During my 2nd period with CFS,  I found that I had a craving for Peanut Butter. The reason, in hind sight, was simple:

• Peanut contains most of the compounds needed to produce red blood cells. [Ref]

Why is this important? Typically CFS has hypocoagulation resulting in low delivery of oxygen. More red blood cells, means more oxygen delivery, the body logical response to lower oxygen levels.

• “Peanut consumption has been suspected of raising plasma very long chain fatty acid (VLCFA) levels in humans”[2012]

A recent article caused me to dig deeper into Peanuts

• “The high consumption of peanuts, walnuts, or almonds significantly reduced the risk for breast cancer by 2-3 times” [2015]
• “Total nut intake was related to lower overall and cause-specific mortality (cancer, diabetes, cardiovascular, respiratory, neurodegenerative diseases, other causes) in men and women.. Peanut butter was not related to mortality.” [2015]
  • i.e. eat peanuts and not peanut butter!!! The processing loose the health benefits.
• “Total nut consumption lowered [ systolic Blood Pressure] SBP in participants without type 2 diabetes. Pistachios seemed to have the strongest effect on reducing SBP and DBP. Mixed nuts also reduced DBP.” [2015]
• “Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health” [2015]
• ” supplementing a usual diet with mixed nuts for 6 weeks had favorable effects on several lipid parameters in Korean women with metabolic syndrome. These findings present a possible mechanism for the cardioprotective effects of nutconsumption.” [2015]
• ” The findings suggest peanuts may be a preferred snack food to include in the diet for maintaining a healthy weight.” [2014]
• “Acute high-oleic peanut consumption leads to stronger moderation of postprandial glucose, insulin, and TNF-α concentrations than CVP and control meal intake.” [2014]
• “Tree nuts appear to have strong inverse association with obesity, and favorable though weaker association with MetS independent of demographic, lifestyle and dietary factors.” [2014]
• ” consumption of peanuts and/or peanut butter is associated with lower weight status, improved diet, and lipid levels among Mexican American children.” [2013]
• “frequent nut and peanut butter consumption is associated with a significantly lower [ cardiovascular disease ]CVD risk in women with type 2 diabetes.” [2009]

Most of the studies were done with 56 g (2 oz) of peanuts per day

• IBD and Crohn’s are 2.18 times more likely to have anxiety disorders [2015]. It is also the case for CFS[2015]
• People will allergies are 2x more likely to develop CFS [2015]
  • “More symptoms were experienced after the fatigue onset than prior to the fatigue onset; however, a considerable number of participants reported experiencing persisting symptoms prior to the onset of CFS. Particularly, rates of hay fever and asthma were higher prior to the illness” [2015]
• ” Taken together, our results introduce cellulose as a novel physiological factor that impacts host-bacterial-environmental interactions and alters the proinflammatory potential of AIEC.” [2015]. Cellulose food includes:
  • Broccoli, Brussels Sprout, Cabbage, Collard Greens, Kale, Horseradish, Rutabaga, Turnip, Chinese Cabbage, Cauliflower, Broccoli Rabe, Daikon, Bok Choy, Radish, Kohlrabi [Ref]
• Volatile organic compounds (VOCs) in breath has been found to be a good predictor of disease state with Crohn’s [2015]. It is likely similar results would be seen with CFS and IBS – but studies need to be done.
• “The traditional management of Crohn’s disease, which is based on progressive, step-wise treatment intensification with re-evaluation of response according to symptoms, does not improve long-term outcomes of Crohn’s disease and places patients at risk for bowel damage.” [2015] This is likely also true for IBS and CFS.
• “The clinical phenotype of the men with CFS (compared to women) was young, single, skilled worker, and infection as the main triggering agent. Men had less pain and less muscle and immune symptoms, fewer comorbid phenomena, and a better quality of life.”[2015]
• ” Cases of CFS had significantly elevated concentrations of transforming growth factor-beta (TGF-β) in five out of eight (63%) studies. No other cytokines were present in abnormal concentrations in the majority of studies, although insufficient data were available for some cytokines. Following physical exercise there were no differences in circulating cytokine levels between cases and controls and exercise made no difference to already elevated TGF-β concentrations. The finding of elevated TGF-β concentration, at biologically relevant levels, needs further exploration, but circulating cytokines do not seem to explain the core characteristic of post-exertional fatigue.” [2015]
• “Neuroimage may be an important key to unveil the central nervous system (CNS) mechanism in CFS. Although most of the studies found gray matter (GM) volumes reduced in some brain regions in CFS,”[2015]
  • ” It has been shown that the time it takes to process a complex cognitive task, rather than error rate, may be the critical variable underlying CFS patients’ cognitive complaints.”[2015]
• Chinese herbs: Cistanches Herba and Schisandrae Fructus suggested [2015]

Working off the premise that CFS (and many auto-immune disease) is based on a stable dysfunctional shift in gut bacteria, I found the following PubMed article interesting:

Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Vandeputte D, Falony G, Vieira-Silva S, Tito RY, Joossens M, Raes J. Gut. 2015 Jun 11. pii: gutjnl-2015-309618. doi: 10.1136/gutjnl-2015-309618.

