Chronic Fatigue Syndrome and the Yeast Connection
By William G. Crook, M.D.
During the past seven or eight years, professionals and the public have been reading and hearing about a disorder that in the words of Dr. David Bell of New York is a "disease with a thousand names." Chronic Fatigue Syndrome (CFS). Although this disorder has been described for decades, even centuries, it came to the attention of the public following a 1984 outbreak which affected several hundred people in Incline Village, Nevada, a resort town on the shores of Lake Tahoe.
It initially was called the Chronic Epstein-Barr Virus Syndrome (CEBVS). However, laboratory studies showed that a lot of people with this disorder did not have elevated levels of antibodies to the Epstein-Barr virus. In the spring of 1988, the name was changed to the Chronic Fatigue Syndrome. And that's the name most people have been using. However, Dr. Paul Cheney and associates in North Carolina have suggested another name, Chronic Fatigue And Immune Deficiency Syndrome (CFIDS).
Still other people didn't like that name either because they felt that the word "fatigue" in the name trivialized the disorder. And they suggested still another name, Chronic Immune Deficiency Syndrome (CIDS).
Even before CIFS came to the attention of most Americans, people in England, Australia, New Zealand and Canada had been writing and talking about a disorder which they called Myalgic Encephalomyelitis (ME). Epidemics of this disorder developed in several hospitals in the United Kingdom including the Royal Free Hospital. So it was called the Royal Free Disease. Epidemics also occurred in Iceland where it was called the Akureyri Disease. Then, in Australia, it was called by a different name.
Another group of professionals in the United States have described a closely related (or perhaps identical) disorder which they have labeled Fibromyalgia Syndrome (FMS). And, as readers of Healthline know, during the past few years many professionals and nonprofessionals in the United States and other countries have learned of the observations of Dr. C. Orian Truss who described a disorder with similar symptoms which he called Chronic Candidiasis.
To learn more about CFS, I attended conferences sponsored by Brown University (1988), the University of California (1989) andthe CIFIDS Association (1990). At each of these conferences, speakers including Dr. Robert Hallowitz and Dr. Carol Jessop reported that the majority of their patients with CFS responded favorably to a comprehensive program which included a sugar-free special diet and antifungal medications including Nystatin, Nizoral and Diflucan.
Because of my interest in CFS, about a year ago I began working on a new illustrated book titled Chronic Fatigue Syndrome and the Yeast Connection -- a "get well" guide for people with this often misunderstood disorder -- and those who care for them. (Publication date: July 24, 1992.)
This book will discuss the many factors which play a part in causing the illness known as Chronic Fatigue Syndrome. These include viral infections, food sensitivities, chemical pollutants, nutritional deficiencies, parasites and psychological stress.
In some individuals with CFS, the illness develops suddenly following an acute epidemic viral infection similar to the one that occurred in Incline Village, Nevada in 1984 or the Los Angeles Hospital in 1930. Yet the observations of Carol Jessop, a leading CFS clinician and researcher, show that this disorder often develops insidiously -- especially in individuals who give a history of:
- Repeated courses of antibiotic drugs in childhood, adolescence or adult years
- Recurrent vaginal yeast infections
- Diets loaded with sugar and alcohol
And, like many physicians who are working with patients with the Candida-Related Complex, Dr. Jessop found that most people with CFS can be helped by a comprehensive treatment program which includes:
- A sugar-free nutritious diet
- Antifungal medication
- Unpolluted home and work environment
- Psychological support
- Essential fatty acids
- Nutritional supplements including magnesium
MAGNESIUM
If you're like most International Health Foundation readers, you've been reading and hearing about the importance of calcium for many years. Many people, especially women, have been taking calcium supplements in their efforts to prevent osteoporosis and other disorders. Calcium is important, but so is magnesium.
During my pediatric residency training many years ago, we used injections of magnesium sulfate to reduce elevated blood pressure in children with acute kidney disease. Magnesium was also used as a laxative. Yet, it wasn't until the mid-60s, after reading several papers by Mildred Seelig, M.D., that I began to learn that magnesium plays an important role in keeping people out of the doctor's office, hospital or nursing home.
Then, in September 1977 1 read an article in Executive Health, on "The Dangers of Not Getting Enough Magnesium in the Foods You Eat." Although emphasis was placed on the abnormalities of the heart and blood vessels, observations were cited that showed that many patients who sought help for insomnia, tension and anxiety were magnesium deficient.
In a study of more than 200 patients, Dr. W. S. Davis, University of Pretoria used magnesium chloride tablets as a possible means of combating insomnia. They reported that sleep was induced rapidly, was uninterrupted and waking tiredness disappeared in 99 percent of the patients.
Anxiety and tension diminished during the day. In addition, no ill effects were noted in a group of patients participating in a longterm study in which before retiring they took eight tablets of 250 mgs. each of magnesium chloride over a 12-month period. (W.H. Davis and F. Ziady, "The Role of Magnesium in Sleep," Montreal Symposium, 1976.)
The Executive Health article also cited the observations of Dr. Edmund B. Fink, West Virginia University School of Medicine in Morgantown. In his address at the international meeting, this magnesium researcher stated that:
- Magnesium deficiency not only exists but is common
- Although it is common, it is often undetected
- Chronic deficiency can produce long-term damage and can be fatal
- The manifestations of the deficiency are many and varied
In a recent letter from Dr. Fink, he also stated that, "Acute magnesium deficiency may also occur following several weeks of diuretics, cisplatin or amino glycoside use."
