“I’m lucky I can work from home. I take meetings lying on the couch and have at least one serious energy crash every day that lasts for 2-3 hours.”
Recovery from ME/CFS and Long Covid can happen. Over the next few weeks, I would like to present examples of patients who have recovered from ME/CFS. I hope you will benefit from seeing the treatments they used, and how they responded.
Read Part One - HERE
Part 2
When I asked about her daily routine, Candace told me, “I awaken every day for work at 4:45 am and immediately have two cups of coffee. I drink another couple of cups an hour after that. Sometimes right before work begins, I take another double shot of espresso.”
“I’m lucky I can work from home. I take meetings lying on the couch and have at least one serious energy crash every day that lasts for 2-3 hours. It’s usually accompanied by a headache. If I need to take a client out in the evening to close a deal, I really suffer the next day with a major crash.”
Post-Viral Syndrome
In Candace’s case, all her symptoms began in the wake of a serious viral illness that occurred ten years ago. Epstein-Barr virus is the cause of mononucleosis. Considering all the symptoms Candace has experienced since that infection occurred, there is no doubt she is suffering from post-viral syndrome. But does this label get us any closer to fixing the problem? Is this the root cause of her illness?
Let me describe my definition of post-viral syndrome: It is a collection of symptoms, frequently severe and disabling, that begin immediately or shortly after a serious viral infection. These symptoms can persist for months or even years.
The occurrence of post-viral syndrome with persistent symptoms such as fatigue, pain, post-exertional malaise (PEM) and headaches, is not uncommon. The SARS epidemic in 2003 was caused by a coronavirus that is a relative of the current coronavirus, SARS-CoV2. Researchers have found that fatigue persisted in more than half of those patients throughout their recovery and 60% reported fatigue at 12-months.
Post-viral syndrome also occurs in people who have recovered from Ebola virus. Post-Ebola symptoms include fatigue, muscle aches, joint pains and sleep disturbances. These symptoms can occur in about 30% of individuals who had an infection due to Ebola virus.
Long Covid, a version of post-viral syndrome, now affects over ten million people in the United States. It usually affects people in the prime of their lives who were previously healthy and it currently has no approved treatment. It’s about time this complex, disabling condition finally gets the attention it deserves.
The House of Cards Scenario
Why do some people get post-viral syndrome, such as Long Covid, and others do not, even though they contract the same genetic strain of Covid-19?
The answer to this question is what I call ‘the house of cards’ scenario. In individuals who develop post-viral syndrome, several imbalances are usually present before the tidal wave of the viral infection sweeps through. They may have symptoms that are subclinical or just being ignored. It’s easy to ignore fatigue and occasional headaches when you’re in your twenties and thirties.
Many people are not as healthy as they think. They can have subtle health vulnerabilities that increase their chances of developing post-viral syndrome. These vulnerabilities include low thyroid or adrenal function, a low vitamin D level, not enough restorative sleep, excessive stress, recreational drug use, or a diet deficient in essential nutrients. In fact, they may have a combination of several of the above and not even know anything is wrong.
My point is this; the occurrence of post-viral syndrome is not only due to the viral infection. It’s just as much related to the underlying state of health of an individual precisely when the viral infection occurs. Another contributing factor is how well a person takes care of themselves during the first few weeks of the initial infection.
The health of a person with post-viral syndrome can be very fragile. It’s important to not just throw treatments at Candace’s symptoms, whether they be natural remedies or medications. The key to a successful treatment program, as well as to one’s ultimate recovery, is to make a proper initial diagnosis and get to the root of the problem.
Candace’s Standard Lab Tests
Blood glucose – normal
Thyroid tests - normal
Liver function tests – normal
Kidney function tests – normal
Antibodies to tic born illnesses (such as Lyme’s disease) – negative
Vitamin D level – 29 (sub-optimal)
Ferritin level – 20 (sub-optimal)
Here are my recommendations to Candace at the end of her initial visit:
Keep a 5-day diet diary
Salivary adrenal hormone assay – To measure your level of adrenal hormones (cortisol and DHEA) over a 12-hour period.
Comprehensive stool analysis - By analyzing a stool sample at a specialty laboratory, I can evaluate the health of your gut microbiome and whether there may be any hidden microbiome imbalances such as bacterial overgrowth or intestinal parasites.
Dilute hydrogen peroxide nebulizer therapy - to help flush and cleanse your sinuses. This can improve the health of your sinuses leading to an 1. improvement in the frequency and severity of headaches.
Support your immune system and mitochondria by taking the following supplements:
Mitochondrial Support Formula - take twice daily
Mitochondrial Stimulant Formula (containing low dose caffeine) - take twice daily
Coenzyme Q-10 100mg – take twice daily
Vitamin D 5,000 i.u. – take twice daily (based on lab results)
Gentle Iron 25mg - take twice daily (based on lab results)
I started Candace on the above nutritional supplements based on her medical history and the results of her previous lab tests. However, I felt it was important to also order several additional tests to further evaluate her health. These functional medicine tests help me ‘look under the hood’ to more deeply assess the status of adrenal function, gut health and any previous exposure to environmental toxins such as mold and pesticides that can weaken the immune system.
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While Candace has been able to significantly recover, there were a lot of curves in the road. Read Part 3 - HERE
Keep Hope Alive!
Jon D. Kaiser, M.D.
Appointments: (415) 381-7655