Overview of CFS/ME protocol
[UPDATED JULY 2022]
This page represents a brief summary of My Book "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 | Paleo Ketogenic Diet | My book - "Paleo-Ketogenic: The Why and The How" The Paleo Ketogenic Diet - this is a diet which we all should follow The Paleo Ketogenic Diet - meals which require no cooking or preparation The Paleo Ketogenic Diet - PK Bread The Paleo Ketogenic Diet - PK Dairy |
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 | |
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 |
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 See Balancing |
My books
- "Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis" contains all the detail of this protocol
- Because of the crucial importance of diet, I wrote My book - Paleo-Ketogenic: The Why and The How to cover the finer detail of how to do the PK diet.
- Because of the wide variety of chronic viral and bacterial infections, allergy and auto-immunity problems, I have written another book "The Infection Game - life is an arms race"
- Also because of the importance of thyroid and adrenal issues, I have written My Book - The Underactive Thyroid - Do it yourself because your doctor won't
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!
My Online Community
Please join my online community -
Postscript - Groundhog Regimes
Overlaying all this, I have developed general strategies for good health, and for dealing with both acute and chronic infections. Please see:
- Groundhog BASIC – what we should all be doing all the time
- Groundhog ACUTE - put in place at the first sign of any infection
- Groundhog CHRONIC – the starting point to treat any chronic infection AND to live to our full potential
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