Dietary Supplement for Chronic Fatigue Syndrome Cure. CFS symptoms, diet, cure.ME, fatigue causes

BENEFITS OF TAKING CAVSOR FOR PATIENTS WITH CHRONIC FATIGUE SYNDROME

Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis (ME), is characterized by persistent exhaustion and most often occurs between the ages of 20–40, although children are sometimes also affected [1]. According to the estimate by the US Centers for Disease Control and Prevention, CFS/ME affects more than one million people in the US [2]. As the name of this condition suggests, the main symptom is fatigue, both physical and mental, which is not alleviated by resting or sleeping [1]. Whereas many healthy people would find moderate physical exercise invigorating, exercise exacerbates exhaustion in CFS patients and may cause extreme exhaustion that lasts more than 24h [1, 3]. Fatigue may be accompanied by any of a number of other symptoms, some of which appear to be directly linked to fatigue: inability to concentrate, poor memory, headaches, insomnia, whereas others are not directly related to fatigue: pain in muscles, joints, lymph nodes, or stomach, headaches, sore throat, lymph node enlargement in the neck or armpits [1, 3].

The exact causes of CFS are unknown but may include infection (in particular, viral infection), immunity-related problems (in particular autoimmune responses), hormonal disturbances, or psychological stress [1, 3]. The results of studies of differential gene expression in CFS patients in comparison with healthy subjects, which were aimed at both elucidating the cause(s) of CFS and developing tools to reliably diagnose it, indicate that etiology of this disorder may be heterogeneous. For example, the study by Kaushik and colleagues [4] suggested a link to organophosphate compound exposure and virus infection, whereas that by Aspler and colleagues [5] implicated persistent inflammation. A later study by Frampton and colleagues [6] found that even using as many as 44 differentially expressed genes allowed to correctly diagnose only about two-thirds of CFS patients, suggesting a high degree of heterogeneity among them. Since the etiology of CFS is not firmly established, no definite cure exists, although most patients improve with time. As CFS is an “under investigated” disease, the US National Institutes of Health (NIH) has recently decided to strengthen its efforts to advance research on CFS and will investigate those symptoms developing soon after onset [2].

In the absence of a definite cure, there are indications that patients with CFS and related conditions have reduced levels of polyunsaturated fatty acids (PUFAs) and that PUFA supplementation may alleviate the CFS symptoms. A double-blind, placebo-controlled study conducted in the UK more than 25 years ago enrolled 63 patients with “postviral fatigue syndrome” who had the condition for one to three years (at that time, the criteria for CFS/ME diagnosis had not yet been defined, and these patients would likely have be diagnosed with CFS/ME today) and 32 healthy volunteers [7]. The authors found reduced levels of n-6 PUFAs in the erythrocyte membranes of fatigue syndrome patients in comparison with healthy controls. They conducted a three-month trial, in which some patients and healthy volunteers were given a supplement (8 × 500 mg daily) containing n-3 PUFAs (eicosapentaenoic [EPA] and docosahexaenoic [DHA] acids) and n-6 PUFAs (linoleic and γ-linolenic acids) and the patients were assessed at the first and the third months. In the fatigue syndrome group, the authors found an increase in PUFA levels and improvements over the baseline in 74% of the patients after one month and in 85% after three months, whereas improvements were found only in 17% and 23% of participants in the placebo group, respectively [7]; no adverse effects were noted.

In a separate publication, one of the co-authors of this study hypothesized that the beneficial effects of PUFA supplementation were likely due to the ability of viruses to suppress n-6 PUFA synthesis in the cells and the necessity of n-6 PUFAs for the antiviral effects of interferon [8].

A later small-scale study (22 CFS patients, 12 healthy subjects) by Maes and coworkers [9] conducted in Belgium found that the n-3/n-6 PUFA ratios were significantly lower in CFS patients than in normal subjects and were significantly correlated with CFS severity, thus lending support for the positive role n-3 rather than n-6 PUFAs in respect to CFS.

