ME/CFS: A new name for Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS), a condition of severe, chronic tiredness, is a well-known term in the medical world and affects between one and four million people in the United States. However, since it was coined in 1988, considerable controversy has arisen over the term CFS. Many patients, advocacy groups, and experts believe the name trivializes the condition and leads to a lack of respect for patients within the medical community; some doctors view the illness skeptically and as a psychosomatic condition, and patients find they receive improper –- or no –- treatment for the illness.

Globally, a number of accepted names for this illness of uncertain cause are used, including Myalgic Encephalopathy (myalgic means muscle aches or pains, encephalomyelitis means inflammation of the brain and spinal cord), Post-Viral Fatigue Syndrome, and Chronic Fatigue Immune Dysfunction Syndrome. In the United States, organizations and doctors recently started calling the illness ME/CFS, for Myalgic Encephalopathy/Chronic Fatigue Syndrome. This combined name reflects the standpoint that the illness is indeed physical as opposed to psychological.

In 2014, the US Department of Health and Human Services contracted the Institute of Medicine to review the evidence and create a clinical definition for ME/CFS, one that might also result in a newer name for the disease(s). Using both terms together in the new name is somewhat controversial since ME has an identifiable viral trigger, while CFS may not, and continues to be diagnosed solely by symptoms. Over time the research will reveal more; for now, patients are thankful that the new combined name reflects a medical basis for the illness.

What is ME/CFS?

ME/CFS affects four times as many women as men, occurs most often in people in their 40s and 50s, and does not draw lines around race. It is a debilitating chronic illness characterized by the following symptoms:

• Extreme Fatigue -- brought on by low levels of, or no exertion. “Post-Exertional Malaise” is a hallmark.
• Unrefreshing Sleep -- disrupted and unrefreshing sleep that increases symptoms of fatigue and pain.
• Cognitive Problems -- characterized by brain fog; difficulties with concentration, attention and memory.
• Pain -- muscle, joint, and all-body pain; headaches are common.

Many patients also experience visual disturbances, gastrointestinal issues, food and chemical allergies and sensitivities, irritability, chills and night sweats, depression and weight changes. A diagnosis is made after ruling out other illnesses that can cause similar symptoms, such as: fibromyalgia, thyroid problems, anemia, Lyme disease, lupus, MS, hepatitis, sleep disorders, and depression.

The Functional Medicine Approach To ME/CFS

Functional medicine uses an individualized, multi-dimensional approach toward working with the symptoms and possible causes of this debilitating illness. While no known cure for ME/CFS exists, addressing underlying health imbalances through diet and lifestyle changes and customized supplementation and other therapies can relieve symptoms, increase function, and allow the person to engage more fully in daily activities.

The functional medicine practitioner will look at possible underlying roots of an individual’s symptoms, such as:

• chronic inflammation
• immune system activation (is a food, infection, or environmental chemical or metal triggering the immune system?)
• impaired functioning in the hormone system
• neurological system dysfunction
• gut inflammation, leaky gut, bacterial infection or other gut dysfunction
• problems with detoxification and methylation
• mitochondrial dysfunction
• poor glutathione activity
• and more

By paying close attention to and working with these possible roots of ME/CFS, the practitioner can help the patient achieve a greater level of relief from debilitating symptoms, and create a lifestyle that supports ongoing health and well-being.

Transition successfully to a special diet

Are you considering going on a special diet, such as the autoimmune Paleo diet, the leaky gut diet, the SCD diet, or the GAPS diet? The thought of a major diet change can bring feelings of uncertainty and questions such as, “Can I handle this? What do I eat for breakfast?” Food powerfully impacts our emotions, and dietary changes can really “rock the boat” in daily life. However, by thinking ahead and employing some simple strategies you can ensure a successful transition and hence better health.

In this article I suggest some surefire ways to help set yourself up for success on your new diet.

Plan ahead and do your research

The most important step is to plan ahead. Why are you changing your diet? Do you understand the potential health benefits? Knowing this will help you move forward with commitment and confidence. Find reputable, current resources through your health care practitioner, at the library, or online. Even an hour of self-education will help you feel more empowered.

Menu planning

Menu planning is key to succeeding at a major diet change. Sit down with your resources, look at recipes, and write out a menu plan for at least a full week. Pick foods you know you will eat so you don’t find yourself falling into old habits. This way you will have backup when you get home late from work or fall behind helping your child with homework. Over time, your menu options will grow. Check out online menu planning services for special diets.

