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Chronic Fatigue

Chronic Fatigue



Looking for a drug cure for Chronic Fatigue Syndrome is a bit like trying to buy a new Buick from a Ford dealer: it just isn't possible. The first rule of fishing is to put your hook in the water, because that is where the fish are. Let's consider nutrition research and see what REAL options are available for the CFIDS patient that has been told to "learn to live with it." 

Vitamin A as CAROTENE: 
Chronic fatigue syndrome encompasses a depressed immune function. Your immune system is stronger when beta-carotene is adequately supplied by the diet.  And, not at all surprisingly, vitamin A deficiency weakens immune function. (Chandra, R. K. "Nutrition and Immunity: Basic Considerations, Part 1," Contemporary Nutrition, Vol 11, No. 11, 1986) "Fewer than 10% of us actually consume "adequate" beta-carotene." (Patterson, B. H. et al, "Fruit and Vegetables in the American Diet: Data from the NHANES II Survey," American Journal of Public Health, 1990, 80:1443-1449). This means that supplements are virtually essential. 

For example: after surgery, the body's inventory of lymphocytes does NOT decrease (as it otherwise will) when large doses of vitamin A are given. (Cohen, B. et al: Reversal of Postoperative Immunosuppression in Man by Vitamin A," Surgery, Gynecology and Obstetrics, 149:658-662, 1979.) 

Beta-carotene supplements in particular have been shown to strengthen the immune system by helping the body to build more helper T cells. (Alexander, M et al: "Oral Beta-carotene Can Increase the Number of OKT4 Cells in Human Blood," Immunology Letters, 9:221-224, 1985.) The amount used in this well-controlled study was 180 milligrams of beta-carotene per day. This is, theoretically at least, the equivalent of 300,000 I.U. of vitamin A per day! Even AIDS patients have benefited from dosages such as this (Graham, N. American Journal of Epidemiology, December, 1993).  Surely AIDS is the ultimate immune dysfunction. 

The body (ideally) can derive 10,000 I.U. of vitamin A activity from each 6 milligrams of beta-carotene consumed. The actual yield is almost certainly lower, however.  Studies using small amounts of beta carotene (20 mg or so) are likely to show no benefit even though the "theoretical" yield would be over 30,000 I.U. of Vitamin A activity. 30,000 I.U. is six times the US RDA for vitamin A. Either that isn't enough, or beta-carotene isn't converted nearly as efficiently as supposed.  Or both. 

The safest way to give Vitamin A is as beta-carotene, as the body will convert it into vitamin A as needed and overdose is automatically avoided.  Excessively large does of preformed, fish oil vitamin A may actually depress immune function; huge doses of beta-carotene do not appear to have that negative effect. 

Vitamin B-COMPLEX: 
The very discovery of the B-vitamins is a story of fatigue itself. The disease "Beri-beri" means "I cannot, I cannot," relating to severe weakness and exhaustion. This "incurable" condition was found to be simply a deficiency of thiamine (B-1). Eating whole brown rice, instead of polished white rice, was enough to effect a remarkable cure from fatigue which no drug on Earth could obtain. 

Here's another one: Pellagra is niacin (vitamin B-3) deficiency. Niacin deficiency results in (among other things) weakness and lassitude (Williams, S. Nutrition and Diet Therapy, 7th Ed., Mosby, 1989, p. 201). 


In your body, food must be broken down into simple molecules like glucose, and in your cells, energy must be released from glucose. A major part of this complex process is called the citric acid or Krebs cycle. This entire, elaborate energy-releasing pathway grinds to a complete halt without the B-complex vitamins. Your body without enough B-vitamins is like a huge, rusty Ferris wheel without oil. It's there, but it's not moving. 

The four B-vitamins most involved with our cellular energy cycle are thiamin, niacin, pantothenic acid and riboflavin. I have focused on the first two, as the last two are actually hard to NOT get, even in American diets. Riboflavin is in all milk products, which cover a multitude of dietary sins for many of us. Pantothenic acid is found in all cells in all forms of life, so it cannot easily be avoided in food. 

