Dr. Jacob Teitelbaum’s Vitality 101 for Chronic Fatigue Syndrome & Fibromyalgia — The Biochemistry of Feeling Great

Editor’s note: Used with permission from Dr. Teitelbaum’s new book “Three Steps to Happiness-Healing Through Joy!” This is Chapter 10.

By Jacob Teitelbaum, M.D.

We are all a combination of matter and energy. We have talked about the energy parts of our being. We have discussed how the mind can create our reality and how we can take charge of its programming instead of having it simply react to outside programming and experience. We also spoke about how emotions and feelings are our soul’s guidance system; how keeping our attention on and doing what feels good helps us get to where we truly want to go and be who we truly are. Now it is time to discuss the physical actors that can powerfully contribute to your feeling great.

Even though these physical factors may seem obvious, it does not hurt to start with the basics. There are four foundations for keeping your body vital and healthy:

1. Feed it properly.
2. Use it.
3. Rest it adequately.
4. Follow your bliss.

I have already talked about following your bliss (this is referring to earlier chapters in the book). Now let’s look at the other three foundations in more detail.

1. Feed it properly. Your body needs several things:

A. Get enough water. Not drinking enough water is a very serious and commonly overlooked problem. Chronic stress can suppress a master gland in the brain (called the hypothalamus). This can make it harder to hold on to water because of a drop in anti-diuretic (“anti-peeing”) hormone and your need for water then increases.

Take a moment to notice if your mouth or lips are dry. Most of you will find that they are dry. If so, you are dehydrated and need to drink more water. Although it is not unusual for those of us under stress to require a gallon of water a day, I do not recommend counting the number of glasses of water that you drink per day because this can get old fairly quickly. Simply notice if your mouth or lips are dry and drink water when they are. I like to keep a glass or bottle of good quality water with me. Water tastes good, gives pleasure, and can be a major energy booster when you are dragging.

In addition, many problems have been associated with even mild dehydration. These problems include fatigue, indigestion, and asthma to name a few. More information on dehydration can be found in the book, Your Body’s Many Cries For Water, by F. Batmanghelidj, M.D.

Drinking sodas or coffee will simply make the problem worse. The amount of sugar in one can of soda can suppress your immune system by about thirty percent for three to four hours. It also can aggravate hypoglycemia (see below), and likely increases the risk of diabetes. I recommend that you limit caffeine intake to one cup (8 to 12 oz.) of coffee or two cups of tea a day. Decaffeinated coffee or herbal teas are fine as long as your stomach is not a major problem, but research suggests that tea is much healthier than coffee in the long run.

Unfortunately, I do not believe that the American water supply is in very good shape, despite governmental claims to the contrary. Sadly, much bottled water is not necessarily better than tap water. Water filters can be iffy as well. The National Sanitation Foundation (NSF) sets standards for filter effectiveness. Before you purchase a water filter, it is reasonable to see how it meets NSF standards. The filter that I have found to be most effective is made by Multi-pure. Multi-pure filters can be obtained from Bren Jacobson at 410-224-4877. I would note that I do not accept money from anyone or any company whose products I recommend.

B. Get proper nutrition. Giving your body proper nutritional support is critical to being happy and feeling good. As the old saying goes, you are what you eat. On the other hand, worrying about everything you eat can make you crazy and neither promotes health or happiness.

I do recommend that you considerably limit the amount of sugar you eat. This does not mean giving up chocolate or treats. It means keeping those things that give you the most pleasure. Simply get a small portion of your favorite sweets, walk away from the serving dish, and savor and enjoy it thoroughly with no guilt. If you feel guilty about eating something, you will likely “inhale” the whole portion before you ever really taste it. I would avoid things without much benefit like sodas that have large amounts of sugar (approximately ten spoonfuls per 12 oz.) and potential toxicity.

Natural sweeteners, such as Stevia, can be substituted and appear to be quite safe and healthy. I also think that saccharin (in reasonable amounts) is fairly safe if you cannot buy Stevia, but I am concerned about the safety of Aspartame.