At least two hypotheses have been put forward to explain the mechanism of PUFA action in CFS. In a series of publications following their pilot study, Maes and colleagues suggested that treatment with n-3 PUFAs such as EPA and DHA would be beneficial for patients with CFS (both EPA and DHA are among the components of Cavsor). This and some other groups have also found reduced levels of n-3 PUFAs in patients with major depressive disorder (see references in [10]). It has been postulated that there is a link between depression and CFS, that both conditions are caused by “the aberrations in inflammatory, oxidative and nitrosative pathways” and that the beneficial effects of n-3 PUFAs are due to their well-known anti-inflammatory effects [10]. The anti-inflammatory action of n-3 PUFAs is well established and is thought to be due to several factors: (i) incorporation of n-3 PUFAs into the membranes of inflammatory cells at the expense of arachidonic acid, which is a precursor of pro-inflammatory eicosanoids; this reduces production of these inflammatory mediators; (ii) the n-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid serve as precursors of anti-inflammatory mediators resolvins; and (iii) n-3 PUFAs modulate the expression of the genes encoding pro-inflammatory cytokines [11].

As mentioned above, infections, including viral ones, are thought to be one of the major factors that trigger CFS, and in its new research initiative on CFS the NIH is going to concentrate efforts on this cause [2]. Puri [12] has proposed a hypothesis to explain the likely link between persistent viral infections, n-3 PUFAs, and CFS. This hypothesis is based on the fact that the enzyme δ-6-desaturase, which is necessary for the biosynthesis of long-chain PUFAs (both n-3 and n-6), is inhibited by many viruses, resulting in PUFA deficit and consequently in multiple adverse effects, some of which are due to altered composition of cell membrane and some to changes in the PUFA-dependent synthesis of anti- and pro-inflammatory mediators.

The hypotheses put forward by Maes and coworkers and by Puri still need to be tested and large-scale trials are needed to elucidate the effects of PUFAs in CFS patients, along with a better understanding of the etiology of this disorder. Nevertheless, taking into account preliminary evidence described above, as well as various beneficial health effects of PUFA supplementation [13], it would make sense for CFS patients to consider taking PUFA supplements such as Cavsor.

References

  1. National Health Service, U.K. Chronic fatigue syndrome. http://www.nhs.uk/conditions/chronic-fatigue-syndrome/Pages/Introduction.aspx (2015).
  2. Cohen, J. NIH refocuses research into chronic fatigue syndrome. Science (2015).
  3. Mayo Clinic. Chronic fatigue syndrome. http://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/basics/symptoms/con-20022009 (2016).
  4. Kaushik, N. et al. Gene expression in peripheral blood mononuclear cells from patients with chronic fatigue syndrome. J Clin Pathol 58, 826-832 (2005).
  5. Aspler, A.L., Bolshin, C., Vernon, S.D. & Broderick, G. Evidence of inflammatory immune signaling in chronic fatigue syndrome: A pilot study of gene expression in peripheral blood. Behav Brain Functions 4, 44 (2008).
  6. Frampton, D., Kerr, J., Harrison, T.J. & Kellam, P. Assessment of a 44 gene classifier for the evaluation of chronic fatigue syndrome from peripheral blood mononuclear cell gene expression. PLoS One 6, e16872 (2011).
  7. Behan, P.O., Behan, W.M. & Horrobin, D. Effect of high doses of essential fatty acids on the postviral fatigue syndrome. Acta Neurol Scand 82, 209-216 (1990).
  8. Horrobin, D.F. Post-viral fatigue syndrome, viral infections in atopic eczema, and essential fatty acids. Med Hypoth 32, 211-217 (1990).
  9. Maes, M., Mihaylova, I. & Leunis, J.C. 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. Neuroendocrinol Lett 26, 745-751 (2005).
  10. Maes, M. An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways. Progr Neuro-psychopharmacol Biol Psychiatry 35, 784-794 (2011).
  11. Calder, P.C. n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 83, 1505S-1519S (2006).
  12. Puri, B.K. Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis (chronic fatigue syndrome). J Clin Pathol 60, 122-124 (2007).
  13. Food and Agriculture Organization of the United Nations. Fats and fatty acids in human nutrition. http://www.fao.org/3/a-i1953e.pdf (2008).