Your online resource for objective ME/Chronic Fatigue Syndrome information

Introduction

One simple way to define Myalgic Encephalomyelitis (M.E.) is to look at the definition of the two words. Myalgic in short means muscle pain or tenderness and Encephalomyelitis means inflammation of the brain and spinal cord. Also known as Chronic Fatigue syndrome (CFS), it is the prolonged and disabling Fatigue that appears to be the hallmark of the symptom. M.E. is far from a new or recent condition, the earliest recorded outbreak of M.E. in the UK appeared in 1957 in the thesis of a Scottish physician, Dr Andrew Wallis in which he discusses an epidemic in Royal Free Hospital in Cumberland in Northern England in 1955. Since then many definitions have been proposed and whilst much effort has been put into giving this debilitating condition a title to which everyone is happy, little it seems has been focused on the disease itself. Indeed it is only relatively recently been recognised by both the World Health Organisation and the UK government as very real, serious neurological illnesses. Numbers of those individuals with M.E. are increasing with a suggested population prevalence of at least 0.2–0.4%. This means that a general practice with 10,000 patients is likely to include up to 40 people with M.E. Due to the difficulties involved with diagnosis (partly because of the variety of symptoms involved) it is reasonably accepted that these figures are likely to be much higher.

Symptoms

Typical symptoms may include:

  • Persistent fatigue over a period of at least six months
  • Impaired memory and concentration
  • Sore throat
  • Tender neck and underarm lymph nodes
  • Muscle and joint pain
  • Headaches
  • Non-restorative sleep
  • Decreased libido
  • Weight changes

Causes

Whilst there is no one cause for M.E., it is believed that around two-thirds of cases of M.E. are triggered by an obvious viral infection, including glandular fever, viral meningitis, viral hepatitis, and, less commonly, infection with bacteria or other organisms. Many of the infections triggering M.E. seem to be ordinary flu-like infections, from which some people don’t recover in the normal way. Other possible triggers appear to be vaccinations, toxins in the environment and, less commonly, physical injury or trauma. People with M.E. have been found to have abnormalities in the nervous system, and a part of the brain called the hypothalamus that regulates sleep, temperature control and appetite, as well as with the immune system. Interestingly as with many conditions it is suggested that genetics play a role, with women appearing to be more susceptible to M.E. than men, as well as clusters within families.

Fatty acids

There is increasing evidence that M.E. may be associated with persistent viral infection and that such infections are likely to impair the ability of the body to make omega-3 and omega-6 long-chain polyunsaturated fatty acids by inhibiting the action of a key enzyme (delta-6 desaturase) involved in fatty acid metabolism. This would, in turn, impair the proper functioning of cell membranes and have an adverse effect on the production of eicosanoids from the long-chain polyunsaturated fatty acids DGLA, AA and EPA. These actions might offer an explanation for some of the symptoms and signs of M.E. A potential therapeutic avenue could be offered by bypassing the inhibition of the enzyme delta 6-desaturase by direct supplementation with long-chain fatty acids such as EPA from fish oil. Whilst supplementing with fatty acids is not a cure for M.E., it can provide long-term relief of many of the symptoms that individuals often experience, including brain fog, fatigue and pain.

Recommendation

Vegepa E-EPA 70 pure EPA fish oil capsules

Vegepa E-EPA 70 – pure EPA omega-3 capsules

Vegepa E-EPA 70 combines the benefits of 70% ethyl-EPA concentrate extracted from marine anchovy oil with GLA and triterpene antioxidants from organic evening primrose oil.  This unique formulation is designed to balance and maintain healthy omega-3 and omega-6 levels providing support for immunity, platelet aggregation, and inflammatory regulation.

Just two Vegepa E-EPA 70 capsules daily provide 560 mg ultra-pure EPA and 200 mg organic virgin evening primrose oil. For children we recommend Vegepa E-EPA 70 Orange Chewables. Adults and children aged eight years and over should take 4-6 capsules daily. For vegetarians, our Echiomega supplement provides a more effective solution than flaxseed oil, with higher conversion to the important long-chain fatty acid EPA.

References

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Caliguiri M, Murray C, Buchwald D, Levine H, Cheney P, Peterson D, Komaroff AL & Ritz J. (1987). Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. Journal of Immunology 139:3306-3313.  

Chaudhuri A. Condon AJ, Surtees RA, Lees AJ, Adock JE, Harding B, Neville BG & Giovannoni G. (2004). Encephalitis lethargica syndrome: 20 new cases and evidence of basal ganglia autoimmunity. Brain 127:21-33.  

Fekety R. (1994). Infection and chronic fatigue syndrome. In: S. Straus (editor) Chronic Fatigue Syndrome. New York, USA: Marcel Dekker.  

Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff AL and the International Chronic Fatigue Syndrome Study Group (1994). The Chronic Fatigue Syndrome: A Comprehensive Approach to its Definition and Study. Annals of Internal Medicine 121:953-959.  

Jones JF, Nisenbaum R, Solomon L, Reyes M & Reeves WC. (2004). Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study. Journal of Adolescent Health 35: 34-40.  

Klimas NG, Salvato FR, Morgan R & Fletcher MA. (1990). Immunologic abnormalities in chronic fatigue syndrome. Journal of Clinical Microbiology 28:1403-1410.  

Maes M, Mihaylova I & Leunis JC. (2005)  In chronic fatigue syndrome, the decreased levels of omega-3 poly-unsaturated fatty acids are related to lowered serum zinc and defects in T cell activation. Neuroendocrinology Letters 26:745-51.

Peet M, Brind J, Ramchand CN, Shah S & Vankar GK. (2001) Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia. Schizophrenia Research 49:243-51.

Puri BK. (2004) The use of eicosapentaenoic acid in the treatment of chronic fatigue syndrome. Prostaglandins Leukotrienes and Essential Fatty Acids 70:399-401.

Puri BK, Counsell SJ, Zaman R, Main J, Collins AJ, Hajnal JV & Davey NJ. (2002). Relative increase in choline in the occipital cortex in chronic fatigue syndrome.  Acta Psychiatrica Scandinavica 106: 224-226.

Puri BK, Holmes J & Hamilton G. (2004). Eicosapentaenoic acid-rich essential fatty acid supplementation in chronic fatigue syndrome associated with symptom remission and structural brain changes. International Journal of Clinical Practice 58: 297-299.

Puri BK, Chronic Fatigue Syndrome: A Natural Way to Treat M.E., (Hammersmith Press, London, 2005) ISBN 1-905140-00-2.

Puri BK. (2007) Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis. Journal of Clinical Pathology 60:122-4.

Tamizi far B & Tamizi B. (2002) Treatment of chronic fatigue syndrome by dietary supplementation with omega-3 fatty acids–a good idea? Medical Hypotheses 58:249-50.