Chronic Fatigue Syndrome

By On · Add Comment

It wasn’t that long ago that to proclaim the existence of ‘Chronic Fatigue Syndrome’ would have prompted the retort “it’s all in your head” in both medical and social settings. It was even given the unflattering nickname ‘Yuppie Flu’ to underline this inherent disbelief of it being anything more than a whining of the well-to-do in relation to life’s general responsibilities. That rather narrow minded view has, thankfully, largely faded away. Medical science now recognises CFS as a constellation of possible symptoms that are underpinned by the presence of fatigue at a level that causes disruption to daily activities in the absence of other medical conditions related to fatigue. It is a complex, multi faceted syndrome that can present in many different ways among the population, and which can be caused by a number of factors. CFS is estimated to affect approximately 10% of the adult population, however this figure varies depending on which diagnostic criteria you use. CFS seems to affect women at twice the rate of men.

The myriad symptoms associated with CFS

In addition to the fatigue mentioned above, associated symptoms of CFS can include:

  • Mild fever
  • Recurrent sore throat
  • Painful lymph nodes
  • Muscle weakness and pain
  • Prolonged fatigue after exercise
  • Recurrent headache
  • Migratory joint pain
  • Neurologic or psychological complaints such as sensitivity to light, forgetfulness, confusion, inability to concentrate, excessive irritability, and depression
  • Sleep disturbance

Source: CDC diagnostic criteria for Chronic Fatigue Syndrome

There is also significant correlation in symptomatology between CFS, Fibromyalgia, and Multiple Chemical Sensitivities. In one study researchers compared symptomatology of 90 patients divided into thirds with either CFS, FM, or MCS and found that 70% of FM and 30% of MCS patients could be diagnosed with CFS according to the CDC criteria.

What causes Chronic Fatigue Syndrome?

The causes of CFS, like its symptoms, can be varied. They can include depression, prolonged stress or adrenal dysfunction, impaired liver function, impaired immune function and subsequent chronic infection, food allergies, and leaky gut. It is important to view every case in an individual light so as to determine the specific underlying drivers of an individuals presentation of CFS. These investigations should ideally be performed under the supervision of a practitioner of functional medicine such as a Naturopath or an Integrative GP, with specific treatment tailored to addressing these specific drivers. There are, however, some fundamental cellular processes that can be examined and treated in most cases of CFS that tend to be common to all. I will review these treatments here, however I want to stress that these approaches will be likely to fail in restoring complete health in the long run without properly addressing the underlying causes.

Mitochondria in crisis

Inside almost every one of your trillions of body cells is a powerful little engine that provides almost all of its energy needs. These engines are called ‘Mitochondria’ and they are an amazing example of symbiosis between an organism of bacterial origin and the human being. Mitochondria basically exponentially multiply the energy producing potential of the cell through a series of chemical chain reactions, and they are absolutely intrinsic to our health. In CFS, the structure and function of these mitochondria appear to be commonly badly damaged. This will clearly have an impact on the energy producing capacity of that individual. Furthermore, the damage to these mitochondria causes a leakage of their contents into the cellular space, prompting an immune reaction in the form of an inflammatory response and thus further destruction of mitochondria. Crucial to preventing mitochondrial damage and dysfunction are Glutathione and Coenzyme Q10.  Both of these perform a protective function as powerful intra-cellular antioxidants. Glutathione can be be taken as a supplement, however due to its poor intestinal absorption it is often better to take it in its precursor form, N-Acetyl-Cysteine. CoQ10 has been shown to be significantly lower in CFS patients, reflecting its increased requirements in this condition.

Magnesium to the rescue (again)

Magnesium is a crucial component in the process by which the mitochondria produce energy in the cell. In one study of 32 CFS patients who received magnesium supplementation, 90% of those receiving active treatment reported significantly improved energy levels, improved emotional state, and less pain. The citrate and aspartate forms of magnesium are particularly beneficial in CFS as both of these chelating agents also take part in the mitochondrial energy production process.

L-Carnitine for premium fuel

The substance L-Carnitine is a crucial transporter of essential fatty acids into the cellular mitochondria, thus providing fuel for their function. This study compared the effectiveness of the drug amantidine (commonly used to relieve fatigue in patients with MS) to L-carnitine in CFS patients. While amantidine provided no clinically significant improvement after completion of the treatment period, L-Carnitine provided statistically significant clinical improvement in 12 of 18 studied parameters.

