M/E - Myalgia Encephalopathy

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

What's really going on?

In the early years of my practice I met many people who had been diagnosed with ME (Myalgia Encephalopathy) or Chronic Fatigue Syndrome (CFS), nowadays the same kind of symptoms are more likely to be described as adrenal fatigue or fibromyalgia but ME/CFS has become an established and accepted label and there are still many people from various parts of the world who are told that this is what is wrong with them and why they are have become so desperately tired and unwell.

Sometimes labels are important, even vital, and give us the necessary starting point to be looking and working in the right direction, and sometimes labels are frankly unhelpful, even harmful. The name 'chronic fatigue syndrome' perfectly fits description of what I would call a truly unhelpful label because it doesn't help you actually understand whats really going on any more than it helps you to know what to do about it. For some people this label even does significant harm because they naturally go online to look it up and then can develop some very negative expectations from reading the accounts of others who have become somewhat lost in the system.

Let me perfectly clear that I do understand that many people do suffer with the exact same symptoms as described in the criteria for diagnosing ME/CFS. I am not exaggerating when I say I have worked with many hundreds of people who have been given this diagnosis and I see how genuinely sick they can become. My argument against ME/CFS as a label is that it does nothing to help us understand the cause of what we are dealing with, it would be much better to start again with an open mind. Then we can ask the most important question, 'what is really going on?'

Post-viral Syndrome

I have met a great many people in my work who have been diagnosed with ME/CFS who, when telling the story of their health problems, have an extremely important answer to the vital question 'how did it all begin?' They talk about having had an infectious illness, in some cases a very long time ago, after which their health has never been quite right since...

The classic picture of the post-viral syndrome is an infectious event at the origin of the troubles and then a cycle of relapsing symptoms since that time that typically include advanced levels of fatigue, aches and pains, swollen glands and, in some but not all cases, signs in the early stages of the problem that the body was trying to mount a fever to rid itself of what, in effect, has become a chronic infection. These signs typically included feelings of being chilled or suffering from night-sweats.


Diaphoresis (also known as Sweating Therapy)

This last point about feeling chilled etc. is a key one to grasp in successfully treating the post-viral syndrome because one of the most effective therapeutic strategies we can bring to this problem is to work with nature and help the body do what it tried but failed to achieve; i.e. to mount a fever! Fevers are widely feared and misunderstood in modern medicine, they are seen as an undesirable side-effects of illnesses which should be squashed as quickly as possible with drugs such as paracetamol or aspirin but, in many cases, nothing could be further from the truth!

There is a place for all drugs at some point in time but nature, and evolution, are not stupid, we have developed the ability to mount a fever simply because it is the fastest and most powerful way to activate an immune system to fight against whatever invader it has detected. Each degree your temperature rises the activity of your immune system practically doubles!

If I have a patient who has clear signs of the post-viral syndrome I will usually employ diaphoresis, aka sweating-therapy, as a front-line approach to help get the condition improving as quickly as possible. We will often begin with them doing a therapeutic sweat at home on the first day or two of their treatment along with taking immune herbs etc. and then, if needed, we repeat the diaphoresis once a week or so until they are clearly very much better. This whole process is outlined in practical detail here.


Immune Health

Sweating therapy can be a life-changing first step but if the post-viral syndrome is at the root of the problem then there will definitely be more work to do to rebuild a healthy immune system. It doesn't really matter what the original infection was. If the pattern is one of deep fatigue and exhaustion after an initial infection, then the main efforts in recovery need to be directed at rebuilding good immune health. In such cases I would say it is essential to lean heavily on the support of the two greatest immune tonic herbs namely Echinacea (more info here) and Astragalus (more here). We do not sell any medicines online but please try to get these from a herbalist or at least a very reputable supplier if at all possible.

Further to that, if you think that the likely true cause for your ME/CFS is in fact a post-viral syndrome then carefully read my article on immune health here.

Echinacea angustifolia


Depression or Anxiety

In my experience the 2nd most common root cause of ME/CFS, after the post-viral syndrome, is depression or anxiety however, we must approach this subject with the utmost care because, if you were not depressed or anxious before you became profoundly tired, then you are very likely to have become so afterwards! So which came first, the chicken or the egg?