Make a grocery list

Make a comprehensive grocery list that fits the menu plan. Some items may need to be bought later for freshness; know what they are in advance.

Clean out the pantry

Before going to the store, empty your house of all prohibited foods. If there are foods you may test later for tolerance, put them in a location that’s not front-and-center. Grab those grocery bags, and go to the store!

Go shopping

Leave some extra time for this trip; you may be navigating new sections of the store, or finding unfamiliar foods. Ongoing, remember to stock up during sales and ask about discounts on case orders.

Batch Cooking

One of the best tools for a special diet is batch cooking. Batch cooking is preparing meals in bulk ahead of time, and refrigerating or freezing for later. Many who follow a special diet prep meals two days a week. On Sunday, you might take half a day to make a crock-pot of stew, prep a bunch of vegetables, and roast two chickens to put in the fridge or freezer. On Wednesday, you might bake fish for two meals, prepare a sweet potato dish for two meals, etc. It may seem like a lot of time to commit in one day, but soon you will come up with an efficient system where most of your food is prepped ahead of time and you save energy doing it.

Batch cooking reduces the stress of cooking every day, and when that moment comes when you might normally say, “Heck, I’m ordering a pizza!” you can reach for that tasty stew in the freezer. Success.

Sourcing local products

Some special diets require hard-to-find food items. You may have some luck at local food co-ops or farmers markets for these products, or even from the farmer directly. Buy bulk where you can.

What about the family?

One of the biggest challenges of being on a special diet is cooking for a family. Ideally, the whole family is on the same diet but anyone with kids knows this is wishful thinking. Depending on the age of your children, explaining why you are eating this way may help encourage acceptance. Some people cook one way for themselves, and one way for the family, but this is a lot of work. Others find they can cook most of the food to meet everyone’s needs, then throw in some extras for the kids (such as grains or potatoes).

Bring your lunch and keep snacks handy

Since you have prepped meals ahead of time, lunch can go in a container with you to work. Also, keep diet-friendly snacks handy in case you are delayed getting home or are hungry between meals. Preventing hunger is one of the best ways to be successful on your diet.

What about restaurants?

Eating at restaurants can be a challenge on a special diet, though more restaurants are becoming aware of special dietary needs. Ask questions, be firm, and don’t order if you are uncertain.

What to do when you fall off the wagon

Just about everyone “falls off the wagon” at some point. Try not to kick yourself for it. Dust yourself off, climb back on, and remember the longer you’re on the diet, the more successfully you will stick to it. Also, when you start to enjoy the health benefits of your diet you’ll find compliance becomes easier. Many foods lose their appeal when they trigger uncomfortable or even unbearable symptoms every time you eat them.

How to go gluten-free the right way

Anyone concerned with health and wellness has heard about the gluten-free diet. Eliminating gluten is critical for those who have celiac disease or non-celiac gluten sensitivity. What many gluten-free newcomers don’t realize is that many common gluten-free foods contain ingredients that just promote a different set of health problems. In this article we’ll discuss how to avoid this common pitfall so you can transition more easily to a healthy gluten-free diet.

The hidden risk in going gluten-free

Many people rely on packaged and prepared foods for the bulk of their diet, such as breads, pastas, crackers, sauces, and mixes. The tendency when going gluten-free is to replace those items with gluten-free versions of the same products. When you look at the label for packaged gluten-free products, however, you will see ingredients such as rice flour, tapioca starch, corn starch, and potato starch, plus a load of unhealthy fats.

Though free of gluten, these highly-processed, high-sugar, high-carb, low-fiber ingredients can contribute to blood sugar imbalances that affect weight gain, mood, brain function, and other aspects of health. Many of these processed foods also lack vital minerals and nutrients, which over time can contribute to micronutrient deficiencies. Overall, the general lack of nutritional density of packaged gluten-free products outweighs their convenience.

Variety, nutrient density, and whole foods key in healthy gluten-free diet When choosing to go gluten-free, keep in mind the basis for any truly health-supporting diet: simple, fresh, whole foods that are as close to their original state as possible. The more processed a food is, the less it has to offer your body in the way of nutrition and health.

Variety and high nutrient-density foods are key for long-term health; a diet of only cheese and rice pasta won’t make you much healthier than your former gluten-laden diet did. When you’re craving the comfort of carbs, go for a baked sweet potato instead of bread. Curb cravings by eating a diet heavy in fresh vegetables and modest amounts of fruit (so as not to imbalance blood sugar). You may need to retool your eating habits but you will be amply rewarded with significant improvements in how you feel and function.

