Chronic Fatigue (Also known as ME in the UK)

Many physicians who work with chronically fatigued patients and those who work in the field of environmental medicine, agree that mold exposure is a major contributor to fatigue. 

Toxins affect individuals in immeasurably different ways, depending on their individual biochemical make-up. There are several key factors that determine how a person will react to toxic exposure.

1. Nutritional status. Vitamins, minerals, amino acids, and other nutrient factors play a vital role in detoxification of foreign chemicals.

2. Stress.

3. Genetics. Due to genetic differences or abnormalities of certain enzymes, some individuals do not detoxify as readily.

4. Length and type of exposure.  This is often forgotten or disregarded by many mainstream physicians.

5. State of health. Someone with chronic illness, liver disease, or altered immunity may be less able to adequately detoxify.

6. Age. Children and the elderly are more susceptible than the average adult.

During the initial exposure to toxic molds, the patient is generally very hyper and has difficulty concentrating.  Many patients are often hyper-ventilating and have trouble slowing down.  This phenomenon has been explained in many ways.  The brain suffers a great attack from the acerbic affects of the fungal exposure.  After the patient has been exposed for awhile, the opposite takes place.  The patient then generally slows down and cannot seem to find enough energy.  The reason many people become so tired is that the body's immune system becomes so confused with the onset of this toxin.  It often soon begins to produce what is called Chloral Hydrate as a defense mechanism.  In the old days this was known as a Mickey Finn.  Men supposedly used to slip them in women's drinks to seduce them.  It is an old fashioned sleeping pill.  The body produces this substance to slow down the growth of this fungus in order to protect the body's immune system.  It also makes the victim very sleepy.  Subsequently, the patient is often misdiagnosed with Epstein-Barr or Chronic Fatigue Syndrome during the cycle of mold exposure.  Upon removal from the place of contamination, many patients seem to become hyper- active again, while some remain persistently tired. 

 

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome has been the focus of increasing national and medical attention over the past decade. A growing number of research investigators are seeking to unravel the interrelationship of the psychologic, immunologic, neurologic, and endocrinologic abnormalities associated with this debilitating disorder. Considerable misinformation still exists regarding the appropriate evaluation and management of the patient. CFS has lead to a necessary new paradigm in take doctor/patient relationship, one in which related information and knowledge have become recognized as critically important tools of healing. The nature of this disease and the fact that no single treatment provides a cure--brings doctor, patient, and loved ones into near constant discussion of a bewildering array of therapies. There is no FDA-approved treatment for CFS. However, there are a variety of both symptomatic medication as well as holistic approaches which have empowered people living with a CFS to take charge of their health. The physician must rely on his/her knowledge and judgment in assessing the risks versus benefits of treatment for each individual patient. One of the greatest lessons I have learned in treating CFS has been the realization that well-informed patients simply make better partners in health-care, and, when knowledge is shared, everyone benefits; there is an unbelievable amount of healing in just the sharing of new knowledge.

Chronic Fatigue Syndrome presents a major public health problem for the 1990s, affecting more than a million people around the world. CFS can strike suddenly and linger for years, threatening personal relationships and careers. And devastating a person's life. Still, a large proportion of the medical community refuses to recognize the suffering it can cause. Patients with this disease cope not only with the illness itself but with the high medical bills, insufficient insurance coverage, and a tragic lack of emotional support often from physicians, caregivers, and even loved ones. Social security disability payments are hard to obtain and the fear of their unknown future looms daily.

Another source of frustration in treating CFS patients has come from my relationships with my peer-physicians over the past 11 years. The first 5-6 years were the most difficult, with the last five years a definite trend toward at least receiving recognition of the disease by many physicians. I have found that the best way to "educate" a disbelieving physician about the disease is to actually send them a CFS patient for evaluation of a specific problem, such as gastrointestinal, cardiac, or neurologic. More often than not, the response that I get is "you know, that patient is really sick." I am still amazed when they are so surprised. My own experiences with CFS have convinced me beyond doubt that it is an organic medical illness. I have seen an array of patients from all different walks of life, including housewives, blue-collar workers, athletes, physicians, nurses, educators, accountants, and lawyers. In general, these people had been productive, on-the-go people, cut down in the prime of their lives.

This year has been the most rewarding in CFS, especially in view of the CDC's new role in the recognition of this disease and attempts at dispelling the popular belief that CFS is a benign, self-limited disease that affects only whites with high incomes. Dr. William Reeves, head of the infectious diseases section of the Centers for Disease Control, has reported that only 12% of the patients with this disease ever fully recover. CDC officials have recently added CFS to the list of Priority 1 - New and Emerging Infectious Diseases. An NIH conference sponsored for physicians treating this disease was held this past year, the purpose of which was to identify outcome measures to be sued in the evaluation of clinical trials. Based on rigorous discussion of outcome measures, clinical studies are now being initiated in this devastating disease. Now more than ever, physicians and scientists are absorbed in scientific efforts to understand the etiology, epidemiology, and pathology of CFS, a complex, multi-system illness. For the physician or researcher willing to tackle this exasperating illness, the payoff is the opportunity to unravel an unsolvable medical mystery and thus preserve the passion of medicine.

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