all the amino acids and all the proteins inside the virus, describe it, take pictures of it, tell you about it. But we can't help the person who's got it. This seems to be a problem.

 

MAJID ALI, MD: The main difficulty is that in the prevailing model of medicine, the disease position... one of my colleagues read one of my (unintelligible) and came back and smiled and said, Majid, I know what you're talking about. I am a disease doctor. You are a health physician. So, I have difficulty relating to you because unless you give me a name of a disease I don't know what to do.

Look at the paradox. Here I'm not interested in a disease name. A disease name is important if you have a life threatening, acute illness where precise diagnosis prompts surgical intervention or drug intervention. It is essential for life. I am talking about chronic immune disorders. Disease name is not important to me.

I do believe a time will come that people will become so enlightened that they will not go to doctors. Did you know, Gary, that a lot of patients come to me not so that I can give them drugs but that I can help them get off drugs?

 

NEIL BLOCK, MD: This is why modern medicine is having so much trouble today. It really is not the answer to the whole situation. That's why we are in a crisis. That's why I exist. That's why people are turning more to natural therapies. The conventional approach is not curative; it's suppressive.

 

ANDREW GENTILE, PHD: Several key points in finding treatments for chronic fatigue involve the choice of an empathic expert. This is someone who believes this entity exists. I do believe it has reached the level of scientific respectability and most practitioners and medical professionals believe that this exists. It's important to have somebody who is updated in the literature and who's seen a minimum of fifty to a hundred patients so that they understand the ups and downs and a variety of new updated treatments, both alternative and traditional, for chronic fatigue syndrome.

This can be done in a number of ways. There are chronic fatigue support groups in every city and every town across this country and frankly across the world. These groups usually have lists of physicians who have tended to specialize. There are national organizations called the Chronic Fatigue Immune Deficiency Syndrome Association, Chronic Fatigue Syndrome Association. These are in Charlotte, NC, Portland, OR, Kansas City, KS. They often maintain a list of people who have seen many patients and who understand this illness and treat it.

It's important to find an experienced believing physician who will finally listen to you because most patients have gone through scores of physicians. We have now a client we're seeing who has seen seventy-five physicians around the world and who has felt almost like giving up. She doesn't really feel that people believe her. A very critical part of treating this illness is the belief systems that we'll get into in hopefully a moment.

The second important thing that I think patients should realize is that being a chronic illness with such a diversity of symptoms, this is a syndrome that is going to fall between the cracks of sub-specialty medicine. It's not going to be adequate to go to a single physician. It's probably worth considering putting together a team which would minimally consist of a GP internist medically trained who works alternatively and traditionally, an allergist/infectious disease specialist and then a psychologist/psychiatrist. This team could coordinate their plan and work together to collaborate a treatment plan that makes the client understand what's coming next and if these treatments don't work why. And if in fact they don't work, what's the next step?

 

MAJID ALI, MD: I think that when you are dealing with very serious devastating chronic illness, hope and the spiritual dimensions are two elements which are absolutely essential for long-term success. I have case histories which truly stretch your credibility. We tried everything. Creating hope, Gary, is a very easy thing to do. Sustaining hope is difficult. I do not believe healing is possible without hope. So, as far as I'm concerned, my task, when I see seriously ill patients--and every patient by the time I've seen them, they've seen at least seven specialists. They've had endoscopies done. They've had biopsies done. They've had CT scans done. By the time they come to me it's not that easy for me to simply tell them, you're going to get better.

But fortunately by the time I see them they've listened to some of our tapes, they've read some of our books. Most importantly, Gary, they've listened to some of the other patients who got better. So that when they come in and our nursing staff, our ancillary staff, myself, they really get a sense that we're serious.

We're serious about physical fitness. I have a book on that. I give seminars on fitness to my patients with fatigue. Regular fatiguing exercise is not good for them. It backfires. I do nutrition seminars for them. I give them one-to-one training seminars on self-regulation. We give intravenous therapy, oral therapy. We look at the problem of yeast overgrowth in the intestine, viral infections. So, it's a broad integrated program. And one thing that we do extremely well... you were asking me, how does my practice differ? I do not give them an option to remain sick. That option doesn't exist.

 

 

TREATMENTS IN CHRONIC FATIGUE SYNDROME

VITAMIN THERAPIES

DR. ALI'S NURSE: This evening I'm making up a chronic fatigue IV protocol. And it's for our patients who come in with chronic fatigue syndrome. What I've put into the IV bottle already is vitamin C, magnesium sulfate, calcium, pyridoxine and pantetheine, and now I'm adding a multivitamin formula.

The patients that come in with chronic fatigue are very tired. They have joint pains. They have headaches, memory loss, lots of different symptoms. And these IVs help to repair their cell membranes and boost their immune system so that they can hopefully function better.