Cellular repair

The oxidative processes mentioned above damage not only the mitochondria housed within the cell, but also the cell itself. This damage is most apparent in the protective membrane of the cell, and through this damage the signalling capacity and utility of the cell becomes badly dysfunctional. This can have wide ranging effects in the body, most of which are encompassed in the CFS symptoms listed above. It is crucial to repair this membrane damage to restore the function of the cell, and this can be achieved by providing the building block of a healthy cellular membrane. Phospholipids in the form of phosphatidylcholine and phosphatidylserine, omega 3 fatty acids from fish and especially krill, tocotrienols from vitamin E, and vitamin D all play a crucial role in this membrane repair.

Herbal energy and adrenal restoration

Common to most cases of CFS is the presentation of low cortisol, a substance produced by the adrenal glands in response to stress. Low cortisol is a sign of adrenal dysfunction and can contribute to symptoms of fatigue and muscular pain. Fortunately herbal medicine is excellent at restoring adrenal function:

  • Licorice extract can increase cortisol levels and provide adrenal support
  • Panax (Korean) Ginseng produces corticosteroid like activity and can thus improve energy and reduce inflammation
  • Rhodiola has been shown in this study to reduce the negative aspects of the cortisol response to prolonged stress in patients with fatigue syndrome, while increasing energy and mental performance
  • Withania (Ashwaganda) is a gentle and restorative herb that can reduce anxiety and improve responses to prolonged stress

I hope the supplements mentioned above give you a starting point to explore the many treatment options available for those suffering from Chronic Fatigue Syndrome. Remember that these treatments, while effective at relieving many symptoms associated with CFS, will not provide true health resolution without significant investigations into the driving causes of cellular dysfunction underpinning any particular CFS presentation.

In wellness,

James

Why heirloom fruit and veg is better for your health

By On · Add Comment

Nearly 2,500 years ago, the Greek physician Hippocrates proclaimed “Let food be thy medicine and medicine be thy food” and at the time this was certainly a fundamental truth that all could benefit from adhering to. However as the decades and centuries have passed, and as techniques of farming and plant cultivation have become increasingly the stuff of laboratory experimentation, our “food” is no longer what it was. This is clearly seen in the prevalence of processed chemical laden food that has flooded our supermarkets, however it is also true in areas of food that may not be so apparent – namely the fruits and vegetables that most would assume are natural, unprocessed, and healthy.

To understand how a fruit or vegetable could be less than optimal for abundant health, you first need to understand the nature of plant phytochemicals and how they can assist our bodies. Phytochemicals are secondary plant metabolites that exist as a third tier of nutrient beyond the simple macronutrients (protein, carbohydrate and fat) and micronutrients (vitamins and minerals) already present. These phytochemicals are thought to play a defensive role in the plant against environmental stressors such as pests, disease, radiation, and drought. Interestingly these phytochemicals have been shown to not only aid the plant in question in becoming more robust and impervious to environmental stress, but to also aid those animals that consume the plant and thus ingest these phytochemicals. Examples of these health promoting phytochemicals are resveratrol from grape seed, caretonoids from yellow-orange fruit and veg, and curcumin from turmeric. These phytochemicals have been demonstrated to be effective in reducing the prevalence of many diseases, specifically the big four of the Western world: cancer, cardiovascular disease, diabetes and dementia.

However this is where modern agricultural techniques have let us down. Over the past century, plant breeders in the areas of edible plants have focused their efforts toward producing ever faster growing, plumper, sweeter varieties of most produce. Interestingly, many of the health promoting phytochemicals have bitter or astringent flavour profiles and thus they are bred out of the plants through this process. This selective breeding, along with intensive industrial farming that saturates the soil with unnaturally high levels of growth promoting nutrients such as phosphorous while at the same time destroying all pest and disease stressors through the application of pesticides, fungicides and herbicides, has effectively resulted in nutrient poor varieties of produce which produce extremely low levels of health promoting phytochemicals.

