Recovering from Chronic Fatigue Syndrome: A Guide to Self-Empowerment (Part 2)
December 18, 2002
By William Collinge, Ph.D.
Chapter 6. Changing Your Lifestyle to Promote Recovery (from Recovering from Chronic Fatigue Syndrome: A Guide to Self-Empowerment)
Editor's Note: Part 1 of this article appeared in the December 11, 2002 ImmuneSupport.com email news bulletin.
Understanding the role of nutrition in health is not one of modern medicine's strengths. Our fascination with pharmaceuticals, microbes, and high tech medicine has diverted our attention away from simpler, more fundamental factors that influence our health on a moment to moment basis. Yet food and nutrition directly and continuously influence the body's resistance to illness.
There are common substances in the normal western diet that are now known to weaken immunity, and should be especially avoided by people with immune-related illnesses. These include refined sugar, caffeine, alcohol, and many kinds of food additives. Other substances are known to be the raw materials of the immune system, actually used in building white cells. Such substances include many vitamins and minerals, especially vitamin C and zinc.
It is easy to become overwhelmed by the mountain of information and claims about various nutrients and immunity. Rather than having to be a research scientist to eat intelligently, there are some broad guidelines which should help you arrive at a reasonably healthy nutritional program.
A Whole Foods Diet
Our bodies evolved throughout history on a diet very different from that which we eat today. We would spend a fortune in health food stores to eat the way our ancestors did. They lived on what we would call a "special diet," one of natural, organic, whole, unprocessed foods. Their fruits and vegetables were only fresh and in season, in their natural state, free of chemical residues.
They ate meat, eggs and poultry that were uncompromised by growth stimulants, antibiotics, or preservatives. They ate fresh fish from unpolluted waterways and oceans. They drank water untainted by agricultural or industrial chemicals. Their immune systems were not burdened with the toxic by-products of modern chemistry.
The concept of a whole foods diet is central in a salutogenic lifestyle. This means unprocessed foods, whole grains, untainted with preservatives or additives, and ideally, if available, organically grown fruits and vegetables. Unchemicalized poultry, eggs and meat can be purchased in many areas (without growth hormones or antibiotics). Fresh water fish should be avoided because of pollution by industrial or agricultural chemicals.
Likewise, shellfish tend to collect toxins and should also be avoided. A good rule of thumb is to read the ingredients on packaged foods. The fewer ingredients, the better. And if there is anything you cannot easily pronounce, don't buy it!
Pure drinking water is increasingly hard to come by. Yet the body is mostly water, and uses water to dissolve toxins and cleanse its tissues. As we have already seen, the activity of the immune system in CFS produces many toxic by-products which must be dissolved and released from the body. The more pure water is, the more "aggressive" or effective it is in dissolving impurities and toxins. Hence, drinking purified water is an important contribution to a healing environment in the body.
There are several kinds of water purifiers available, and using any one of them is probably an improvement over drinking tap water. Two major types are carbon filters and reverse osmosis. While reverse osmosis is slower and more expensive, it is generally more effective in filtering out impurities. The ultimate best have both carbon filtration and a reverse osmosis membrane working together, but again, anything is likely to be better than nothing. Most filters are accompanied by lab test results which, if you feel you can trust them, give a way of comparing the effectiveness of filters.
An alternative is to purchase bottled water. The drawback to this is that you may not know the quality of the water, or what method of purification was used. It is possible that so-called "natural spring water" can have high levels of impurities even though it is packaged beautifully. And, of course, not all impurities are man-made. Water coming from natural sources can be contaminated with toxic levels of substances occurring naturally in the environment. Thus, the safest course is usually to have your own purification process.
"Hypovitaminosis" is thought by some physicians to be an important feature of CFS. This refers to vitamin deficiency at the cellular level, which may not be reflected in conventional tests of vitamin levels in the blood. According to Paul Cheney, M.D., the elevated cytokine levels in CFS can block the vitamin utilization pathways in immune cells, producing a "hypovitaminosis syndrome" which further impairs immune functioning. For this reason Dr. Cheney recommends multivitamin therapy for CFS patients.
This gives us even more reason to consider supplementation as an important part of your recovery plan. Your immune system is already working overtime and depleting its resources by being in a state of hyper-arousal. In order for it to heal it needs the energy and raw materials that can only be provided through nutrients.
One physician who integrates a nutritional approach into treatment of CFS is Murray Susser, M.D., who states: "The body is designed for aboriginal eating. So if you're not eating beetles and worms and grubs and the like, then you're not going to be healthy no matter how smart you are about nutrition--unless you find the right supplements to make up for that lack." According to Dr. Susser, "functional" vitamin tests can be used to determine to what degree your cells are actually using the vitamins you take in. Such tests are not yet widely available in mainstream medicine, but, along with therapeutic trials, have revealed a great deal of hypovitaminosis in CFS patients.
