How to Manage Chronic Pain in Lyme Disease

Content Notice: This post contains information about suicide. If you’re dealing with suicidal thoughts or find yourself in a crisis situation, call the National Suicide Prevention Lifeline (in the United States) at 1-800-273-8255.

Lyme disease is a complex of infections transmitted by the bite of a tick that can cause, among other things, debilitating muscle and joint pain. Pain that does not go away can make you desperate like nothing else will. Trying to find treatment can be frustrating at best and deadly at worst. Following are some important things to know when dealing with chronic pain.

Coping with Chronic Pain

1. See a pain management specialist. The right physician is key to finding good pain control. Most physicians are now referring patients with pain to specialists at pain management clinics. The treatment of chronic pain has become a specialty in its own right, as chronic pain can be very difficult to treat and can cause its own set of problems. Although a physician doesn’t necessarily have to understand chronic Lyme disease to be helpful, the important thing is finding a person who agrees with your own philosophy of pain management. But be wary of switching doctors frequently as it is to your benefit to have an established relationship with one doctor who can manage your pain. If you can’t find a doctor, ask for recommendations from other patients in the Lyme disease community with whom they’ve had a good experience.

2. You have options. There are many different treatment modalities for managing pain. Most people think only of narcotic medication. Narcotics can indeed be a very effective way to treat pain, but they are most effective for short-term pain. Long-term, chronic pain gets a little tricky, but it is not impossible to treat. Some of the other treatment options for managing pain include:

  • Physical or occupational therapy
  • Exercise as tolerated
  • Supplements and other natural remedies for pain
  • Massage therapy
  • Antidepressants
  • Topical agents
  • Biologics
  • Biofeedback
  • Electrical stimulation
  • Anti-seizure medications
  • spinal injections
  • Chiropractic care
  • Acupuncture
  • Anti-inflammatories and non-narcotic analgesic medications, such as acetaminophen
  • Cbd oil
  • Medical cannabis

Typically, treating chronic pain successfully usually requires a combination of these modalities.

3. Consider supplementing pain medications with other therapies. While pills are usually the first method of pain management we want to try, they may not be the best choice. There are always side effects that accompany the benefits of pills. Many of them are minor but some of them can be devastating over time, like kidney or liver damage. It is important to know what medicines you are taking and what side effects and drug interactions can occur if certain pills are combined — especially if you’re taking medications for Lyme disease treatment as well. If you need pills for pain relief, sometimes interventions such as stretching, exercise, cold or hot compresses, aromatherapy, or warm baths can reduce the amount of medicine you need. Exploring these options for reducing pain may be very beneficial for reducing the overall amount of medicine you need to control pain.

4. Look into cognitive behavioral therapy. Cognitive behavioral therapy, (CBT) a form of mental health therapy, can be effective in helping you to manage chronic pain. Mental health counselors can help you find coping methods and can help you work through marital or family stress caused by the effects of chronic illness, and help you manage daily stress that may be contributing to your pain, among many other things. Don’t be afraid to consider this form of pain management.

5. Have a support system. Many people with chronic pain consider suicide. Often, they don’t want to end their lives but just desperately want relief from the circumstances, ongoing pain, and persistent Lyme disease symptoms. Finding the right resources and having a support system can make a big difference when you are trying to treat and cope with pain. Don’t be afraid to reach out to others who might be able to provide encouragement and support. For help in a crisis situation, call the National Suicide Prevention Lifeline (in the United States) at 1-800-273-8255.

6. Watch for new developments on the horizon. One new form of therapy is based on the findings that our brains have neural pathways that form when certain activities are performed by our nervous system repeatedly. It was once thought that these neural pathways were unchangeable, but modern medicine has discovered that these pathways are indeed changeable, and refer to this phenomenon as “neuroplasticity.” This field of medicine has had great successes in rehabilitative medicine and is definitely an area of medicine to look out for, for future advances in pain management. One such tool to consider is Dynamic Neural Retraining (DNRS), which might be beneficial to some Lyme patients battling chronic pain.

Treating chronic pain can be frustrating, but don’t give up hope. There are many different resources available to you. Use every resource and as many different treatment modalities as you can to help in managing your pain. While the pain may not go away completely, it can be made more tolerable so that you can still have the life you want.

This article was first published on on November 9, 2015 and was updated on November 16, 2019.

Laurie MillerLaurie Miller, RN BSN MS, is an author, nurse, wife, and mom who has lived with chronic pain and illness for 9 years. She enjoys reading, spending time with family, and blogging at God-Living with Chronic Illness.

Flexeril for Fibromyalgia Pain, Sleep Problems and Daytime Fatigue

If you struggle with fibromyalgia symptoms like chronic pain, it can be an exhausting endeavor to find the right medications or supplements to ease your ongoing discomfort. Let’s examine Flexeril, a well-known muscle relaxer that’s been around for more than 40 years. Is it a drug that can provide some relief? Let’s take a look.

Flexeril for Fibromyalgia Pain

Flexeril (cyclobenzaprine) is FDA approved for the short term relief of acute musculoskeletal conditions like muscle spasms. Currently, it’s not approved for long term usage or to treat fibromyalgia (FM).

Still, fibromyalgia specialists sometimes prescribe Flexeril for use as a sleeping aid and to reduce fibromyalgia pain. But at a standard Flexeril dosage, it has a sedating effect often carries over to the next day, worsening fatigue.

However, there may be a better way of prescribing Flexeril; not only a way that improves sleep and pain, but to actually lessen feelings of daytime fatigue also.

There are two key innovations to consider when taking Flexeril:

  1. Taking a lower than usual dose of Flexeril at night in the 2 mg to 5 mg range instead of the usual 10 mg dose.
  2. Taking Flexeril every night for many weeks, not just as an intermittent sleeping pill.

Key Study

The lead author in a 2011 study, was Harvey Moldofsky, M.D., now Professor Emeritus at the University of Toronto. Dr. Moldofsky’s career-long research on fibromyalgia has provided major contributions to understanding our field. For example, Dr. Moldofsky’s 1975 article was the first to prove the relationship between fibromyalgia pain and abnormal patterns of sleep. His most recent publication on fibromyalgia was in 2015.

For this research, Dr. Moldofsky’s Toronto team conducted a double-blind study of 36 patients with FM. Half were given “low dose” Flexeril/cyclobenzaprine starting at 1 mg and working up to the 4 mg range. The others received a placebo. These were taken every night for over eight weeks.


Low dose cyclobenzaprine made a positive difference, with very few major side effects. Patients on the placebo did not improve.

Here are the main numbers:

  • Pain: Pain intensity levels were scored prior to starting treatment and after eight weeks. For the Flexeril group, pain severity decreased by 26.1%. The “P value” was less than .01. (That is, the probability (P) of this result being obtained by chance was less than one chance in 100. A P value of <.05, is considered to be “statistically significant.”) The placebo group had no change in their pain.
  • Daytime Fatigue: For those taking Flexeril, daytime fatigue scores decreased by 14%. This difference was statistically significant (P=.039). For those on a placebo, daytime fatigue did not improve.
  • Sleep: Patients taking Flexeril increased their average sleep time by about one-half hour. Those on a placebo slept about the same as they did before. Flexeril may also have improved the quality of sleep by reducing the occurrence of disruptive brain wave patterns.
  • Anxiety and depression: After eight weeks, patients taking low-dose Flexeril improved on their anxiety/depression score by 24.1%. (P=.012). The placebo group’s anxiety/depression score decreased also but by just 3.8%.

After eight weeks, patients were asked to rate whether they had improved since starting treatment. Those taking low-dose Flexeril tended to rate themselves as improved (P=.001). Those taking a placebo did not. The treating doctors (who did not know which group the patient was in) agreed that the Flexeril patients had improved, while placebo patients had not.

Flexeril Side Effects

1. Headaches: Side effects in this relatively small study were mild and occurred about as often in both groups. The only adverse event that was rated as severe was a headache. This occurred in a patient taking the placebo.

2. Irregular heart rhythm: Beyond this study, the most serious potential side effect for Flexeril (cyclobenzaprine) is prolongation of the QT interval, a  potentially life-threatening irregular heart rhythm, on the electrocardiogram. This can be important since a long QT interval increases the risk for serious heart rhythm problems.

But a fair number of medicines also increase the QT interval. Among these are:

  • Antibiotics like Zithromax, Biaxin, Cipro, and Levaquin
  • Heart medicines, including Amiodorone and Flecainide
  • Several cancer medicines
  • Anti-nausea drugs such as Odansetron/Zofran and procholorperazine/Compazine
  • Many antipsychotic medicines
  • Tricyclic antidepressants such as Elavil (amitryptiline) or Pamelor nortriptyline

Note that a physician would usually avoid combining these medicines with Flexeril. Clinicians might consider which patients should have an EKG read out of their QT interval.

3. An increase of Flexeril in the blood: Other commonly used medicines tend to increase the blood level of Flexeril/cyclobenzaprine, thereby increasing Flexeril’s effect on prolonging the QT interval. This interaction is most likely for medicines that compete with Flexeril for the same liver detoxification pathways.

A word of caution: Persons with liver disease, certain heart rhythm abnormalities or a known prolongation of their QT interval might best avoid Flexeril (and other drugs that prolong the QT interval).

The Takeaway?

As far as fibromyalgia treatments and medicines go, Flexeril at 5 mgs (the lowest commercially available dose) is relatively safe and relatively inexpensive possibility for fibromyalgia. Therefore, if you have fibromyalgia, consider discussing an option like this with your clinician. Perhaps start with a 2.5 mg dose at night (one half of a 5 mg pill). If 2.5 mgs doesn’t make you too tired the next day, then consider increasing to 5 mg each night for an eight week-long trial. If 5 mg makes you tired, go back to 2.5.