To demonstrate just how depleted these phytonutrients can be, below is a diagram outlining the differences between some heirloom and modern varieties:

corn nutrient comparison

 

Bill Marsh/The New York Times; illustrations by Matt Curtius

It becomes clear that if we are to seriously attempt to maximize our health, we must choose our fruits and vegetables wisely. When shopping look for the more exotic varieties of produce, and don’t shy away from those blemished and slightly insect nibbled apples – they are likely to contain more phytochemicals due to greater exposure to environmental stress than their plump and perfectly waxed cousins.

There is another layer to this issue, and that is the length of time from when produce is harvested to when it arrives on your plate. Most major supermarkets will cold store fruit and vegetables for days or even weeks before you have the chance to purchase them. What many do not know is that this produce is not dead once it is harvested, it continues to respire and pursue its cellular processes, and over time this will deplete the produce of crucial nutrition. As an example: broccoli, kale, and spinach are all highly recommended nutrition dense foods, however within two or three days from harvest they may have half or even less of their original antioxidant levels. Buying local produce at farmers markets is a great way to ensure your produce contains the highest levels of nutrients (apart from growing and harvesting it yourself of course!).

So here are my tips for ensuring the fruits and vegetables you eat contain the highest level of nutrition possible:

  • Buy heirloom varieties of fruits and vegetables whenever possible. Swap examples include:
    • Swap orange carrots for purple carrots
    • Swap large tomatoes for multi coloured heirloom cherry tomatoes
    • Swap white potatoes for small fingerling varieties
    • Swap iceberg lettuce for rocket, kale and baby spinach
  • Eat your produce as soon as possible from purchase, especially broccoli, asparagus, kale and spinach
  • Buy you produce from local farmers markets
  • Store your produce well. For example, the best way to store leafy greens is to place them in a zip lock back, squeeze out all the air, prick a dozen or so small holes with a pin in either side of the bag, then store in the fridge.

And finally, have a go at growing some of your own produce. Even if you live in a small apartment, a few pots of herbs such as rosemary (full of incredible antioxidants by the way), thyme and basil, along with a small cherry tomato bush, will greatly boost your phytochemical intake and improve your health. If you live in a house with some land, why not reclaim some of that boring lawn and create a raised garden bed. You’ll be amazed at what you can grow yourself. I recommend purchasing heirloom seeds from a website such as Green Harvest and trying your hand at some ‘purple dragon’ carrots or ‘green sprouting calabrese’ broccoli – the flavour of produce you grow yourself can never be beaten!

In wellness

James

Coeliac disease and non-coeliac gluten sensitivity

By On · Add Comment

Browse any supermarket aisle these days and you’ll see a multitude of products offering the latest in what is considered ‘healthy’ food. These can include many brightly listed ‘free froms’ including:

  • Free from artificial colours
  • Free from artificial preservatives
  • Free from artificial sweeteners
  • Free from added sugar

However by far the most popular ‘free from’ of the moment is to be ‘free from gluten’. Gluten is the arch villain of the food world these days, and not without some good cause. Gluten is a protein found in the endosperm (seed covering) of the wheat plant, and can trigger severe inflammation and subsequent malabsorption in the small intestine of those who are reactive – namely those with coeliac disease. Now although the long term effects of the malabsorption caused by coeliac disease can be dire (the most profound of which seems to be a clear association with early death), until recently the medical attention paid to this condition amongst the general public was relatively scarce. This was mainly due to the fact that coeliac disease seems to affect approximately 1% of most populations and although this is relatively high compared to many other diseases, the prevalence is not high enough to warrant a widespread campaign of education and gluten elimination amongst the general populace.

Here’s where it gets controversial – recent studies have indicated that it is not necessary to have distinct coeliac disease in order to develop many of the signs and symptoms associated with it. These disease states tend to be grouped under the term ‘non-coeliac gluten sensitivity’ and some data suggests the prevalence of NCGS may affect up to 6% of the general population. This is a figure that starts to look much more deserving of attention, however at this stage there still tends to be a prevalent medical opinion that gluten sensitivity is only clinically relevant for those with clear coeliac disease. Thus many who present with symptoms of chronic diarrhea and weight loss, and who test negative to the human antitissue transglutaminase antibodies (Ig A anti-tTG) or jejunal biopsy commonly used to determine coeliac disease, are not instructed to eliminate gluten as a possible trigger.

