Chronic Fatigue

Making Sense Out Of Chronic Fatigue

Fatigue is one of the most common symptoms people go to naturopathic doctors for. Severity can range from just feeling tired after work to Chronic Fatigue Syndrome and being unable to work.

This is a non-specific symptom with many possible causes. Therefore putting together a treatment plan requires some detective work. Like with any other issue the case begins with a full history. Then review of any past labs, in office assessment and then consideration of additional functional lab tests if needed.

Video about how Naturopathic medicine can help people have more energy and feel better.

Common causes of chronic fatigue

The following are possible triggers for chronic fatigue that are either often ignored or poorly treated in conventional medicine:
  1. Chronic infection such as Epstein Barr, Cytomegalovirus (or other viruses) and tick borne illness such as Lyme disease.
  2. Parasitic infection. Can include worms or single cell parasites such as Entameba histolytica.
  3. Food allergies – especially to Gluten which many more people are becoming aware of the past few years.
  4. Dental foci. Infections in the mouth or toxicity from past dental work.
  5. Candida or chronic fungus/yeast infection.
  6. Toxicity to heavy metals, plastics or the numerous other chemical toxins we are all exposed to daily.
  7. Side effects of prescription drugs. This may include psychiatric drugs.
  8. Insomnia.
  9. Emotional stress including PTSD.
  10. Hormonal imbalances related to thyroid hormone, estrogen, cortisol and blood sugar.
  11. Anemia – often missed by MDs.
  12. Poor diet, nutrient deficiencies.

Chronic Fatigue Syndrome Sample Case​

The following is posted with permission of the client.

This case summary is intended to show how individualized assessment is used in breaking down a case and proper treatment.

It can be noted that not many different herbs were used in this case. The few that were given did work remarkably well.

Initial Visit

  • 18 year old male. Symptoms getting progressively worse over past 2 1/2 years
  • Extreme fatigue. Even standing up is difficult. Has had to stop going to high school because he is incapable of doing any school work
  • Insomnia – despite fatigue can not fall or stay asleep. Sleeps about 2 hours a day at random times
  • Chronic constipation, stomach aches and heartburn
  • Daily headaches and whole body aches (at time of initial visit – has had a constant migraine for past 3 days)
  • Frequent urination and pain after urination. Has to pee every 20 minutes. (Earlier on in illness was even suspended from school for going to the bathroom so much)
  • Bone pains, says legs hurt, like growing pains
  • Elevated heart rhythm
  • Blurry vision
  • Frequent temperature changes – calls it “hot flashes”
  • Sensitive to sounds
  • Conventional treatment including anti-depressants did not work
  • Numerous supplements for energy and adrenal function did not work

Initial plan was some compound homeopathics for energy and sleep. Functional lab tests ordered: saliva cortisol, stool test and porphyrin test for toxicity

2 1/2 week follow up

Sleep is slightly better, except innervated (sleeping more at night). Basically feels the same. Labs show an increased toxic burden (porphyrin test). Cortisol is basically normal.

New protocol includes:

  • Rhemannia herbal tincture – 1/4 teaspoon twice a day. Rhemannia is an important herb for the kidneys. In multiple ways case points to weakness in kidney: he is preoccupied with fear (in Chinese medicine kidneys are associated with fear), bone pain (again, relates to kidneys in Chinese medicine), frequent urination, and increased heart rate along with insomnia (this again relates to Chinese medicine – where the kidneys are related to the heart – so that if weak, heart symptoms may manifest). Kidneys are often weak in chronic fatigue cases.
  • Teasel herbal tincture – 1/4 teaspoon twice a day. This was given with a similar rational to rhemannia. Teasel is a good herb for many different types of infections. It’s often use for Lyme disease. This did not turn out to be a Lyme disease case, but many symptoms matched an overall teasel picture (especially pain in muscles and bones).
  • A set of compound homeopathics given to assist in detoxification (primarily to buffer any response from herbs, but additionally porphyrin test showed a toxicity burden)
  • SyImmune – a homeopathic for general immune system support added. This given to not just boost immune system function, but calm down potential detoxification effects,

Follow up one week later

Came in for an emergency visit – symptoms actually worsened on the above plan. It was determined that teasel was to strong. It was taken out of plan for now, to be gradually restarted at just 1 drop per day

Came in with additional labs. CBC was “normal” – except for slightly high normal eosinophils on repeated lab tests (about 4.0% – not very much elevated – but this mild elevation was on previous labs as well). Based upon this additional parasitology tests ordered.

One month later

Although still very tired, seeing some improvement with chronic fatigue.

Urinary frequency and sleep are now normal!

Bone pain is still present

Additional lab tests show elevated anti gliadin antibody (very sensitive to gluten) and antibodies to Entamoeba histolytica (although not typically considered serious, in susceptible people this can cause numerous symptoms and be a major contributing factor to symptoms).

The major turning point was normalizing sleep. Going from 2 hours of disorganized sleep to night, to what was close to a normal sleep cycle in about 6 weeks. Even if every else is done correctly, the body needs to sleep to recover from such illness. Insomnia was not treated with sleeping pills or even sedating herbs. What helped the most was Rhemannia, given according to Chinese Medicine assessment (kidney yin deficiency).

One month later

Went back to medical doctors for extensive testing – the stress of this itself caused a minor setback in recovery

Gastroenterologist found nothing

MRI testing found nothing

Chronic fatigue gradually improving. Actually began to try exercising. Although this may not sound like good progress, 3 months prior fatigue and muscle pain was so bad – was almost not able to stand and walk.

Note – despite at this point extensive blood work and imaging from numerous medical doctor over past 2 years, the only labs that have show any hint of underlining problem was the slightly elevated eosinophils, Entamoeba histolytica and gliadin antibodies.

Glutamine added to protocol – to aid in repair digestive system function and boost energy.

Isopathics added in – to turn on immune system function.

One week follow-up

Quickly came back concerned over a sore throat since starting isopathics. Was assured that this is a healthy, detoxification response and sign of the immune system turning on. Encouraged to continue with protocol.

One month later

Most symptoms are not present, or very minor (headaches, frequent urination, “hot flashes,” increased heart rate, and insomnia),

Chronic fatigue and brain fog and bone pain are still present.

Reports “white” “stringy” stuff coming out in stool – which based upon comparison to online photos appears to be a parasite.

Note: aside from entameba histolytica – no parasite was ever found on lab tests, but it’s hard to argue with visual confirmation that the patient is seeing parasite come out.

Summary 4 months later

Gradual improvement although signs of parasite continue. Eventually followed up with an infectious disease doctor who used antibiotics against Entameba histolytica.

After aggressive antibiotic use for 1 month – Entameba histolytica was finally cleared on lab test with infectious disease doctor.

Following this was clear signs of prostate infection. Instead of going back to MD for antibiotics came in for a natural alternative. Isopathics cleared this up in a few days.

At this point chronic fatigue symptoms significantly improved from when started a few months ealier.

People with severe fatigue often have numerous food sensitivities. While it’s important to avoid triggering foods, they are often given treatment plans in which foods themselves are considered the enemy. Certain foods such as sugar, conventional dairy, wheat, any junk food, are not healthy. However, severe allergic response to a large range of typically healthy natural foods indicates a different problem.

In this case, he went from being able to eat virtually nothing, to able to tolerate a much larger range of foods once pathogens in digestive system where cleared. So food allergies may be part of a larger problem effecting immune system response, than being the problem in and of itself.