Don’t prejudge whether Flexeril actually helps until the full trial is done. I contacted Dr. Moldofsky, who said that in his study there were no interim measures of effectiveness taken between baseline and eight weeks. My guess is that the maximum benefit from low dose Flexeril would take more than a few days to be noted, but fewer than eight weeks.

Is Flexeril right for you? Your doctor probably has not memorized all of the potential interactions of drugs you may be taking and Flexeril, but your pharmacist’s computer should know. Ask your pharmacist specifically whether any of your medicines increase the QT interval and whether any of your medicines use the same liver pathways as Flexeril (Cytochromes P450 3A4 or P450 1A2, or to a lesser extent P450 2 D6).

This article was first published on on August 8, 2016 and was updated on November 13, 2019.

Richard Podell, M.D., MPH, is a graduate of Harvard Medical School and the Harvard School of Public Health. He has been treating patients with ME/CFS and Fibromyalgia for more than 20 years. A clinical professor at New Jersey’s Robert Wood Johnson Medical School, Dr. Podell see patients at his Summit, NJ and Somerset, NJ offices.


Continue reading “Flexeril for Fibromyalgia Pain, Sleep Problems and Daytime Fatigue”

5 Supplements to Cope with Irritating Insomnia Tonight

Gone are the days where I could fall asleep as soon as my head hit the pillow. Instead, I have what my doctor refers to as “intractable” insomnia, meaning it’s stubborn and difficult to treat. It appeared as one of my first Lyme disease symptoms, and it’s remained a problem throughout the last several years of treatment. My insomnia was so severe, I lost the ability to nap altogether, and I wondered if I’d ever regain that essential function. I had become a professional insomniac without trying.

In the early years, I tried every herb, supplement, medication, and lifestyle adjustment anyone suggested to me to get to sleep, and I spent a ton of money on things that were of no help to my situation. My body was begging for sleep, and yet, it was the one thing that seemed to elude me. But I refused to give up on obtaining some precious shut-eye, and I continued to experiment with a variety of products to support my sleep.

Although this aspect of my healing is still a work in progress, I’ve gone from zero sleep (which inevitably landed me in the ER) to sleeping about half the time most nights —a small victory for which I am grateful. I rejoice in any amount of healing that’s taken place in my body.

For most people, poor sleep with Lyme disease seems to be the norm rather than the exception. Over time, however, I’ve managed to gather a few items that consistently aid my ability to sleep, and I’d like to share those with you in this article. I call these supplements my “sleep cocktail.”

Below are five supplements I use to augment my insomnia treatment.

Poor Sleep with Lyme Disease

1. Phosphatidylserine: An adrenal saliva test I’d done a few years ago revealed elevated nighttime cortisol levels, which made it difficult to fall asleep because my body was constantly in fight mode. My Lyme-treating nurse practitioner recommended I give this supplement a try. Phosphatidylserine lowers cortisol levels. When I take it before bed, it reduces stress, lowers cortisol, and helps my body enter into a state of relaxation.

2. Liposomal glutathione: Glutathione is a master antioxidant and detoxifier in the body, and the liposomal form penetrates the gut lining for greater absorption into the bloodstream. A bottle of liposomal glutathione can be pricey, so I choose to reserve its use for when my neurological Lyme symptoms are flaring, or I’m experiencing a Herxheimer reaction from an aggressive Lyme disease treatment. With regards to sleep, taking the supplement at night seems to lessen my insomnia, reduce pain, and decrease the burning sensation I often feel in my brain and spinal cord.

3. Melatonin: Melatonin is a hormone made in the pineal gland of your brain. It helps control your sleep-wake cycles and causes you to feel sleepy at night. Your body produces melatonin as it gets dark in preparation for you to fall asleep, and it decreases production when your eyes see the light. Since I routinely have trouble falling asleep, I’ve found melatonin to be useful in cutting down the time it takes me to fall asleep.

Additionally, I use a sleep mask to minimize my exposure to light and optimize my body’s melatonin production —which can potentially keep me awake. Darkness encourages the body to wind down.

4. CBD Oil: For the last seven years, I’ve dealt with throbbing nerve pain in my teeth and jaws due to chronic Lyme disease, which often keeps me up at night. Despite many dentist and doctor visits, no one had been able to come up with a way for me to control the pain. One doctor’s best guess was that I was experiencing facial muscle spasms. I spent several weeks seeing a chiropractor to work on my neck alignment and muscle tension, but my pain never improved. I’d resigned to the idea I would just have to “live with it.”

Enter CBD oil.

I’ve heard of other patients having success with this supplement, but I’m in the beginning stages of exploring its benefits. During my research, I discovered a 2012 study involving mice that showed CBD oil was able to reduce chronic and neuropathic pain without the psychoactive effects of cannabis or other pain-relievers. Since CBD oil is now more widely available, I decided to give it a try. Although I’m new to using it, I can honestly say my facial nerve pain is significantly diminished, and I’m able to sleep better as a result of having less discomfort.

5. L-theanine: L-theanine is an amino acid precursor to the calming neurotransmitter called GABA. It crosses the blood-brain-barrier, and therefore, directly affects the central nervous system, helps reduce anxiety, and induces a state of calm. A unique property of L-theanine is that it doesn’t make you drowsy like some prescription sedatives or sleeps aids; rather, it slows down brain activity so that you can fall asleep. L-theanine is one of my favorite supplements, and I’ve used it as part of my sleep regimen for many years and so far, it hasn’t lost its effectiveness.

Bottom Line?

For many people, insomnia can be a disabling symptom of Lyme disease. Sleep is an essential component to recovery from any chronic illness. When you can’t sleep, you simply can’t function in a productive manner. In addition to the options that I’ve listed that have worked for me, there are a wide array of other natural sleep remedies that you may find helpful. If you’re having trouble sleeping, please don’t give up the search to find something that works for you. With some trial and error, you can create your own “sleep cocktail.”

I’d love to hear about the supplements that have helped you. Please feel to continue this conversation by leaving me a comment.

This article was first published on on June 20, 2017 and was updated on October 30, 2019.

Jenny Lelwica Buttaccio, OTR/L, is an occupational therapist and certified Pilates instructor whose life was transformed by Lyme disease, chronic fatigue syndrome and interstitial cystitis. She is creator of the DVDNew Dawn Pilates: pilates-inspired exercises adapted for people with pelvic pain. Jenny is a health and wellness advocate and blogger who writes about her journey on The Lyme Road as she continues to pursue her personal healing with the support of her husband and two rescue pups. You can find her on Instagram: @jenny_buttaccio or Twitter: @jennybuttaccio


Continue reading “5 Supplements to Cope with Irritating Insomnia Tonight”

Coffee Alternative Boosts Mental Focus

Coffee Alternative Boosts Mental Focus

Reprinted with kind permission of LifeExtension

Sometimes you need a way to clear afternoon brain fog.

Coffee can do the trick, but for many people, drinking coffee later in the day can interfere with sleep, upset the stomach, lead to a jittery feeling, and result in a later “crash.”

There is an herbal alternative.

Scientists have identified a unique spearmint extract that, like coffee, helps the brain focus.

It even boosts short-term working memory. But it’s stimulant-free and won’t cause any of coffee’s common side effects.

Available in a convenient, instant spearmint tea, this extract contains high levels of phenolics, health-promoting compounds found in plants, particularly rosmarinic acid.

And this spearmint extract goes beyond offering a mental boost.

A recent, clinical study demonstrated that it also enhances the ability to quickly initiate unplanned changes in direction or speed. This can help performance during exercise or sports, and lead to fewer falls in the elderly.

Staying Mentally Sharp

A majority of Americans are very concerned about staying mentally sharp. While many turn to coffee for a daily boost in focus, attention, and concentration, almost two-thirds of consumers report that they are trying to limit their caffeine intake.

In fact, a whopping 64% of men and women in the U.S., and 74% of those over 55, drink coffee daily, in part for the short-term increase in focus it provides.

Researchers recognized the need for a drink that enhances mental focus as quickly as coffee, while being free of caffeine and other stimulants.

Role of Memory in Mental Focus

Role of Memory in Mental FocusWorking memory is the part of short-term memory that stores information and allows it to be used even while you’re engaged in another mental task. It plays a crucial role in other cognitive abilities that include problem solving and decision making.

If your working memory isn’t in top shape, that will make it harder to focus and concentrate.

Add to this the fact that working memory declines about 10% per decade after age 40, and even faster after age 70.

Nutrients that boost working memory can play a crucial role in being able to focus and concentrate, especially with increasing age.

Also important to cognitive function is spatial working memory. That’s the ability to recall where items are arranged in space, such as the layout of your home or how to get around town.

Researchers investigated many options, and ultimately found that spearmint extract targets all these areas of mental focus and concentration.

Supporting Mental Focus

Scientists have demonstrated in various studies that spearmint extract enhances the underlying elements of mental focus. It can:

  • Boost alertness, mood, and vigor,
  • Improve working memory and spatial working memory,
  • Improve one’s ability to get to sleep at night, and
  • In animals, promote the creation of new brain neurons, protect existing neurons, and boost neurotransmitter levels.

A recent study found that spearmint extract also boosts reactive agility, the ability to react rapidly when quick, sudden changes in direction or speed are needed. This type of agility can help prevent falls in the elderly and improve participants’ sports and exercise performance.

Spearmint extract’s effects for cognitive support have been verified in a range of studies.

Attention, Concentration, and Brain Function

Scientists found that just a single 900 mg dose of spearmint extract led to significant improvements in attention and concentration in human subjects in as little as 2.25 hours. With longer-term use, over 30 days, they continued to show these same cognitive benefits.