An abundance of research has shown that certain vitamins are important in healthy immune functioning. These include vitamins A (retinol), B1 (thiamin), B2 (riboflavin), B6 (pyridoxine), B12 (cyanocobalamin), folic acid, pantothenic acid, C (ascorbic acid), D, and E. Minerals affecting immunity include copper, iron, magnesium, manganese, selenium, and zinc. There are also essential amino acids and essential fatty acids that play a role in immunity. An excellent summary of research on nutrition and immunity is offered in Nutritional Influences on Illness, by Melvyn Werbach, M.D. (Third Line Press, Tarzana, CA, 1987). This kind of information is widely available now, and there are many other books that could be recommended in popular book stores.
What Should I Take, and How Much?
Most people are best advised to get individualized help in answering this question. Vitamin and mineral supplementation should be guided by a knowledgeable health professional. Proper amounts must be taken, because both deficiencies and over-supplementation of some nutrients can adversely affect immunity. Also, some nutrients need to be taken in combination with others (zinc with copper, for example). Do not rely on the RDA (recommended dietary allowances) for guidance. These were never intended as therapeutic guidelines, but rather were designed for minimal nutritional requirements of mass populations during World War II. It is beyond the scope of this book to give specific recommendations, and it is essential to work closely with a qualified nutritionist or physician in planning your supplementation.
The Absorption Issue
One important issue in supplementation is that of absorption. Supplements taken by mouth are of course not as well absorbed as those taken by injection. In fact, many CFS patients have benefited from vitamin B12 injections. However, since oral administration is most common, it is important to know that certain forms are better than others.
Tablets which have been pressed together are less well absorbed than encapsulated crystallized vitamins. The hard tablets are often heated to a temperature far above where the vitamins can maintain their effectiveness. Vitamins B and C, for example, lose their potency at 180 degrees, but in tabulation machines often reach temperatures of 400 degrees.
Maintaining Colon Health
Finally, supplementation can be a means of maintaining colon health. As discussed earlier, yeast overgrowth in the colon and in the rest of the body is a common problem in people with CFS which contributes to immune dysfunction, allergies, food sensitivities, and immune over-activation. Yeast problems often develop when antibiotic therapy kills the healthful bacteria that populate the colon. Further, the standard American diet (the "S.A.D.") promotes yeast overgrowth with its refined sugar and highly processed foods.
As Carol Jessop, M.D., states: "I think that there is a lot of strong information to suggest that (CFS) patients have yeast overgrowth or parasitic intestinal overgrowth. In my clinical experience, when I document yeast and prescribe treatment, the patient's immune system seems somewhat less activated, and therefore, may be better able to deal with the agent or agents that are causing this syndrome... I think that this is one of the reasons my patients improve over a period of time."
The first line of defense against yeast overgrowth is a diet high in complex carbohydrates (such as whole foods, whole grains), and low in simple carbohydrates (such as sugar, white flour, refined products). There are many good books available on anti-yeast diets and recipes. Essentially, a whole-foods diet with minimal refined products or simple sugars will help prevent yeast overgrowth.
Supplementation with acidophilus, especially during and after any antibiotic therapy, will help restore a balance of healthful bacteria in the colon. Unless the form of acidophilus is of a type which is unaffected by stomach acid, it needs to be taken on an empty stomach (usually first thing in the morning) so it is not destroyed on its way to the colon.
There are also supplements such as odorless garlic tablets, Mycocidin, and ParaMicrocidin which help fight yeast overgrowth. Holistically-oriented physicians are usually well-informed about the issues of yeast treatment.
Yeast overgrowth is best diagnosed by purged stool testing and blood testing, and may need to be treated with antifungal drugs. According to Dr. Jessop, the great majority of patients with CFIDS are not tested using purged stool samples and are not correctly evaluated for this condition. There are effective antifungals available now, and as Jessop reports, such treatment gets into the nervous system and results in improvement in the symptoms of cognitive dysfunction affecting many people with CFS.
CHANGING YOUR PHYSICAL ENVIRONMENT
Changing the physical environment around you can have a surprising effect on your moods and inner states. Plants or flowers, cleanliness and neatness, clean windows, repositioning furniture, and lighting are all subtle changes that can create a more emotionally comfortable environment. When you make such changes, the mere action of doing so makes a statement about taking charge and valuing yourself.
Beyond the aesthetics, however, is an even more important issue of avoiding toxic materials in your environment. In Chapter 5 we discussed how the environment is involved in sensitivities and sensory dysfunction in CFS. To reiterate, cleaning materials in particular are offenders in terms of exposing you to immunosuppressing toxins. Given your state of vulnerability, it is best to use only natural and nontoxic cleaning materials.