I would say that about ninety percent of our fatigue patients have responded well to this therapy. We see quite a bit of progress with them. It does take more than one IV. Doctor Ali usually will order a set of five to begin with. And after that he can measure their response to see how deep their problem is and whether or not they require more IVs.

 

MAJID ALI, MD: I look at vitamin drips as a sort of a way of jump starting the cellular enzymes. The enzymes, which are energy enzymes or detoxification enzymes, are dependent upon minerals and vitamins. If I feel that I have enough time and the patient is not acutely ill or he hasn't been chronically ill for many years, then I will try to use a more conservative approach. But when I see people who have severe incapacitating fatigue, then... in fact, we've done some studies where one group was not treated with intravenous therapy and another group was treated. Intravenous therapies speed up the recovery process enormously.

 

DR. ALI PATIENT: This is something that has really helped me. I came to see Dr. Ali a couple of years ago with severe neurological symptoms, severe fatigue, unable to read and memory loss. I came to him and he did some allergy testing and put me on the IVs which I did quite often for months once a week.

My progress was slow but I have progressed and I'm much better than I was in the beginning. There's been a great improvement.

 

GARY NULL, PHD: What do you put in a vitamin C drip?

 

MAJID ALI, MD: We have about fourteen different formulations. We call them our intravenous protocols. And they are designed to manage different types of problems. For example, for chronic fatigue or chronic immune problems, we focus on vitamin C, magnesium, molybdenum. Molybdenum is a mineral which is a co-factor for sulfide oxidation, the enzymes which are involved in detoxification. We will focus on zinc. We focus on calcium. We do include vitamin B12, multivitamin B complex members. So, most of our intravenous protocols have anywhere from fifteen to eighteen different items. And of course the concentrations change depending upon the requirements.

 

NEENYAH OSTROM: I think that certain vitamins, like the antioxidant vitamins, particularly C and E and A, are going to turn out to be very efficacious in treating chronic fatigue syndrome just as they are going to turn out to be very helpful in treating AIDS patients because they are fighting the same immunological battle essentially. Their immune systems are under constant attack by free radicals and other things created by viruses and in some cases bacterias. These vitamins help to re-equilibrate and to repair damage that is done by these molecules. So, I think that they are going to turn out to be very helpful because they help boost the immune system.

 

MARTIN FELDMAN, MD: First, we have to have the vitamins and minerals really right because they are the building blocks or the foundation of the whole immune body's house. The nutrients are very, very simple but most of the time people coming in with immune problems are deficient in vitamin A, vitamin B6, vitamin B12, vitamin C, bioflavinoids associated with the C group, vitamin E, gammalinolenic acid and essential fatty acids, and the two minerals, zinc and selenium. All those most be put into order before you can give any other immune support.

For immune strength or immune power, vitamin A can be taken as pure A in doses of between 10 and 25,000 IU per day. But a fertile female should be taking beta carotene because it will be converted by the body into as much A as the body wishes and there is no hint or possibility of toxicity. And that could be 15,000 to 25,000 IU per day of beta carotene.

Next would be vitamin B6. I would go between 100 to 200 mg on the upper limit. But you really have to be tested at some point to see if 200 might be on the high end.

C, you can do via bowel tolerance but we should consider, number one, a sago palm source, not a corn source; we should have a buffered powder if we want to get good doses in. Buffering agents neutralize the acidity.

Vitamin E should be started at 300 IUs, maybe up to 600 IUs a day. Emulsified E is sometimes helpful if digestion needs a little help.

Bioflavinoids, we have quercetin, an excellent bioflavinoid, between 250 mg a day and 1000 a day. Pignogenol, another excellent bioflavinoid, between 50 and 150 mg a day.

Beyond that we go to the essential fatty acids whereby sesame oil, a tablespoon a day or sunflower or safflower or soybean oil are excellent sources and a tablespoon is a good dose.

Gammalinolenic acid can be found in black currant seed oil or evening primrose seed oil or borage oil. These can go between 100 mg a day and 350 mg a day.

Zinc--picolinate is the best form--between 20 and 50 mg a day. Selenium, either oceanic selenium or selenomethionine, between 100 and 300 micrograms a day.

 

NEIL BLOCK, MD: If the proteins come out low or the amino acids are missing we can individually try to supplement the amino acids. And of course if the minerals are lacking or the B vitamins we can give those individually or in tandem trying to use an economy of scale and not have a patient take more than ten or fifteen bottles at a time.

How do we go about treating the hormonal imbalances that contribute to chronic fatigue syndrome? I would say that I probably have 20 to 25 percent of my fatigue syndromes on thyroid, for instance. And I prefer to use the more natural brands of thyroid but there are at least a half dozen occasions where I've locked horns with endocrinologists who feel very strongly that only the artificial works, something that's called synthroid.

