Treatment of Chronic Fatigue SyndromeTreatment of this condition is both very simple and extremely complicated. It is simple in that the instructions, diet, and remedies used aren't particularly difficult to use or extensive in nature. On the other hand, complex emotional factors are always present and involved and these must be dealt with or the treatment will fail. The physician who is not in emotional harmony with his patients, or who does not have unending patience, should not take on himself the treating of this condition.
The diet used for this malady is of great importance though no single diet will help all patients. We usually suggest a low stress diet--one that provides in as readily assimilable form as possible and as pleasantly as possible all the nutritive materials needed for satisfactory body function with especial emphasis placed on those compounds that are needed to regenerate the adrenal glands. The diet should be arranged so these foods are most easily digested, absorbed, and metabolized. It should exclude all foods that contain toxic substances, that place an added stress on the system, and that require more energy in their digestion and assimilation than they actually return to the body in nutritive value (refined foods, heavy fatty meats, etc.) .
We have found that a modification of our hypoglycemia diet and our basic maintenance diet best fulfills these requirements (See the diets in the appendix of this book). The frequent meals, the high protein, and the increased fruits and vegetables of the hypoglycemic diet also seem to fit the needs of the hypoadrenal patient. However, the hypoadrenal patient is usually not as sensitive to a small amount of starch as is the hypoglycemic patient.
All foods chosen should be as free of pesticides and additives as possible. Although organically grown foods are not an absolute prerequisite, we find that where they or their home grown counterparts can be obtained, recovery is more rapid. An attempt should also be made to obtain chicken, fish, lean meat, and other proteins from as reliable a source as possible, so that they are fresh and free from the chemical additives that are still being used in many of these products today.
The hypoadrenal patient frequently has a poor appetite (anorexia), and it is often difficult to get him to eat any but minuscule amounts. In these patients, it is all the more important that every mouthful of food be as nutritious and as non-stressful as possible--that is, free as possible from chemical contamination. All chemical compounds not normal to the body place stresses on its adaptive apparatus, of which the adrenal is a prime factor. It is usually important to have these patients eat small amounts frequently. Gradually as the treatment progresses, the anorexia will abate. In time, they may develop such ravenous appetites that you end up having to control what you took great pains to stimulate in the early stages of care.
Experience has demonstrated that one of the first functions to weaken in functional hypoadrenalism is the digestion. Therefore it may be necessary to offer digestive aids to these patients to help them utilize the foods they ingest. It may be well to use some of the more advanced diagnostic procedures such as Complete Stool Analysis, Heidelberg pH digestive test and other hi-tech procedures to determine exactly what the individual patient requires in the way of help with his digestion and assimilation.
With poor digestion and assimilation these patients often exhibit multiple allergies due to incompletely digested proteins entering the blood stream. In many of our patients this has advanced to the degree that they are known as Universal Reactors, that is, someone who reacts to everything. In these patients the physician must not only test for the digestive weaknesses but also for incomplete assimilation (Leaky Gut Syndrome).
Once our patient has been tested for digestive and assimilation imbalances and placed on a proper diet, specific supplementation for supporting the adrenal gland can be begun. Now that we have the ASI test we are able to individualize all such remedies. What each individual requires depends to great degree where he or she is in the progression of this malady according to the chart of Dr. Selye. Those remedies that would be indicated in the exhaustive stage would not be best in the resistive stage and vice versa.
In the exhaustive stage we usually suggest a supplement containing vitamin C, calcium pantothenate, vitamin B6, and raw adrenal and spleen substances. These last compounds--which we believe to be absolutely vital to proper adrenal regeneration in the exhaustive stage--are made by desiccating bovine adrenal gland at below body temperature, so as not to destroy any of the delicate RNA and DNA factors necessary to promote a rapid recovery.
Occasionally, we find a patient sensitive to some of the auxiliary substances in this product and in this instance we substitute an item that contains mainly the desiccated adrenal gland substance without added amounts of specific vitamins or other glandulars.
As this condition is beginning to be recognized by more and more physicians there are ever increasing efforts to produce natural products that will help these patients. Therefore, we are always on the lookout for better remedies. Several new ones have shown promise. You can be certain that as the premier Center in the nation (world?) that treats this condition we will always have the most advanced remedies available to help you.
Besides those agents mentioned above, we see to it that our patients have adequate amounts of the other supplemental elements needed to insure rapid recovery. Unfortunately, as also mentioned above many of our patients have difficulty with their digestion and so we must choose such remedies carefully so that they do not cause reactions due to poor assimilation of their various components.