In one study, 11 healthy adults who were experiencing typical age-related problems with memory took 900 mg of spearmint extract with breakfast for 30 days. The volunteers were given a battery of computerized cognition tests one hour before taking the initial dose. These tests were repeated after four hours, and again after 30 days.

Four hours after the first dose of spearmint extract, average scores showed:

  • 46% improvement on a task requiring attention and concentration,
  • 121% improvement on a second task requiring attention and concentration, and
  • 39% boost in planning ability.

Thirty days after the initial dose, average scores demonstrated:

  • 35% improvement on a test of reasoning,
  • 125% improvement on a test of attention and concentration, and
  • 48% boost in planning ability.

These findings show that supplementation with spearmint extract has both immediate and longer-term benefits for cognitive function.

Next, scientists investigated this extract’s effects on a healthy, young, and active population. In a double-blind study, 142 healthy, recreationally active men and women were enlisted, who took either 900 mg of a proprietary spearmint extract each day for 90 days, or a placebo.

Improvements in sustained attention were measured at day 30 and day 90. Scores on cognitive tests requiring complex attention were improved at day seven. Response times for correct answers were also faster.

The study authors concluded that this spearmint extract enhances attention and “improves cognitive performance in a young, active population.”

Improvement in Working and Spatial Working Memory

Turning to effects on memory, scientists enlisted 90 people, averaging 59.4 years of age, who had age-associated memory impairment.

Participants in this randomized, double-blind, placebo-controlled study took either 900 mg or 600 mg of spearmint extract or a placebo every day at breakfast for 90 days. The extract was standardized to contain 24% total phenolics and 14.5% rosmarinic acid, one of spearmint’s brain-protecting components.

After 90 days, the 900 mg of extract led to an improvement in working memory of approximately 15% and a 9% improvement in spatial working memory, compared to the placebo.

This suggests, “that this extract could improve working memory equivalent to that which may have diminished over a decade of life,” the study’s authors wrote.

What You Need to Know

  • Phenolic compounds in spearmint extract have been shown in human studies to significantly improve focus and attention, as well as concentration, plus working memory and ability to get to sleep at night.
  • Preliminary data suggest that spearmint phenolics like rosmarinic acid promote the creation of new brain cells and protect existing neurons.
  • Recent research on humans shows that spearmint extract also improves reactive agility, the ability to rapidly respond physically.
  • Spearmint extract does all this without caffeine or other stimulants, making it a natural and healthy alternative to coffee.
  • A spearmint extract delivering high phenolic levels, especially of rosmarinic acid, is now available in an instant, sugar-free spearmint herbal tea. It comes in one-cup, convenient grab-and-go packets for a quick boost in cognitive performance.

Making it Easier to Fall Asleep

The results of this study also demonstrated beneficial effects on sleep and mood, both of which help support daily attention, concentration, and focus. Making it Easier to Fall Asleep

Participants in the 900 mg spearmint group reported improvements in their ability to fall sleep. And they were more alert when they woke up.

The improvements were so pronounced that they were similar to those seen with commonly used sleep aids, researchers noted, but without the negative side effects that often come with them.

In addition to boosting daytime alertness and concentration, these effects might halt the longer-term decline in cognitive health associated with reduced sleep.

Using a standard psychological-rating scale, improved mood was observed in those taking 900 mg of spearmint extract.

Taken together, all these effects can make a huge difference in an individual’s mental focus and function.

Promotes Brain Neuron Formation

Beyond improving cognition, the phenolics present in the extract promote neurogenesis, the formation of new brain cells.

In cultures of cells from the hippocampus, the brain’s center of working memory, spearmint’s rosmarinic acid significantly enhanced the growth of new cells.

Not long ago it was believed that people stop growing new brain cells after adolescence. But a 2018 study in the journal Cell Stem Cell found otherwise.

Postmortem examination of the brains of people who died at various ages revealed that healthy, older individuals without cognitive impairment or neuropsychiatric disease maintain neurogenesis well into old age.

This has changed medicine’s view of brain aging. Now that scientists know new brain cells are being formed, the focus has shifted to learning how quickly an individual produces them. A person’s neurogenic rate may be vital in determining how well the brain functions and focuses.

Research suggests that spearmint extract provides the brain with support to optimize its potential for neuron creation. This can lead to improved focus and long-term cognitive function, and may help those at risk for age-associated memory impairment.

Increases Neurotransmitter Levels

Spearmint has also been shown to protect existing brain cells and the blood vessels that nourish them.

Phenolics in spearmint inhibit the enzyme acetylcholinesterase, which breaks down the memory-associated neurotransmitter acetylcholine.

These phenolic compounds also inhibit harmful oxidative stress. One specific phenolic, rosmarinic acid, was shown to protect key memory centers of animal brains—such as the hippocampus and cortex—against cellular damage from this stress.

Improves Reactive Agility

In a double-blind study that appears to be the first of its kind, scientists recently assessed the effects of spearmint on a connection between mental and physical performance.

Reactive AgilityThey gave 142 healthy, active volunteers, aged 18 to 50, either a placebo or 900 mg of spearmint extract daily for 90 days. Subjects avoided caffeine for 10 hours before and during the study. Using a special audio-visual device and footplates, researchers evaluated reactive agility, the physical ability to quickly react to a stimulus.

At days 30 and 90, the spearmint group demonstrated significantly greater reactive agility than the placebo group, showing a faster association between cognition and physical response with spearmint supplementation.

The study’s author concluded that the spearmint extract appeared to be safe and have potential benefits for athletic performance.

Another study demonstrated that participants subjectively experienced energy improvement. This double-blind experiment involved 10 healthy individuals who had been sleep-deprived for 24 hours, during which time they had participated in very stressful, antiterrorism training.

Unlike the placebo group, those taking 900 mg daily of the proprietary spearmint extract containing rosmarinic acid reported increased feelings of energy. They also reported experiencing greater attention and focus. However, the researchers found that the overall results were less than conclusive, and called for further study.

A Quick Mental Boost

All these successful, human studies employed 900 mg of aspearmint extract containing more than 50 phenolic compounds, standardized to 24% total phenolics and 14.5% rosmarinic acid.

This same dose of the extract is now available in just one serving of a sugar-free, instant spearmint tea.

Researchers achieved this high phenol concentration by using a gentle water-extraction process and an innovative drying technology. This preserves the phenolics and the rosmarinic acid more fully than typical steam-extraction methods.

This herbal tea comes in grab-and-go packets that make one cup of tea in seconds. Just pour the contents into a cup, add hot water, and stir—no steeping required.

This instant refreshment delivers an immediate boost in mental focus and working memory without caffeine, and without the potential for a later “crash.”


People seeking an alternative to coffee can now get a quick boost in focus, attention, and concentration with a spearmint herbal tea.

Human studies show that phenolics like rosmarinic acid, abundant in spearmint, enhance mental focus and working memory during the day, and improve one’s ability to get to sleep at night.

Early lab data suggest spearmint compounds may promote the creation of new brain cells.

A human study found that a spearmint extract can also increase reactive agility, a brain-muscle reaction that can benefit athletic performance. Another study showed that the extract enhanced feelings of energy.

In human trials the spearmint extract has been shown to be safe, without any adverse side effects.

Available in one-cup, grab-and-go packets that deliver a high concentration of rosmarinic acid and other phenolic compounds, this sugar-free, instant spearmint tea provides an ideal, caffeine-free way to quickly increase mental focus while improving cognitive health.

For references see original article here.

Powerful Models Accurately Predict Response to Exercise and Treatments in ME/CFS

Reprinted with the kind permission of Cort Johnson and HealthRising.

How close are we to understanding chronic fatigue syndrome (ME/CFS) when we can accurately predict how the greatest stressor of all – exercise – affects ME/CFS patients’ physiology? Nothing, after all, whacks a person with ME/CFS like exercise. That’s a nice question to ask.

We’re not there yet – the models being produced aren’t comprehensive enough – but the fact that they’re successfully incorporating important elements of two of the major systems (immune/endocrine) of the body suggests we’re on our way to teasing out major factors in this disease.

It’s taken an unusual approach to get to this point. It’s pretty clear that ME/CFS arises out of the dysregulation of numerous systems, yet too often researchers approach these systems as if they exist in isolation from each other. That approach, these two research groups – Gordon Broderick’s group based at the University of Rochester and Dr. Klimas’s group based at Nova Southeastern University – believe is a big mistake.

Hypothalamic Model of ME/CFS

A possible model of ME/CFS explains why. This model proposes that a stressor, such as an infection, triggers one stress response system (hypothalamus/pituitary/adrenal [HPA] axis) to activate the other stress response system (ouch!) (the sympathetic nervous system or fight/flight system) to create a positive feedback loop (an ongoing disease situation) kept alive by an inflammation in the hypothalamus.

It makes sense that the hypothalamus might be involved. In fact, a couple of years ago, Dr. Bateman concluded that everything in ME/CFS could begin with inflammation in the hypothalamus.

Located deep within the brain’s limbic system, the hypothalamus is tasked with maintaining the body’s internal balance – or homeostasis. The link between the endocrine and nervous systems, the hypothalamus produces the hormones which regulate the other hormones in the body. It directly regulates:

  • Heart rate and blood pressure (autonomic nervous system)
  • Temperature
  • Fluid and electrolyte balance
  • Appetite and body weight
  • Glandular secretions in the stomach and intestines
  • Production of substances that influence the pituitary gland to release hormones
  • Sleep.

Inflammation in the hypothalamus could be sustained by increased levels of just three cytokines (interleukin (IL)-1b, IL-6, and tumor necrosis factor-a (TNF-a). Put all these factors together and you could have the ongoing inflammatory/hormonal/autonomic nervous system mess that is ME/CFS.

