Author Archives: lassesen

Unknown's avatar lassesen 10:12 pm on December 24, 2013  

Sleep Apnea and Chronic Fatigue Syndrome

Sleep Apnea is a diagnosis du jour. It occurs in over 30% of the population for one type, Obstructive Sleep Apnea[2008], with a much higher rate for older individuals (at least 44%) and overweight individuals. The incidence for men is almost three times the incidence for women (the opposite ratio seen for CFS). Nose cartilage grows with age which is one factor for the increasing incidence. The article Sleep apnea as the cause of chronic fatigue syndrome [1994] suffers from the title being read and not the content (which speculates that it should be investigated and is not a demonstrated fact).

These common medical conditions have a higher incidence of sleep apnea: type 2 diabetes [68,69], polycystic ovary syndrome [70–72], refractory hypertension [73], coronary artery disease [74–76], congestive heart failure with systolic dysfunction [77–79], and stroke [80–82].  Wait, CFS, IBS and FM are not in this list.

CFS and Sleep Apnea share some common symptoms: fatigue, depression. A health professional can easily mis-conclude that Sleep Apnea is the cause of CFS — because: more than 50% of CFS patients have sleep apnea (the fact that more than 50% of age and weight match healthy population have sleep apnea is ignored).

  • Undiagnosed and comorbid disorders in patients with presumed chronic fatigue syndrome. [2013] found that ~ 30% of patients that met the Fukuda criteria for CFS had any sleep disorders.  This is the same rate reported elsewhere for the general population.
  • Sleep apnea and psychological functioning in chronic fatigue syndrome. [2009] found “Participants (CFS, SAHS, controls) completed questionnaires and were evaluated for SAHS ( sleep apnea/hypopnea syndrome ); 68 percent were subsequently diagnosed with SAHS. CFS participants with and without SAHS did not differ”. Again, CFS incidence matches that of the general population
  • Sleep disorders in patients with chronic fatigue. [1994]  “In conclusion, chronically fatigued patients with suggestive symptoms may have potentially treatable coexisting sleep disorders that are not associated with meeting criteria for CFS or a current psychiatric disorder.” This is a round-about way of saying that there is no detectable relationship between the incidence of CFS and the incidence of sleep disorders.

So bottom line:  sleep apnea is independent of having Chronic Fatigue Syndrome. I know a person that was given a CFS (and a Lyme diagnosis) that recovered when treated for sleep apnea. This is not surprising because most medical professionals (apart from rigorous research professionals) tend not to follow published criteria or do the tests that should show a problem that is CFS, namely:

  • Very high 1,25D levels — this is an autoimmune indicator (does not indicate which one)
  • SPECT scan having major abnormalities (MRI will be normal)
  • Inherited Coagulation Defects and hypercoagulation when the full panel of tests are done (often only one or two are done)

Many of my readers may have sleep apnea, or any one of a dozen treatable conditions that share symptoms with CFS. You may wish to review your medical tests that indicate if you have CFS. If none of the above have been done — approach your MD to order one of them. If the result is negative, you may wish to press for a second one of them. If all three are negative — then you likely have a different condition (which your MD may not like — because he will need to identify it and treat you!)

Unknown's avatar lassesen 8:29 pm on December 22, 2013  

Autoimmune Diseases: Infrared Saunas

During my relapse, Costco had a sale on for Infrared Sauna which triggered a memory of them being significantly helpful for CFS or IBS. After confirming that on PubMed we purchased one as our Christmas present and used it daily (which may have helped with my remission further).  With the Multiple Chemical Sensitivity relapse triggered over Thanksgiving, we have found that it has been very helpful for improving symptoms. In one sense, this should be “common sense” obvious — you sweat out the chemicals that you are sensitive too!

I tend to be very skeptical about “common sense”, especially after hearing all of the common sense cures for Chronic Fatigue Syndrome coming from family, friends and medical professionals. So a review of the current literature on PubMed felt like a good activity to do as a one-year after report to the community. We still use it (although not as frequently as we should — unless there is a flare).