And again I mentioned before giving the male female hormones when necessary and trying to adjust either the adrenals or the pancreas, the pancreas using chromium, chromium picolinate, the adrenals using some of the glandulars or homeopathics, and sometimes things like licorice that tend to help a multiple batch of hormones.

And lastly for pituitary adjustment, one can use, I mentioned arginine before but one can use glandulars. One can use some of the homeopathics, and also, on rare occasions, I have to use a lot of amino acids to try to build the neurotransmitters such as the precursors tyrosine, thenylalanine, and tryptophan, up until it was unfortunately removed from the market.

And lastly, I am not afraid to use correctly and in small doses, other legitimate medications that are prescribed and gotten from the pharmacy. I tend to shy drastically away from the tranquilizing family, such as valium and librium but I do make uses of the antidepressants on occasions. Very often a patient has tried these things before, or has even gone to other holistic physicians and then turned up in my office. And they may just need one or two things to turn the body around on multiple levels. And with the neurotransmitters being very easily adjusted nowadays with the less toxic antidepressants, things like Noripromine, Pamelor and Nortriptyline and especially the newer ones like Paxil and Zoloft, with a drastic lack of side effects and a response beginning in two to four weeks, the patient can know at least the direction they're going. And after suffering for two, four, six years, it's nice to get some indication where the use of all these therapeutic agents within a matter of two to four weeks will help.

 

NEENYAH OSTROM: There is one drug that is currently in clinical trials and being evaluated by the Food and Drug Administration that is called Ampligen). It's a drug that appears to fix a very important immune system antiviral pathway, a natural antiviral pathway that occurs in the body. This drug appears to work not only in chronic fatigue syndrome patients but it also appears to help AIDS patients a great deal, which is yet another thing making the two epidemics.

 

MICHELE GALANTE, MD: The role of antibiotics is certainly there in cases where all else is failing, where the system has been debilitated from too much drug usage before. But if you can get yourself to the state where the energy of your system is strong enough, then it will take care of itself. You can be brought to a state of health through the proper treatments.

 

HERBAL THERAPIES:

LETHA HADADI D,AC: The tradition of herbology is very rich in China and we have many, many herbs to choose from for building the immune system and building strength. A couple of major ones are a form of ginseng called don sen. In latin it's codinopsis. Another one is astragalus. When you use both of those together the codinopsis lifts our energy up and the astragalus sends our defenses out to the surface. So we don't catch colds so easily. We don't feel weak. We don't perspire too much. So we build strength with Chinese ginseng with neutral ginseng or false ginseng and with astragalus. And we kill germs, we kill viral infections with honeysuckle flower, with andrographis, with dandelion also. When we build strength and kill germs, that's very, very important for keeping us strong.

But we also have to build blood. And many of the Chinese blood builders are very, very effective. (Sounds like han yin saw) is one of them. It grows wild in our American southwest. It's called eclipta alba in latin. It builds blood without creating any other problems like inflammation. You can take this in powder form everyday and it builds blood. One from the health food store is called fo-ti. Fo-ti builds blood and keeps us cool which is very important for people with fever.

When we use herbs to help viral infections, we have to do a couple of things. A major part of herbal treatments is antibiotic, anti-inflammatory herbs. There are many of them that we can find very easily. Dandelion is a cleansing herb that makes us feel more comfortable and cooler. Dandelion can be used in salad, can be cooked in soup, and can be found in the health food store in capsules.

Also, honeysuckle. Honeysuckle flower grows outside in a garden and we can take handfuls of honeysuckle, boil this every day as a tea and it will eliminate sore throats and fever. And it will kill pneumonia germs and staff germs and strep germs.

There are three kinds of ginseng and it's important when we use ginseng to know what they do. American ginseng gives us more moisture, more saliva after a fever. Chinese ginseng called don shen gives us energy. It's an energy boost and makes us feel more lively. Don shen or false ginseng makes us feel stronger without making us feel hotter. We can use any of these in soups.

Cayenne pepper plays a role in health in that it is very stimulating and very heating and it increases our circulation so that we feel stronger, we have more energy. It can be used by people who don't find it too irritating.

There are herbs for relaxing the nervous system when we are too anxious to sleep. A very good one is Siberian ginseng. It can be taken in an extract form. We can find it in a health food store. Or a capsule.

Another good herb for helping us sleep is valarian. It's a western herb. You can take a capsule of that before bed. It quiets the nervous system.

For people who are depressed for any reason, a good way to deal with this is to bring this into our center, to ground us and to feel more whole. There is an herbal combination that's nice for this. It's ginger and mint. Mint brings the worries out of the head and ginger helps burn them away because it's digestive and heating and it brings us warmly into our center. That's a very combination as a tea.

Here's a combination that uses Chinese and western herbs. It's called High Energy. Gota cola is one of the herbs, American ginseng, damiana, red clover, peppermint and cloves. The cloves is the part that strengthens adrenals and lungs. Even if you don't have this combination, even if you're at home and you're tired and it's late afternoon, you take a pinch of cloves, add hot water and drink it as a tea, and it will pick up your energy. It will make you breathe deeper. It's especially for people who are pale, weak, they have a very pale tongue.