So what do you do if you suspect that you have a sensitivity to gluten, or indeed coeliac disease? The first thing to determine is whether anyone in your immediate family has confirmed coeliac disease or NCGS, as there seems to be a clear genetic component in the development of these states. An easy and affordable way to determine whether you are reactive to gluten specifically is to eliminate it from your diet for a period of between four and eight weeks (depending on the severity of presenting symptoms), assess your symptom patterns throughout this elimination phase, and then reintroduce gluten containing foods and see if your symptoms re-emerge (assuming they did disappear during the elimination phase). This type of elimination challenge does require some effort on the part of the patient and I always suggest performing this assessment under the supervision of a health professional such as a dietician, nutritionist or naturopath. If this suggests gluten sensitivity then it is very important that you undergo the Ig A anti-tTG test (or jejunal biopsy) mentioned above to rule out or confirm coeliac disease due to the serious nature of this condition.

Should coeliac disease be confirmed, a strict avoidance of gluten containing foods is imperative. The foods containing gluten are:

  • Wheat (including ancient forms such as spelt)
  • Rye
  • Barley
  • Oats
  • Malt
  • Brewers yeast

There are many hidden sources of gluten and gliadin contained in processed foods, and as such a wholefood diet which excludes pre-packaged and processed additives such as sauces and other condiments should be followed as closely as possible.

The addition of pancreatic enzymes may provide some benefit during the early stages of gluten elimination, as they can assist in relieving the digestive load and thus freeing up our natural digestive processes to break up problematic proteins such as gluten before they trigger an immune reaction. Even more promising is the fungal sourced enzyme dipeptidyl peptidase IV (DPP-IV) which specifically targets the gliadin protein. The ongoing use of DPP-IV may prove beneficial to those with coeliac disease or NCGS so as to negate any possible damage caused by consumption of hidden sources of gluten.

Supporting liver function may be indicated in those with a predisposition to food sensitivities, as the Kupffer cells found in the liver should sequester any immunologically active material once absorbed through the intestinal wall and prevent it from triggering an immune reaction in the body. Prevalence of food sensitivity may indicate a weakness in this process, however many interrelated factors such as the degree of gut permeability as mentioned below must be considered before deciding on liver function as the target for treatment. The herbs milk thistle and schisandra may assist in restoring liver function.

Whether a confirmation of coeliac disease is determined or a non-coeliac gluten sensitivity seems more likely, there will certainly be some damage to the mucosal lining of the small intestine from prolonged exposure to gluten, and as such healing this damage is a priority of treatment. Glutamine is a crucial amino acid for the repair of the small intestinal mucosa, as is the mineral zinc. The herb golden seal is also excellent for the repair of intestinal mucous membranes. The herbs chamomile, turmeric and boswellia are particularly beneficial as anti-inflammatory agents in the intestinal tract, and the use of high dose fish oil as an up-stream suppressor of systemic inflammation should also be considered.

Avoiding any environmental allergens such as dust, pet hair, cigarette smoke and exhaust fumes is crucial in minimizing allergenic tendencies. The ubiquitous pesticide glyphosphate has been linked to the development of celiac disease and thus choosing organic produce is an important consideration when shopping for groceries. Adequate sleep and stress reduction are also important steps in reducing inflammation and allowing the body to heal.

As a final note, it is important to state that it is entirely possible to survive (many would say thrive) on a diet free of the grains containing gluten that I have listed above. Certainly moving to a more whole food diet free of processed chemical additives can only be a good thing for your health, and going gluten free can often have this effect as an unintended consequence (although as the food manufacturers cotton on to the popularity of gluten free foods there are more and more heavily processed options flooding our supermarkets).  Use your discretion and read every ingredient panel of the processed foods you buy – you may be shocked at the number of health damaging additives the most basic food item can contain.

In health,

James

How to make Bulletproof coffee

By On · Add Comment

Hi all,

Well it’s all the rage with coffee aficionados and health fanatics, and if you do it properly there’s no going back to that boring flat white!