A smart transition to a healthy gluten-free diet

Although any major dietary change is challenging, a healthy switch to a gluten-free diet can be easy and rewarding with some mindful lifestyle habits. Below are some tips to help with the transition:

1. Learn to read and understand nutrition fact labels

You will quickly develop an eye for those low-nutrient, highly processed ingredients, and learn what products contain them. These should never, or rarely, be in your grocery cart. Also, learn which common ingredients have hidden gluten in them, and eliminate them from your kitchen.

2. Make whole, unprocessed foods the bulk of your diet

Whole, unprocessed foods are the foundation for any diet that supports long-term health and wellness. Avoid the packaged food aisles, make friends with the bulk and produce departments, shop your local farmer’s market, and if you don’t already cook at home…

3. Learn to cook from scratch

- Cooking from scratch can be satisfying, easy and very rewarding

- Cooking at home means you know what’s in your food, and you can more successfully avoid gluten cross-contamination

- Batch cooking meals that you can refrigerate or freeze and re-heat makes it much easier

- A crock pot, blender, and food processor are very useful for making big-batch meals ahead of time

- Many fabulous blogs are devoted to healthy gluten-free home cooking

4. Mindfulness at the grocery store

When you pick up a package of processed gluten-free food, ask yourself if you’d normally eat it, or if you’re picking it up just because it says “gluten-free.” You may find yourself putting a lot of things back… especially if you look at the nutrition label!

5. Commitment

Remember every day why you have chosen to go gluten-free; you are honoring your own body and long-term health by making a positive choice. Stick with it!

The functional medicine approach to high blood pressure

The most commonly diagnosed medical condition in the United States is high blood pressure, or hypertension, and blood pressure medications are among the top 10 most commonly prescribed drugs. However, these medications can cause undesirable side effects. It’s better to address the underlying causes of high blood pressure—research shows diet and lifestyle changes are just as effective or even better than medications in lowering high blood pressure.

Why should you be concerned about high blood pressure? High blood pressure increases the risk of heart attack, heart failure, kidney failure, diabetes and peripheral vascular disease. Thirty percent of the population has high blood pressure, and another 30 percent has pre-hypertension, or somewhat elevated high blood pressure. Men are more likely than women to have high blood pressure before the age of 45, but after 65 the ratio reverses. African Americans and Mexican-Americans are at an increased risk.

Diet and lifestyle changes most effective approach

Instead of treating symptoms, address the actual causes of high blood pressure for lasting better health. Studies have shown that lifestyle changes alone can reduce risk of heart disease by a dramatic 90 percent. Lifestyle interventions influence the fundamental biological mechanisms leading to all chronic disease. For instance, regular exercise is one of the best ways known to control high blood pressure. Other important factors include a whole foods diet rich in plant fiber and low in sugar and sodium, maintaining a healthy weight (a BMI less than 25 is ideal), not smoking, and managing stress, such as through yoga, meditation, walking, and laughter.

Adding the functional medicine approach

In functional medicine, we look for why the person has high blood pressure rather than simply at what can be done to lower it; it’s a person-centered approach, versus a disease-centered one. Factors to consider include genetic predispositions, nutritional deficiencies, environmental triggers, and lifestyle habits, such as:

• Deficiencies in nutrients such as biotin, vitamin D, vitamin C, B1, choline, magnesium and CoQ10.
• Toxic levels of mercury.
• Hypothyroidism: Appropriate management of a thyroid condition such as autoimmune Hashimoto’s hypothyroidism can normalize blood pressure.
• A lack of dietary potassium and too much sodium. Balancing these nutrients can help balance blood pressure.
• Magnesium deficiency. Many people are deficient in magnesium, which can help relax the blood vessels.
• Chronic systemic inflammation.
• Elevated blood sugar and metabolic syndrome (pre-diabetes), which are related to hypertension.
• Hormonal imbalances, such as an estrogen deficiency, can lead to high blood pressure.

By addressing these and other factors, a functional medicine approach addresses the root cause of high blood pressure. Research has shown that up to 62 percent of high blood pressure patients were able to go off their anti-hypertension medications and maintain normal blood pressure by making diet and lifestyle changes. Eating a whole foods, vegetable-based diet and avoiding processed foods will help keep you sufficient and balanced in the right minerals to support healthy blood pressure.

Ask my office for more information on how you can address the root cause of your high blood pressure.