Mastering Your Life: How to Conquer CFS and Fibromyalgia
Guess what? Medical researchers in Ireland have shown the relationship between the adrenal gland and CFS. Another team at Harvard has demonstrated that the interaction of the Hypothalamic-Pituitary-Adrenal axis can be an important factor in Fibromyalgia and Chronic Fatigue Syndrome. Of course, we have preached this gospel for over four decades now, but it is good to see that there is now medical substantiation of our long help theory and practice. Read all about it here:
New research by two different respected sources has recently confirmed what we have been teaching for decades: Chronic Fatigue Syndrome and Fibromyalgia are caused by a weakened adrenal gland system and/or a "damaged" Hypothalamic-Pituitary-Adrenal (HPA) axis. A research team in Ireland has recently demonstrated by specialized computer tomography that the size of the adrenal glands of Chronic Fatigue Syndrome patients may be reduced by over 50% in comparison with those of a normal individual. Meanwhile, a group of Harvard Medical School researchers found that in Fibromyalgic [CFS] women, "the HPA axis-a complex brain-to-body pathway involving the hypothalamus and the pituitary and adrenal glands-is damaged. As a result, it does not properly regulate production of cortisol, a hormone with widespread effects throughout the body."*
*Complete copies of these articles are available at the end of this mongraph.
While we are pleased to see our long-time efforts with CFS and Fibromyalgia verified and vindicated, we are sorry that these findings give further assurance that no "magic" cure for CFS is to be expected. That is to say, there will not be a pill, vaccine or serum that will suddenly restore the Chronic Fatigue Syndrome patient to his old vibrant health. This is true because, as this medical evidence demonstrates, there are organic changes created in the body by the stresses that have brought on the Chronic Fatigue Syndrome and/or Fibromyalgia. Therefore, any valid treatment of these conditions must be able to address and correct the underlying causes of these organic changes and not just attempt to palliate symptoms or whip the already weaken glands and neurological structures into temporary action.
This new research gives increased credence to our long established treatment for both these conditions, which is:
- (1). To give the natural remedies needed to rebalance and repair the damaged Hypothalamic-Pituitary-Adrenal axis.
- (2). To use those remedies and passive therapies that are able to regenerate the weakened adrenal glands.
- (3). To teach patients to Master their lives so that they will learn to live efficiently and productively while they are regenerating. they are also taught to program their thoughts as to prevent a reoccurrence. "Man becomes the thoughts he thinks"--Paracelsus
Forty-five years of experience with both these conditions has taught us that, given the proper care and patient cooperation, the weakened adrenal gland can be regenerated and the "damaged" HPA axis repaired. This monograph is designed as a short synopsis of the Mastering Your Life program that is designed to accomplish these ends. However, before the patient can productively follow this program, they must understand something of the nature of the adrenal gland, the HPA axis and the way they function in the body.
We may think of the adrenal gland as the battery of the body. As long as it is fully charged we can work and play all day and not feel exhausted. However, if we overstress our adrenal gland, it can reach a point where it is not able to put out enough of its hormones for our needs. When this occurs, the Hypothalamic-Pituitary-Adrenal axis is activated and the pituitary gland and hypothalamus send out "signals" for the adrenal gland to work harder. The adrenal gland will then go into "overdrive" in an attempt to keep up with the needs of the individual. If the individual's stress is short lived, the activity of the HPA axis will eventually return to normal and the overworked adrenal gland will have an opportunity to rest and regenerate since its excessive stimulation has been removed. However, if the stress is unremitting the hypothalamic and pituitary continue to over-stimulate the adrenal gland until it is so weak that it can no longer respond to the stimulation and its hormone production becomes drastically reduced.
The Adrenal Stress Index (ASI) test shows us that patients in stages one, two or three have elevated adrenal gland hormone (cortisol) levels and therefore have an increased activity of the HPA axis, while those in stages four, five, six and seven have a decreased HPA axis activity due to the inability of the adrenal gland to respond to stimulation of the pituitary and hypothalamus.