Adding Women into the Equation

That HPA axis/immune model works, but it has a glaring hole – women. It can’t explain the much higher ratio of women who have ME/CFS.  It’s possible women’s greater susceptibility to infection and/or autoimmunity plays a role, but even then, any model of ME/CFS has to take into account women’s complex hormonal situation.

In fact, researchers have for years shied away from including the complexity that women’s hormones add into the equation.  So few female mice studies were being done at the NIH, for instance, that in 2014 Francis Collins mandated that NIH-funded mouse studies include female mice.

However, there’s been no shying away with this team. Instead, they’ve embraced the complexity of the female hormonal system and its manifold effects in a way no one else has done.  The new model incorporates the HPA axis (corticotropin-releasing hormone [CRH], adrenocorticotropic hormone [ACTH], and cortisol), the hypogonadal [HPG] axis (estrogen, follicle-stimulating hormone [FSH], GnRH 1, luteinizing hormone [LH], and progesterone), norepinephrine, dopamine and immune factors (IFN-g, IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-10, IL-13, IL-15, IL-17, IL-23, TNF-a, B-cells and NK functions).

It may be the first of its kind. It may be that no other model has so comprehensively incorporated sex hormonal findings into its results. The good news is that it appears to have worked.

The Big Test

Once they had their model, they gave it the big test: could it predict what happens in ME/CFS before, during and after exercise?

Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically Relevant Phenotyping of Women With Chronic Fatigue Syndrome. Matthew C. Morris, PhD1; Katherine E. Cooney, BSc1;Hooman Sedghamiz, MSc1; Maria Abreu, PhD2,4; Fanny Collado, RN2,4; Elizabeth G. Balbin, MSc2,4; Travis J.A. Craddock, PhD2,3;Nancy G. Klimas, MD2,4; Gordon Broderick, PhD1,2,5; and Mary Ann Fletcher, PhD2,4. Clinical Therapeutics/Volume xxx, Number xxx, xxxx

This study collected blood 10 times before, during and after (up to 24 hours) a maximal exercise test in 88 women (43 ME/CFS / 45 healthy controls). It measured frequencies of B cell (CD19+) and natural killer (NK) cell (CD3-CD56+) populations, cytokines (IFN-g, IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-10, IL-13, IL-15, IL-17, IL-23, TNF-a) as well as estrogen (estradiol) and progesterone (at 4 time points).


This finding suggests that the set of candidate mechanisms embodied in the endocrine immune circuitry model offer a framework for accurately reproducing the immune response to exercise. Authors.

The methodology is way beyond me and the authors do note several issues including a lack of data for some elements of the modeling, but a remarkable thing happened: the model was able to predict what happened to the immune/endocrine systems in ME/CFS both during rest and exercise. Consider how difficult it must be to characterize the complex interactions in these systems at rest – something no one else to my knowledge has done – and then to throw in the huge impact that exercise must have on these systems – and get that right as well.  This is clearly a  robust model and a remarkable achievement.

The model found, if I’m reading it right, no less than 26 different ways to tweak these systems so as to arrive at an ME/CFS-like state. All the simulations, interestingly, involved “widespread endocrine dysfunction”.

Immune Hits

The exercise part of the study found that exercise does, indeed, whack the immune systems of people with ME/CFS quite hard: the levels of almost half the immune markers (IL-1b, IL-2, IL-4, IL-5, IL-6, IL-13 as well as the NK cells) were significantly altered in the ME/CFS group.

As noted above, the immune test results suggested the group’s crazily complex models were right on; i.e. the modeling actually predicted perfectly the immune findings the testing revealed at rest and were within 5% of the immune findings during and after exercise.

Sex Hormones

The modeling predicted the women with ME/CFS would have significantly higher estrogen levels (p<.002) at rest and throughout the exercise study – and they did. It also predicted transient up-spikes in progesterone would occur and a trend (p<.07) towards elevations in progesterone was found as well.

Predicting the Future

Once they knew the modeling worked, the researchers pushed it to predict what the heck else was going on in ME/CFS. It turned out that the immune and endocrine dysregulations found were just a prelude: the modeling also predicted that a host of other markers (ACTH, cortisol, estrogen, GnRH1, IL-17, IL-23, LH, and TNF-a, IL-1a, B-cell activation, CRH, and dopamine levels) would be thrown off by exercise.

The models suggested, then, that exercise was massively altering many areas of ME/CFS patients’ physiology – which would come as no surprise to anyone with this disease. All in all, the model/exercise study indicated exercise was triggering the following processes in women with ME/CFS.

  • Inactivation of the HPA axis
  • Overactivation of the HPG axis
  • Heightened sensitivity to inflammatory stimuli, driven primarily by three cytokines (IL-1b, IL-6 and TNF-a) (particularly in the brain).

The model also predicted that:

  • Inflammation in the brain is present (via the upregulation of chemokine (C-X-C motif) ligand 8 and IL-23).
  • Dysregulation of the female hormone system has impacted the blood brain barrier, allowing immune cells to infiltrate the brain (Jarred Younger is exploring the possibility of an impaired blood/brain barrier now. A blog on that is coming up.)


Neuroinflammation is clearly a topic Dr. Klimas is very interested in, and the paper suggested that the Epstein-Barr virus and/or mitochondrial issues in the hypothalamus in connection with mast cell activation could be causing it.

With Jarred Younger and another Univ. of Alabama at Birmingham researcher (McConathy) diving into a large brain imaging study, and with Ron Tompkins at the Open Medicine Foundation-funded Harvard ME/CFS Collaborative Research eager to use Harvard’s brain imaging facilities, and with Dr. Klimas apparently interested in modeling neuroinflammation in ME/CFS, we will hopefully learn much more on the role neuroinflammation plays as time goes on.

Context Matters

We often think of the body in terms of test results or data points, but single data or even multiple data points are hardly able to capture what’s going on in a complex, dynamic system like the body.  The upshot of  modeling studies like these is that more traditional studies, with their focus on identifying “abnormal levels” of a factor, may be missing something vital: biological context.

Several ME/CFS studies, for instance, which appeared to fail to find evidence of significant alterations in female hormone levels, may be missing the forest for the trees. These studies didn’t account for the outsized roles some female hormones could play once put into the altered endocrine-immune networks the models suggest are present in ME/CFS.

The fact that the models put forward in this paper suggest that overactivation of the HPG axis (estrogen, progesterone, etc.) is a major driver in women with ME/CFS indicates how stark the differences between a systems and non-systems approach to ME/CFS can be.

Predicting Responders

The modelling efforts – which can assess how all kinds of inputs will tweak ME/CFS patients’ systems – are also being used to predict the effect of different drugs – in this case, Rituximab and Ampligen.

We know that Rituximab didn’t work out in ME/CFS and Ampligen is still up in the air – and the computer simulations largely bore this out. They suggested Ampligen would either work really well or have no effect at all. A return to health, however, occurred in only a “small fraction of the simulations run”.

The Rituximab simulations did not suggest the drug would return ME/CFS patients to health, but that it might help ward off some “highly pathologic states” and offer a partial remission for a small number of patients.

The modeling effort also predicted which type of patient might benefit from each drug. It suggested, for instance, that ME/CFS patients with a certain biological profile (low levels of IL-1a, IL-17, and cortisol, intermediate levels of progesterone and FSH, and high estrogen levels) might benefit from Ampligen, while those with another biological profile (low norepinephrine, IL-1a, chemokine (C-X-C motif) ligand 8, and cortisol levels; intermediate levels of FSH and GnRH1; and high TNF-a, LH, IL-12) might benefit somewhat from Rituximab.

The potential of these kinds of models – to create personalized drug treatment regimens for people with ME/CFS based on their particular endocrine, immune and autonomic nervous system results – is clearly huge. That’s a good thing, as the authors noted that the great heterogeneity found within ME/CFS (“the multiple disease phenotypes”) presents real challenges.

Dysregulation, Not Irremediable Damage

The good news was that, again if I read it right, the models suggest that ME/CFS is a disease of altered endocrine-immune regulation, not overt or irredeemable damage (i.e. to the basic circuits). Those circuits have just been, as the authors have asserted in the past, pushed into a kind of altered reality. The circuits are functioning abnormally, but are not in themselves damaged: they just need to be pushed, prodded, and enticed back to normal functioning.


For me, this is all fascinating stuff, but what I’m really excited about is the process underway.

It’s encouraging that the newer, more extensive model rested on – and ultimately validated – their earlier, less sophisticated model; they’ve had it right since the beginning. It’s more than impressive that their models are actually able to predict the changes that occur when people with ME/CFS are put under the greatest stressor ever – exercise.

Even more encouraging is the fact that these models are being used to predict helpful treatments which are now being tested. It seems too much to ask, quite frankly, that any treatments at this stage will be a complete success. I would never expect the answer to come tomorrow, but a 30% improvement would be life altering – and if they can get that far, that success should lay the foundation for more.

Plus, even in the worst-case scenario (were the current drug trials to fail), the results will be fed back into the program and help them produce better, more accurate models of this disease. So long as Klimas, Broderick, Morris, Crawford et. al. can continue to get funding – and Dr. Klimas just got a major GWI grant – they should be able to keep improving their models of GWI and ME/CFS. (Next up, there appear to be models which incorporate mitochondrial metabolism, mast cells and neuroinflammation.)

There’s no doubt that this is cutting-edge stuff, with all that implies – potential breakthroughs as well as considerable risks. Consider how powerful, though, it would be to be able to put your immune and hormonal results into a computer and have it spit out a series of possible treatments that might shift your health back towards normal.

About the Author: ProHealth is pleased to share information from Cort Johnson.  Cort has had myalgic encephalomyelitis /chronic fatigue syndrome for over 30 years. The founder of Phoenix Rising and Health Rising, he has contributed hundreds of blogs on chronic fatigue syndrome, fibromyalgia and their allied disorders over the past 10 years. Find more of Cort’s and other bloggers’ work at Health Rising.