Besides avoiding excess sugar and caffeine, recognize that it is normally healthier to eat foods that are less processed and still contain the original vitamins, minerals, and enzymes. Also remember that eating food that is fun and leaves you feeling good (from a centered place) is also a very healthy thing to do. There is no one diet that is best for everyone, or even best for any given person throughout their whole lifetime. So listen to your body—it will tell you what it likes and does not like. Simply remember to check in with your body a few hours later so you can tell if the food really made you feel good or if it was simply a craving or addiction.

Indigestion is also rampant. Interestingly, this usually comes from poor digestion—not too much stomach acid! The enzymes present in food are critical for proper digestion. The enzymes that digest our food are also what ripen them. Because of this ripening, food manufacturers learned decades ago that they could extend the shelf life of food from one week to as long as a decade by destroying the enzymes present in the food. This was wonderful for the food processing industry but, unfortunately, I suspect it is a major cause of the indigestion that is epidemic today. Acid-lowering medications like Prilosec and Nexium are not best sellers because one makes too much stomach acid.

If this were the case, we would need less of these medications as our stomach acid production decreased with age. On the contrary, it is poor digestion that results in any stomach acid being irritating. Turning off stomach acid will turn off the pain, but it further worsens digestion and nutritional status.

I suggest that people take digestive enzymes. When taking enzymes, you will find that your digestion improves dramatically, as well as your overall sense of well-being. In addition, your body’s digestive enzymes do not work well in cold temperatures. If you have indigestion, drink sips of warm water instead of cold liquids with your meals.

There are over fifty different nutrients that are critical to your well-being and many of these are low in the Standard American Diet, appropriately abbreviated SAD. No matter how hard people try, it is difficult to get optimum nutrition from the SAD diet. Yearly, the average American gets about one hundred and fifty pounds each of sugar and flour added to their diet in food processing. This means that approximately one-third of your caloric intake has been stripped of most of its nutritional value.

Combined with food processing and the increase in nutritional needs because of the stress seen in day-to-day American life (e.g., infections, pollution, toxic chemicals, toxic people, etc.) many people are at high risk for feeling awful. It frustrated me that people needed to take over twenty tablets of supplements a day to optimize their basic nutritional status.

The most critical functions of these nutrients include:

Fueling your energy system. The B-vitamins make up the backbone of energy production and transport. In addition, magnesium is a key player in hundreds of critical reactions in the body and is markedly suboptimal in most Western diets. Many other nutrients, including Malic Acid (which comes from apples), folate, and several amino acids are also critical for your energy systems to work well.

Supporting a happy and healthy mind. “Brain fog” is becoming an increasing problem in our society. The B-vitamins, especially B-1 and B-12 are critical for mental clarity. Inositol also helps promote being calm and can be especially helpful for those who are anxious. Many amino acids (proteins) are critical for adequate neurotransmitter levels (e.g., serotonin, dopamine, and epinephrine). Deficiencies of these amino acids and neurotransmitters, as well as many vitamins and minerals, can commonly cause depression. I suspect you will be amazed at how much happier you feel when you get adequate nutritional support.

Proper tissue repair and function. Being in chronic pain will not help you to feel good. Any of a number of nutritional deficiencies will trigger chronic muscle shortening and pain. Many of you will find that chronic pain problems go away when you get eight hours of deep sleep a night and take the nutritional support needed for your muscles to heal and relax. The same nutrients may dramatically improve your hair, nail, and skin quality. Treating infections and hormonal deficiencies (see below) is also critical if one wants to eliminate chronic pain.

Proper immune function. Many nutrients are critical for proper immune function. Chronic low-grade infections are very common in Americans these days. These include everything from chronic sinusitis to fungal overgrowth in the bowels, skin, nails, and elsewhere. If you have a diagnosis of spastic colon you probably have a bowel infection that your doctor may not know how to look for. Vitamin C (e.g., 200-500mg a day), vitamin A, zinc, selenium, and folate are only a few of the nutrients that are critical for immune system support. Most people do not get optimal amounts of these nutrients.