Bulletproof coffee is basically black coffee blended with unsalted butter and MCT oil (produced by refining coconut oil), with the health benefits of sustained energy without the coffee crash as well as increased mental alertness and energy well beyond what a standard cup of coffee would provide. It is also generally well tolerated by those who normally feel queasy after a milk heavy grande latte. However like all culinary experiences the quality of the ingredients as well as the techniques of production are everything. You should use organic coffee (did you know that coffee plantations are one of the most heavily pesticide sprayed crops?) as well as organic butter from grass fed cows which gives a creamier consistency once blended. And yes, you must blend the coffee and not just stir it with a spoon so that you properly emulsify the fats – unless of course you enjoy a thick film of pure butter sitting on top of your black coffee.

I use the ‘Mini Porlex’ ceramic burr grinder to grind my beans fresh – this is the best way to preserve the natural antioxidants found in vast quantities in coffee beans, and ceramic grinders do not produce the antioxidant destroying heat an electrical blade grinder would. The quality of the bean is also very important – please throw out the instant freeze dried floor scrapings you may have stored in your cupboard and invest in some quality java. I love the ‘BUN’ brand of coffee and choose the locally produced variety grown in the lush sub-tropics of Byron Bay.

I also use an ‘Aeropress’ coffee plunger, which is basically an extremely high tech french coffee press. The difference is that the quality seal on the Aeropress produces a huge amount of pressure for extracting the liquid coffee goodness from the beans. Have you noticed how expensive a high quality coffee machine can be, and that the cost usually correlates with the bar pressure capability the machine can produce? The Aeropress basically produces this same extreme pressure, and you don’t have to take out a second mortgage to afford one!

So here is the process (watch the video above for a visual blow-by-blow):

  1. Grind your beans (or use pre-ground beans that are as fresh as possible)
  2. Place one tablespoon of organic unsalted butter into the bottom of your mug (or blender jug)
  3. Place between 1 teaspoon and 1 tablespoon of MCT oil into the mug / blender (I recommend starting with the teaspoon and building up to the tablespoon over a week or so to avoid what Dave Asprey, Mr Bulletproof himself, refers to as ‘Disaster Pants’)
  4. Pour your extracted coffee onto the butter and MCT oil
  5. Blend away!
  6. Enjoy the creamy and health promoting goodness

That’s it. Please try it out for yourself and leave a comment below so that we can all share the love of bulletproof coffee (and hopefully not stories of ‘Disaster Pants’).

In wellness,

James

Super yummy home made ice cream

By On · Add Comment

Have you ever read the ingredients list on tubs of ice cream at the supermarket. It becomes frighteningly clear that most commercial varieties of this delicious desert (or breakfast if you are so inclined!) have far more sinister items contained within than just frozen cream. There are a number of chemical thickening agents, artificial flavors, colors, and preservatives. Not to mention a truckload of sugar. But not to worry, help is at hand. Try the healthy ice cream recipe below and you will never frequent the frozen food section of your local supermarket again (and you really can eat it for breakfast and not feel guilty).

  • Take 600ml of fresh cream and pour it into a saucepan
  • Add a 400ml can of coconut cream
  • Add 2 tablespoons of honey
  • Add 2 teaspoons of vanilla bean paste
  • Stir this together on low heat until it is hot but not simmering
  • In a heatproof bowl whisk together 3 egg yolks
  • Pour the hot cream mixture slowly over the egg yolks, whisking the whole time
  • Place the bowl in the fridge until the mixture is cool
  • Place the cooled mixture into your ice cream maker (believe me it is worth the investment) and churn for approximately 25 minutes

Voila, a tub of super creamy, super healthy ice cream. For a chocolate version, just add 2 tablespoons of raw cacao to the recipe above.

Enjoy!

Yours in health,

James

Concrete Jungle Juice

By On · Add Comment

This is a great pick-me-up juice that can really satisfy those hunger cravings throughout the day. Start by adding 1 teaspoon of chia seeds and 1 tablespoon of psyllium husks to about 100ml of water in a glass.  Put this aside while you prep the following ingredients.

Add the following to a blender:

  • 1 tablespoon of a green foods powder like Vital Greens
  • A small handful of blueberries
  • One banana
  • A teaspoon of Acai powder
  • A heaped tablespoon of Pea Protein (I really like the Vital Protein in vanilla flavor)

Add the soaked chia and psyllium (it will have formed into a gluggy paste) plus about 300ml of extra water, then blend for a minute.