How to Cut Mounting Medical Bills with Fibromyalgia

Between doctors, specialists, and natural therapies, medical costs in today’s day and age with  fibromyalgia can be overwhelming. The financial burden can cause some people to make unwise financial decisions, while causing others to stop seeking fibromyalgia treatments altogether because of a lack of funds. As a nurse, I have seen some patients mortgage houses to pay off medical bills. I have seen other patients lose houses and cars because of the continual financial drain. It’s quite possible to lose everything due to the financial burden of medical care, but it doesn’t have to happen that way. It is possible to make it through the maze of medical costs without sacrificing everything that you hold dear. After years of accumulating medical expenses as a patient myself, I have learned many things about paying for these expenses, which you may find helpful, too.

Following are a few ideas to help you if you find yourself with mounting stacks of medical bills on your counter:

Tackling Medical Bills for Fibromyalgia Treatments

1. Review your medical bills: Check your medical bills to ensure you are not being charged for unnecessary costs. Hospitals and clinics bill insurance (and you) based on a diagnosis code or procedure code. This means that they bill for an estimated cost of the entire procedure rather than the actual procedural costs itself, including the cost of paying medical professionals, use of facility equipment, and the number of supplies used during a procedure. It is possible that you are being charged for items or services that you don’t actually need so ask for itemized statements when necessary. If you were billed for a particular item or service that you did not use, it can be removed from the bill, or the amount can be refunded to you if payment was already received.

2. Be proactive about payment plans: When you are sick or experiencing chronic pain and have to go to numerous providers and hospitals, the piles of medical bills can be enormous. You will get one from every doctor and service provider, as well as from every laboratory and radiological facility you used. You will also be billed separately for emergency physicians and anesthesiologists. It’s overwhelming, to say the least.

Thankfully, if you initiate contact with the business office, most hospitals are very willing to work with you, offer financial aid, and set up a payment plan with payments that are within your means. Don’t wait until bills are past due to do this. Explain your financial situation to them, including your income and the number of medical bills you have incurred. Ask if you qualify for financial assistance, which will enable you to pay less for each bill. Being proactive with medical bills will always work to your advantage.

3. Consolidate your accounts: For patients with brain fog, one thing you may not know is that medical bills may have different account numbers for every clinic visit and every hospital visit. It is usually possible to combine those account numbers so that you will only have one clinic bill payment and one hospital bill payment, but you will probably need to ask the business office to do this for you. The benefit of this is that you will have one hospital/clinic payment rather than five payments going to five different account numbers at the same hospital/clinic. You will usually need to deal with the hospital business office and the clinic business office separately.

4. Visit business offices in-person whenever possible: When setting up a payment plan for large medical bills, it is usually best to go down to the business office to discuss this in person. I have known patients who have reduced their payments significantly just by being there in person. You may only find out during a face-to-face discussion that you are eligible for discounts based on your income or lack thereof. Of course, with fibromyalgia symptoms, it may be difficult for you to get down to the business office, but it will most likely work to your benefit to do so. Always tell the business office personnel if you are “self-pay” (meaning, you don’t have insurance) or are on disability, because you may be eligible for greater discounts on medical care.

5. Try to avoid extra loans: Don’t take out a loan or second mortgage to pay off medical bills. Most hospitals and health systems will work with you to pay for your healthcare costs, whereas most banks do not. You don’t want to lose your home in order to pay off medical bills, the payments of which could be reduced with a simple visit to the business office.  Remember that if you still owe money to the bank for your home, including a second mortgage or line of credit, the bank owns your home and can repossess it at any time if the payments should stop. If you must, consider refinancing your home instead so that your monthly mortgage payment is less. This may then enable you to contribute more towards your medical bills.

6. Take advantage of local credit counseling services: These types of services are often free and can be very beneficial in helping you to set financial goals, plan a working budget, and pay off debt, including medical debt. Sometimes, the credit counselor will arrange to receive one payment from you and then pay individual bills for you. While this may seem humiliating, it can also greatly reduce your stress. The agency can help you figure out how to set up a cash-only system, whereby you pay for groceries, gas, and other living expenses using cash only. This type of system enables and encourages you to stop using credit/debit cards to pay for expenses. Using a system of envelopes designated for Food, Gas, Personal Needs, Entertainment, etc. (in which you put cash after you get paid) provides the benefit of helping you see exactly how much money you have left for each category each month. Over time, as you learn to stay within your budget and pay your bills, your credit will be re-established as well.

7. Don’t pay more than you can afford: It is important to remember that the amount that you are paying toward your medical bills needs to work for you, as opposed to simply meeting the hospital’s minimum requirement. Don’t agree to pay an amount that is completely outside of your ability to pay. Many times, business office personnel will ask you to pay a set amount, but if you can only pay $25 per month, then tell them that is all you can pay at this time, although that may change in the future. As long as you are paying something, the account cannot be turned over to a collection agency. It may take ten years to pay off that bill, but by paying what you can realistically pay, you can be sure that you will have enough money left over for living expenses.

8. Determining your actual needs versus your desires: If your spending is out of control, it needs to be pared down so that your needs can be met, and your medical bills can be paid to the best of your financial ability. This is sometimes a difficult thing to do, no doubt, so post your financial goals somewhere so that you can be reminded of them often and so that the sacrifice you are making to pay your bills seems worth it.

9. Don’t ignore your medical bills: Try not to let bills remain unpaid for months. Your credit will be continually reduced each month if this happens, and the bills will be turned over to a collection agency. Many times, though, even collection agencies are willing to work with you. It is important to explain your situation, including the fact that you are unable to work due to chronic illness to pay off medical bills. It helps to understand the way collection agencies work:

Most agencies pay an agreed upon amount to hospitals to assume responsibility for collecting the debt. The bill is no longer owed to the hospital; it is now owed to the collection agency. In fact, it is illegal for hospitals/clinics to continue billing you for that particular bill (although they will still bill you for future bills). If you are able, most agencies will offer you a reduced amount if you can pay cash for the entire amount at one time. Often, agencies will reduce the amount that you owe based on your financial circumstances. They will also allow you to set up a payment plan to pay the bill off. Ask if there is more than one account in your name, and make sure they combine those accounts so that you only make one payment per month.

10. See if you qualify for resources: Medications for a fibromyalgia patient can be expensive, so check to see if you can benefit from some of the resources available for medical costs, and prescription costs in particular, including:

  • NeedyMeds: This company provides a prescription savings card, which enables those eligible to get discounts on certain medications at participating pharmacies throughout the nation.
  • Healthcare Alliance: This organization also provides a similar prescription assistance card for those having difficulty paying for prescriptions.
  • RxAssist: This website hosts a database of drug assistance programs provided by pharmaceutical companies that enable patients to receive assistance with numerous medications.
  • Medicine Assistance Tool: This search engine helps people find prescription assistance programs, as well as free or low-cost healthcare clinics.

The medical bill maze can often seem worse than the medical problem you are facing due to fibromyalgia symptoms, particularly because the medical bills can follow you long after a flareup improves. But being aware of the above information can help you find your way through the maze, and hopefully, bring you the peace of mind that you need to focus on the recovery of your health.

This article, originally published on June 17, 2016, was updated on November 8, 2019.

Laurie MillerLaurie Miller is an author wife, mom, registered nurse, and patient with chronic illness. She enjoys spending time with family, reading, and blogging at Contact her at to join.

A Doctor’s Perspective: 10 Important Factors that Affect Healing from Lyme Disease

By now, most of us already know that healing from Lyme disease takes time and a multi-faceted approach to treatment. Most of us will try herbal protocols, medications, detox, meditation, exercise, and more to improve Lyme disease symptoms. But what happens when your healing plateaus? Is there a way for you to get unstuck?

Below, Lyme-literate physician (LLMD) W. Lee Cowden shares insights into the areas which might be able to help you get moving in the right direction again. Besides tick-borne infections, there are 10 really important factors that affect recovery from chronic Lyme disease. Let’s take a look.

Factors That Affect Healing from Chronic Lyme Disease

1. Toxins:  Toxins, especially mercury and mycotoxins (mold toxins), affect immunity, brain function and the mitochondria, or the energy-producing furnaces of the cell. A build up of toxins in your body can leave you feeling drained, foggy headed, and more. If you haven’t done so yet, considering including detox treatments for Lyme disease, such as infared sauna, dry skin brushing, rebounding, or Epsom salts baths, into your daily routine.

2. Poor hydration: So many people consume liquids besides water, but many of these fluids are actually dehydrating to the body (alcoholic beverages, for example). Instead, drink two ounces of water every 15 minutes throughout the day.

3. Hypoxia: Also known as oxygen deprivation, hypoxia results from shallow breathing. To help oxygenate the cells, practice deep breathing daily.

4. Electromagnetic pollution: With cell phones, iPads, and other devices, we’re surrounded by an electromagnetic field (EMF), which can make some people feel exhausted, anxious, stressed, or more. The biggest culprits are Wi-Fi, cordless phones in the house and electric smart meters. To restore your body, unplug your Wi-Fi, cordless phones, and appliances in your bedroom at night.

5. High carbohydrate foods: If you eating too much sugar and starch, you may unknowingly be feeding fungi (like Candida) and bacteria. Avoid consuming too many carbohydrates in your diet, and especially unhealthy ones.

6. Parasites: Many chronically ill people have untreated parasites in the gut, liver, spleen, and pancreas. Additionally, most people with Lyme disease don’t consider that they might also have worm and protozoal parasites. Diatomaceous earth can eliminate some of these microbes.