COMMENTS BY BAKER, GALLAND AND GABY
In spite of these reports, I put little emphasis on the use of this important mineral in managing my pediatric and allergy patients. Then, in the early 80s, after learning about candida-related disorders, I consulted Dr. Sidney MacDonald Baker regarding magnesium. Here are his comments:
"Magnesium deficiency is widespread. The average daily need for magnesium for an adult is between 500 mg. and 1000 mg. and a lot of people simply aren't taking in that much. For my patients, I recommend oral magnesium chloride.
'The pharmacist can make it up in a 25 percent solution. The usual dose is 1-2 teaspoons a day. However, it should be diluted in water or another liquid so as to make it palatable and non-irri1ating. After people have been taking the magnesium solution for a while and obtain a good clinical response, I sometimes switch them to SLOW-MAG (Searle), the pill form of magnesium chloride."
A year or two later, as I was working to update and expand The Yeast Connection, I learned more about magnesium from Leo Galland, M.D., a former associate of Dr. Baker.
Galland, like Baker, pointed out that magnesium deficiency occurs more often than generally recognized. In discussing the food sources of magnesium, he said,
"The richest sources of magnesium are also the richest sources of essential fatty acids...Seed foods (including whole grains, nuts and beans). Other foods which are relatively rich in magnesium include buckwheat, baking chocolate, cottonseed, tea, whole wheat and leafy green vegetables including collard greens and parsley. The mineral is also plentiful in seafood, meats, nuts and fruit. What's more, you can protect your magnesium stores by avoiding the magnesium wasters: saturated fats and soft drinks, especially those containing caffeine."
In discussing magnesium in a recent editorial, Alan R. Gaby, M.D., said,
"Properly administered magnesium is entirely free of adverse side effects. Equally important, its cost is negligible.
"The neglect of magnesium as a safe, effective and exceptionally inexpensive treatment for cardiovascular disease parallels asimilar neglect of other inexpensive and less toxic therapies in the treatment of virtually all major categories of disease. Broad scale adoption of those medically sound alternatives, most of which are not under patent by pharmaceutical companies, could save countless lives and save billions of dollars each year." (Journal of Advancement in Medicine, 1, 4:179-81, 1988.)
Reading about the effectiveness of magnesium and other nonprescription remedies (including the essential fatty acids) makes me wonder about the need for some of the expensive and potentially toxic drugs that are sometimes used to control symptoms in people with CFS.
INTRAMUSCULAR MAGNESIUM IN CFS
In a recent study carried out in the United Kingdom, investigators described the efficacy of intramuscular magnesium in people with CFS (I.M. Cox, M.J. Campbell and D. Dowson, "Red Blood Cell Magnesium and Chronic Fatigue Syndrome," The Lancet, 337:75760, 1991.)
In a randomized, double-blind, placebo-controlled trial, 20 patients with CFS had lower red cell magnesium levels than did 20 healthy control subjects matched for age, sex and social class.
ADDITIONAL COMMENTS
At the November 1990 CIFIDS Conference, Charlotte, North Carolina, Dr. Carol Jessop commented:
"Low magnesium levels are common and can only be found using a test whereby you collect a 24-hour urine sample to test for magnesium. You then load the patient with 400 to 500 mgs. of magnesium a day for three days. You take another magnesium urine test on the third day to see how much the body retains. If they retained greater than 50 percent, it is significant because magnesium is very important in muscle relaxation. Many of my fibromyalgia patients improved with the addition of magnesium to the diet.
"Low zinc levels are also common although only 32 percent of patients show this on the blood tests. Blood tests are not as accurate as sweat tests which are hard to do in the office. But many patients either have poor wound healing or leukonychia (white spots on the fingernails) which are signs of zinc deficiency. Both of these trace minerals are absorbed in the gut and, I think, are being malabsorbed by our patients."
In a conversation with me in August 1991, Dr. Stephen Davies, editor of the Journal of Nutrition in Medicine said,
"CFS patients are nearly always deficient in magnesium. Our research studies show that they're frequently deficient in zinc and copper, too.
Comments by Dr. Sherry Rogers:
"It is becoming increasingly apparent that magnesium deficiency (MD) is underappreciated and underdiagnosed. At the same time it can be responsible for a vast array of seemingly unrelated symptoms. ... To compound the problem, medications that are usually prescribed for these symptoms have the side effects of further lowering the magnesium." (S.A. Rogers, M.D. "Unrecognized Magnesium Deficiency Masquerades as Diverse Symptoms: Evaluation of an Oral Magnesium Challenge Test," International Clinical Nutrition Review, 11, 3:117-29, July 1991.)
SUMMARY
To summarize: Magnesium appears to be safe, inexpensive and effective in helping patients with a variety of health problems including CFS. And, even in the absence of laboratory studies, magnesium sulf ate or magnesium chloride should be a part of the treatment of the person with CFS.
PPNF recommended book: Candida Albicans Yeast-Free Cookbook
Marion Patricia Connolly and Associates of PPNF
A comprehensive cookbook and diet plan for those with Candida and other fungal infections. Includes complete information regarding meal planning, forbidden foods, and how to change your eating habits. Many tasty and satisfying recipes, along with carbohydrate charts and menus. (Page Diet). . To learn more: CLICK HERE:
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