Other critical nutrient functions include (among many others) maintaining healthy blood vessels to prevent heart attacks and strokes, maintaining proper hormonal balances, maintaining healthy bones, and preventing birth defects.

As you can see, adequate nutritional support is critical to feeling good. Be especially sure to get at least 50mg of B-complex vitamins and 500mg of vitamin C daily, as well as minerals such as 200mg of magnesium (as the glycinate), 15mg of zinc, 200mcg of selenium, and 150mcg of iodine. Adequate protein (eggs, beans, rice, nuts, and corn are good sources) and essential fatty acids from fish (at least three serving a week of tuna, salmon, herring, or sardines—or 5 grams of fish oil per day which does not have the mercury present in the fish) are also important. Dry eyes, mouth, and skin often reflect essential fatty acid deficiency, as does premenstrual syndrome (PMS). For PMS take 3000mg of evening primrose oil, 50mg of vitamin-B, and up to 250mg of magnesium daily. After three months, the primrose oil only needs to be taken the week before your period.

Eggs or whole grain cereals can make a healthy and quick breakfast. There are wonderful Chinese, Mexican, Japanese, Italian, etc., meals, too. Use common sense. You do not have to eat junk from fast food restaurants.

C. Treat hormonal deficiencies. If you are tired, achy, have weight gain, and/or cold intolerance you probably have an under active thyroid gland and can feel better if treated with natural prescription thyroid (I prefer Armour thyroid). Fatigue associated with hypoglycemia (sudden anxiety relieved with eating) and low blood pressure often responds to supporting your adrenal (stress) glands.

Taking 1000mg of vitamin-B-5 twice a day (Pantothenic acid), 100mg of Panax ginseng twice a day, plus vitamin-C can help your adrenals heal as can natural hormone treatments. Estrogen deficiency often manifests itself by your feeling worse in the week before your period, with poor sleep, brain fog, achiness, and loss of libido. If these symptoms are present, along with hot flashes and decreased vaginal lubrication, a trial of natural estrogen and progesterone (not the dangerous “horse estrogens”) may be warranted. Low libido and depression are also common with testosterone deficiency in both men and women. It is important to note that blood tests will miss most cases of hormonal deficiency. There is an old saying, “Treat the patient—not the blood test.”

2. Use your body properly.

A. Get fresh air and exercise. We sometimes forget how important fresh air and exercise are to our well-being. Research has shown that exercise is as effective in elevating mood and treating depression as Prozac. The good news is that you do not get side effects (e.g., sexual dysfunction) or the “sticker shock” that goes along with taking these antidepressants. Exercising outside in order to get fresh air can make a big difference when weather and air quality conditions allow.

Exercise has many beneficial effects. Beyond its overall effects on conditioning, weight loss, and decreased risk of heart disease and other degenerative diseases, exercise also raises endorphin levels. These are your body’s natural opioids and make you feel good (which is where the expression “runner’s high” literally comes from). In addition, exercise raises growth hormone. This is a critical hormone that drops as we get older. It is taken by many people to help them stay young. The problem is that it costs $12,000 a year to take growth hormone injections. Exercise is a much less expensive way to get the same effect. Other ways to raise growth hormone include getting deep sleep and great sex (see below).

Do not run out and try to make up for lost time. Begin with walking as far as you comfortably can. Remember, “No pain, no gain” is stupid. Pain is your body’s way of saying, “Don’t do that.” Walk so that you feel ‘good tired’ at the end of the walk and then better the next day. You can then increase your walking by one minute each day as long as it continues to feel good to do so. When you are up to one hour of walking a day, you can begin to increase the intensity with exercises like bike riding, rowing, etc. I do not recommend jogging on hard surfaces because I think this is not healthy for our musculo-skeletal system. Use your will-power to go out and begin the exercise. Then focus on having fun (I used to jog to the Haagen-Dazs ice cream store). Feel free to “stop and smell the roses,” blow on dandelions, or whatever feels good along the way. In addition, find a friend to exercise with on a regular schedule. Otherwise, there is a tendency to come up with silly excuses to not exercise.

