Recovery from ME/CFS and Long Covid can definitely happen!
Start with Part One - HERE
Part 3
After her initial visit, Candace began taking a nutritional supplement program to support her immune system, nervous system and mitochondrial function.
While her standard lab results had always been normal, I felt it was important to 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.
Functional Medicine Lab Tests:
1. Comprehensive Digestion and Stool Analysis – The results showed Candace had a relatively healthy GI microbiome. I added a probiotic supplement to her regimen to provide additional support.
2. Mycotoxin Assay (for mold toxins) – Many people are exposed to air-borne mold toxins every day without knowing it. I personally lived in a house that had high levels of mold toxins and didn’t have a clue until I started developing serious symptoms (itching, weight loss, anxiety and shortness of breath). Fortunately for Candace, her mycotoxin assay came back normal.
3. 12-hour Adrenal Hormone Test – Candace had borderline adrenal function (in the morning and early afternoon). This is relatively common in patients with post-viral syndrome and can directly contribute to fatigue, brain fog and other symptoms of post-viral syndrome.
Healthy adrenal glands release the majority of cortisol first thing in the morning, and the level then gradually declines over the course of the day.
The above graph shows Candace’s early morning cortisol level is at 14 with the ideal range being between 15-25 (circle). It also shows her noon cortisol level at 4 with the ideal range being 5-10 (circle).
In my experience, many people with post-viral syndrome have some degree of adrenal insufficiency. The ‘hyperactive immune response’ (sometimes referred to as cytokine storm) affecting a significant number of people with Covid-19 infection, can occur due to sub-optimal adrenal function. Advanced age, poor nutrition, and too little restorative sleep can contribute to sub-optimal adrenal function.
The adrenal glands are both amazing and underappreciated. When we’re stressed, they release adrenalin to help us ‘push through’ the stress. Adrenalin releases glucose into the bloodstream, dilates your pupils, quickens your heartbeat, inhibits proper gut function and raises your blood pressure. All that potential energy is designed to be released in the form of physical exertion, such as escaping from a wild animal or finishing a key project at work. However, if adrenalin is being constantly released in your system and all you do is sit in your chair and work on your computer, unhealthful effects can occur.
Over time, too much adrenalin in your system can lead to hypertension, cardiovascular disease, immune abnormalities, diabetes, irritability, anxiety, and headaches.
Your adrenal glands do much more than release adrenaline. They also release cortisol, fludrocortisone and DHEA (dehydroepiandrosterone). These hormones affect your mood, energy, blood pressure and immune function. Decreased production of these hormones often occurs after sustained periods of stress. Significantly diminished adrenal function can also trigger autoimmune conditions.
I describe cortisol’s function to my patients in the following way, “Cortisol provides your nervous system a boost of energy first thing in the morning when you need it the most. Forgive the mix of metaphors but it puts wind in your sails and gives you a head of steam.
I find sub-optimal cortisol and DHEA levels in most of the patients I see with Long Covid, fibromyalgia and ME/CFS. While supplementing these hormones alone may not reverse these complex conditions, adding just the right amount of hormonal supplementation to micronutrient mitochondrial support can make a huge difference in how a patient feels in a relatively short period of time. Getting these two pieces of the program right can make a world of difference in how quickly a patient responds.
At the end of our second visit, I had the information I needed to properly treat Candace’s post-viral syndrome.
Full Spectrum Treatment Program
Diet
· Modified Mediterranean Diet
· Limit coffee to 2 cups in the morning
Supplements
· Mitochondrial Support Formula 2x/day (breakfast and lunch)
· Mitochondrial Stimulant Formula (containing a low dose of caffeine) 2x/day (breakfast and lunch)
· Coenzyme Q-10 100mg 2x/day
· Vitamin D 5,000 units (125mcg) once daily
· Chelated Iron 25mg once daily
· Probiotic capsule once daily
Medications
· Hydrocortisone 5mg 2x/day (with breakfast and lunch)
Exercise Program
· Walking the dog and hiking – maximum 2-3 miles per day
Mind-Body Techniques
· Strategic Pacing
· Healing Time – 30 minutes 2x/day
Under the mind-body heading, I recommended Candace practice a technique I call ‘Healing Time’. I developed this technique to aid in my own recovery from ME/CFS which occurred shortly after my medical training finished. I went on to suffer from fatigue, post-exertional energy crashes and frequent sore throats for over fifteen years.
Internship and residency training programs are not conducive to good health. There is incredible stress, a profound lack of sleep and poor eating habits. After a grueling six-year stretch including medical school, residency and working as an ER doctor, I developed chronic fatigue syndrome and chronic pain that put me flat on my back way more than was normal for someone in their twenties. While I could still work, I spent many hours lying on my office couch in between patients. I felt sick most of the time.
Several of the techniques I now recommend to my patients are were ones I developed to emerge from the depths of my own ME/CFS condition.
‘Healing Time’ can also be termed ‘Prescribed Rest’. It is best described as consciously turning over all your energy to your body for a 30-60 minute period each day to let it use however it deems necessary. Your body knows what to do with this energy. It will use this rest period to begin ‘refilling your deep reservoir’ of energy and vitality. It will use it to help your nervous system heal.
There are three requirements for ‘Healing Time’ to be most effective:
1. Lie down in a recumbent position
2. Minimize sensory input (no phone, music, reading materials, etc.)
3. Breathe slowly and deeply
I remember how, several weeks after I began using this technique, I noticed my energy level start to improve. I certainly felt better when I got up after doing an hour of healing time, than when I initially laid down. As I recovered from ME/CFS, I transitioned to using ‘Healing Time’ on more of an as needed basis.
After many years of implementing my own full spectrum healing program, the ongoing improvement in my condition turned into a complete recovery. This process can take years. While I still take good care of myself, I no longer have ME/CFS and live a perfectly normal life.
I recommended to Candice that she practice two 30-minute sessions of ‘Healing Time’ per day to allow her nervous system to recuperate in between her other activities.
I also believe practicing ‘Healing Time’ helps heal the vagus nerve, a key component of the parasympathetic nervous system. A strong parasympathetic nervous system is a key to rebuilding one’s overall health and vitality.
By using a full spectrum healing approach, including proper diet, micronutrient supplementation, hormonal support, and better pacing, I now had confidence that Candace would soon notice her energy improve.
It’s very important to appreciate that a full spectrum healing program consists of multiple pieces that work synergistically to help you heal.
The Results
I'll describe Candace’s response in the next installment of her recovery story.
Read Part 4 - HERE
Keep Hope Alive!
Jon D. Kaiser, M.D.
Appointments: (415) 381-7655