2009.10/11 On Managing Fatigue and My Adrenal Fatigue Treatment Plan

EXCERPTED FROM MESSAGE TO SUSAN

} Hi Kim,

Howdy Susan!

} Can you remind me all the things you've tried and what their effects were (or
} is this on your website?)?  I had somehow thought you thought you had cured it
} previously?  Or had it gotten much better and then worse?

Much of the unfolding of CFS on my life is chronologued in The Essential Kim
from 1997 onward.  Here's a cogent early summary:
  http://www.ugcs.caltech.edu/~kel/TEK/1998.04.17_Chronic_Fatigue_Syndrome_Update.shtml

At no point in my experimentation did I find a cure, but I did find three
different ways to manage to condition.  To wit: managing merely reduces the
severity of the symptoms to functional levels, whereas curing gets rid of the
origin of the symptoms.  If I were to stop a management plan, then in about
3-7 days I would get a distinctive film of goo in my nose, which would signal
an impending crash within days.  That film of goo has been my "canary in the
coalmine", and one of the major indicators that I've used to measure the
effectiveness of different approaches.

Here's the three management plans I discovered, in brief:

1) Masquelier's OPC-85 250mg/day (aka Grape Seed or Pine Bark Extract).  This
antioxidant had an immediate marked impact and gave a remission of symptoms
on the order of weeks.  It was particularly effective when combined with
digestive enzyme supplements (I could take merely 100mg / day), but I found I
could take it by itself at higher dosage with the same effect.

Also note that I tried every other antioxidant that I was aware of, and most
of them did nothing.  A rare few (like Vitamin C) actually seemed to worsen
my fatigue; none of them had the "magic bullet" effect that OPC-85 did.  In
the case of Vitamin C, I now believe that I've been suffering from copper
biounavailability:
  http://www.drlwilson.com/articles/copper_toxicity_syndrome.htm
and that the Vitamin C was chelating excess copper from my system.  I've
actually just finished a copper purging regimen and am going to try to make
the copper more bioavailable by increasing my glutathione and ceruloplasmin.  

2) Hyberbaric Oxygen Therapy 90 mins / week (in steady state).  HBOT (or HBO2
as it is sometimes called) gave remission on the order of days (or perhaps
more accurately, sessions, which I did once per day initially).  It also had
the highest peak of energy of all the three plans, and perhaps not
coincidentally, was the most expensive and hardest to maintain.  Here's some
more info on it:
  http://www.ugcs.caltech.edu/~kel/TEK/1999.09.13_Hyperbaric_Oxygen_Treatment.shtml

If I ever become crazy rich, I will likely have an HBOT chamber installed in
my bedroom.  Ur, right next to the cages filled with well-oiled swedish
masseuses.  ;-P

3) The Great Estrogen Experiment, ongoing diet, mainly revolving around
increased eggs, soy, and peanuts.  I'm uncertain about the remission time
here, because I started the diet and then gradually reduced the OPC-85 in
50mg doses until I felt comfortable everything was stable.  Also, I started
with a much larger diet and then narrowed that as well.  Here's a couple 
pages, one dealing with the origin of the GEE and the other with the initial
findings:
  http://www.ugcs.caltech.edu/~kel/TEK/2007.03.25_Great_Estrogen_Experiment.shtml
  http://www.ugcs.caltech.edu/~kel/TEK/2007.08.26_GEE7_Initial_Results.shtml

I've discovered through many other dietary experiments that I respond very
well to proteins and fats and badly to sugar and fruits.  This phase
demonstrated to me the essentialness of ample cholesterol in my diet.  In
fact, I now believe that 90% of the health recommendations we got when we
were kids were harmful bunk (but that's another topic  ;-)

For completeness, let me talk about my current beliefs and approach.  I now
believe the CFS I've been experiencing is Adrenal Fatigue:
  http://www.drlam.com/articles/adrenal_fatigue.asp?page=1
and one of the pages that stood up and shook me silly was this one:
  http://www.tvernonlac.com/
It described an unfolding condition punctuated by 5 key phases:
  1) Overworked adrenals and sugar addiction
  2) Poor digestion culminating in candida
  3) Food allergy development (lactose intolerance in my case)
  4) CFS and Toxic metal symptoms
  5) Adrenal Burnout
which is, in order, a short summary of my life.  :-O  The events listed above
span several years, and I had previously thought they were unrelated.  To see
them all in the same constellation, interconnected, convinced me this is what
I have.  In addition, it also explains outliers I had previously been unable
to account for (like, when I reduced my CFS symptoms with the GEE, I also
reduced my lactose intolerance).

Here's an outline of my current treatment plan: 
* Stress-free living, not just social stress but bodily and chemical also
* Heavy Sleeping at particular times (10PM - 9AM, afternoon rest in sun)
* Laughing, more fun, removing negative sources and people
* 1 tsp RealSalt in 1 cup water every morning; drink water liberally
* 2 eggs daily; protein and fat with every meal.  Carb low breakfasts
* Eat meats, organ meats, and fish.  Favor red meat and liver
* Eat broccoli, corn, seeds, nuts, carrots, tomatoes, and yogurt
* Avoid sugar, starches, wheat, flour, fruits, bananas, melons
* Aim for 50% raw, whole foods (e.g. don't boil corn, cook brocolli, etc.)
* Supplement sparingly as needed

The supplements are intended to nudge the body during the reversal of each
phase.  So, for example, during the copper elimination phase, I took 1000mg
of Vitamin C daily.  Soon I'm going to stop that and take N-acetyl-L-cysteine
(NAC) pills as a way to raise gluthathione levels, etc.  My reading suggests
that less supplementation stimulates the adrenals less, and it also gives me
a better sense of what is contributing to what.