One of the premise of my treatment model is that any thing that produces an objective change of gut bacteria is a good change. One path has been selective probiotics, this is looking at another path.

Oh, what do I mean by objective change?

• Frequency
• “Floaters” vs “Sinkers”
• The  bouquet of the stools — who says that smellless stools are healthy???
• Consistency: pellets, loose, solid, diarrhea.

Another path may be to alter stool consistency by changing of diet. A diet high in roughage can often result in 3-5 stool movements a day, other’s may have it as an event that occurs every few days only.

“Results Stool consistency strongly correlates with all known major microbiome markers. It is negatively correlated with species richness, positively associated to the Bacteroidetes:Firmicutes ratio, and linked to Akkermansia and Methanobrevibacterabundance. Enterotypes are distinctly distributed over the BSS-scores. Based on the correlations between microbiota growth potential and stool consistency scores within both enterotypes, we hypothesise that accelerated transit contributes to colon ecosystem differentiation. While shorter transit times can be linked to increased abundance of fast growing species in Ruminococcaceae-Bacteroides samples, hinting to a washout avoidance strategy of faster replication, this trend is absent in Prevotella-enterotyped individuals. Within this enterotype adherence to host tissue therefore appears to be a more likely bacterial strategy to cope with washout.”

For clarity:  (low scores: firm stool and slow transit, high scores: loose stool and fast transit).

Remember where we are!!!

We have a stable dysfunction gut microbiome. We want to make it unstable and hopefully nudge towards  a functional one.

Food to consider (typically not in most Western diet – typically we eat only 1/2 of the recommended fiber intakes of 20-35 g/d,[1998])

• Bran – Rice, Wheat and Oat brans are different in their impact
  • ‘The apparent digestibility of plant-derived neutral sugars decreased significantly when wheat but not oat bran was consumed. The apparent digestibility of neutral sugars provided by wheat bran was 56%; the apparent digestibility of those provided by oat bran was 96%.” [1998]
  • Wheat bran extract alters colonic fermentation and microbial composition, but does not affect faecal water toxicity: a randomised controlled trial in healthy subjects.[2014]
  • “rice bran phytosteryl ferulates mediate anti-inflammatory effects by down-regulating the inflammatory transcription factor, nuclear factor κB (NF-κB), which in turn reduces expression of inflammatory enzymes such as COX-2 and iNOS, and proinflammatory cytokines such as IL-1β, IL-6 and TNF-α.” [2011]
  • “support that SRB[Heat-stabilized rice bran] consumption can affect gut microbial metabolism” [2015]
  • “As markers of CRC risk, , faecal water genotoxicity was determined using the comet assay and faecal water cytotoxicity using a colorimetric cell viability assay. Intake of WBE induced a shift from urinary to faecal 15N excretion, indicating a stimulation of colonic bacterial activity and/or growth. Microbial analysis revealed a selective stimulation of Bifidobacterium adolescentis.”[2014]
  • Suggestion: Have porridge for breakfast and add 1/4 cup of some form of bran to it.
    •  A bran muffin has typically 1/8 cup of bran in it, so the alternative would be two a day.
• A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs
  • A diet low in FODMAPs reduces symptoms of irritable bowel syndrome.Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. [2014]
  • Low FODMAP diet information
  • “Diets differing in FODMAP content have marked effects on gut microbiota composition. The implications of long-term reduction of intake of FODMAPs require elucidation.”[2015]
  • Suggestion: Take Prescript Assist and/or Align concurrent with this diet change, both have been shown effective for IBS.

Full Article.

Background

Some CFS and other autoimmune conditions may be caused by Endocrine disruptors. “Endocrine disruptors are chemicals that may interfere with the body’s endocrine system and produce adverse developmental, reproductive, neurological, and immune effects in both humans and wildlife.” [National Institutes of Health] “Endocrine disruptors can:

• Mimic or partly mimic naturally occurring hormones in the body like estrogens (the female sex hormone), androgens (the male sex hormone), and thyroid hormones, potentially producing overstimulation.
• Bind to a receptor within a cell and block the endogenous hormone from binding. The normal signal then fails to occur and the body fails to respond properly. Examples of chemicals that block or antagonize hormones are anti-estrogens and anti-androgens.
• Interfere or block the way natural hormones or their receptors are made or controlled, for example, by altering their metabolism in the liver.”[National Institutes of Health]

Epigenetics is the turning on or off of DNA due to environmental influences such as the endocrine disruptors. This means that the complexity of treating some conditions is far from trivial. In terms of classic CFS research, Dave Berg’s work on hypercoagulation (too much coagulation) could be associated with endocrine disruptors impacting control of coagulation.

Thyroid Hormones

Thyroid issues are common with CFS, with naive treatment of this symptom in isolation of the panorama of other associated symptoms being too common. Our knowledge is very limited, researchers state that these complexities “render human studies very difficult”[2012]. A few of the known or strongly suspected disruptors include:

• polychlorinated biphenyls or PCBs [2012][2014]
  • Between 1865 and 1914, large amounts of PCBs were released into the environment, to the extent that there are still measurable amounts of PCBs in feathers of birds currently held in museums [Wikipedia]
  • as late as 2013, PCB contaminated sewage was found on farm land in the US. Some crops may have been feed to chickens exported across the US.
• phthalates[2012][2014][2013]
  • “The study showed that exposures from phthalate-containing medications can far exceed population levels from other sources… they are used as inactive ingredients in producing enteric coatings [on pills]”[wikipedia]
  • Phthalate parent compounds and/or their metabolites have recently been implicated as a cause of breast cancer[wikipedia] [2014]
• bisphenol A (BPA), [2012][2014][2013]
• brominated flame retardants [2012]
• perfluorinated chemicals [2012]
• triclosan (TCS) [2014]
  • found in soaps, detergents, toys and, surgical cleaning treatments, shampoos, deodorants, toothpastes, mouth washes and cleaning supplies.
  • Triclosan has been associated with a higher risk of food allergy.
  • Banned in Minnesota to start in 2017
• parabens [2014]
  • found in shampoos, commercial moisturizers, shaving gels, personal lubricants, topical/parenteral pharmaceuticals, spray tanning solution, makeup,^[1] and toothpaste. They are also used as food additives.
• phenols [2013]
• benzophenones [2011]
  • added to plastic packaging on food
  • named Contact Allergen of the Year [2014]
• organotins [2011]
  • as stabilizers in polyvinyl chloride.
  • worldwide ban by the International Maritime Organization for use on boat hulls
• Lavender and Tea Tree Oils [2007]

“A high individual exposure to one chemical was often associated with a high exposure to other of the chemicals and the possibility of combination effects of multiple simultaneous exposures…. 100-500-fold higher than the median level were seen in some participants.” [2013]

What to do?

The ideal first thing is to get measured for your levels of the known disruptors. This can be a challenge because most of the results were done with research test. There is a lot of literature [NIH][EPA] on how to determine if a substance is a disruptor as well as citizen-science initiatives. There are significant problems with getting a clinical lab to accurately test even some of these chemicals (and even thyroid levels are a problem to test). There appears to be only a single lab claiming appropriate testing across a range: NMS labs. Genova Diagnostics offers some testing of BPA via urine sample. Reduction can present a challenge. Some of them appear to be reduced by fasting, but that also means that after the fast, extreme care need to be taken to not re-introduce them. Some, like PCBs and dioxin’s, are prone to concentrating in fat and may require alternative approaches, for example, Olestra has been shown to be unusually effective in removing these [1999] [1999] [2002][2005]. Colestimide has been effective in another study [2007]. Olestra is preferred as it does not require a prescription, and is used in certain brands of potato chips(labelled as Olean chips). Personal experience with several people that are chemical sensitive has been much faster recovery and less symptoms using Olestra after a triggering exposure (although there was resistance eating these “gross chips that produce smelly farts”).

Diet Impact

• “Grains, flour and dry mixes and total fish consumption were positively associated with BPA… Non-fresh vegetables and poultry were both positively associated with BPA” [2014], i.e. reduce
• “phthalates were associated with consumption of certain foods (i.e. chocolate and ice cream)”[2014] – note that this is standard commercial products being cited. For craft products, be very careful they may use contain these chemicals still.
• “We observed that fasting status significantly affects the concentrations of MEHP, MEHHP, MEOHP, and MCPP metabolites analyzed in this study.” [2013]

Environmental Impact

• “phthalates were higher among mothers and children… due to higher presence of PVC in floorings and wall coverings [2014]
• “statistically significant (p<0.05) positive associations in boys for cologne/perfume use… girls for colored cosmetics use… conditioner use… deodorant use… and other hair products.. We demonstrated that personal care product use is associated with exposure to multiple phthalates in children.” [2013]
• “Urinary concentrations of MEP[monoethyl phthalate] showed a positive relationship with the number of personal care products used” [2011]
• the use of a few specific products including liquid soap, hair care products and sunscreen was positively associated with urinary concentrations of some phenols or phthalate metabolites.”[2015]

Alternative Heath Suggestions

The typical suggestion is for a “cleanse” of some form. It is a panacea treatment for almost everything with roots in religious beliefs: ” You are ill because you need to cleanse your soul and your body” and is often religiously believed by some alternative health practitioners. My typical attitude is simple: “show me the peer review studies showing that this specific cleanse is effective for this specific study?” I agree with Harvard Medical School and researchers who tried to find any supporting evidence for any conditions. With that said:

• Yes, fasting (or any type) appears to reduce these disruptors, it is simple to understand: the body eliminates toxins naturally and ongoing. Stopping the addition of new disruptors by not eating will drop the level
• Chinese herbs for nourishing Shen-yin and removing Xiang-fire (NYRF) may be effective [2010]

Eating Suggestions

Many endocrine disruptors come from food wraps. The longer that the wrap is on something, the more the disruptors will leach. Avoid food packaged in boxes (which will often be coated on the inside) or in plastic containers. Avoid anything which has a emulsifier (often ice cream, many chocolates). Eating out may be a high risk activity.