Thus, we find a certain symptomatic crossover point in the progress of the CFS patient. Those patients in stages one, two and three tend to have symptoms of anxiety, panic attacks and insomnia along with some fatigue. Those patients in stages four, five, six and seven tend more toward severe exhaustion and fatigue with occasional insomnia. Taking these facts into consideration, it should be obvious that the various stages of CFS must be treated quite differently from one another. This is one of the main reason that those who attempt to "treat CFS" rarely succeed. To succeed in treating this condition you must treat the patient and their individual stage and not the condition.
If may be of interest to discover that the Harvard study has confirmed the fact that the HPA in CFS and Fibromyalgia patients may be both overactive (stages one, two or three) or underactive (stages four, five, six or seven): "Some studies have suggested that women with Fibromyalgia [CFS] have decreased function of the HPA axis, while others have found that there may be an excess activity in the same system. In both cases, levels of key hormones are affected, in turn resulting in the symptoms of Fibromyalgia [CFS]." However, they have yet to relate these facts to the progressive weakening of the adrenal gland. It is obvious that while the scientific community is starting to look in the right areas for the cause of CFS and Fibromyalgia, they have a great deal of catching up to do before they will be able to offer substantial help to these patients.
Dedicated Patient Cooperation
Once the patient understands the nature of the adrenal gland and the HPA axis, he can begin to cooperate in his own recovery. The basis of all such cooperation is for the patient to take those measures that are required to help the adrenal gland to regenerate and the HPA axis to repair itself. The patient's part of this process consists of: 1. Following the physician's remedy instructions. 2. Keeping him informed of all developments and changes in the patient's feelings. 3. Doing what he can to reduce stress in this life and following the pattern required for the regeneration of the adrenal gland and the restoring of expended reserve vitality.
This last essential to recovery is one of the hardest for the patient to understand and implement. Perhaps we can make it more understandable by the use of an analogy-that of the patient's bank account. The non-CFS individual is like a man who has a good weekly income and a fair sized bank account. Should he lose his job (come under severe or unremitting stress) he can live on his bank account until he is able to find work once again. When he is able to find work (his stress is over or substantially reduced) he can stop withdrawing from his bank account and begin to replace what he removed so that he will be prepared for future emergencies. Even if his new job gives him less income than his previous one, he must still not go into debt. He must learn to readjust his lifestyle so that he not only has enough to live on, but enough left over to help him to rebuild his depleted bank account. This is exactly what the CFS patient must learn to do if he is to ever function, as he desires.
The Chronic Fatigue Syndrome patient has, in essence, "lost his job" in that his body is not producing enough adrenal gland energy each day to pay for the energy expended during that day's activities. Each day he is spending more money (expending more energy) than he is earning (the adrenal gland is not able to recoup at night all the energy expended during the day) and so he must draw on his bank account (reserve energy of the body) to survive. Eventually his bank account runs dry and he begins to experience the classical symptoms of Chronic Fatigue Syndrome or Fibromyalgia.
Since his reserve energy (bank account) is depleted, he must learn to live with the small amount of energy (income) that the weakened adrenal gland is able to produce each day. He must even do more than this if he is to improve and rebuild his vitality bank account; he must learn to expend less energy each day than his adrenal glands are able to recoup during that day. The simple advice I give most patients at this time is, "Don't do anything you don't have to do." Only in this way will the body be able to rebuild its reserve energy account. This recouping may come from a good night's sleep and from various shorter rest periods during the day. In some severe patients there may be little that the he can do except rest for most of the time in the beginning of our care, but as our treatment begins to work he will be able to gradually return to guarded activity.
Such resting is not a problem when the patient is in the early stages of regeneration since he has little desire for anything else, but it can become more difficult later on. As the adrenal glands of CFS patient begin to regenerate, he will find times when he feels almost like his old self again. He is usually so overjoyed at this circumstance that he will invariably overdo and quickly use up the new energy thus forcing himself back into deep exhaustion (adrenal debt) once again.