Again I want to emphasise that, first of all, in dealing with ME/CFS you must rule out the post-viral syndrome. Do they have swollen glands, do they get physical aches and pains, did they get chills or any kind of fever in the early stages of becoming ill or do they still get night sweats now. A yes to any of those questions does not mean you can rule depression or anxiety completely out but they should no longer be at the top of your list. In practice it is really a matter of carefully listening to the answer to this most important question, 'what was happening in your life when you first became sick?'

People know when they had been under just too much stress and had reached a breaking point. If they have never been well since they had a kind of nervous system meltdown, then you would be unwise to focus on immune health or other matters first and foremost. In this case you must understand that the nervous system as just as physical a part of the body as any other part and know that it is something that can always be healed with the right approach and the right support.

Note that I have been writing depression or anxiety but these are not one and the same thing. A person who has what can be called 'anergic depression' has, as their dominant symptom, a profound loss of energy and motivation whereas a person who is suffering from chronic anxiety will have, underlying their tiredness, a deep and abiding tension and worry. Depression comes with a feeling of sadness, even grief, anxiety comes with much stronger feelings of worry, it is a kind of internal 'agitation' as distinct from an internal 'flatness'. There are a number of cross-overs in how we can effectively treat both depression and anxiety but there are also some key differences of the best herbs to use and the best strategies to focus on.

That said, I have found that, time and time again, if people are ready to do what's required and are willing to let Nature in to help them that they do inevitably get well from both depression or anxiety. Remember what I said at the beginning, that it is to be expected to have some feelings of depression or anxiety after being very fatigued for any length of time but, if you honestly feel that depression or anxiety, or both, are in at the roots in terms of causing your chronic fatigue symptoms then most definitely carefully read the article on depression here and/or the article on anxiety here.

Scutellaria lateriflora (Skullcap)


The next most common cause for ME/CFS is a simple deficiency of one or more of the many elements that are essential for energy metabolism. The brain is the most sensitive organ in the body and the first symptoms of deficiency of any of the essential nutrients can simply be tiredness, even profound tiredness. The number one deficiency in the world is iron and I test nearly of my own patients for low iron when they first come in and I can tell you for a fact that a lot of people are anaemic without realising they are! Less common are the blood deficiencies of vitamin B12 and folic acid but these can certainly also be checked for in a routine blood test in any case.

Further to a blood test to rule out the essentials there are often other visible 'tells' that deficiencies are a key issue, especially in the growth of hair on the head and the nails of the hand. Losing significant amounts of hair can be caused by stress but it can also be a sign of nutritional deficiency. Likewise, signs on the nails such as weakness, slow growing, splitting, spots etc. can all be clues that something essential may be lacking.

In New Zealand we have extremely low levels of Selenium in our soils (the second lowest in the world), likewise zinc and magnesium are chronically low in population studies done both here and elsewhere. I do not personally go in for a lot of nutritional supplement for most people but I am an advocate of a good multi-vitamin/mineral once a day along with some extra omega-3 fish oil if the diet is low in these healthy fats. Supplements aside, there is truly no substitute for a healthy diet and this is where tiredness that comes from deficiency is by far the biggest issue.

If you know that your diet is a long way off what could be considered healthy then don't kid yourself that your tiredness has nothing to do with this. It can't be overemphasised what a difference eating well can make to good health. Give yourself a score out of 10 for your diet -- 10 being as good as you could imagine and 0 being as bad as you could get. If you score yourself below 7 (and you are presumably reading this because of excess tiredness) then you need to know that you have to do some work in this area.

The biggest issue with food and fatigue is the vicious cycle that happens when people who are too tired go for refined and processed foods because they are quick and easy to prepare and their high sugar and intense flavours trick us into thinking they will make us feel better. I know that there is a lot of conflicting and crazy advice out in the health world but the simple and practical advice I've written up in a page on excellent nutrition is dependable information and may help to point you in the right direction in this vital matter; you can find it here.


ME/CFS & Toxicity

A further major potential cause of CFS can come from excess toxicity in the body. Low grade poisoning from things like heavy metals or other environmental toxins can and does cause deep and unrelenting tiredness long before it shows up in such classic patterns as bad skin or joint pains. If you instinctively feel this may be an issue and/or you can see that when your symptoms are worse your tongue gets a more off-colour, unhealthy looking coating on it then you should at least consider this as a possible contributor to the problem. The subject of detoxification has many myths and misinformation in it; I've written a short article on the key points, including a section on 'how do you know if it's necessary' here

ME/CFS & Thyroid Health

No-one can be in any doubt that a low functioning thyroid gland can cause major issues with energy and fatigue. Unless you have a) never been to a doctor with your fatigue symptoms or b) your doctor got their diploma in the mail, this will have been ruled out as a primary cause from a simple laboratory blood test. Where things get murky is when an underactive thyroid gland is a contributor to the issue and, if we don't help it to get working properly, progress will be very slow indeed. Thyroid health, and a process of getting a more sensitive picture of where it is at by measuring your morning temperature, is written up here.