Something I'm strongly consider reintroducing to my plan is a digestive
enzyme supplement with each meal.  It's become clear to me that my body
uptakes different nutrients in wildly varying degrees depending upon my
energy level and other factors.  Since one of the problems that occurs after
the food allergy phase is difficulty absorbing nutrients, anything that skews
uptake in my favor seems beneficial.  Right now I'm choosing between
Sustenase (which I have a known favorable reaction to) or a bile-based
product like GB-3.

} I guess when I say it is 99% better, it means a combination of me adapting,
} and getting better, in that I feel pretty normal most of the time.  I feel
} like there is something not quite right that I would like to be improved.

I feel a similar way: I can manage things so that I can live a reasonable
life, but I know deep down that I'm not healthy and fit.  For a very long
time I resigned myself to that situation; if that was the best that could be
done, I should just accept it and move on with my life.  

Recent events from a variety of sources has now convinced me that we should
never accept less than complete health.  Now that I've learned about Adrenal
Fatigue and have reached certainty that I have it, I am hell bent on curing
this condition once and for all.

So hold onto hope and don't give up.  Whatever we have, we can figure it
out, and we can cure it.

} So, here is my experience:
} At first I had extreme fatigue (but almost anti-sleepy) and intermittant fever
} (in the mid-99's), and felt wiped out by 10 minutes of housework or walking,
} felt totally lousy all the time.  I started walking 10 minutes 4 times a day
} (with resting after each of these), and tried to gradually increase this.  I
} tried to, when I felt wiped out, not do anything.  I tried to eat well.
} Gradually over a few years I felt better.  I also found I did best with
} exercising in water, where my temperature is regulated better.  After a while
} I felt pretty much OK most of the time, especially if the temperature was
} cooler.  We kept our house temperature very cool.  I always feel worst in the
} afternoon or mid-evening, and notice when the inside temperature is above 74
} degrees I feel lousy.  When I found out I was allergic to wheat I thought that
} this would perhaps get me the rest of the way to feeling good.  I do not think
} I noticed a huge improvement in how I feel (other than digestively) from not
} eating wheat.  I've continued to slowly improve over the last 3 years.  Now I
} do not get fevers anymore.  I feel kind of lousy from not having much sleep
} the last year, but feel pretty much within the normal range.  Every now and
} then I feel feverish and lousy not related to being sick, and every now and
} then I'm exercising and suddenly feel extremely tired, and try to stop
} exercising.  I continue to exercise every day for 50 minutes (in 2-3 chunks)
} including 15 minutes where my heartrate is elevated, and continue not to eat
} wheat.  I feel awful now if I eat wheat for a few days.

When you get tired, does your mind feel slow / foggy or does it race?
You say you've felt tired but anti-sleepy... have you had insomnia?
Do you sweat profusely?  If so, is it connected clearly to something(s)
(exertion, temperature, diet, etc.)
Do your muscles ache?  In particular when you feel tired?  Or just feel weak?
Do you get dizzy when standing up quickly / prefer to lie down to think?
Have you noticed anything else related to temperature?

} I am very interested in the adrenal possibility and that you are feeling
} better.  I looked through the site (
} 
} http://www.drlam.com/articles/adrenal_fatigue.asp?page=1) and some of the
} symptoms do not fit me very well.  E.g. I crave sweet foods, I don't feel
} better on vacation, I don't feel better after eating; but some things fit
} well, e.g. I've always had enormous difficulty getting up in the morning.  Is
} there a test for this?  I did a saliva test for cortisol in 2004, and it came
} back overall low, especially in the morning.  What do you recommend I do to
} check this out?

Well, first of all let me say that I believe it likely that we actually have
different conditions.  There are many many things that cause the enervating
symptoms that we've both experienced, and even within CFS there are
recognizably distinct "sub-categories" so to speak.  Adrenal Fatigue fits me 
like a glove, but the character of the fatigue you've described in the past
and just now has just as many divergences as similarities.

Of course, it's also prudent to rule AF out, or see whether it is a minor
eliminatable factor.  As far as I am aware, there are only two clinical ways
to determine whether you have AF: the saliva cortisol test, and ACTH
measurement (from blood tests).  Multiple samples need to be taken on the
same day in order to be accurate:
  http://www.adrenalfatigue.org/what-is-saliva-testing.html

There are also several hueristics one can use to determine AF.  One is the
pupil test, and the other is Ragland's sign (which doesn't measure AF
directly, but rather the low salinity and thus low blood pressure that is
commonly associated with it).  This page describes these two tests as well as
the many characteristic symptoms of AF:
  http://www.naturalnews.com/019339_adrenal_fatigue_adrenal_glands_chronic_stress.html

Another way suggested to diagnose it is using hair mineral analysis, but from
what I've read this is mostly unreliable:
  http://en.wikipedia.org/wiki/Hair_analysis_%28alternative_medicine%29

Hope this all helps!