His slightly regenerated adrenal gland is like a battery that has been given a partial recharge. It may start the car and seem normal, but it has no endurance and so it will soon give out. While the driver with a rundown battery, like the Chronic Fatigue Syndrome patient, may be in a hurry to "get going" once again, both will do well to give their batteries a chance to fully recharge before attempting to "take them on the road."
One statement we hear every day from one or more CFS patients is: "Oh, I had such a good week last week that I thought I was cured, but this week is terrible, I can hardly get out of bed." Obviously, our treatment is beginning to recharge their battery, but as they feel the new energy, they quickly use up every bit of it doing things they have not been able to do for a long while. We can't blame them. They have been in a state of CFS suspended animation so long that they simply cannot help themselves trying for something like a normal life as soon as they detect even a hint of their former energy. However, they must learn a lesson from this experience and not let it happen too often or they will never make the full recovery they desire. They must learn to allow their adrenal battery to come to a nearly full recharge before they attempt to return to a full active life. They need to restrain their ambition and rest their adrenal gland even though they seem to have the energy to do more. This is only a surface energy that will be quickly exhausted if they fail to conserve it.
We hate to be the ogre that has to keep telling our CFS patients to rest and not expend energy that we have helped them to develop, but if they do not do so they will never make the recovery they so fondly hope for. It is our ardent desire to have every one of our patients return to normal activity as soon as possible, but this must be done in carefully planned graduated steps and not in great leaps that will only have them fall flat on their faces.
Rule of the Hand
As the patient gains vitality he can begin to use the "rule of the hand" to gradually regulate his activity. In this rule, the fingers of the hand represent effort and the spaces between the fingers represent rest. Under this rule the patient is allowed to work for a few minutes, but must then rest for an equal amount of time. We usually suggest that the patient begin with only ten minutes for each work and rest segment. As the patient continues to improve this time for work may be increased, but the rest time must still equal that for activity.
In my early writings on CFS, I used to speak of chronic Chronic Fatigue Syndrome. That is CFS in those patients who may have congenital weakness of the adrenal gland. While this theory was scorned by the medical establishment of the day, the new Irish research, mentioned at the beginning of this monograph, substantiates my previous contention. While I am pleased to be vindicated, I am sorry to for those with such petite adrenal glands. It is all the more important for these individuals to learn to master their own adrenal destiny than for the CFS patient with a normal, but overstressed gland system. As of this time, there are no regular tests to determine the size of CFS patient's adrenal glands, but if more researchers validate the Irish study, these may be forthcoming. As of now we have to determine if a patient has a less than full functioning adrenal glands by the ASI test, our long experience and the response of the patient to treatment.
Mastering Your Life
Mastering Your Life is the ability of the patient to learn to regulate his own stress expenditure levels. Without this no real cure for Chronic Fatigue Syndrome and Fibromyalgia is possible. Occasionally it may be that the CFS patient has an important task they must do. This can usually be accomplished without too must backsliding if they are willing to accept the fact that they may need to rest for several days following this extra exertion. If they do not do this they will certainly create a further weakening of the adrenal gland system.
Mastering Your Life means learning to manage your body's vitality in the same way you manage your finances. You always need to have more coming in than is going out. If this is not possible at times, then you must do what is necessary to see that a positive balance is reestablished as soon as possible. In this way, Life Mastery means that the CFS patient must learn to become an adult; someone who is ready, able and willing to sacrifice today for a better life in the years ahead.
Mastering Your Life also teaches us that, even though a CFS patient may not have the adrenal gland reserve of other individuals (that is he does not make as much money as others) what vitality (money) he has is as good as anybody's. That is to say that as long as the adrenal patient lives within the energy potential of his individual adrenal gland system, he can feel normal. His job is to learn how to do this, while ours is to help him to steadily increase the vitality of this system.
The Recent Medical Research Articles
This is an article send to us by one of our European patients. His comment regarding it was, "This articles explains Dr. P's treatment and why it takes so long for the adrenals to recover and resume their normal size."
Psychoneuroendocrinology 1999 Oct; 24 (7): 759-68
Small Adrenal Glands In Chronic Fatigue Syndrome
A preliminary computer tomography study. Scott LV, Teh J, Reznek, R, Martin A, Sohaib A, Dinan TG Department of Psychiatry, Trinity College Dublin Medical School, St. James's, Hospital, Ireland.