The color can be a questionable browny green, and the juice will become a bit thick due to the fiber content, but it tastes good and is packed with nutrition.

Enjoy!

In good health,

James

Stress grrrrrr

By On · Add Comment

Unless you’re sitting on a mountain top somewhere calmly contemplating the wonder of the universe as you send radiant compassion to all living beings, this post is for you. Why? Because apart from a few rare fully enlightened souls in this world, all of us are painfully familiar with stress.  You know, that persistent feeling of being pulled in opposite directions by the myriad of tasks, worries and responsibilities that litter our everyday lives.

Fortunately, there are some great remedies to help ease the burden of this all too common condition.

Herbal stress formulas are fantastic at providing a feeling of ease and calm that helps us look beyond the stress of the moment. The Ginseng family of herbs are traditionally used to support energy levels and alleviate stress, but it’s important to know which varieties are suitable in which circumstances. Siberian Ginseng is nourishing and calming while at the same time mildly energy providing, and is helpful when an individual feels ‘burnt out’ and in need of replenishing. Withania, often referred to as Indian Ginseng, is even more nourishing and calming without the element of energy provision. Use Withania if you suffer from adrenal exhaustion and need to undertake a period of rest and recovery. Korean Ginseng is the energy booster of the bunch, with a much more robust ability to spike working capacity and get you through a tough day, however be aware that if used under conditions of adrenal exhaustion this herb may exacerbate symptoms.

Don’t forget your minerals!

Often associated with stress is physical tension, primarily felt in the muscle tissue of the body. Magnesium is your ally here, a mineral that can quickly and effectively relieve most types of muscular tension. Make sure you get a good quality supplement – the diglycinate and citrate forms are particularly fast acting and effective. Avoid the oxide form as it is poorly absorbed and often associated with diarrhea. However if the muscular tightness is prolonged and without relief (that is, a more sustained cramping without any twitching) then you probably need to add some calcium as well. Look for the citrate form and avoid the carbonate form.

Vital vitamins

Under stressful conditions the body uses up many of your stored vitamins, particularly the B vitamins. Look for a good vitamin B complex to replace these crucial metabolic workhorses. A high strength multivitamin wouldn’t go astray either as there are many other vitamins and minerals that will be utilized to a greater degree under times of stress.

That’s it for my top stress supplements. Remember to take three deep breaths when you feel those stress levels rising – it’s amazing what this simple technique can do to help you through the tough patches in your day.

In good health,

James

Tabata terror!

By On · Add Comment

You’ve all heard it before: “Just 20 minutes of exercise per day is all you need to stay fit and healthy”. Personally, to find 20 minutes in my day to do anything for myself other than maintain an acceptable level of hygiene can be a challenge. So if I do find that time then I really want to make it count. Read on to discover the best way to achieve your physical best with this small window of time…
20 minutes of exercise doesn’t sound too hard, does it? However if you take that 20 minutes and team it up with a sadistic Japanese sports physiologist, you get a crazy little thing called Tabata. It’s a simple approach with devastating consequences: 20 seconds of any given activity followed by 10 seconds rest, repeated 8 times. Then pick another activity and repeat the process. Do this with 4 activities in total. Then throw up or pass out.
Seriously though, this is absolutely the most effective and intense combination of cardiovascular and muscle building exercise you can do in such a short period of time.
Sleep in and can’t go for that 10km jog before work? Tabata.
Only have a small window of opportunity before the baby wakes up from her midday sleep? Tabata.
Feel like you’ve got some excess energy after your double shot latte and have some time to kill before your next meeting? Tabata (just make sure your work colleagues understand your post Tabata shaking limbs and pallor are not symptoms of withdrawal from an extended drug habit).
The most common exercises incorporated into the Tabata workout are push ups, pull ups, plank, and squats. If you are feeling particularly masochistic you could throw in a round of burpees at the end. Take a minute between the end of one activity set and the beginning of the next to clear the dancing lights from your field of vision and have a brief but intense internal conversation about how you don’t really need to do that next round of pull ups because there are far more pressing concerns like scraping the scum off the inside of the garbage can lid.
You can download a number of free Tabata timer apps for smart phones that make sure you don’t “accidentally” speed up the counting process.
Sayonara!