Overview of CFS/ME protocol

From DoctorMyhill
Jump to: navigation, search

By Craig Robinson

This page represents a brief summary of "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis" by Dr Sarah Myhill

The Energy Equation

This equation is easily summarised as:

                                     "Available Energy = Energy Delivery MINUS Energy Demand"


Whether your individual energy equation is in 'surplus' or 'deficit' will depend on many components as below.

  • If your energy equation is in surplus, you will feel well, and the more in surplus it is, the better you will feel
  • If your energy equation is in deficit, you will feel unwell and will have significant symptom load, and the more in deficit you are, the worse you will feel

The various components of this energy equation can be altered by the use of interventions such as mitochondrial support and pacing. The idea is to get the energy equation 'into balance' or better still into surplus!

In more detail, the Energy Delivery side of the equation will include the following components:

  • Fuel in the tank --Diet, hypoglycaemia, micronutrients and gut function
  • Regular servicing --Sleep
  • The engine-- Mitochondria
  • Oxygen and fuel delivery --Heart, lung, blood supply
  • Accelerator pedal-- Thyroid gland
  • Gear box --Adrenal gland
  • Exhaust system-- Liver, kidney, detoxing
  • The driver of the car --The brain

And the Energy Demand side of the equation will include the following components:

1.Normal energy expenditure:

  • Housekeeping duties – basic metabolism: heart, gut, liver, kidney, lung, hormonal function
  • Physical activity
  • Mental activity

2.Wasteful energy expenditure:

  • Immunological holes:

a. Inflammation for healing and repair
b. Inflammation in infection
c. Useless inflammation in allergy and autoimmunity

  • Emotional holes.

Looking at each of these 'delivery' and 'demand' components in turn will lead to an individualised protocol for each sufferer.

For example, some may need to address thyroid issues and chronic viral presence, whereas for others detoxification may be crucial.

Overview of protocol

  • Energy delivery mechanisms – using the car analogy:
Energy Delivery Mechanism Analogy "Reality" Detail / Reference - follow the links on these links too!
Fuel in the tank Stoneage diet or better still Paleo Ketogenic Diet Stone Age Diet Ketogenic diet - the practical details My book "The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds"
Basic package of supplements Nutritional Supplements

Multivitamins, multiminerals, essential fatty acids, vitamins C and D

Fermenting gut Fermentation in the gut and CFS

Low carbohydrate, high fat diet, possibly digestive aids (acid with food, 90 minutes after food Mg carbonate, digestive enyzymes, bile salts). Probiotics eg Kefir
Anti-microbials such as vitamin C at night, possibly herbs or prescription drugs

Regular servicing Sleep Sleep is vital for good health - especially in CFS

8 hours of quality sleep at night, waking naturally and feeling refreshed

Engine of the car Mitochondria CFS - The Central Cause: Mitochondrial Failure

Supplements: ubiquinol 200mgs, acetyl L carnitine 1 gram, niacinamide 500mgs-1500mg slow release, D-ribose 10 grams, glutathione 250mgs
(Possibly 4 months of detox regimes – eg FIR saunaing)
See Detoxing - Far Infrared Sauna (FIRS) and Detoxification - an overview

Oxygen and fuel delivery Heart, lung, blood supply No heart disease, lung disease.

No anaemia.

Accelerator pedal Thyroid gland Thyroid - the correct prescribing of thyroid hormones
See also Conducting the CFS orchestra – how to put yourself in charge
Gear box Adrenal function Adrenal Gland - the gear box of the car (DHEA and cortisol)
See also Conducting the CFS orchestra – how to put yourself in charge and Common Hormonal Problems in CFS - Adrenal
Exhaust system Liver and kidney Routine blood and urine tests for liver and kidney function.
Driver of the car The brain See Chapter 14 of my new book - "The Infection Game - life is an arms race"
  • Energy expenditure
Energy Expenditure Comment Detail / Reference - follow the links on these links too!
Basic metabolism

(basal metabolic rate)

(uses 67% of all energy generated) We need this to stay alive!
Doing all the above will make this much more efficient.
Physical energy PACING Boring but essential.
If too much physical energy is expended then there is a switch from aerobic to anaerobic metabolism with the production of lactic acid.
This is painful, slows mitochondria even more and turns virtuous cycles into vicious cycles.
See Getting enough rest - an essential part of managing CFS and Chapter 15 of "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis"
Mental energy PACING - The brain comprises 2% of body weight but consumes 20% of all energy Mental pacing!
Use different parts of the brain, vary mental activity.
Again boring but essential
See Getting enough rest - an essential part of managing CFS and Chapter 15 of "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis"
Immunological energy Acute infections Viral infections - avoid them and treat them aggressively
The immune system is our standing army – armies are greatly demanding of energy and raw materials!
See also Infections: how to prevent and cure – first improve the defences and my new book "The Infection Game - life is an arms race"
Chronic bacterial infections eg Lyme Lyme Disease and other Co-infections and my new book "The Infection Game - life is an arms race"
Chronic viral infections eg Epstein Barr Valacyclovir in the treatment of post viral fatigue syndrome
and
Chronic viral presence in CFS/ME and my new book "The Infection Game - life is an arms race"
Allergy Category:Allergies,autoimmunity and infections and see my new book "The Infection Game - life is an arms race"
Autoimmunity Autoimmune diseases - the environmental approach to treating and see my new book "The Infection Game - life is an arms race"
Immunological self-perpetuating fire – the OH/NO/OO cycles Antioxidants
Inflammation
Correct anti-oxidant status – high dose vitamin B12 by injection often very helpful and see my new book "The Infection Game - life is an arms race"
Emotional energy Difficult! Identify and address causes of stress.
Consider psychological counselling.
Ensure good sleep - -even if this means prescription hypnotics and see Chapter 21 of "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis"
See Healing the Emotional Hole in the Energy Bucket

My books

A model for moving in the right direction

Craig Robinson wrote Chapter 24 of "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis" and this describes a model of how you can expect to see your symptom load reduced [or increased!!] depending on :

  • Your level of compliance with your individualised protocol
    and
  • The incidence of 'negative events' [eg viral assualt] which are out of your control.

Please see "Catastrophe theory: why we get into and how we get out of CFS"

Charles Dickens

Charles Dickens was only too aware, personally, of the applicability of this equation, when translated into monetary affairs:
"Annual income twenty pounds, annual expenditure nineteen pounds nineteen and six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery" (Mr Micawber from David Copperfield. Charles Dickens (1812-1870) )
So it is with energy as it is with money!


Sarah Myhill Limited  :: Registered in England and Wales  :: Registration No. 4545198
Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK. Tel 01547 550331 | Fax 01547 550339