ME/CFS and Insomnia

This may seem like such an obvious thing to say but you might be described at how many people have been given the ME/CFS label when the true root of their health breakdown is that they are just not sleeping well. If this is the case for you then straight away you have to get acquainted with the herbs in Nature that help relax the body into a better state for deeper and healthier sleep starting with but not limited to Valerian root (more info on it here). Sleep is such an important subject that if you are not sleeping you really must put it at the top of your list for what to do! More info here.

Valeriana officinalis (Valerian)


The Tonics

I can't write about ME/CFS without talking about the great tonic herbs. In my view, and that of many others in this work, the two top energy tonics in all the natural world are Panax Ginseng and Withania somnifera. Panax Ginseng is known as the 'Emperor tonic' in Chinese medicine and has been revered for millennia for its ability to restore energy. Withania is equally as highly regarded in the great Ayurvedic system of the Indian sub-continent and likewise has a tremendous history of use for all kinds of problems where increasing a person's vital energy is understood to be the key to their healing. If you will use either or both of these herbs, then I certainly encourage you to learn a lot more about them; I write about Panax Ginseng in much more detail here and Withania root here.

Because they are such important tools in my own practice I've gone to some lengths to obtain the best possible quality dried herb of each in its raw form, which we then we get encapsulated by a local company. On the one hand this means I know exactly where they come from and can guarantee their quality, on the other it also means we cut out all the middle men and can supply herbs to our patients most economically! I mostly use the capsules of the two combined but I also use them singly in their raw form as a simple powdered slurry in water (Ginseng) and an evening drink made with the cut herb and milk decocted together over a gentle heat (Withania)

Panax Ginseng and Withania may be my favourite energy tonics but they are by no means the only herbs I use when people are tired and run down and in practice I will typically combine a handful of herbs together for my patient to take each day for as long as their support is required. For example, the humble Hawthorn, both leaf and berry, has been seen to restore physical vitality to the hearts of many hundreds of people who were tired and unable to restore their fitness before they made good use of its certain help - more on it here. Another great favourite is St John's wort and, much more than just the natural 'anti-depressant' it has been marketed to be, I have tremendous respect for its ability to nourish an exhausted nervous system; learn more about it here.

Hypericum perforatum (St John's wort)


Permission to rest!

Many people who go on to get chronic tiredness have an upbringing or a nature to push themselves hard in whatever they do and may not take well to being idle. For such people, the most important step of all in the healing process may be simply giving themselves permission to rest when tired.

This probably sounds simple and you could easily gloss over it (especially if it applies to you!) but in fact this can be the greatest challenge to the healing process and can be the thing that can sabotage what would have otherwise been a successful recovery.

Of course if you have a deficiency, or toxicity, or an immune or mental health issue then that must be attended to. Further to that only you can really know how much you push yourself through fatigue at times when you could actually let go and let your tiredness guide you towards the you need. It's a strange, counter-intuitive concept to think of tiredness as a friend but sometimes that is exactly what it can be... this brief poem sums up what I mean here.

Only you can say if you know how to give yourself permission to rest when you are tired. If you do, don't worry about this, but if not -- think about it. This could be the thing that makes or breaks your future health. If you want to relax but are struggling with actually doing it then it may be that some of the commentaries or music I have put up on the site may help, you can find them here.

Constitutional Health Note:

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as helping you to improve your energy. Constitutional health is an old and fascinating way of understanding our differences and to demonstrate how it works if you are a hot and dry person (an Eagle) then immune health matters are often a key issue in the fatigue, if you are a hot and damp person (a Tiger) then toxicity or insomnia often come up, if you are a cool and damp constitution (a Bear) then mental health matters commonly need the most attention and if you are a cool and dry person (an Elephant/butterfly) then deficiency (and low thyroid function) are the leading causes of fatigue. There is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd