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Possible use of repeated cold stress for reducing fatigue in chronic fatigue syndrome: A hypothesis – Source: Behavioral and Brain Functions, Oct 24, 2007

  [ 184 votes ]   [ 2 Comments ]
By Nicolai A. Shevchuk • • October 26, 2007

Background: Physiological fatigue can be defined as a reduction in the force output and/or energy-generating capacity of skeletal muscle after exertion, which may manifest itself as an inability to continue exercise or usual activities at the same intensity. A typical example of a fatigue-related disorder is Chronic Fatigue Syndrome (CFS), a disabling condition of unknown etiology and with uncertain therapeutic options.

Recent advances in elucidating pathophysiology of this disorder revealed hypofunction of the hypothalamic-pituitary-adrenal axis and that fatigue in CFS patients appears to be associated with reduced motor neurotransmission in the central nervous system (CNS) and to a smaller extent with increased fatigability of skeletal muscle. There is also some limited evidence that CFS patients may have excessive serotonergic activity in the brain and low opioid tone.

Presentation of the hypothesis: This work hypothesizes that repeated cold stress may reduce fatigue in CFS because brief exposure to cold may transiently reverse some physiological changes associated with this illness.

For example, exposure to cold can activate components of the reticular activating system such as raphe nuclei and locus ceruleus, which can result in activation of behavior and increased capacity of the CNS to recruit motoneurons.

Cold stress has also been shown to reduce the level of serotonin in most regions of the brain (except brainstem), which would be consistent with reduced fatigue according to animal models of exercise-related fatigue.

Finally, exposure to cold increases metabolic rate and transiently activates the hypothalamic-pituitary-adrenal axis as evidenced by a temporary increase in the plasma levels of adrenocorticotropic hormone, beta-endorphin and a modest increase in cortisol. The increased opioid tone and high metabolic rate could diminish fatigue by reducing muscle pain and accelerating recovery of fatigued muscle, respectively.

Testing the hypothesis: To test the hypothesis, a treatment is proposed that consists of adapted cold showers (20 degrees Celsius, 3 minutes, preceded by a 5-minute gradual adaptation to make the procedure more comfortable) used twice daily.

Implications: If testing supports the proposed hypothesis, this could advance our understanding of the mechanisms of fatigue in CFS.

Journal: Behavioral and Brain Functions. 2007 Oct 24;3(1):55 [Epub ahead of print] PMID: 17958903, by Shevchuk NA. Molecular Radiobiology Section, Department of Radiation Oncology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA [E-mail:]
[Note: To access a full text PDF of this article at no charge, click here.]

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Article Comments Post a Comment

Shevchuk hypothesis
Posted by: sb439
Oct 31, 2007
When I was healthy and took a cold shower, I would warm up afterwards and feel awake and fit and alert. Since I've developed CFIDS (I've had it for at least 11 years no), this is no longer the case: when I take a cold shower, even only moderately cold (that is lukewarm), my metabolism cools down completely and I shiver for hours afterwards, and feel rather ill. I think I read somewhere that this change of response to cold and heat exposure (when I get exposed to heat, I warm up more than other people in the same room and keep warm longer, I tested this repeatedly) has been observed in other people with CFIDS. This suggests to me that the Shevchuk hypothesis may not work out. More importantly, I wonder whether his suggested human experiment may not make the test persons with CFIDS iller. Just a thought ...
Reply Reply

Posted by: glemsk
Nov 8, 2007
yeah, this article is bizarre. cold exacerbates the whole deal. geez.
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