Older Treatments
In years past we often supplemented our basic therapy for the more serious patients with certain injectable compounds. These were not drugs in the usual sense, but were nutritional compounds that could only be satisfactorily absorbed when placed directly into the muscle or bloodstream.
The three we used most commonly were a calcium preparation called Calphosan, adrenocortical extract (ACE, an aqueous solution produced by several companies) and injectable vitamin Bl2.
A few years ago the FDA decided that the ACE was an "obsolete" drug. This was a true stroke of genius on their part. Since ACE had been used for decades without adverse or side effects there was no way the FDA could outlaw it. However, by declaring it "obsolete" they effectively removed its "grandfathering" and so before a drug company could again produce it they would have to go through the multi-million dollar process of resubmitting this compound for FDA approval. Since there simply was not enough demand for this remedy to offset the tremendous expense of gaining FDA approval, all manufacture of ACE was discontinued in this country. Thus forcing any physician who desired to support the adrenal gland to use the expensive preparations of the established drug houses. Substances that, unlike the ACE, only weaken the adrenal gland in the long run.
There has been an effort by some small manufacturers and a few foreign pharmaceutical houses to make ACE available to Chronic Fatigue patients but these efforts have either been stopped by the powers-that-be or else the finished product was so poor as to be useless.
Calphosan, a non-irritating injectable calcium compound, also seems to have left the market, although it does not seem to have been at the "request" of the FDA. (Recently we understand that Calphosan is again available.)
Now that our government, through its FDA, has done all it could to prevent functional hypoadrenal patients from obtaining the substances they require to get well, we had to seek such healing in another direction. We have found the use of certain physical therapeutic modalities can be used to take the place of these "obsolete" items. We use a treating unit called the Magnatherm,* which produces a pulsed, electromagnetic wave that can be directed to pass through the adrenal glands, liver, and spleen. In our experience--perhaps through increased blood supply to these organs-- the Magnatherm acts as a regenerating agent to aid in adrenal regeneration. Through the use of these treatments, we have been able to replace the ACE to great extent. The Magnatherm and other modalities that we use to help our functional hypoadrenal patients are discussed in greater detail in later chapters.
*Manufactured by the United Medical Equipment Co., Kansas City, MO.
Other Therapies That Help
It's been my observation that most hypoadrenal cases also have nerve-muscle-bone displacements and tensions in the area of the shoulder blade and along the upper thoracic and lower neck areas. These we treat with mild ultrasound therapy and with finger pressure, working the sensitive areas to gradually eliminate the muscle-nerve spasms and in turn any bone displacements. In some of the more sensitive patients, this work must at first be handled with great delicacy; but as improvement occurs, the pressure may be increased. In fact, we find that as the adrenal condition of our patient improves, he becomes less and less sensitive to this treatment, and he finds it increasingly more pleasant. This phenomenon is discussed at greater length in our chapter on Tissue Sludge. We find this Tissue Sludge is present in many conditions besides adrenal insufficiency.
This gives you some idea of the basic therapy we use to help functional hypoadrenalism. The big secret with such therapy is knowing just when to use each of the items and just how much of each modality to use. This cannot be taught; it must come from long experience. However, as difficult as it is to select each day the best treatment schedule for each patient, this is still the easiest part of the treatment. The most difficult part is that which must take place within the patient by his own efforts. From the beginning, he must realize that his present way of life has caused his problem and this life-style must be changed if improvement is to be expected. We usually ask the patient to analyze his entire life-style and to make every effort to reduce or eliminate all the habits that may cause stress on his adrenal glands. In addition, we try to make the patient realize that he has a physical condition. Most patients are convinced they have some kind of emotional or psychological disorder.
Because the condition is physical, there are certain physical requirements for its correction. The first and most important of these requisites is rest. If the adrenals are to recover, even under the treatment I have described, the patient must have a great amount of rest. Only in these rest periods can the adrenal glands regenerate. This, of course, is true of any organ but is particularly vital for the adrenal.
Normally the adrenal glands regenerate during a night's sleep the vitality they expended during the previous day. They are then ready the following morning to go through another day of equal rigor. In hypoadrenalism, the glands are exhausted. They have expended more vitality than they can make up for in a single night's sleep. Thus, if they are going to return to normal, they must regenerate more than the body expends. If the glands can't do this, they won't recover. They may not get worse, but they won't get better. For this extra regeneration, rest is required--much more than the usual eight hours a night.
The example I usually give my patients compares them to their bank accounts. The reserve of the adrenal glands is like money in a bank account held for emergencies. Let's say you have a thousand dollars in the bank, and every night you deposit a hundred dollars. If during that day, you spend a hundred dollars, the reserve fund is still intact.