Technically it is called Far Infrared Radiation although the alternative types have been known to use the terms  “biogenetic radiation” and “biogenetic rays”; in Japan as  “Waon therapy”; in Italy, “phytothermotherapeutic treatment”. This radiation have a lot of low level effect on biological organisms and process. There is evidence that it will help some cancers and encourage other cancers [2012].

Studies have shown for human or animal studies that it helps[2012] for following auto-immune (or associated to) conditions:

  • Rheumatoid arthritis
  • Diabetes Type II [2010]
  • Ankylosing spondylitis [2009]
  • Allergic rhinitis
  • Fibromyalgia [2009], [2008] “All patients experienced a significant reduction in pain by about half after the first session of Waon therapy “,
  • Chronic Fatigue Syndrome [2007] [2005]
  • Sjögren syndrome [2007]
  • Mild depression [2005]
  • Chronic Pain [2005]

There were no FIR studies located for Irritable Bowel Syndrome, IBD, UC or Crohn’s — although inference would suggest those would likely also benefit. However we do find some related articles:

I was also surprised to find Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study[1986] and then found some 33 articles looking at psychological treatment for  functional gastrointestinal disorders. The studies are likely valid – in that stress chemicals results in the microbiota changing (and thus we would get statistical results saying that it improves it). Not a single study found that it resulted in remission.   This is an important catcha looking at treatments: many treatments may improve most conditions by altering some process that produces a symptom; the treatment may be totally irrelevant to remission of the condition.

What I could not find was any studies on shifts of human microflora (gut bacteria) as a result of the thermal treatment. There was several studies on the successful use of heat (SECCA procedure) for the treatment of fecal incontinence however the latest studies[2009] found that the SECCA procedure had 87% of patients with complications and earlier success was not repeated.

Unknown's avatar lassesen 2:02 am on December 22, 2013  

Catecholamines, Heart Palpitations, Chronic Fatigue Syndrome and Bacteria

Health Rising recently had a nice article published on Nov 1, 2013 on the research of Dr.Visser on this common symptoms of CFS patients. Later in the month there was also a video.

Reading the article, I noted that catecholamines appears to be a significant part of the symptom. Catecholamines is a family of chemicals consisting of  epinephrine, norepinephrine, dopamine and hydrocortisone: cortisol. This caused me to wonder what we knew about the microflora and catecholamines. A search on PubMed found 1880 articles — too much information for most people!

Articles summarizes what I was expecting “These results indicate that gut microbiota play a critical role in the generation of free CA[catecholamines] in the gut lumen.” [2012] and a treatment that some would like: ” Dark chocolate reduced the urinary excretion of the stress hormone cortisol and catecholamines and partially normalized stress-related differences in energy metabolism (glycine, citrate, trans-aconitate, proline, beta-alanine) and gut microbial activities (hippurate and p-cresol sulfate)….   a daily consumption of 40 g of dark chocolate during a period of 2 weeks is sufficient to modify…” [2009]

And their impact on species typically overgrown in CFS is significant [2002], which is why stress often worsen CFS symptoms — the overgrowth increases.

It is interesting to read the NIH list of items that increases catecholamines (and thus risk of palpitations)

  • Acetaminophen (Tylenol, Paracetamol, Anacin)
  • Albuterol
  • Aminophylline
  • Amphetamines
  • Buspirone
  • Caffeine
  • Calcium channel blockers
  • Cocaine
  • Cyclobenzaprine
  • Levodopa
  • Methyldopa
  • Nicotinic acid (large doses)
  • Phenoxybenzamine
  • Phenothiazines
  • Pseudoephedrine
  • Reserpine
  • Tricyclic antidepressants

The only thing listed for reducing were prescription drugs.  However, a little research on PubMed found

During the research I found 1 2013 article: “Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence“, which list some familiar herbs and some new-to-me ones that were deemed to be effective in the studies reviewed  (Yes — an already researched list!). I am assuming that their mechanism is reducing catecholamines levels.