7. Leaky gut syndrome: Leaky gut, also known as intestinal permeability, can cause digestive and systemic problems. The likely culprits?  Leaky gut often stems from microbes, electromagnetic pollution, toxins, and other factors. Leaky gut creates food allergy reactions, which in turn cause immune reactions and adrenal gland stress.

8. Hormone imbalances: Adrenal fatigue and thyroid under-activity, due to adrenal stress or iodine deficiency, or both of these things, can impede healing. When the adrenals and thyroid don’t function properly, then the boy’s temperature goes down and in turn, its immune function. Adrenal and thyroid support is important component to include as part of any Lyme disease treatment.

9: Methylation issues: Detoxification problems and methylation defects, which includes defects in glutathione production, can hinder progress and make you feel crummy. It’s important to support the liver in order to heal from Lyme disease, with the proper methylators, herbal remedies, and liver detox support remedies.

10: Emotional issues: Many people are unaware of the toll emotional issues can take on the body, especially subconscious issues from intrauterine trauma and early life traumas, which have the most impact upon health. Resolving these is likewise essential to healing. Seek out a therapist whose familiar with Lyme disease if you feel like you might be hitting roadblocks in your recovery due to emotional issues.

By considering all of these factors when implementing your  Lyme disease treatment protocols, you’ll be well on your way to improving immune function, increasing energy, and overcoming persistent Lyme disease and coinfections.

This article was first published on on November 23, 2015 and was updated on November 7, 2019. 

William Lee Cowden, MD is a US board-certified cardiologist and internist, and Chairman of the Scientific Advisory Board for the Academy of Comprehensive Integrative Medicine, or ACIM. He has been practicing integrative medicine since 1975 and teaching integrative medicine since 1987.

Can You Really Train Your Brain to Ease Your Fibromyalgia Pain?

Train Your Brain to Ease Fibromyalgia Pain

Your brain is an incredibly powerful organ –– the command center for your entire body. Whether you’re awake or asleep, conscious or unconscious, your brain is constantly at work, ensuring that you keep breathing, your heart keeps pumping and every organ in your body continues to function as it’s supposed to. You’re seldom even aware of at least 95% of what your brain is doing. But did you know that it’s possible to influence how your brain operates, even on an unconscious level? Yes, you can actually rewire your brain and guide it into a healthier, more healing path –– a path that can lead to less pain and fewer fibromyalgia symptoms.

Research into the mind-body connection has exploded in the last few decades. Things we long suspected––like the idea that stress negatively affects our physical health––have been empirically proven to be true. While other things we thought we knew about the brain have been proven to be completely untrue. For example, neural pathways in the brain were originally thought to be permanently set, however, scientists have since discovered that the brain has neuroplasticity –– the ability to continuously change and form new neural connections throughout a person’s lifetime.

Train Your Brain to Reduce Fibromyalgia Symptoms

Although I knew our brains were super powerful, it wasn’t until I read Get Back into Whack, a new book by Sue Ingebretson,* that I understood just how much potential there is for me to actually train my brain to reduce my fibromyalgia symptoms.

If you’re a regular ProHealth fibromyalgia reader, you may be familiar with Sue since she’s been a frequent contributor for more than six years, with well over 100 articles published on Her first book, FibroWHYalgia, an Amazon chronic illness best seller, tells the story of her search to find the root causes for her fibromyalgia and her subsequent journey to recovery.

Sue’s newest book, Get Back into Whack, is the result of her work as a medical researcher, Master NLP Practitioner and health coach. She was determined to find the best way to help her clients, as she explains in Chapter 1.

I want all of my clients to experience the healing transformation that I’ve found. I want them all to feel in charge of their personal healing options. I want my clients to conquer rather than cope with their limiting symptoms.

Sue Ingebretson: Author, Health Coach and Friend

Sue Ingebretson

Sue Ingebretson

Before I tell you more about some of the life-changing things I learned from her book and in the interest of full-disclosure, I have to confess that this is not a totally unbiased review. I’ve had the privilege of working with, being coached by and being friends with Sue for more than six years. We first met when ProHealth’s founder, Rich Carson, recommended her as a potential writer for ProHealth.

As we discussed possible article ideas, I was captivated by Sue and her personal story. At that point, she was only the second person I had ever met who had recovered from fibromyalgia. What made it even more intriguing was the fact that both attributed their recovery to nutrition and other natural means. I had to know more.

After several conversations and dozens of questions, I asked her to work with me as my health coach. It wasn’t a decision that came easily for me. Other health coaches I’d heard about seemed rigid, insisted on strict adherence to their requirements and were apt to scold if you didn’t follow their instructions to the letter. I tend to be resistant to drastic changes, so I knew that type of coaching wouldn’t work for me. Fortunately, Sue is nothing like that. In fact, she may be the kindest, least judgmental person I’ve ever met. She treaded lightly, accepting me as I was and gently encouraging me to make changes as I was ready and able. In the end, choosing to work with Sue was one of the best decisions I’ve ever made. She has made a huge difference in my health and my life. And in the process, we have also become close personal friends.

Over the years, Sue taught me quite a bit about the brain, and how we are able to consciously guide and direct what it does –– even when we’re not consciously aware that it’s doing anything. But Get Back into Whack took me so much deeper. Not only does Sue clearly explain how the brain works in layman’s terms, she also maps out practical steps we can take to rewire our brain’s neural pathways so it is functioning in the most optimal way possible to meet our own individual needs.

What Does the Brain Have to do with Fibromyalgia?

If you have fibromyalgia, you’re well aware of just how hypersensitive and over-reactive our bodies can be. Often it feels like all of our senses are in overdrive; we’re much more sensitive than the average person to light, sound, smells, tastes and of course, touch. As a result, pain and other fibromyalgia symptoms abound.

All of that suffering naturally leads to negative thoughts. (After all, who has happy, positive thoughts when they’re in severe pain?) But did you know that those negative thoughts are actually instructing your brain to continue over-reacting to external stimuli? It soon becomes a vicious cycle. On the other hand, when you learn how to train your brain to tame down the pain, your other fibromyalgia symptoms will be tamed down as well.

What Get Back into Whack Has to Offer

Train Your BrainIn Get Back into Whack, Sue acts as a guide, leading you through the labyrinth of your brain. Although explaining how the brain works is a serious and complex subject, her light-hearted, sometimes humorous approach makes it fun to read.

This book is so jam-packed with valuable information, it’s hard to single out just a few highlights, but I’ll try. Here are some chapters that I found particularly interesting and helpful:

Chapter 2 – “The Great Mental Divide” is fascinating as it details how the brain functions, defining the unique characteristics of both conscious and nonconscious thought patterns. Some examples:

  • The conscious mind is analogous to the captain of a ship (the nonconscious mind, the crew). The conscious mind declares a destination, and the nonconscious mind says, “Aye, aye Captain!”
  • The conscious mind is the goal-setter, the nonconscious mind the goal-getter.
  • The conscious mind can be critical and judgmental. The nonconscious mind does not judge the intentions of the conscious mind. It only follows given directions.

Chapter 4 – “The Pain Brain & Chronic Symptoms” will be of particular interest to you if you have fibromyalgia. It discusses the relationship between the functions of the brain and how the body perceives pain, as well as delving more deeply into the importance of understanding the mind-body connection. This chapter also contains what may be my favorite quote from the whole book, “Our thoughts have the power to tell our bodies at the molecular level how to function.” That is a powerful truth!

Chapter 7 – “Motivation Mastery: Potholes & Bridges” answers the age-old question of “why is it that I do what I don’t want to do?” It explores the connection between our intentions and our actions and provides a method to amplify motivation (which improves results).

Chapter 9 – “Stress: Waiting for the Stop Sign to Turn Green” discusses what impact stress has on the brain itself as well as a discussion about one of the primary subjects of this book – the Autonomic Nervous System (ANS). The chronic illness body becomes “stuck” in the fight, flight, or freeze response of the ANS, and suggestions for counteracting this effect are shared.

Chapter 10 – “Sketch Your Own Success Blueprint” provides a detailed and powerful strategy to put what you’ve learned into practice called the ADAPT and GROW technique. Step-by-step details of this method are illustrated as a blueprint for success. A real-life case study of putting the ADAPT and GROW technique into action follows in Chapter 11.

My Wake-Up Call

When Sue first asked me to read an early draft of this book, I was going through a bit of a rough patch and feeling a little overwhelmed. The coaching aspect of our relationship had been on hiatus for about a year due to the fact that we both were experiencing heavy workloads. I knew I missed our weekly chats, but what I didn’t fully realize at the time was what an important part those regular coaching sessions played in helping me stay on a positive, healing path.

The best thing that first reading of Get Back into Whack did for me was to wake me up to the fact that, without even being aware of it, I had allowed myself to slip into a downward spiral of negative thinking. Since I’ve always thought of myself as a very positive person, it really took me by surprise. I was shocked to discover that my negative thoughts had been, in effect, telling my brain that I was never going to get better and would continue to go downhill physically. Of course, my nonconscious mind was obediently working to carry out those “orders.”

Thankfully, that wake-up call was exactly what I needed. Once I realized what was happening, I immediately took steps to change my conscious thought patterns, which in turn caused my nonconscious mind to reverse course as well. It wasn’t long before I began to improve physically as well as mentally and emotionally. Now I try to stay very aware of my thoughts and quickly turn around any negative thoughts that try to creep in.

I can honestly say that even if Sue were not my friend, I would highly recommend Get Back into Whack simply because of what it has done for me.

Meet the Author

I asked Sue to answer a few questions to help you get to know her and why this book is so important to her.

Karen: Why did you choose the title Get Back into Whack?

Sue: When I returned home from Texas after doing a TV interview for my first book, FibroWHYalgia, I felt accomplished. Like, I’d done what I set out to do.

