Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), is a severe debilitating condition, characterised by prolonged periods of fatigue. It is often experienced with numerous accompanying physical symptoms such as pain, an inability to concentrate and/or poor memory.
The condition’s name Myalgic (meaning muscle pain or tenderness) Encephalomyelitis (meaning inflammation of the brain or spinal cord) goes some way towards explaining the cause and symptoms of chronic fatigue, but many other factors contribute to the development of this complex condition. ME/CFS manifests in a variety of symptoms –any or all of which can be experienced by the sufferer.
The earliest known ‘outbreak’ of the condition was in 1955 at the Royal Free Hospital, yet little has been done since that time to understand the causes or develop treatments for the condition. ME has only recently been recognised as a real and serious neurological condition by the WHO and UK government.
Between 0.2 and 0.4 % of the population – up to 40 in every 10,000 people – are thought to suffer with ME but, because of the difficulty with diagnosing the condition and the need for symptoms to persist for several months before a diagnosis is confirmed, it is very likely that considerably more people are affected.
Typical symptoms may include:
- Persistent fatigue over a period of at least six months
- Impaired memory and concentration
- Sore throat and generally feeling unwell
- Tender neck and underarm lymph nodes
- Muscle and joint pain (if this is a major problem check for fibromyalgia)
- Non-restorative or disturbed sleep
- Decreased libido
- Weight changes
- Low mood, frustration or anxiety
- Poor temperature control
- Hypersensitivity to sound, light and other stimuli
- Digestion and appetite problems
ME/CFS can be triggered by a number of factors, though around 60% of cases start after a viral infection of some sort. The most common virus triggers for ME are glandular fever, the herpes virus, meningitis and in some cases hepatitis or gastroenteritis. Many non-viral infections can also be associated with onset of CFS. Other triggers can include vaccinations, physical trauma due to an accident, surgery or aggressive medical treatments. Environmental toxins and mental or emotional stress also appear to play a role in increasing the likelihood that a person will develop CFS, but these latter are not generally thought to cause CFS when experienced alone.
Researchers have found that CFS sufferers often have altered functions of chemical processes in the brain and central nervous system, as well as an abnormally low capacity to create energy within the cells.
“Reduced energy production capacity in ME/CFS sufferers results from damaged or dysfunctional mitochondria.”
One of the processes heavily affected in CFS sufferers is fatty acid production and low levels of fatty acids, particularly EPA, are a common feature in CFS patients. EPA, along with other fatty acids, is vitally important for the proper functioning of the immune system and in regulating inflammation, which is also negatively affected in CFS. Fatty acid deficiency is therefore a considerable problem, given that high levels of inflammatory cytokines are known to produce symptoms of fatigue, as well as pain and muscle aches. EPA also plays a crucial role in cellular communication and is particularly important for brain function and central nervous system activity. At the same time, viral infections (common in ME/CFS) directly reduce the activity of the enzyme delta-6-desaturase, needed to make long-chain fatty acids such as EPA from plant foods in the diet, which further adds to the severity of CFS symptoms.
Activity of the hypothalamus, the part of the brain responsible for regulating sleep, temperature control and appetite, as well as the immune system, appears to be either hyperactive or very underactive in CFS sufferers, both of which contribute to fatigue.
Some cutting-edge research and clinical evidence suggests that the reduced energy production capacity in ME/CFS sufferers results from damaged or dysfunctional mitochondria – tiny cellular structures in our cells responsible for turning food into energy. Mitochondria can be damaged or affected by toxins and stress, either mental (for example, the demands of daily life, relationships, work issues or trauma) or physiological (due to high free radical production from everyday chemical reactions and poor nutrition).
There is some support for the role of food intolerance and sensitivities in the onset and progression of CFS symptoms. Identifying which foods may be contributing to your symptoms may be helpful in condition management and recovery.