Asian doctors always look at the tongue. If you have a red tongue you need cooling herbs. If you have a pale tongue you need clove or ginger or heating herbs.

 

DIETARY CHANGES:

MAJID ALI, MD: What are the foods that can help support the immune system? Let's take them by groups. Let's first take carbohydrates. I generally recommend that my patients should ease off on foods that cause allergies. For example, corn and wheat are the big culprits. You try to go on the other side, wild rice, brown rice, unusual grains like amaranth, quinoa, soy products are very good, teff, spelt, those are good. The other good sources of carbohydrates are lentils, different types of beans. Generally, potatoes, tomatoes and yams, that's okay but again in moderation. So, those foods which have white flour, no, no. White rice, no, no. That's general.

Let's now go on to proteins. In general, again, the best sources of proteins in my judgement still are beans, lentils and grains. Egg, I believe, is an excellent food. Unfortunately, a lot of people are allergic to it. So what I recommend is that in one 25 hour period in a week they can have two eggs for breakfast. For example, if you out to have breakfast, Saturday and Sunday could be eggs breakfast. The rest of the week, no.

I do recommend protein drinks in the morning because amino acids give you sustained energy. Carbohydrates give you roller coasters. Unless you are in an endurance type of physical activity. Then you do need carbohydrates. But I think most people, without that kind of endurance training, they can do much better. So, generally I do not recommend too much of the beef, again because of the problem with allergy. You are much better in unusual meats, venison, pheasant. There are places, and we provide a list for our patients where you can order these unusual meats. Cornish hen, turkey is fine, hunted fish is good, deep sea fish. Cultured fish, they're beginning to put fungicides when they culture their fish in fisheries. So again, I make a difference if when you're going to have fish go for the deep sea fish. I guess the exception is if you have serious mercury sensitivity. Then you should avoid fish.

Let's talk about fats. Healthy fats are absolutely essential for us. Why would the good lord put healthy fats in the cell membrane of each one of our hundred million cells if they were not essential. So I do not limit fats. I think oxidized, processed, denatured fats are bad fats. So animal shortening, corn oil, palm oil, coconut oil, these are not good oils. On the good side, if you don't have milk sensitivity, butter is an excellent choice. Ghee is excellent. The best way to make ghee is to take butter and gently warm it and take the white part off. First of all it is delicious. Second, I found out that many people who cannot tolerate butter because of dairy sensitivity then can tolerate ghee very well. I think virgin olive oil, the type that you find in Italian villages.... In essence, go away from processed oil. So this business of canola oil, which is processed oil... all processed oils are best avoided. Avocado oil is an excellent source of monounsaturated oil. Again, if it is processed avocado oil, I would say no.

In terms of supplemental oils, flax seed is excellent. I recommend that people should make a habit of using flax seed on their salad dressing. Taste is changeable so once we know what is good for us we acquire a taste for it.

 

MICHELE GALANTE, MD: What we like to do is introduce a lot of wide foods, foods which are as, the word applies, are living. Things which come right from nature which can be eaten without cooking, such as, of course, fruits, vegetables, sprouts. Sprouts have tremendous energy, a lot of enzymes and much nutrition. These foods take little energy to digest and give much energy back.

 

DOLORES PERRI, RD: I've heard how dietary changes have changed the course of people's disease. What I feel is that more and more people should take control of the way they're eating and eat more foods in their natural state.

Now we're here at the health food store. Many people walk into a health food store like they're walking into a strange land. There's nothing to be afraid of. It's just that you need to be familiarized with it.

Let's stop with the fruit and vegetable counter. Here we have all the greens. The greens are what I think you want to juice and eat, just not cook them too much. We have arugula, we have red leaf lettuce, green leaf lettuce, we have butter lettuce, red chard, green chard, kale. We have mustard greens, we have broccoli, beats, carrots, turnips, parsnips. They're root vegetables. They're very, very healthy. And they're high in calcium. You don't have to get your calcium from dairy. You can get your calcium from all the green leafy vegetables. The chlorophyll is what you need to oxygenate your blood. Just think of all these beautiful colors. This is what's wonderful. It's a picture. It's a sight just to see them and eat them. Radishes, green peppers, eggplants. You can make babaganoush. There's bok choy. Ginger is wonderful to flavor any juice. Celery is a good diuretic. You want to use the celery. Carrots juice is high in beta carotene. All the green leafy vegetables are high in beta carotene and chlorophyll.

Right over here we have all our sprouts. We can't get better protein than this. Just don't be afraid to use them. Everything is grown there. It's all there. There's the root. The protein. It's an excellent source. You put that into a salad. You don't have to do anything. You just throw it into a salad and it really will make anything you're eating.

