Recovery From ME/CFS - Part 3
Updated: Nov 1
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.
Start with Part One - HERE
After her initial visit, Candace began taking a nutritional supplement program to support her immune system, nervous system and mitochondrial function.
However, I needed to order several additional tests to take a deeper look at her health. These tests help me ‘look under the hood’ to better assess the status of her adrenal function, GI microbiome and any possible exposure to environmental toxins such as mold and pesticides.
Functional Medicine Lab Tests:
1. Comprehensive Digestion and Stool Analysis – Candace has a relatively healthy GI microbiome which only required adding a probiotic supplement.
2. Urine for Mycotoxins (mold toxins) – Many people are exposed to air-borne mold toxins every day without even 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 unusual and serious symptoms (itching, weight loss, anxiety and shortness of breath). Fortunately for Candace, this test was normal.
3. 12-hour Adrenal Hormone Test – Candace had borderline adrenal function (in the morning and early afternoon).
This graph shows Candace’s early morning cortisol level is at 14 with the ideal range being between 15-25. It also shows her noon cortisol level at 4 with ideal being 5-10.
Healthy adrenal glands release the highest level of cortisol first thing in the morning, and the level then gradually declines over the course of the day, until there’s virtually none present at night.
In my experience, most people with post-viral syndrome have at least some degree of adrenal insufficiency. The ‘hyperactive inflammatory response’ affecting a large percentage of people with Long Covid may result from sub-optimal adrenal function that is present when Covid first hits. Age, poor nutrition, an inadequate amount of restorative sleep and chronic stress often contribute to sub-optimal adrenal gland function.
Our adrenal glands are both amazing and underappreciated. When we are stressed, they release adrenalin to enable us to ‘push through’ the stress. Adrenalin releases glucose into the bloodstream, dilates your pupils, quickens your heartbeat 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. However, when adrenalin is released, and all you do with it is continue sitting in your chair and working, unhealthful effects can occur.
Over time, too much adrenalin in your system can lead to hypertension, diabetes, irritability, anxiety, headaches and chronic pain.
Your adrenal glands do a lot more than release adrenaline. They also release cortisol and DHEA (dehydroepiandrosterone). These hormones affect your mood, energy level and how your immune system functions. A low level of these hormones can occur after prolonged periods of stress and lead to chronic fatigue, depression and immune hyper-reactivity which sometimes progresses top an autoimmune condition.
I describe adrenal 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. To mix metaphors, It puts the wind in your sails and provides you with a head of steam.
I find sub-optimal cortisol and DHEA levels in most patients with Long Covid, fibromyalgia and ME/CFS. While supplementing these hormones may not reverse these conditions by itself, combining proper hormonal supplementation with mitochondrial support and lifestyle changes can make a huge difference in how patient feel over a relatively short period of time.
At the end of her second visit, I now had the information I needed to properly treat Candace’s post-viral syndrome.
Full Spectrum Treatment Program
· Modified Mediterranean Diet
· Limit coffee to 2 cups in the morning
· Mitochondrial Support Multivitamin 2x/day (breakfast and lunch)
· Mitochondrial Stimulant (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
· Hydrocortisone 5mg 2x/day (with breakfast and lunch)
· Walking the dog and hiking – maximum 2-3 miles per day
· Strategic Pacing
· Healing Time – 30 minutes 2x/day
· Use a CPAP machine for sleep apnea
· Massage and bodywork as needed
JK: I’d like to provide additional details about a mind-body technique I specifically recommended to Candace called ‘Healing Time’. I developed this technique to aid in my own recovery from ME/CFS, which I suffered from for over fifteen years beginning at the end of my medical training.
Internship and residency training programs are not conducive to good health. There is incredible stress, a profound lack of sleep and usually poor eating habits. After a grueling six-year stretch including medical school, residency and working as an ER doctor in a busy hospital, I developed chronic fatigue syndrome and chronic pain that put me flat on my back way more than was normal for someone under the age of thirty. While I could work, I spent many hours lying on my office couch between patients. I did not feel well most of the time.
I recommend several of the techniques I used to emerge from the depths of my own ME/CFS, to help my patience recover from theirs.
‘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 it, however it needs to, in order to begin ‘refilling your deep reservoir’ of energy and vitality. It will use it to help your nervous system heal.
I believe this technique helps heal the parasympathetic nervous system. A strong parasympathetic nervous system is necessary to rebuild health and restore balance.
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
Here is a brief excerpt from the full description of ‘Healing Time’.
“Feel your body. Notice any areas of tension, hurt, or pain. Gently...begin to notice them. Make no judgments. Acknowledge the presence of any discomfort. And then slowly, allow your awareness to move a little closer to this area, the area where you feel tension or pain. As you get quieter, breathe deeply, expanding your abdomen completely. Deep breathing is important. Allow your awareness to come as close to your discomfort as you feel comfortable and then, just be with it. Just experience the place that exists between tension and no tension, between feeling good and not feeling good. Just sit there, on the boundary of your discomfort, and be with it, just as you might spend time being with someone who is ill. Continue to breathe deeply. Nowhere to go, nothing to do, just to be with yourself and whatever discomfort you may be feeling. Give it the attention that it is asking for.”
I remember how, after I began using this technique, I noticed my energy coalescing and starting to get stronger. I certainly felt better when I arose after taking an hour to do the technique than when I initially laid down. As I recovered from ME/CFS, I transitioned into using ‘Healing Time’ on an as needed basis.
After many years of implementing my own full spectrum healing program, the ongoing improvement of my condition turned into a complete recovery. This process took 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 and energy to ‘catch their breath’ in between her work and other activities.
I was confident that, by using a full spectrum healing approach, including proper diet, vitamin supplementation, hormonal support, and better pacing, 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.
I'll describe Candace’s response to the above treatment program in the next installment of her recovery story next Wednesday.
Read Part 4 - HERE
Please forward this blog to your family and friends.
Keep Hope Alive!
Jon D. Kaiser, M.D.
Appointments: (415) 381-7655