In the same way, the adrenal glands have a considerable reserve held for emergencies, and they are able to regenerate (deposit money) at night while they rest. During the day, if we expend no more energy (money) than the adrenals are able to build up at night, we still have our adrenal reserve (the thousand dollars). If an emergency arises and we must use some of the thousand dollars, we must do one of two things. We must either make more money or spend less so we can deposit more into the bank account to build it up to its reserve level. This same philosophy works with the adrenal glands.
When the adrenals are exhausted, to produce regeneration it is necessary to expend less energy during the day than the adrenals build up during rest. In this way, some of the energy the adrenals build during this rest can go toward building their reserve.
The Golden Rule for Chronic Fatigue Treatment
No matter what therapeutic means are used, there is one vital fact all hypoadrenal patients must remember. The only way that the adrenal glands can regenerate is for the patient to expend less energy than the adrenal glands can regenerate during that same day. Every part of our treatment helps the patient toward this objective, but if he doesn't get sufficient rest or he places himself in stressful situations that use more energy than the adrenals can regenerate during that day, he will never recover from hypoadrenalism.
When our patients come to me and tell me they are not improving under our treatment and their postural blood pressure and other indicators of their condition verify this fact, I must lay the fault directly at their own feet. In no instance has this blame yet been unjustified. If they expend more energy during a day than they are able to rebuild at night, they will surely retrogress. When this situation is explained to patients and they start living within their glandular means, they invariably improve.
The patient will often ask, "How much rest must I have?" The answer is simple--whatever is necessary to produce proper adrenal regeneration. Some people have to make only a very small change in their daily routine. While other patients with severe hypoadrenalism must have near total rest for long periods. The average is somewhere in between.
The rest needed is indicated by the patient's response pattern. It is necessary to reduce his activities until improvement falls within expected limits. The patient must reduce his activity and obtain enough rest to produce a steady but consistent improvement. If he is not improving, he is doing too much and allowing too much stress in his life. There are no exceptions to this.
Even though the hypoadrenal patient often believes he has a mental or psychological problem, it is not the neurosis that causes the symptoms but the symptoms that cause the neurosis. The feelings he fears are the symptoms of the adrenal condition which are physically caused. I find it good therapy to constantly confirm this fact to the patient. In the early phase of treatment I find myself constantly restating, "Now remember you are as sane as anyone. This is a physical condition you have and it will be corrected in due time. All you have to do is listen to me, follow my instructions, keep up with your medications and treatments, and you'll be just fine." This by the way is not just positive thinking; it is a fact.
The psychological problems in hypoadrenalism are usually intensified by past therapies. Before we see these patients, they usually have been to physicians who have either assured them that there is nothing physically wrong with them, or have suggested that they see a psychiatrist.
Now, we at the Center come along and tell them just the opposite--that there is something physically wrong with them and that they don't need a psychiatrist. Whom should they believe? Their other physicians are usually men well thought of in the profession, and after all, the Beverly Hall Corporation Healing Research Center is not the Mayo Center, so just why should they listen to us? The only way I can prove that we are correct is by getting the patient well. Unfortunately, this takes time in hypoadrenalism. And so the period from the first interview and diagnosis until the real improvement begins can be a time of frustration and doubt for the average patient. What we say sounds practical, and they certainly hope we are right because no one else has given them any real help but they cannot forget the fears that have been such an integral part of their lives for so long.
At this time, all the psychological skill and diplomacy a physician possesses must be called into play. I mentioned earlier that I groan a little whenever I discover another hypoadrenal patient. This is the main reason--I know that this period must come and that during this time I and my staff will be called on to use all the tender loving care we can muster. To shorten this period, we have tried to incorporate into our therapy every legitimate, harmless, nontoxic method known to hasten improvement. It is a happy day when the patient finally says, "Doctor, I'm getting better. I feel like a new person." They will often say, "You know, Doctor, yesterday I felt better than I have in five years." When this happens, the physician breathes a sigh of relief, for he knows that the first critical period is over.
Another incident in the early stages of hypoadrenalism should be mentioned. A type of negative feedback occurs in the hypoadrenal syndrome; it works in the following manner. The symptoms of hypoadrenalism produce worry and concern in the patient, which in turn produce stress tending to worsen the condition. However, these emotions also stimulate the adrenals forcing them to keep going even though near exhaustion. This stimulation keeps the patient going at the expense of the adrenals, which go into debt in regard to their own reserve of energy. Much like our own country's huge national debt.