We have wheat grass. Wheat grass is high in chlorophyll. An ounce of wheat grass juice is equivalent to 22 ounces of the choicest vegetable that you can imagine.

Americans don't eat enough vegetables. Just have some more vegetables. Have more of the live foods. Then you'll start seeing some changes.

If you notice, right over there it says only organic certified produce sold here. At least you can feel free that there are no pesticide residues and fungicides on this. We have to be very careful when we're juicing something because we're getting a very concentrated source of pesticides if you're using regular produce. At least here you can be safe of that. Especially if your immune system is compromised in any way you don't want to have any toxins, pesticides, fungicides, herbicides in your body.

 

MICHELE GALANTE, MD: The patient's got to take an active role in the therapy. The patient can't expect to just have the doctor do to them something and have them become all well. It's an active process, especially when we're talking about the nutritional aspect. The patients that I see, all of them, are taken off of corn, wheat, yeast, sugar and dairy products, processed foods of all kinds, coffee, alcohol and drugs as much as possible, chemicalized foods and synthetic foods and Equal and Sweet and Low and all these artificial sweeteners right off the bad.

That will help a patient who isn't, let's say, the most severe of the patients. That will help all of them. But there are those few who will not respond right away. But that should help most of the patients most of the time. And that's the great beginning.

 

MARTIN FELDMAN, MD: A very good point regarding the role of detoxification in chronic fatigue is a major, major aspect of the whole problem. Because many of the persons who do break down into chronic fatigue states have, in addition to a deficiency of various nutrients, a toxicity which is impairing the body's ability to achieve immune power. Toxicity goes across many, many categories. It can be caffeine; it can be cigarettes; it can be pesticides; herbicides; it can be junk food; it can be sugar; it can be pollutants in the air; it can be chemicals. So this is a major aspect of all health especially for anyone with chronic fatigue or anyone who is HIV positive. They should really be detoxified in an intelligent fashion.

 

HOMEOPATHY:

MICHELE GALANTE, MD: I'd like to talk a little bit about homeopathy which is my specialty. Homeopathy has been very effective against chronic fatigue syndrome. The treatment of homeopathy is quite different than probably anything most people are experiencing. Homeopathic remedies are used in micro dosage. We have many hundreds and thousands of homeopathic remedies all made from natural substances. They are effective in curing and treating many conditions including the ones that we have been talking about today.

To talk about one particular therapy is not appropriate because each person has their own constitution and the classical homeopath works to find that constitutional remedy or the remedy that is appropriate to the detailed picture of symptoms that the patient presents at that particular time.

You can't speak of one or two remedies as being the cure for chronic fatigue syndrome because the homeopath looks at the entire person, mentally, physically and emotionally, in order to evaluate and determine a homeopathic remedy. The remedies are chosen based upon the symptoms that they would cause in a healthy person in a large dose. If that matches with the clinical presentation of the sick person, then that same substance is given in small doses. Or likes cure likes or the law of similars.

Homeopathy has had a much more pervasive effect upon our society than most people realize because, for example, vaccinations and immunizations originally came from homeopathic therapy. I do not recommend allergy treatment, for example, through the usage of what I call bad homeopathy which is the use of shots and drops of substances in what we feel, as homeopaths, are too large a dose. Again this is similar to vaccinations in that you're using the principle of homeopathy badly by giving a large dose of the same counteract the same. Homeopathy is based on the law of similars. So you would want to give something that was of a similar nature but not necessarily the exact same nature.

 

ACUPUNCTURE:

ABIGAIL RIST-PIDRECCA, RM, OMD: This is an acupuncture chart. The charts were originally made five thousand years ago. We now can test the validity of the acupuncture points because of the electromagnetic energy that flows through these pathways. We can test them because wherever there's an acupuncture point there's a low electrical conductivity. It's like a little doorway to that particular pathway.

We can test them with some of the equipment that we have nowadays. In those days, it's a baffling situation how they actually found this system to be so.

The chi or the bioelectromagnetic energy flows through these pathways. Wherever there are disease processes occurring you'll find a blockage. The acupuncture needles inserted in these different points--there are 365 points--actually open these pathways and let that energy flow smoothly through those meridians.

The other thing that occurs when using acupuncture is that it dilates the blood vessels so the vessels can open. You get more circulation, more nutrients, more oxygen flowing through those meridians which is important in all forms of health.

The immune system is a complex system. We're seeing that because of children being vaccinated very early on in life that the immune system function is actually being hampered. So, we're seeing a lot of these immune system problems and disease processes and pathologies occurring.

I just want to talk about the actual process of puncturing or needle insertion. We have needles that are presterilized in ethylene gas. They're totally sterilized before we even take them out of the package. And then after we use a needle they are thrown away in a container which MDs and other people use, infectious waste containers, and they are incinerated. So, there's no cross contamination question because of this process. If you do go to an acupuncturist, one of the first questions I would ask as a patient consumer is if they do use disposable needles.

