A Herbal & Functional Medicine approach to CFS/ME
As a unique individual, the underlying causes that lead to your symptoms & eventual diagnosis with the condition ME/CFS are as individual and unique to you.
You are Unique!
Nobody else has had the same life journey as you have, nobody else has your genetics or microbiome composition, or the same nutrition. A whole person, systems based approach helps the practitioner discover the triggers & mediators of both lifestyle & environment that contribute to the eventual manifestation of dis-ease throughout a person’s lifetime, from preconception to the present time.
It is this tool in our history taking that enables us to personalise treatment, bearing in mind the framework that most commonly leads to symptoms and eventual diagnosis of this complex and debilitating disorder which include:
- Chronic infections
- poor gut health
- altered microbiome composition
- endocrine system imbalances
- poor capacity for detoxification/toxin exposure
- immune system dysregulation/inflammation
- nutritional deficiencies & a decline in mitochondrial function
..to name a few!
Common Threads
Often in ME/CFS, there is a history of chronic infection, most commonly with Epstein Barr virus which is responsible for Glandular Fever, but there may be a history of other viruses especially from the Herpes family. (1) We call these ‘stealth pathogens’ undiagnosed chronic Lyme disease with it’s co-infections falls into this category too.
Various Disorders
Even if there are no symptoms of digestive disturbance (although I commonly find a diagnosis of IBS has been given alongside ME/CFS) the composition of the microbiome and the health of the gut barrier is key. It’s worth noting that typical symptoms in ME/CFS, such as digestive disorders, depression, cognitive issues, and even fatigue itself, are also deemed to be closely associated with gut microbiome dysbiosis (imbalance) and studies have shown differences in the composition of microbes in cases of ME/CFS in comparison with healthy individuals. (2)
I use an in depth microbiome analysis via stool & sometimes where there is yeast suspected, microbial urine analysis alongside.
Endocrine System
Endocrine system imbalances that are woven into the tapestry of underlying causes often come about due to chronic stress. Living in fight or flight/burn out/adrenal stress, adrenal fatigue are some of the synonym’s for the more correct term of chronic sympathetic nervous system overdrive or HPA axis dys-regulation. A constant state of elevated stress hormone cortisol is exhausting and unsustainable & eventually communication between the brain (Hypothalamus Pituitary) & the body (Adrenal) breaks down leading to low cortisol levels and chronic fatigue. This is very different from Addisons disease which is an autoimmune condition.
The Thyroid
The Thyroid can also join in with this body brain conversation and I often find there is an under active thyroid or at least a subclinically low thyroid hormone output. It is important that the Thyroid is properly tested to include T3 ( the most active form of thyroid hormone, converted from T4) as well as T4 ( Thyroxine made by the gland itself) and not just TSH which is a messenger hormone from the pituitary gland.
Nutritional Deficiencies
Nutritional deficiencies are common and again not routinely tested for in mainstream medical practice. The most common I find are Vitamin D, Magnesium, B Vitamins, Zinc and Omega 3. Sometimes there are also genetic variants which affect transportation, sensitivity & absorption of these nutrients which can impact mitochondrial functioning & methylation, all of which can contribute to the symptoms found in ME/CFS. My training in NutriGemonics has been so helpful aiding to discover how our nutrition and environment affect gene expression, in some cases it has been life changing.
Methylomes of the blood cells of patients with FM and CFS in three independent studies have shown methylation changes that appear to be implicated in the pathogenesis of these syndromes. (4)
Environmental Toxins
We are all exposed to environmental toxins a greater or lesser degree, but we do not all have the same capacity to metabolise & remove these toxins. This accumulation of toxins can be harmful to cellular function and can impair the structure and function of the mitochondria. Toxins can also stimulate the immune system, causing inflammation, oxidative stress and immune system dys-regulation.One example is mycotoxin illness from the toxins found in mold. There is a growing body of research here
5) and/or burdens from common environmental chemicals such as those found in plastics for example phthalates, which have been shown to affect thyroid function (6)
Treatment Plan
Once we have a good idea of the underlying themes and have maybe have results from some Functional and Genetic Testing, a treatment plan using beautiful organic herbal medicines, targeted nutritional supplements, lifestyle and dietary recommendations can be put into place to assist you on your path back to wellness.
Formulating a Herbal Medicine prescription is very much person centered, however common themes in a prescription for a person with CFS/ME include herbs with adaptogenic, nervine, immune modulating and anti-inflammatory actions and may include:
- Eleuthrococcus senticosus
- Astragalus membranaceus
- Rehmannia glutinosa
Medicinal Mushrooms such as:
- Ganoderma lucidum
- Cordyceps sinensis
- Avena sativa
- Hypericum perforatum
- Boswellia serrata
.. and so on!
I would advise not to take this list of herbs to make your own prescription as there are herb drug interactions to consider and each formulation must be based on each individual’s presentation and underlying reasons.
references
(1) https://pubmed.ncbi.nlm.nih.gov/32129496/
(1b) https://pubmed.ncbi.nlm.nih.gov/34867935/
(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908121/
(3) https://pubmed.ncbi.nlm.nih.gov/15036250/
(4) https://pubmed.ncbi.nlm.nih.gov/38054109/
(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872248/
(6) https://www.sciencedirect.com/science/article/pii/S0160412021004207