That’s why I was so startled by this question from a friend, “What else do people with fibromyalgia need to know?” Goodness — I hadn’t even unpacked my luggage yet!

But later that night my mind was still spinning on that question. I thought about how out of whack we all feel when dealing with chronic illness. And, I knew we needed better, more helpful, information on how to Get Back into Whack. I hopped online right then and there and grabbed the domain.

I should be embarrassed to share this, but that was in 2011!

Karen: What inspired –– or should I say compelled –– you to write this book?

Sue: That’s a good choice of words, Karen~ I was compelled. As I started to write this book years ago, I began with what comes so easy for me: I outlined all the things people need to do to heal and transform their lives. (It could have been a relatively short book.)

But then a reader shared this, “I absolutely love FibroWHYalgia and I feel motivated to make changes. Now, I need a FibroHOWalgia!”

My mind began to spin again. What’s missing in fibromyalgia books and coaching programs? It’s human nature to want a list of what to do. But that doesn’t mean we’ll do it, right? What’s really needed is an explanation of why we don’t always follow through … why we sabotage our own behaviors … why we sometimes succeed yet fall short at other times.

I had to figure out all of this for myself, first. I jumped into the topics of habit formation, neuropsychology, and the neuroscience of the brain. This set me off on the next (and most powerful) part of my own healing recovery.

After many years of research, experimentation, and classroom trainings, I finally understood the workings of the brain – and I had the science to back it up. At that point, I couldn’t stop writing if I tried. I included everything needed to understand how to adapt to healthy changes and how to make those changes last.

Karen: What kinds of benefits can someone with fibromyalgia expect by learning how to rewire their brain?

Sue: This question brings up the most exciting part. When we rewire our brains to think in specific ways, we find that our actions naturally follow. Did you catch that? We act without effort, artificial motivation, or even willpower.

Most people believe that our thoughts are a result of our experiences – but it’s more like the reverse is true. Our thoughts (which follow very distinct patterns) filter and define everything we experience.

Therefore, when we enlist the brain’s natural patterns to work for us––rather than against us––dealing with life’s ups and downs becomes easier.

This is the astonishing power of working with the natural tendencies of the brain and the mind.

Once readers become aware of the strategies outlined in this book, they’ll have what they need to avoid the challenges that can keep them feeling stuck. They can adopt new and simple habits (of their choice) and move toward the path of healing the chronic illness body.

Karen: Why is Get Back into Whack different and what do you most hope readers will gain from reading it?

Sue: Many have already shared that this book is an unexpected surprise. Most readers expect information about what to eat, how to exercise, and how to get to get better sleep. And, information about all of these topics is included, for sure.

However, I realized a key principle while I was writing. It’s equally important to solve the problem of, “what to do” as it is to solve the problem of, “what gets in the way.” This is a subtle, yet powerful, shift in how we look at our healing challenges.

When I first began coaching over 15 years ago, after I got to know the needs of my clients, I handed them tailor-made food lists and fitness suggestions. Most followed through with my guidance and support. But some didn’t. I had a lot to learn about that “what gets in the way” part of human behavior.

In a light-hearted and humorous way, this book shares that journey and takes the reader along the way. After the first several chapters, readers will be able to optimize their brains for peak performance and take action on their healing plans. They’ll be able to do this without feeling that one foot is on the gas and the other is on the brake.

What I want readers to come away with is true insight and a better understanding of how healing happens. I pray they finish with a deep sense of peace and comfort about who they are, what health struggles they’ve already come through, and what possibilities lie ahead. In other words, I want them to finish Get Back into Whack feeling encouraged, informed, inspired, and filled with hope for the future.

Your Opportunity to Get Back into Whack

The official launch date for Get Back into Whack is Tuesday, November 12. For a very limited time, the digital version will be available on Amazon for only $0.99 and the print version for $12.99 –– both are significantly reduced prices. I would encourage you to set a reminder or mark your calendar so you don’t miss the chance to take advantage of these special low prices. There is also a Get Back into Whack Workbook that will be available in a month or so.

* In addition to being an Amazon chronic illness best-selling author, speaker and workshop leader, Sue is an Integrative Nutrition & Health Coach, a Certified Nutritional Therapist, a Master NLP Practitioner, and a Clinical Therapeutic Hypnotherapist. You can find out more and contact Sue at

Karen Lee Richards is ProHealth’s Editor-in-Chief. A fibromyalgia patient herself, she co-founded the nonprofit organization now known as the National Fibromyalgia Association (NFA) in 1997 and served as its vice-president for eight years. She was also the executive editor of Fibromyalgia AWARE magazine. After leaving the NFA, Karen served as the Guide to Fibromyalgia and Chronic Fatigue Syndrome for the New York Times website, then worked for eight years as the Chronic Pain Health Guide for The HealthCentral Network before coming to ProHealth. To learn more about Karen, see “Meet Karen Lee Richards.”om/library/showarticle.cfm?libid=28715″>Meet Karen Lee Richards.”

Lyme Disease and Coinfections: Is Babesia Making You Sick?

Unfortunately for those of us with Lyme disease, the Lyme bacteria Borrelia burgdorferi is very rarely the lone pathogen transmitted during a tick bite. Usually, it comes along with various other coinfections – bacterial, viral, and parasitic. The range of possible coinfections is one of the reasons Lyme disease is so difficult to diagnose and treat, and why symptoms range so widely from person to person.

What is Babesia, a Coinfection of Lyme Disease?

One of the many possible Lyme coinfections is a microscopic parasite called Babesia. Babesia has evolved for many hundreds of thousands of years, and can survive in almost every known animal, including reptiles.

There are at least 100 different species of Babesia, twelve of which are known to infect humans. The most common species to infect humans are Babesia microti and Babesia duncani. All the species of Babesia are related to malaria, and their symptom profiles are similar. 

Babesia makes its home inside red blood cells (RBCs), especially within the capillary networks of the blood-rich spleen and liver. Even small concentrations of Babesia can cause very serious symptoms, especially when the parasite is combined with Lyme disease. This is due to the fact that Lyme and Babesia seem to work together — creating an inflammatory cascade in the human body that makes it difficult for the immune system to recognize the invaders and develop antibodies. Most of the symptoms of Babesiosis are due to this increase in inflammation.

Symptoms of Babesia

As with Lyme and other coinfections, symptoms of Babesia range from zero all the way to organ failure, coma, and even death. The severity of symptoms depends largely on the state of the individual’s immune system upon infection, as well as on the number of different coinfections present. 

Symptoms of Babesia don’t seem to depend on the concentrations of the parasite found in the blood, as mentioned previously. Small concentrations can cause severe symptoms. This is one reason Babesia can be difficult to diagnose.

Most people infected with Babesia experience flu-like symptoms within the first four to nine weeks after infection, such as:

  • Fever
  • Headache
  • Chills
  • Drenching night sweats (a hallmark symptom of Babesia) 
  • Pain
  • Malaise
  • Fatigue

For some, the initial flu-like battle will clear the parasite. For others, the symptoms are relapsing, and they can worsen over time. If the infection persists, symptoms can include:

Many of these symptoms overlap with Lyme and other coinfections. This is primarily because tick-borne diseases tend to cause a cascade of inflammatory chemicals like cytokines, as they seek to disable the immune systems of their hosts; the more pathogens present, the more severe the inflammatory response.

How Do I Get a Babesia Infection?

Babesia is transmitted by deer ticks, along with Borrelia, or Lyme disease. The Babesia endemic areas in the United States include the Northeast, areas around Minnesota and Wisconsin and the West Coast from Northern California up through Washington. 

However, ticks are spreading due to climate change, and the risk of Babesia infection is growing. Human populations have eliminated most large predators (such as wolves and mountain lions), and have decreased populations of smaller predators (such as coyotes, owls, and foxes) that previously kept deer, mice, birds, and other transport vehicles for ticks lower. We humans also continue to expand into previously unsettled wooded areas. Where there is an abundance of deer, mice, and birds, there are ticks. Where there are ticks, there is a risk of infection.

Testing and diagnosis

If you get a tick bite, the very best way to protect yourself is to test your tick right away for pathogens. You can use online services such as for this. It will save you lots of time and money if your tick turns out to be infected — as you will find out immediately which bugs you need to fight.

Most conventional physicians don’t seem to be familiar with any of the Lyme coinfections, including Babesia. Especially if you don’t live in an endemic area, it’s unlikely you will be tested by your primary care doctor. (I do live in an endemic area, and Babesia never crossed my conventional doctor’s mind, even with my relapsing fevers.)

In order to find reliable tests, you will most likely have to work with a Lyme specialist, functional MD, or naturopath, and pay out of pocket for specialty tests through companies like IGenex. The best possible test for Babesia is a combination of a blood smear (which looks for parasites in red blood cells) with a PCR test, which looks for Babesia DNA in whole blood. These tests are not cheap, but they are accurate. 


Even though Babesia is classified as a parasite, it does respond to some antibiotics. It also responds to Malaria drugs. Your Lyme-literate doctor will be able to offer you drug options.

Babesia also responds to herbal treatment. Stephen Harrod Buhner details an herbal protocol for Babesia in his books and online, and I have found it to be very effective in my own body. Herbal treatment takes a bit longer than drug treatment, but can be gentler, creating fewer side effects. Also, as plants are constantly evolving, pathogens don’t develop resistance to them in the same way they do to pharmaceuticals.

As with any Lyme infection, treatment is personal. There seems to be no one-size-fits-all approach for any of the Lyme coinfections. What works for one of us will trigger unwelcome symptoms for another. Work with your doctor and your own intuition to create a treatment plan specific for your unique body. Over time, Babesia symptoms should lessen and eventually resolve.