Before we use the needle on the site, I want to take John's pulses, as I mentioned before, to see what kind of energetics I have to work with and what I have to, in fact, do.

The first position on the left pulse is the heart. And then coming to the superficial site, moving up a little bit on the same position, is the small intestine. The second position is the liver and the next position is the gall bladder. Kidney is the last position and the bladder.

What I'm trying to find out is how the energetics are flowing through John's meridians. There is a chart here of meridians. The meridians are pathways or energies that the bioelectromagnetic energy flows through. That tells us what kind of state of balance we have going in the body. That gives me an idea of what I have to do with that kind of balance to make these processes work more smoothly.

I know that I have to enhance the immune system. In this case, we'll be using some points at the ankle to tonify the kidneys. The roots of life are responsible for the energy that goes to the immune system. We'll work on some lung points on John as well and also some liver points.

The rickshaw runners in China were said to be able to run three miles after having this point needled. I believe that they do use them also on race horses before races. It's a depression just about four fingers underneath the site of the knee cap in a down position. Take a breath and breathe out. This point has traditionally been needled for enhancing the immune system in any and all infection processes.

 

JOHN: I felt that. That is a shock.

 

ABIGAIL RIST-PIDRECCA, RN, OMD: Sometimes you'll feel a fleeting response, an electric sensation much the same as when you bump your elbow, the funny bone, and that's the fleeting response of the electromagnetic energy I spoke of before which is the chi. That chi is the life force that we all contain, every living being, animal, plant, contains this chi. When you release this chi you'll feel that response of electricity. It's not pain. Just that electric kind of fleeting.

 

JOHN: It's nice.

 

TAI CHI AND QI GONG:

ERIC SCHNEIDER, NE: One of the benefits of tai chi that one increases one's awareness both internally and environmentally. And then one can choose and decide which path they're going to work on. If there's something physically wrong or if there's something in the environment that needs to be correct, they can use the energy that they have in their bodies to go towards the conflict and resolve it rather than spend a lot of time worrying and obsessing and doing all the other things that we do to avoid a conflict and deal straightforward with the conflict.

The other benefit is that in the body there is a core of energy that one is born with. We call it the prebirth chi. It's sort of like what you're born with. It's what you've got. We know people who can go out and party all the time and they wake up the next day at 6:00 in the morning and they're fine. And then take someone else, completely a different person, and they party all night and they can't get up the next day. That's just the natural reservoir.

The way one can increase their storehouse of energy is through practicing something like tai chi. The process is the environment has energy. That energy is brought into the system. And it's brought into the system vis a vis just the simple breathing apparatus. The body goes through an alchemical process converting that to useful chi in body.

Once you have a center to work from, once you know where that is, once you have a place in your body where you can go, the environment is not as stressful or experienced as stressful as it was prior to your practice. You start to cultivate, in meditation terms, a part of you that can observe phenomena without grabbing onto it running with it and without getting crazy about it. You can sort of ground yourself and say, this is what's happening now and what can I do about it and what are my options and how am I feeling? You can start to assess your own experience.

They call tai chi chuan a ten year practice. You get three years small gain and ten years great gain. It takes ten years to get what they call a (sounds like gung chia). The gung chia is the task framework, the framework to get your body to have a certain type of frame that works a certain kind of way and can contain energy. As the mind cultivates and stays balanced with the body the whole system starts to grow.

This is not a quick fix. There is no such thing, in my opinion, of anything that is worthwhile that is done quickly. Everything takes time that has any lasting effects.

 

GUIDED VISUALIZATION AND IMAGERY:

ANNE FOGELSANGER, LM, TH: Hello. My name's Anne Fogelsanger. Tonight we'll be working together learning how to use visualization and relaxation techniques in order to connect our body and our mind.

There's a new science called psychoneuroimmunology. It's finding out, more and more, that all the different experiences that we're having in the body, the different emotions, different thoughts that we're having, actually have a chemical and electrical reaction inside of us. Really everything that we think has a reaction.

We're also realizing that with this reaction we can actually have a tremendous impact on the body itself on the functioning of the body, the physiology of the body, on the entire immune system. All of the different immune deficiency conditions--AIDS, HIV, chronic fatigue syndrome, cancer--really respond wonderfully to these techniques.

What I'd like you to do is to find a comfortable position on the floor. You can stretch out on your back, stretch your legs out. Make sure your legs are a little bit apart, your arms are down by your side. If you'd like to keep your knees bent, if you have some tension in your lower back, you can bend your knees up keeping your feet on the floor. Otherwise you can just stretch your legs out, close your eyes and take a deep, easy breath.