We strongly recommend ensuring that your diet avoids any factors that could contribute to worsening symptoms of CFS. Ideally, your diet should be low in carbohydrates in order to regulate blood sugar levels, with rich sources of good quality proteins and fats for slow and steady energy release.
Your diet should also be rich in vitamins, minerals and antioxidants to support chemical processes and energy production. Animal protein, such as eggs, meat and fish, is important to help repair cellular damage caused by toxins and high stress levels, as well as replenish functional proteins involved in cellular communication and central nervous system function. If you eat a strict plant-based diet, it is important to ensure you achieve good levels of protein from sources such as quinoa, nuts, seeds and pulses.
It is also important to avoid any foods that will add toxins and stress to the body. Choosing foods that are natural, unprocessed and do not contain any added ingredients or preservatives will help reduce the energy needed to process and eliminate the unwanted ingredients and chemicals found in many modern foods. Reducing trans fats and high sugar foods will help keep inflammation levels low, as these foods increase stress and in turn increase cytokine production, which worsens CFS symptoms. Where possible, choose organic, local vegetables and organic, pasture reared or free range meats, eggs and dairy products to help reduce indirect consumption of antibiotics, pesticides, hormones and environmental toxins, which can add to the body’s toxic load and deplete energy reserves in trying to eliminate these from the body.
“Your diet should also be rich in vitamins, minerals and antioxidants to support chemical processes and energy production.”
If you suffer from food intolerances, an elimination diet may help with symptom reduction and recovery. Symptoms of food intolerance are not limited to digestive issues and many people suffer a range of issues that can lessen or disappear when removing the trigger food(s) from the diet. It may not be necessary to test for specific sensitivities and the accuracy of tests is still variable, though a basic screen might be useful as a starting point, as certain sensitivities can cause cross-reaction to other foods that are not the real problem.
Supplementing with long-chain omega-3 EPA and omega-6 fatty acid gamma-linolenic acid (GLA) provides the body with the pre-formed omega-3 and 6 fatty acids most heavily affected by altered fatty acid production.
Bypassing the need for the body to perform several complex, inefficient conversion steps to produce these long-chain fats from shorter-chain dietary fats means the energy needed for this process is spared and normal fatty acid levels can be restored more quickly and effectively. Pure EPA supplementation directly increases EPA levels, helping to restore an optimal AA to EPA ratio, which results in reduced inflammation and enhanced immune function. EPA and GLA also give rise to products that inhibit viral replication and act as antiviral compounds, as well as supporting brain function and cellular communication.
Phytosterols, present in cold-pressed organic virgin evening primrose oil (EPO), the source of GLA in Igennus products, are important cholesterol-like molecules found in plants that are in part responsible for the health-enhancing effects of fruit and vegetables. Those found in EPO exhibit antibacterial and antifungal activities and have numerous anti-inflammatory effects, including the reduced production of pro-inflammatory products derived from the omega-6 AA. In addition, specific triterpenes (another group of health-promoting plant molecules unique to unrefined virgin EPO), possess free radical-scavenging and anti-inflammatory properties.
“EPA and GLA also give rise to products that inhibit viral replication and act as antiviral compounds, as well as supporting brain function and cellular communication.”
Homocysteine is a by-product of the methylation cycle – a vital biochemical process involved in the production of brain chemicals and antioxidants, and genetic control. Levels of homocysteine are directly inﬂuenced by blood levels of the B vitamins folic acid, B6 and B12. Supplementation with these vitamins supports the recycling of homocysteine, helping to prevent a blockage in the above-mentioned processes and subsequent health issues. Of particular importance in CFS is homocysteine’s role in producing glutathione, a powerful antioxidant that helps to reduce oxidative stress and thus protect against cell and mitochondrial damage. Supplementation with these specific B vitamins also helps improve neurotransmitter production and cognitive function – a useful mechanism to help address the commonly experienced symptom ‘brain fog’.