After the patient comes under our care and accepts his problem as a physical condition that is going to be overcome, he stops worrying about it to a certain degree, and the stimulation due to worry and anxiety is removed from the adrenals. The glands will now begin to rest and regenerate by reducing their hormonal output. The patient consequently feels more tired and exhausted than he did when he first came to us. At this time, we intensify our treatment and usually our efforts more than offset this hormonal withdrawal period. If the adrenals have been badly abused, however, there is usually a lag period between the time the glands begin to rest (because of the removal of anxiety) and the time before therapy has an opportunity to build new strength into the glands. Because of this, for a week or two after we first see the patient, he may seem to worsen.
In the early days of my practice, I lost some patients because they thought that the advice of other doctors was correct, for our treatment at first made them feel worse, not better. I wasn't certain at that time what was happening physiologically. I did know, however, that those who persevered soon improved and all got better in time.
Now that this lag period is understood, I can forewarn patients. In some patients, the lag period is very short; in others it isn't noticed at all. Surprisingly, if the patient is very bad and the glands are near complete exhaustion, anxiety has little stimulating effect because the glands are incapable of responding. Thus, we have a mechanism that spares the most severe and the mild cases from this exhaustive stage, but is most likely to be noticed in those of medium severity (the average patient). At least the patient who experiences this lag time can be reassured that his condition is not severe or the glands would not react in this fashion.
Back to Dr. Selye
If we again examine the chart of Dr. Selye, we can see what is happening to these various patients. Note that there are two exhaustive stages and two stages in which the patients may seem somewhat normal. Also remember that in order to regenerate a patient we must move him from the right to the left of the chart. The first exhaustive stage is the mild case of functional hypoadrenalism. We have only to move him one place to the left for a cure. Usually this patient responds well to our therapy and has no or only a slight "lag" period. Basically he has nowhere to go but up.
The second exhaustive stage is a much different thing entirely. If not helped quickly he is near complete adrenal collapse. As he is treated he will pass through all the various stages to his left on the Selye chart. The physician must take this into account so as to know exactly what is required by this patient in each of the stages he must go through.
In the center, or resistive stage of this condition (where most of our patients now fall), we find a patient who experiences the strange combination of anxiety and exhaustion at the same time. These patients are exhausted but they often have difficulty sleeping because their adrenal gland is being overstimulated in an effort by the body to "keep up." This combination of anxiety and exhaustion is unique to functional hypoadrenalism and can truly be understood only by those who experience it. It is these patients who, as they are moved back to the left on the chart, go through the first stage of exhaustion again. Actually, what really happens is that the artificial support from their body that created the anxiety is corrected and they are then able to feel the exhaustion that has been a part of their nature since they first began their travel to the right on the Selye chart.
With these resistive patients the physician must use his diplomatic skills to explain the situation thoroughly to the patient and his family. Unless the family understands what the doctor is attempting, they will often do much to offset the therapy. The family can make or break the best of treatments. Unless they understand the phases and purposes of the treatment, they can cause anxieties that thoroughly debilitate the hypoadrenal patient.
It is advisable to call family members in for another reason. Hypoadrenal weakness is often hereditary. If one member of the family has this tendency, others may also, though perhaps not as severely. I always suggest to the family members that we take the postural blood pressure, an ASI saliva test and perhaps a glucose tolerance test if their histories are suspicious. It is rare not to find one or two in the family who show signs of early adrenal weakness. Suggestions on diet and instructions on controlling stresses around them do much to prevent full-blown hypoadrenalism from developing.
When the patient reaches the stage where he finally starts feeling some of his old strength, energy, and ambition returning, the second traumatic period in his control is at hand. Now he becomes cocky and feels his condition is nearly cured. He overexpends his newfound energy. He may get away with it for two or three days, and then boom! He is practically flat on his back. He feels almost as if he had had no therapy at all. He can't understand what's happened.
Using our bank account analogy, we can explain this circumstance. Because of his treatment, the patient has gradually built some adrenal reserve and the glands finally have started to secrete more hormone into the bloodstream. He begins to feel normal. What does he do then? He goes on a spending spree. Instead of making $100 a day, he now makes $125. Unfortunately, he feels so affluent, he spends $200. But he can overspend for just so long; then the reserve is gone. Like the spendthrift, the hypoadrenal will rapidly overspend what little reserve he had built up.
This frequently happens two or three times to patients in the second stage. I warn my patients what will happen, but they all do it anyway. It seems that one experience is worth a thousand warnings. So when the patient tells me of his troubles, I very carefully (as I have done before) explain exactly what has happened and that he must be careful to accept the improvement without overexpending. If he doesn't listen and continues to repeat these episodes, his recovery is retarded and much valuable time is lost.