Notice where you feel that breath. Are you feeling the breath just in your chest? Try on your next breath to take your breath all the way down into your abdominal area so that as you're breathing you're taking in this air. Remember, this air is our life force basically. It's our life affirming energy. It's that new oxygen that's going to come into your body. It's going to bring new life, new energy. It's going to bathe your body.

The white blood cells are also increasing. They're very, very strong and powerful. They can defeat anything in their path. This white light is continuing to fill your body.

And now I'd like you to take a deep breath. Slowly open your eyes. You're no longer within the circle of stones. That white healing light is always out there for you. Always there as a support, as a loving presence, as a reminder that you are able to affect your immune system. You are able to take in what you need in order to find balance and health.

 

IMAGERY AND HEALING:

DR. PAUL EPSTEIN: I'd like to share a few examples of people that I've worked with who have healed themselves of immune system disorders--chronic fatigue, arthritis--in illustrating the journey of healing and helping them understand and connect with themselves.

One of the techniques and the therapeutic modalities that I utilize to help people explore and listen to their illness and find meaning is imagery: A therapeutic technique that assists people to explore through symbols and words in the subconscious, the language of the subconscious, symbols, the meaning of their illness. It's similar to the work that Bernie Siegal has done in terms of asking people to draw their illness as a representation of their subconscious beliefs and attitudes towards it.

In exploring it, usually what comes up is the issue that is at the core of where the healing is. In doing imagery with people, they may get in touch with childhood wounds that need healing, abuse from the past. They may get in touch with the fact that the work that they're doing isn't.

Two such cases of chronic fatigue is one person for whom the fatigue was a way of getting attention and love. She had not yet let go of trying to get love and attention from mom and dad. She was still stuck at that place. And the pain and the grief of not having that love and attention was not only weakening her immune system but keeping her stuck in how she was living her life that kept her sick.

 

MAJID ALI, MD: What I demonstrate, Gary, to my patients every Wednesday is that the way you look at the world around you determines the state of your biology under your skin. And that is literally and figuratively true. In other words, you can be in a meditative mode, in a healing, self-regulatory mode, and your heart activity, your brain function, your muscle energy, your skin energy, will all be like (sounds like cancer spreading). Or you can be trying to be figuring things out, cleverly thinking your way out, and then your biological profile is like the New York City skyline.

I call this mode a stressful mode that causes disease. The other mode is an even steady state energy mode and that's a respiratory mode. It is entirely possible for every single person to learn that in as short a period of time as perhaps three sessions of two hours each.

In our work our goal is to, number one, perceive this energy. Number two, to understand how these changes in energy profoundly affect various electrophysiological profile. And number three, can we allow this energy to guide us into a healing mode? So we want a transition from an ordinary thinking stressful mode, which causes disease, into a nonthinking meditative deep respirative healing mode. That's our goal. And why I use this technology primarily to help you understand that this is not real.

 

DR. PAUL EPSTEIN: Another factor is that many people may have a number of practitioners assisting them. And that's important. No one doctor can heal a person with chronic fatigue or AIDS or any immune disorder. They need support socially, emotionally, psychotherapy perhaps, a medical doctor, an immunologist, a naturopath. But at some point it has to be integrated.

 

 

A HOLISTIC HEALTH MODEL

 

MICHELE GALANTE: A homeopath will tell you that a person is not well if they are feeling ill at ease in the mind or ill at ease in the heart, I should say emotionally speaking. So, just having a physically healthy body is not enough for people. People want more.

Of course, it's not to say that doctors and physicians are the cure to making people happy but we find tremendous, tremendous help from homeopathic therapy which affects the mental, emotional state in a very positive way. It helps to reattune what is called the vital force in homeopathy which causes the person to get well. There's an old saying. Hahnemann said in the 1700s that disease was caused by this disattunement.

What the remedies do in their tiny doses are, in a sense, stimulate or catalyze or realign or stimulate the realignment of the system to heal itself. This is the capacity which we all have. We've got to realize that the body is living. It's a tremendously powerful organism and it can heal itself. It has healed itself long before antibiotics and it will continue to heal itself long after antibiotics fall out of favor.

 

MAJID ALI, MD: I've learned that one thing doesn't work: A physician telling his patient, "Don't smoke" doesn't work. A physician telling his patient, "Don't drink coffee" doesn't work. A physician telling his patient, "Don't eat sugar snacks" doesn't work.

I've learned another thing that really works. When a child can understand, at the deeper visceral intuitive level, that what he eats affects his condition, then you have enlightened that child. Once we know something we cannot unknow it.

I believe that when you are working with, let's say, a 27-year-old man who has just lost his wife, lost his home, his wife has divorced him, he has two daughters he can't see, he has lost his children, he has lost his job--I'm telling you real life stories--how does a person like that pull himself out? That's where the spiritual comes into the picture. They eventually reach a stage where they truly are not afraid of fear anymore. And then the process of recovery begins.