B. Have great sex. The approach in this book can help increase your libido and get you back in touch with your natural passion, which is pretty powerful (that is why there are so many rules trying to rein it in). In addition, a study by scientists at Scotland’s Royal Edinburgh hospital found that an active sex life contributes to both looking and feeling young. Researchers studied over 3500 women and found that those who had sex at least three times a week appeared ten years younger than their actual age. The chief researcher, David Weeks, feels that this youthfulness is because sex increases production of growth hormone. Isn’t science wonderful?

C. Make time for yourself and loved ones. We get so busy in our lives that we sometimes forget who is important to us. While lecturing away from home on September 11, 2001, I learned an important lesson. Despite phone lines being jammed, I knew exactly who I needed to check in with. These were the people that I wanted to have with me for the rest of my life. Sometimes we take these special people for granted. Be sure to make time to spend with them. As you continue to do the three steps we talk about in this book, you will find that you spend less time with people whose company you do not enjoy, and more time with those who it feels good to be with.

One of the most important people for you to be with is yourself! We often forget to make “self-time.” Hundreds of years ago, before light bulbs were developed, sleep often lasted twelve hours a day beginning with when it became dark. People would usually fall asleep for a few hours and then wake up for two hours before going back to sleep. This time was spent in lovemaking or for being with one’s self. It was a time to explore dreams, feelings, and generally reconnect with one’s self. This self-time is very precious. When it comes to self-time, be sure you “pay yourself first.” This brings us to the third foundation for staying vital.

3. Rest your body adequately.

A. Get enough sleep. To many of you, the idea of eight hours of sleep a day may seem absurd and decadent. Even one hundred years ago, however, when we began to become industrialized, the average American was getting nine hours of sleep a night. Then light bulbs were developed. We are now down to six and one-half to seven hours of sleep a night on the average, and this is not adequate for most people. In addition, the quality of our sleep has suffered.

I discussed above how stress can cause hypothalamic suppression and therefore increased thirst. Your hypothalamus also controls your ability to sleep and your hormonal system. As stress increases in our society (along with the use of caffeine and other stimulants), insomnia and inadequate sleep have become epidemic. Inadequate sleep then causes fatigue, “brain fog,” immune suppression, and general irritability.

This is another example of “pay yourself first.” Start to make time to get eight hours of sleep a night. If you are a new mother, it may be best to have the baby in a bassinet or in bed next to you for the first six months so that middle of the night feedings become easier.

Despite sensationalized worries about keeping a baby in our beds (everything we do or don’t do carries some risk), having the baby sleep in your bed is normal in pre-industrialized cultures. It is suspected that the normal movements that occurred by the parents being in bed with the baby decreased the risk of sudden infant death syndrome. It also allows the mother to nurse more easily without having to fully wake up in the middle of the night. If you do wake up with a baby during the night, be sure to take naps during the day when the baby is sleeping. This is more important than catching up on housework and may prevent post-partum Fibromyalgia.

In addition to the insomnia caused by stress, we are seeing an increase in sleep disorders such as sleep apnea and restless leg syndrome. Sleep apnea is associated with loud snoring, followed by gasping for breath as the airway closes, during which time the person is unable to breathe. This is similar to having a pillow over your head thirty to fifty times a night until the lack of oxygen wakes you up enough to force you to breathe deeply. Sleep apnea is more common in those who are markedly overweight, have high blood pressure, have a shirt collar size over 16.5, or have sleepiness during the day. A history of falling asleep at the wheel while driving is much more common in people with sleep apnea.

Although machines and masks that keep the airway inflated can treat sleep apnea effectively, only one out of four people are able to tolerate these “C-PAP” machines. Most others find it too obtrusive. A much more effective way to treat sleep apnea is weight loss—even ten to fifteen pounds of weight loss can help dramatically. In addition, in many people sleep apnea occurs mostly while they are lying on their backs. If this is the case, putting a tennis ball into a pocket that is then sewn into the “small of the back” of the pajama top can take care of the problem. When the person lies on their back, it becomes uncomfortable, so they roll on to their side. As our society becomes heavier, sleep apnea is becoming more common.