[Medline record in process]No inclusive or satisfactory biomedical explanation for chronic fatigue syndrome (CFS) has as yet been forwarded. Recent research suggests that a dysregulated hypothalamic-pituitary-adrenal axis (HPA) may be contributory, and in particular that there may be diminished forward drive and adrenal under-stimulation.
In this preliminary study we wished to examine a cohort of CFS patients in whom evidence for such hypofunctioning was found. Our aim was to establish whether these patients had altered adrenal gland size. Patients were recruited from a fatigue clinic. Those who fulfilled the Centre for Disease Control and Prevention (CDC) criteria underwent a 1 microgram adrenocorticotropin (ACTH) stimulation test, a test of adrenal gland functioning. Eight subjects (five females, three males) with a subnormal response to this test underwent a computer tomography (CT) adrenal gland assessment.
Measurements were compared with those from a group of 55 healthy subjects. The right and left adrenal gland bodies were reduced by over 50% in the CFS subjects indicative of significant adrenal atrophy in a group of CFS patients with abnormal endocrine parameters. This is the first study to use imaging methods to measure adrenal gland size in CFS. It is a limitation of this study that a selected CFS sample was employed. A future larger study would optimally employ an unselected cohort of CFS patients. This study has implications not only for the elucidation of CFS
pathophysiology, but also for possible therapeutic strategies.PMID: 10451910, UI: 993 81217.
Fibromyalgia: Malfunctions in Two Key Body Systems May Contribute to Disorder. New Findings May Help Unlock the Secrets of This Controversial Illness
By L.A. McKeown
WebMD Medical NewsNov. 16, 1999 (New York) -- According to the findings of a recent study, women with Fibromyalgia may have malfunctions in two key systems-the autonomic ("automatic" or self-controlling) nervous system and the HPA axis, which regulates production of certain hormones and the body's response to stress.
Boston researchers discovered that the HPA axis-a complex brain-to-body pathway involving the hypothalamus and the pituitary and adrenal glands-is damaged. As a result, it does not properly regulate production of cortisol, a hormone with widespread effects throughout the body.
"Impairment of these neuroendocrine systems may explain the [underlying body-system malfunctions] of Fibromyalgia as well as the overlap in signs and symptoms between Fibromyalgia and related disorders," [Chronic Fatigue Syndrome] write Gail K. Adler, MD, PhD, and fellow Harvard Medical School researchers. The study was conducted at Brigham & Women's Hospital, affiliated with Harvard, and published in a recent issue of the American Journal of Medicine.
A chronic disorder, Fibromyalgia is characterized in part by extreme fatigue, widespread musculoskeletal pain, multiple tender body points, and sleep disturbances. It affects an estimated 3 to 6 million Americans, primarily women of childbearing age.
The existence of Fibromyalgia as a distinct disorder has sparked a great deal of controversy over the past decade. This is due in part to a lack of traditional scientific standards to define or explain Fibromyalgia and other poorly understood, often-overlapping conditions such as chronic fatigue syndrome, irritable bowel syndrome, depression, and migraine.
Some studies have suggested that women with Fibromyalgia have decreased function of the HPA axis, while others have found that there may be an excess of activity in the same system. In both cases, levels of key hormones are affected, in turn resulting in the symptoms of Fibromyalgia.
The HPA axis and the autonomic nervous system are the major pathways for body responses to stressful conditions-for example, pain, low blood sugar, low blood pressure, exercise, trauma, and infection. Both systems also are influenced by genetic and environmental factors and by chronic illness. "Furthermore, factors associated with Fibromyalgia, such as medication use or changes in physical activity, could influence these systems," Adler and colleagues write. "However, because [affected hormones] and the autonomic nervous system influence pain, alertness, gastrointestinal motility, fatigue, blood pressure, and immune function, dysfunction of either of these systems might contribute," they say, to the start of Fibromyalgia or its persistence.
1999 WebMD. All rights reserved.
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