 

DR. PAUL EPSTEIN: In terms of helping people I as a doctor need to prescribe. I need to coach and I need to teach. The patients need to get involved and take responsibility and empower themselves and believe that healing is possible.

Working together in a partnership, they can have MDs and therapists and internists and immunologists and nutritionists and personal trainers. It isn't the fact that any one of those things is better than any other. It's the integration in the whole being where healing happens. People need guidance and support to know that that's possible.

 

GERALD GOLDBERG, MD: For a lot of people the notion is that an illness itself forces them to change their lifestyle. The problem that most people have is they work on an assumption that in changing their lifestyle they have to give up one set of beliefs and then suddenly adapt a totally new set of beliefs. In essence, people are reluctant to adapt new sets of beliefs because they feel they're leaving their own belief systems behind.

It's much akin if you imagine a belief system to a room. Most people react to change as though they've lived their whole life in a room. Somebody comes along and opens up the door and there's a corridor and multiple rooms down the hallway. Most people are confronted with the notion, however, and react as if once they leave that room they can never go back to it again.

Their security is tied up in their belief systems. They don't realize, in effect, that they have the flexibility of moving to and fro and adding to their belief systems. Most people exist existentially, if you want, or react as though they are forced to abandon who and what they are when in reality they don't have to. Ultimately, their ability to seek help will actually cause them to grow. It's not a rejection of a previous lifestyle in a real sense. It's only an adaption. And once they feel comfortable with that adaption, should they then make a decision, that's where they really have choice.

 

DR. PAUL EPSTEIN: What's needed in treating and supporting people with immune system disorders like chronic fatigue or HIV virus or AIDS or arthritis or allergies is another approach. This approach is not so much looking for the cure or the fix or the treatment that's going to work for everybody but one that's individualized and one that's holistic and one that supports the patient, empowers the person to get involved in their care and to have hope and belief that healing is possible.

Those two points, over the years of my practice, are the ones with which patients have told me I've helped them the most: to believe that healing was possible when they didn't have hope and to know and believe that there were things that they could do to heal themselves because I don't heal anybody. And therapies don't heal anybody. They support people to heal themselves. What's involved here in terms of my work as a physician is to support the self-healing process of each individual and to guide them in that process.

For healing to happen things need to change. That's one of the messages of illness. My job is to help people to explore and listen to and understand the message of their illness as the key, perhaps, to unlock the door to recovery. Once people are involved in that process, my sense is that that's where healing happens.

So after the diagnosis and after the medications, natural or otherwise, there still needs to be an exploration of the question, where is the healing for this person? Many studies show that this journey of healing, that people need to engage in, that their illness is calling to them to embark upon, is really where it's at with immune disorders in particular. Mostly because we might have conditioned immunosuppressive responses built into our attitudes, our beliefs, the way we live our life, the way we think, the way we eat. And our illness is telling us, we cannot fix it from the outside. If it had been fixed from the outside with a drug or the right therapy as exclusive treatment for a condition, they wouldn't end up in my office.

So people are not being healed from chronic fatigue with a magic bullet or a quick fix. They are healing themselves by engaging in a self-healing process. That involves looking at their life and meaning.

 

MAJID ALI, MD: I have hope. I'm an optimist. But I think I have reasons for optimism. My optimism is not coming from the powerful influences. Listen. Disease, drug medicine, is incarcerated in a model of perpetuating disease. But enough people are beginning to understand that there is a difference in absence of health and disease.

 

GARY NULL, PHD: There you have it. Seems rather complicated, doesn't it? But it's not. It's based upon the knowledge that we don't become sick overnight. The symptoms may manifest but the condition took years and years. And it wasn't from one virus. It wasn't just the Epstein Barr virus or cytomegalovirus or the herpes or mycoplasma or parasites or low blood sugar or electromagnetic pulses or mercury fillings or environmental pollutants or water pollution or emotional stress. It's a combination of all these things.

In order to detoxify our system, it takes time. It might take you a year to really cleanse, getting on a rotational diet, getting rid of the foods that you commonly eat that are addictive in your system and polluting to your system. Getting rid of processed foods. Bringing in healthy foods. Exercising as much as you can for your body's needs. Meditating. Stress management. Acupuncture. Guided visualization. Qi Gong. And of course eating a diet that honors the body.

Just ask yourself this. If you are what you eat, why not eat that which you really appreciate becoming? You don't want to be a twinkie. You don't want to be a hot dog. You don't want to be a pizza. So get rid of the junk and bring in the good stuff. But also bring in good thoughts. As we've seen, the mind is a very powerful healer as it is a slayer.

Each day if you process wellness, if you focus on wellness, and if you surround yourself with people willing to support you in your quest, there will be a time when you'll be beyond your chronic fatigue. Every day you'll look forward to doing something else that encourages and honors the body, mind and spirit. I'm Gary Null. Thank you very much for watching.