Restless Leg Syndrome (RLS) is another common problem that interferes with sleep. RLS is when your legs keep jumping or moving throughout the night. Because of this restlessness, even though you may be unconscious for eight hours a night, you feel like you have run a marathon. This results in very poor quality sleep. Many nutritional deficiencies, especially iron deficiency, can trigger RLS. Our normal ranges for blood tests miss very clinically significant nutritional or hormonal deficiencies. This has been documented in a number of studies, including my own research. Natural remedies can also help many people with RLS and insomnia in general.

What natural approaches can help me sleep?

It is, of course, important to begin with proper sleep hygiene. Your bed should be used for sleeping and lovemaking, not problem solving and work. Develop a routine of going to bed at the same time each evening. Your body will then be trained to fall asleep. In addition, avoid stimulants like coffee before bedtime. Alcohol, while sedating you, will worsen the quality of your sleep. If you have trouble sleeping, do not leave your clock where you can see it. “Clock watching” is counterproductive.

Most sleeping pills actually worsen sleep quality by keeping you in light sleep (called Stage 2) that does not “recharge your batteries.” Fortunately, many natural remedies can be very helpful for sleep, are not addictive, and are well-tolerated. These remedies include valerian, hops, L-theanine, wild lettuce, Jamaican dogwood, and passionflower. In addition, these other natural remedies may be added and are also helpful for sleep: 200-300mg of magnesium (in the glycinate form—less if it causes diarrhea), 500 to 1000mg of calcium, 300mg of 5-HTP (less if you are on antidepressants—note that 5-HTP takes six weeks to work), Kava Kava (may very rarely cause severe liver problems, so do not use it if you have liver problems), 80 to 160mg of lemon balm, and/or 1 to 4gm of tryptophan (a prescription amino acid). If you have trouble staying in deep sleep, there are also CDs that are made to purposely help increase these stages of deep, restorative sleep.

Tired, achy, have brain fog, and can’t sleep? If so, you might have a process related to Chronic Fatigue Syndrome and/or Fibromyalgia. I believe these syndromes are now very treatable. For those of you would like more information on effective treatment of these syndromes, visit my Web site at www.endfatigue.com. The site includes a very sophisticated interactive computer program that can analyze your medical history and blood tests. The program can help determine which treatments (both natural and prescription- although it can now be done entirely without prescription) are most likely to work in your specific case if you have Chronic Fatigue Syndrome, Fibromyalgia, or chronic fatigue and pain in general. It will then teach you how to use the treatments. The web site has many tools that can be accessed at no charge, and can help you get your life back! My book, From Fatigued to Fantastic!, also has much more information on treating these problems.

To summarize, supporting your body can help improve mood, increase energy, and decrease pain:

1. Feed it properly.

A. Get plenty of good, quality water. If your mouth or lips are dry, you are dehydrated.

B. Eat what makes you feel good. This usually means avoiding sugar and eating food that is not overly processed. The average American diet is awful. An excellent, once a day, nutritional supplement can be very helpful.

2. Use it.

A. Get exercise and fresh air. Do not push to pain or exhaustion.

B. Have a full and satisfying sex life.

C. Spend fun time with those you love—especially yourself.

3. Rest it adequately.

A. Get eight hours of sleep a night. Natural remedies can help.

4. To quote Joseph Campbell, Follow your Bliss!

Remember: That which makes you feel good
(from a centered place) is usually good for you!

Used with permission from Dr Teitelbaum’s new book “Three Steps to Happiness-Healing Through Joy!”

Dr. Teitelbaum is a board certified internist and director of the Annapolis Center for Effective CFS/Fibromyalgia Therapies. Having suffered with and overcome these illnesses in 1975, he spent the next twenty-five years creating, researching, and teaching about effective therapies. He sees patients from all over the world in his office in Annapolis, Maryland (410-573-5389). He is the senior author of the landmark study “Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia — a Placebo-controlled Study”. He lectures internationally. He is also the author of the best-selling book From Fatigued to Fantastic! and the recently released Three Steps to Happiness! Healing through Joy. His web site can be found at: www.Vitality101.com.

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