Coenzyme Q10 (CoQ10) is a key molecule needed by the body to produce the body’s energy currency ATP, which is often depleted in individuals with CFS/ME because of mitochondrial dysfunction. Mitochondrial failure, low dietary intake, high oxidative stress and ageing all increase the body’s need for CoQ10; supplementation helps overcome the deficiency in CoQ10 supply commonly observed in CFS. Ubiquinol is the most potent, body-ready form of CoQ10 and is especially beneficial for overcoming CoQ10 deficiency, improving energy levels, enhancing sleep and improving cognitive performance. CoQ10 in the ubiquinol form is also a very powerful antioxidant, ideal for helping to reduce potential damage caused by high toxin and stress levels in CFS/ME.
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Pharmepa RESTORE & MAINTAIN and Vegepa E-EPA 70 provide 70-90% EPA omega-3 concentrate, extracted from wild anchovy oil. Taking preformed EPA bypasses inefficient enzyme conversions and helps to restore normal eicosanoid production. Pure EPA in Pharmepa RESTORE and Vegepa E-EPA 70 specifically helps to restore an optimal AA to EPA ratio (a more accurate measure of omega-6 & omega-3 balance), resulting in reduced inflammation and enhanced immune function. Both Pharmepa MAINTAIN and Vegepa E-EPA 70 combine EPA with GLA and triterpene antioxidants from organic evening primrose oil. EPA and GLA work together to produce substances that inhibit viral replication and provide beneficial antiviral properties, particularly helpful in CFS/ME. Phytosterols in organic, cold-pressed virgin evening primrose oil also offer antibacterial and antifungal properties, along with anti-inflammatory effects, thus further supporting a healthy AA to EPA ratio. Pharmepa MAINTAIN also provides omega-3 EPA in combination with DHA which acts to optimise the omega-3 index (EPA & DHA content of cell membranes) and support healthy cell structure and omega-3 levels long term.
The Pharmepa RESTORE & MAINTAIN protocol aims to optimise the omega-3 index to ≥8%, the minimum level required to achieve optimal therapeutic benefits.
For vegetarians, our Echiomega supplement provides a more effective solution than flaxseed oil, with higher conversion to the important long-chain fatty acid EPA.
Homocysteine levels, as above, can be managed effectively via supplementation with Homocysteine Control, supporting efficient neurotransmitter production, increased antioxidant levels, reduced oxidative stress and improved cognitive function.
CoQ10, essential for the body’s production of the energy molecule ATP, is often depleted in CFS patients due to mitochondrial failure. Ubiquinol CoQ10 is especially potent as it is in a ‘body-ready’ form for instant uptake, while the patented delivery system VESIsorb® ensures CoQ10 blood plasma levels are reached rapidly and remain at therapeutic levels for longer.
The RESTORE & MAINTAIN protocol aims to optimise fatty acids levels for intensive therapeutic benefits.
- For more severe cases of ME/CFS we recommend following our therapeutic Pharmepa RESTORE & MAINTAIN protocol, starting with 2 -4 capsules daily of our 90% pure EPA supplement Pharmepa RESTOREfor a minimum of 6 months before introducing omega-3 DHA and omega-6 GLA for long-term health maintenance with Pharmepa MAINTAIN.
Vegepa is a tried and tested product in CFS and has been recommended by leading CFS specialists including Dr Myhill and Dr Raymond Perrin for oer 10 years. Vegepa has a proven track record in CFS and remains our most cost effective pure EPA supplement.
- Adults and children aged eight years and over should take 2-4 capsules twice daily.
- For young children we recommend Vegepa E-EPA 70 Orange Chewables.
Echiomega Echium Seed Oil – for vegetarians & vegans
Adults and children should take 4 capsules of Echiomega twice daily to provide a sufficiently high dose of long-chain omega-3s. Take Echiomega with food for optimum absorption.
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Adults and children aged twelve years and over should take 1 tablet 3 times daily, at mealtimes for optimum absorption.
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