Another interesting effect of the adrenals is the lag period between actions done and reactions upon the person--making it difficult for the patient to relate cause and effect. Let me explain. When activity expends adrenal secretions, the glands valiantly keep trying to pour them out. Even after this activity, the adrenals keep going for a short time before they rest. Then, sometimes hours, sometimes a day or two after we have stopped our activity, the adrenals relax. It is then that the reaction becomes apparent.
Patients constantly say to me, "I am so tired today, Doctor, and I can't understand it. I've been resting the last couple of days." I always say, "Yes but what did you do over the weekend?" "Oh, that was fun, Doctor." The patient went bowling or skied, but really he felt good. The little old glands were just working their heads off, and it wasn't until two or three days later that they finally relaxed to regenerate. This is a typical adrenal pattern. Once explained to the patient, he can learn to judge his own activities and govern himself accordingly. We always attempt to teach patients responsibility for their condition. We tell them what will happen if they overdo but allow them to make the decision if they desire to overdo or not. As they do so they learn to control their destiny.
Some Additional Suggestions
A few more comments on small things that can affect hypoadrenal patients are appropriate here. Crowds of people seem to have a strong enervating drain on all hypoadrenal patients. The worst seem to be meetings in which banality and bickering are rife.
If we subject the patient to treatment or remedy costs he is not readily able to pay, an unrequited stress is placed on him that worsens his condition. Thus, it is easy to aggravate the very condition that we are trying to correct. This is another factor not taken into account by many Centers, and yet it does have an undeniable effect on the patient's improvement.
Long telephone calls also exert some strange weakening effect on those people who are sensitive. I usually ask my patients to limit all calls to five minutes. I personally feel that the restricted frequency range of the telephone somehow adversely affects the adrenal gland.
The most difficult part of the therapy is to teach the patient how to prevent stresses from affecting him. We can't avoid stresses, so we must learn to deal with them. In truth, the stresses that seem to cause the most common forms of hypoadrenalism really don't exist in the first place. Worry over things that might happen often causes more anxiety than the consequences that do occur.
Often patients are concerned or anxious about problems that are none of their business. Events that befall us generally fit into two categories. First are those for which we must take some action because they are directly related to our own existence and responsibility. The only way of overcoming them--which must be done if we are to remove the anxiety and stress involved--is to take some kind of action to correct the situation. Our responsibility here is to take action as rapidly and as thoroughly as possible. The more we procrastinate, the greater the anxiety and adrenal tension we build.
On the other hand, some problems beset us that no possible action on our part can correct. Most of these are none of our business in the first place. I find one of the most common problems of this nature is that of parents worrying about their grown children, a sister worrying about a brother, or a daughter worrying about her mother. Except for minor children under our own personal care, we have no control of other persons. If we have no control, we have no direct responsibility. I know it is useless to tell a mother not to fret about a grown child or a wife not to be upset about a husband's bad habits. Yet in all my years as a counselor, I have never seen such anxiety produce any beneficial results. Can it do anything but injure us? Admittedly the whole world is imperfect. We are imperfect creatures, each trying to do his best to seek salvation in some shape, form or manner. There is yet no unanimity of opinion about what is the best way. Yet some of us are filled with concern as we judge the actions of others. Jesus would not judge, how then should we? It has been my experience that such anxieties cause more hypoadrenal disorders than all the other causes put together.
We at the Healing Research Centers are now in the planning stage of a new Center we consider to be a Healing Sanctuary. In this Healing Sanctuary we will be able to take patients and remove them from as much stress as possible, thereby allowing their body to begin the regeneration of the adrenal gland in a controlled environment. This will allow us to minimize the early lag period that so frequently accompanies the patient with functional hypoadrenalism. This same Healing Sanctuary will be available for all patients who feel the need to reduce stress in their lives so that their bodies can begin the healing process. The body is a marvelous healing entity but it requires the proper atmosphere and environment to do so. That we intend to provide in our new Healing Sanctuary. This Center with be the culmination of my own long experience with stress-related conditions. No detail from the paint and wall covering to the music available is too small not to have my personal attention.
Although long, this is one of the most important chapters in this book. Almost all known diseases are affected by the stability of the adrenal glands. Many authorities now believe that hypoadrenal function may cause symptoms of allergy, asthma, chronic inflammatory states, and a great variety of other conditions affected by the many secretions produced by these glands. The therapy applied in hypoadrenalism is also helpful in many of these conditions. In almost every chronic ailment treated in our Centers, some form of adrenal support is used, and I believe that further research in the medical field will continue to substantiate our work in this area.
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