Other possible offenders include the glue in carpeting. Especially avoid new carpeting unless it is clearly marked as natural and nontoxic. Also problematic are toxins and fumes escaping from paint and new building materials, such as the glue and formaldehyde in plywood. In fact, in many cases of CFS, encounters with toxic substances appear to have played a significant role. Make sure those around you are also aware of materials which are harmful for you.
Very often creating the environment you need requires standing up for your needs, as Marge tells us: "My contractor installed this fiberboard in the attic that released terrible glue fumes. I just decided I wouldn't accept it, and I didn't have to understand the chemistry or justify it in order to tell him to remove it. At first I did a real number on myself about `inconveniencing' him, but I decided, after all, it was my house. So I asked him to return it and just use wood."
Is CFS a disease of lifestyle? No. Can lifestyle change provide the major impetus to recovery? Absolutely. As we have seen, there is a great deal you can do to create a lifestyle that will support you. I have suggested a lot of changes here. However, there is no need to feel overwhelmed and think that you have to do everything according to this or any other book. Beware of any voices in the head saying you have to `do it right'! And, fortunately, with the growing recognition of CFS in the health community, you do not have to do it alone. In the next chapter we will explore the variety of psychosocial support services are available to help you make the changes you wish, and make them last.
EXERCISE 1: ASSESSING YOUR LIFESTYLE
The exercise below is offered as a review and summary of major points to consider in evaluating your own lifestyle. All of the items listed affect your ability to resist illness. Take plenty of time to consider each answer, and go deeper than your first impressions.
Instructions: Place one of the following symbols beside each item, signifying how well you feel you are doing with that item:
+ means you are doing well with this
o means you are doing "so-so" and could improve
- means you definitely need to improve with this
A. I drink purified water.
B. I drink enough purified water.
C. I eat breakfast.
D. I eat on a regular schedule.
E. I am careful to avoid processed foods.
F. I eat fresh fruits and vegetables.
G. I take appropriate supplementation.
H. I avoid refined sugar.
I. I minimize red meat intake.
J. I avoid alcohol.
K. I avoid caffeine.
L. I read the labels on food packages.
M. I avoid foods with chemicals I can't pronounce.
A. I avoid smoking or breathing smoke.
B. I watch minimal television.
A. I keep my environment free of toxic chemicals and fumes.
B. I keep my environment relatively quiet and peaceful.
C. I keep my environment beautiful and uplifting.
A. I communicate my feelings clearly.
B. I communicate my wants and needs clearly.
C. I say "no" without feeling guilty.
D. I am free from unresolved, festering conflicts.
E. I am free from preoccupation with old hurts.
F. I avoid "toxic relationships."
G. I have relationships which nourish me.
5. Emotional expression:
A. I allow and express sadness.
B. I cry freely.
C. I allow and express fear.
D. I allow and express anger.
E. I allow and express love.
F. I allow and express joy.
G. I laugh freely.
A. I am free of guilt and self-judgment.
B. I forgive myself for past mistakes.
C. I love and accept myself.
7. Alone time:
A. I spend some quality time alone each day.
B. I let my mind rest.
C. I relax.
D. I spend time in introspection.
A. I get mild, comfortable exercise when I feel able.
B. My work activity is free of anxiety and compulsiveness.
C. My home-making activity is free of anxiety and compulsiveness.
D. I allow myself to rest when I need to.
9. Pleasure and enjoyment:
A. I get some genuine pleasure or enjoyment each day.
B. I initiate contact with friends I enjoy.
10. Physical touch and contact with others:
A. I have physical contact with others.
B. I give and receive affection.
C. I accept affection gracefully without having to talk about it or having to give something back right away.
11. The spiritual dimension of life:
A. I have a spiritual or religious understanding for my life which assists me to feel peaceful, hopeful, and at ease with my life.
B. I have personal goals which make my life worthwhile.
C. I have a deep, valuable purpose for being well.
D. I truly believe in my purpose for being well.
E. I am living life according to my deeper values.
A. I actively seek information about my health on my own.
B. I ask my doctor questions and keep asking until I am
C. I practice some form of self-help activity each day.
EXERCISE 2: IMAGINING A HEALTHY LIFESTYLE
Develop an image of what would be the optimal lifestyle to promote your healing. Include all the areas discussed in this chapter and anything else you feel would be important. Especially include seeing yourself doing what would be most fulfilling and inspiring to you.
It may be helpful to write down a description in first person, present tense, of how you are living in this healthy lifestyle. Let this image become something you contemplate regularly, and gradually it will begin to influence your lifestyle choices day be day.
For more information, visit http://www.healthy.net/collinge/.
© 2002 William Collinge, Ph.D.
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