  •  Piper methysticum [Kava]
  • Matricaria recutita, [German Chamomile]
  • Ginkgo biloba, [Ginkgo]
  • Scutellaria lateriflora, [Blue skullcap]
  • Silybum marianum, [Milk thistle]
  • Passiflora incarnata, [Purple Passionflower]
  • Withania somniferum, [Ashwagandha]
  • Galphimia glauca, [Thryallis]
  • Centella asiatica, [Centella]
  • Rhodiola rosea, [Rosavin]
  • Echinacea spp., [Echinacea]
  • Melissa officinalis [Lemon Balm]
  • Echium amoenum [Borage]

Each has different chemicals, so it you have regular palpitations — you may wish to discuss with your medical profession about trying each of these for a week to see if any has a positive effect.

Unknown's avatar lassesen 5:31 am on December 16, 2013
Tags: Misdirection   

Depression: “Natural”, CFS, and other forms

Often CFS patients have their problem ascribed to depression. MDs then attempts to treat the patients with conventional depression medication with results contrary to what they expected [Distinguishing between depression and chronic fatigue syndrome 2013]. As Dr.Bell mentions, “The constant fatigue and other symptoms would cause anybody to be depressed. Claiming depression causes the fatigue is naive and dismissive”. As a result of a recent conversation, I thought a little review on the state of research on depression may be nice. There have been a lot of very interesting recent publications.

Depression can have several sources:

It is my belief the CFS is primarily the last one – specifically biological agents(gut bacteria alteration), although the others may be a factor in some. This is not my theory — it was proposed 70 years ago and there has been little scientific followup – see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038963/ for a good write up.

One of the key predictor of the severity of depression is vitamin D level (Relationship between vitamin D and depression in multiple sclerosis. [2012], Vitamin D Status during Pregnancy and the Risk of Subsequent Postpartum Depression: A Case-Control Study(2013), Low vitamin D levels are associated with symptoms of depression in young adult males (2013). It also impacts gut bacteria: Vitamin D regulates the gut microbiome and protects mice from dextran sodium sulfate-induced colitis. (2013), Vitamin D and prebiotics may benefit the intestinal microbacteria and improve glucose homeostasis in prediabetes and type 2 diabetes (2013)

An interesting article that I spotted while reviewing the literature was Could yeast infections impair recovery from mental illness? A case study using micronutrients and olive leaf extract for the treatment of ADHD and depression (2013) — which agrees with some reports of Olive Leaf Extracts lessening some CFS symptoms over the years.

Unknown's avatar lassesen 4:29 am on December 3, 2013  

Brain – Gut Bacteria: Recent Research

NPR recently had a program where they found the brain MRI’s and gut bacteria were related. The program is here. An example quote:

…they’ve found changes in both brain chemistry and behavior. One experiment involved replacing the gut bacteria of anxious mice with bacteria from fearless mice. “The mice became less anxious, more gregarious,”  It worked the other way around, too — bold mice became timid when they got the microbes of anxious ones. 
 

This suggests that many psychologists and psychiatrists may be replaced by a bottle of ‘designer probiotics‘. One example from the literature referenced as a probiotic containing:

  • Bifidobacterium animalis subsp Lactis,
  • Streptococcus thermophiles,
  • Lactobacillus bulgaricus, and
  • Lactococcus lactis subspLactis.

Additional articles on this area are:
http://www.optibacprobiotics.co.uk/blog/2013/05/could-probiotics-affect-brain-function.html

Unfortunately, the brand or source of this fermented milk was not given. I have been unsuccessful locating any commercial offering precisely matching this offering. Some Kefirs come close, Onaka appears to be a closer match, as well as  Danone’s Activia (“Bifidus Regularis”) which has 3 of the 4 species listed (once you wade thru advertising renaming of species).