Shona Curley lives and works in San Francisco. She is co-owner of the studio Hasti Pilates, and creator of the website Shona teaches meditation, bodywork and movement practices for healing Lyme disease, chronic illness and pain.

Novel Insights into Overtraining Syndrome Suggest Chronic Fatigue Syndrome (ME/CFS) Connection

Reprinted with the kind permission of Cort Johnson and HealthRising.

Were you an avid exerciser prior to becoming diagnosed with chronic fatigue syndrome (ME/CFS)? Are you sure you were diagnosed correctly? Symptomatically, overtraining syndrome (OTS) and ME/CFS appear almost identical. Symptoms like fatigue, pain, post-exertional malaise, sleep problems and cognitive issues pervade both “syndromes”.

If it was not for the different triggers (“overtraining” vs infection, toxic exposure, “stress” in ME/CFS), the apparently more severe loss of function and greater duration seen in ME/CFS, one might think they were the same disease.

While some websites state that recovery from overtraining often takes several months, at least one, citing a 2012 paper – states recovery can take months to years, and that the condition can be “irreversible”. Not only can OTS stop training, it can affect “activities of daily living”, and may even end one’s athletic career,

In fact, it’s quite possible that some of the more athletic of us have an unremitting case of overtraining syndrome. One wonders if Jamison Hill, a weightlifter and athletic trainer, for instance, could have been diagnosed with overtraining syndrome.

Then again, it may not matter what you were diagnosed with. This study suggests, although the authors don’t state so, that it’s quite possible that ME/CFS and OTS are two branches of the same tree – one associated with athletes and the other associated with non-athletes.

A Methodological Mess Resolved

One difference, interestingly enough, is the degree of rigor with which the two diseases are in some ways being studied. While ME/CFS is being studied rather haphazardly, a group of researchers have committed to slice through the methodological issues pervading the OTS research fields to try and get at some answers which stick…

Just as we’ve learned in numerous review papers in ME/CFS, the OTS researchers trying to make sense of the field (and its variable results) were confronted with a bewildering array of possible confounding factors which involved the usual suspects: problems with selecting patients, problems with diagnosis, problems excluding participants when necessary, problems with the control groups and, last of all, problems with the tests and procedures performed.

The research group created the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) project which has encompassed a series of rigorously produced studies designed to methodically uncover biomarkers, etc.  It appears that they’re succeeding. (They are also, like Ron Davis and the Open Medicine Foundation, making their raw data publicly available.)

Novel Insights Suggest Chronic Fatigue Syndrome (ME/CFS) Connection

The four studies that led up to this overview paper (“Novel insights of overtraining syndrome discovered from the EROS study“) produced some fascinating insights. First off came a simple but important insight into how athletic training results in significant metabolic and endocrine changes, including some changes that the OTS group retained: even though they were ill, in some ways they were still “fitter” physiologically than the healthy controls.

Not so with some other measures. The OTS group had regressed in a wide variety of metabolic, endocrinologic, etc. measures. In fact, the group had fallen off the wagon to such an extent, so to speak, that their tests were similar – no doubt to their horror – to the inactive healthy controls. This indicated that the overtrained athletes had lost some of the “conditioning” that had enabled them to be athletic. (Conditioning in this context does not refer to lack of exercise, but rather to the biological state needed to carry out intense athletic activities).

Plus, the study uncovered some upregulated results which suggested an attempt to compensate for their “reduced conditioning”.

Interestingly, most of the over-trained athletes’ test results were within the normal range. No doctor would consider anything amiss with the apparently “normal” test results they displayed.

These test results were only normal, however, when compared to the healthy controls. When compared to their healthy athletic peers, a large number of their test results were significantly abnormal.

This brings up an interesting situation. We know that no matter how inactive a healthy person is, they do have the capacity to exercise and get stronger – a capacity the OTS athletes have lost. Yet their results appeared absolutely normal. This indicates that even a string of seemingly normal or within-range test results – put together – can result in disease! A redefinition of what’s “normal” is clearly needed.

t also suggests single test results do not nearly tell the story. Instead, it can take a constellation of abnormal (for athletes) but normal (for non-athletes) test results to produce an inability to exercise.

This theme – a constellation of seemingly minor but still significant changes working together to produce illness – is showing up more and more as medical research takes the performance of systems into account.

We saw it in Dr. Klimas’s studies which identified immune hubs in ME/CFS that alter the importance a cytokine might have. In that scenario, even normal levels of a cytokine, could, if the cytokine is embedded in a hub which confers more importance on it, produce extraordinary changes. We’ve seen it in Jarred Younger’s Good Day/Bad Day medical study which suggested that, even at normal levels, leptin may be an important immune driver in ME/CFS.  We saw it in Dr. Montoya’s study, which found few significant increases/decreases in cytokine levels, but still found that even at their “normal levels”, cytokines still strongly predicted fatigue levels.

The fact that none of these studies produced results that would raise a red flag to a doctor – and that none of the changes seen in the OTS group were found in all the individuals – suggests that searching for the magic bullet in OTS is fruitless. Far better to look to identify a series of changes in a system, which together, end up in a significantly altered metabolic (or other) state.

When compared to their athletic peers, the study found a wide variety of significant alterations. They included:

  • blunted and late GH (growth hormone), cortisol and prolactin responses to a central stimulation test (possibly causing reductions in athletic performance).
  • reduced testosterone levels (possibly causing reduced muscle mass).
  • increased estradiol levels without a concurrent increase in testosterone (reduced testosterone-to-estradiol ratio) (possibly caused by metabolic abnormalities; body composition changes found).
  • worsened mood states (particularly fatigue, vigor, depression and confusion) (fatigue is a “mood state?”), (probably resulting from sleep issues, hormonal dysfunctions).
  • changes in body metabolism and composition (reduced metabolic rate and fat burning, more body fat, less muscle mass and hydration (possibly caused by hormonal changes that result in a state of catabolism (muscle breakdown) and hypometabolism.

Increased levels of creatine kinase and catecholamines (eg. norepinephrine/epinephrine) were also found and were believed to result from prolonged muscle recovery times and, with regard to the catecholamines, an attempt to stimulate the recruitment of energy.

Not all of the above findings in OTS have been reported in ME/CFS, but reduced testosterone (reported by doctors), blunted cortisol, increased estradiol, reduced growth hormone output, reduced metabolic rate and fat burning, reduced hydration (blood volume), muscle catabolism and hypometabolism have at one time or another been found in ME/CFS.

Given that most of the “abnormal” results in the OTS study were in the normal range, one wonders if a re-interpretation of past, seemingly negative results might be in order in ME/CFS.

Another Hypometabolic State?

However, while the changes from individual to individual differed, a general central effect was found – which led the author to advance a hypothesis – one which, they noted, needs to be validated by larger studies. That hypothesis, encouragingly, is similar to one that has arisen out of the metabolomic studies in ME/CFS.

It proposes that overtrained athletes are stuck in a hypometabolic state characterized by a “procatabolic environment”,  in which the overtrained athletes’ muscles (instead of fats) are being broken down. The “global reduction in metabolic pathways” found, they believe, may have been produced to save energy and redirect energy for essential pathways during a state of (energy) starvation.

While metabolomic studies do not appear to have been done in OTS, the ME/CFS and OTS groups appear to be arriving at a similar conclusion – a starvation-like state may exist – perhaps Naviaux’s Dauer state. Hypometabolism, catabolic environments and a starvation-like scenario have all been applied at one time or another to ME/CFS. Hypometabolism is believed be an adaptive state that humans or other organisms can enter into in response to a variety of triggers.  (Hypermetabolism has been proposed for ME/CFS as well!).

While the study focused on metabolic and endocrine factors, the authors proposed that virtually all the system dysfunctions found in the body (metabolic, hormonal, inflammatory, immunological, neurological, cardiovascular and psychological) have worked together synergistically to create a “dysfunctional hypometabolic” state found in OTS.

Say Hello to “Paradoxical Deconditioning Syndrome”

Interestingly, the researchers did not find overtraining to be a factor;  i.e. very high levels of exercise are not necessarily associated with OTS. Instead, they found that high levels of study (>8 hours/day); lower levels of carbohydrate, protein and total caloric intake, and poor sleep – in combination with athletic training – all increased the risk of coming down with OTS.

Therefore, the authors propose OTS be called “paradoxical deconditioning syndrome” – a strikingly similar name to the “systemic exertion intolerance syndrome (SEID)” name proposed by the Institute of Medicine report for chronic fatigue syndrome).

A Collaboration Waiting (Begging?) to Happen?

ME/CFS and OTS potentially have a lot to offer each other. Using a stringent methodology – one which has probably not been employed in ME/CFS – the EROS researchers have been able to uncover numerous metabolic and endocrinologic abnormalities.

I was unable to find, however, any maximal exercise or metabolomic studies – two areas ME/CFS is strong in. The recent paper from Gordon Broderick’s and Dr. Klimas’s groups, which integrates endocrine-immune modeling with extensive sampling during exercise, would surely interest these OTS researchers. The ME/CFS field is also becoming strong in mitochondrial studies – another area of potential interest in OTS.

This is a collaboration practically begging to happen.  Similar findings are cropping up in two mysterious diseases that are defined by the inability to exercise.  Maybe a session devoted to the similarities and differences between ME/CFS and overtraining syndrome at the next IACFS/ME conference coming up from June 10-13th at Stony Brook University on Long Island would help spark some collaborations.

About the Author: ProHealth is pleased to share information from Cort Johnson.  Cort has had myalgic encephalomyelitis /chronic fatigue syndrome for over 30 years. The founder of Phoenix Rising and Health Rising, he has contributed hundreds of blogs on chronic fatigue syndrome, fibromyalgia and their allied disorders over the past 10 years. Find more of Cort’s and other bloggers’ work at Health Rising.