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by Richard Firshein, D.O.
March 10, 2000
What, then, is fatigue?
It's a good question and a hard one to answer. Fatigue is both the most common and the most elusive condition I see. It's the problem few doctors take seriously, yet it's the symptom of a wide range of illnesses. How do you actually describe fatigue? You can't measure it in the blood or urine. There is no test to prove that somebody is exhausted. Fatigue is unlike other conditions. You can see the changes in an arthritic joint, you can measure blood sugar elevation in diabetes, you can perform pulmonary function tests in asthma, and you can run an EKG in heart disease. You can even measure high levels of vital antibodies in the blood of patients suffering from chronic fatigue syndrome (CFS)-an immune disorder in which fatigue is a major symptom-but this is not diagnostic.
As noted before, magnesium allows our muscles to relax. If our bodies become calcium deficient, we can borrow from the large reserves contained in our bones, but when our bodies become magnesium deficient, we must borrow from the already low supply in our muscles. But as our muscles lose magnesium, calcium charges in to replace it, and, as a result, our muscles grow tense and cramped. This can result in debilitating problems, especially the exacerbation of chronic fatigue symptoms.
Magnesium has had a profound impact in the treatment of this disease.
Chronic fatigue syndrome, according to the Centers for Disease Control, is a diagnosis of exclusion, meaning that certain conditions must be ruled out before a true diagnosis can be made. There are specific major and minor criteria that must be fulfilled for at least a six-month period. Some of the conditions that are ruled out include hypothyroidism, Lyme disease, and other chronic illnesses such as diabetes, hypoglycemia, or multiple allergies.
It is known that intracellular magnesium deficiencies exist in patients with this disorder.
A lack of magnesium in the cells would disrupt the flow of energy that causes muscle relaxation and a regular heartbeat. Some pioneering doctors have started treating CFS patients with magnesium injections and found them helpful. One patient of mine, a 50-year-old industrial engineer, suffered with chronic fibromyalgia, a painful muscle condition, as well as severe fatigue. When I tested his magnesium levels, I found them to be very low. Weekly injections were able to bring him back to a normal level of energy, and his muscle pain diminished dramatically.
Another patient of mine was virtually cured by magnesium, along with other supplements and dietary changes. Joan was a 45-year-old psychiatrist with an easy smile and genuine warmth who came to me in desperation. She had suffered from symptoms of chronic fatigue for over 10 years. Her condition began as an acute viral illness, with sore throat, muscle and joint pains, fever, and flu like symptoms. Yet instead of getting better, she just got worse and worse, until she was barely able to continue working. Like many patients with this ailment, she'd never had a significant previous medical condition. She was a hard worker and dedicated to her patients. She worked long hours. Before she came to me, she had tried innumerable treatments, from consulting a psychiatrist herself to trying antidepressants, acupuncture, homeopathy, natural remedies in health food stores, and regular "mainstream physicians." Since she had just begun a separation from her husband, she was usually told her condition was related to stress and depression. In other words, a psychiatrist – a medical doctor-- was told her own condition was psychosomatic, or "all in your head."
When I saw her, 10 years after her initial symptoms had begun, she was indeed depressed and demoralized from the lack of understanding she'd received. “I know something is wrong," she insisted, "but no one believes me." A series of blood tests suggested she was right. She had high levels of anti-bodies to Epstein-Bar-r virus, Cytomegalovirus, and HHV-6, a herpes virus. Antibodies to three different viruses is unusual; although many people are exposed to viruses like Epstein-Barr, for some as yet unknown reason, certain people become quite ill as a result, often chronically. Joan's Natural Killer cells were at a very low level of 10 (normal ranges from 20 to 250). Her red blood cell magnesium, one of the markers I use to diagnose this condition, was also low. We were beginning to understand Joan's problem. Now we had to solve it.
As part of the treatment for CFS, I take a comprehensive took at the patient's condition and check for many allergies the patient might have, since 80 percent of chronic fatigue patients suffer from them. I also check for nutritional and hormonal deficiencies. Fortunately for Joan, with the exception of several key foods to which she was allergic, these tests came back normal.
I treated Joan with a variety of supplements, and magnesium was first on the list. I find 500 milligrams of magnesium aspartate per day is an optimal oral dose. But with a patient like Joan, who has been ill for years, I also gave her some supplementation with intravenous magnesium and vitamin C, to help flood every cell in the body with this needed nutrient, particularly during acute flare-ups.
Magnesium alone, of course, can only do part of the job in a severe and chronic illness. Joan's complete program included antioxidants such as vitamin C, energy-boosting amino acids such as tyrosine, the herb ginkgo to improve cerebral circulation, coenzyme Ql0 to energize the cellular mitochondria, and Siberian ginseng, an excellent herb that helps patients cope with stress more effectively.
Source: Firshein, Richard D.O. “The Nutraceutical Revolution.” The Berkely Publishing Group, New York. 1998.
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