Scientific research indicates, over and over again, that B-complex (and other) vitamin deficiencies weaken immunity. A considerable number of supporting references appear in Nutritional Influences On Illness, by M. R. Werbach, M.D. (Keats, 1988). This book is a valuable collection of nutrition research abstracts (summaries). Pages 243-251 and 418-423 can be applied to CFIDS. 

Nutritionists, dietitians and physicians often discount these findings by maintaining that vitamin deficiencies are extinct in our modern civilization.  For example, FDA has now actually deleted B-vitamin information from food nutrition labels because they perceive it to be unnecessary!  Such opinion does not stand up to close examination of the scientific literature, which confirms widespread nutritional failings coast to coast.  Nor does it explain the large number of CFIDS patients who have taken large quantities of vitamin supplements and noticed remarkable improvements. 

It is common supplemental practice to include a B-complex vitamin with every meal. Even more frequent doses have been known to help more severe cases. 

Very large doses of vitamin C have been successfully used to boost the immune system for 50 years. Frederick R. Klenner, M.D. pioneered megavitamin C therapeutics back in the 1940's, giving thousands of milligrams of vitamin C by injection for a wide variety of viral illnesses.  In his 1948 paper on treating viral pneumonia with vitamin C, he writes: 

“This picture will then develop to the point where severe frontal headache is noted along with a feeling of weakness in the lower extremities so marked that the patient complains of a dragging sensation when moving about in bed. This weakness persists for some days... The patient can hardly support his body weight without the fear of buckling at the knees.” (p 36) 


“The purpose of this paper is to outline a new and different form of treatment for this type of virus infection which in 42 cases over a five-year period has given excellent results... The remedy used was Vitamin C (ascorbic acid) in massive doses.” (p 37) 


(Klenner, F. R. "Virus Pneumonia and its Treatment with Vitamin C," Southern Medicine and Surgery, February, 1948, p 36-46. 

One cannot easily help but draw a significant parallel with CFIDS symptoms. If chronic fatigue is to a lesser or greater extent caused by a virus, the immune-building and virus-stopping properties of large doses of vitamin C need to be revisited. 

Viral pneumonia is a worthy foe, but the supreme test for vitamin C must surely be AIDS. 

Robert F. Cathcart, M.D. has published his successes with enormous doses of vitamin C against many viral illnesses. Even among his patients with fully developed AIDS, improved length of life and quality of life are the rule, not the exception. Often, increased energy levels and increased resistance to disease can be demonstrated in AIDS patients only with the highest doses of vitamin C imaginable: up to 200,000 milligrams of vitamin C daily.  It is likely that CFIDS requires a lot of vitamin C as well, but almost certainly less than this. (Murray, F. "Vitamin C and AIDS: Another Direction?" Today's Living, September, 1987, p 5-25) 

The question, of course, is HOW much vitamin C does one need, exactly? Too little and you miss maximum benefits; too much is wasteful.  Dr. Cathcart gives vitamin C to bowel tolerance, which is the maximum amount the body can take without having diarrhea. Any person can monitor this level at home, all by themselves. Dr. Cathcart says that the sicker you are, the more "C" you can (and will) hold. As you get better, you will not be able to hold as much, so down comes the dose to an amount, again, just below that which would cause loose bowels. It is a self-adjusting process. ("Vitamin C in Massive Doses Does Work," Today's Living, December, 1981, p 10-11, 60-64) 

This brilliant, Nobel Prizeworthy finding is simple, relatively inexpensive and remarkably safe. According to the many persons I have interviewed, the "take all the vitamin C you can possibly hold" plan also WORKS. Still, it is the one principle most consistently overlooked, even by doctors and authors writing about nutritional therapies for CFIDS! I now judge a nutrition book not by its cover but by checking to see if Cathcart's bowel-tolerance principle is in the “Vitamin C” section. If not, the reader is missing out on one mighty effective therapy, unless s/he reads Cathcart, R. F. "Vitamin C in the Treatment of Acquired Immune Deficiency Syndrome," Medical Hypotheses, 14:423-433, 1984 and Pauling, Linus  How To Live Longer and Feel Better (Freeman, 1986). 

CFIDS is not AIDS, of course. I use this as an extreme case of immune failure and the fatigue that is known to accompany both AIDS and pneumonia.  Mononucleosis is even more closely related to CFIDS. What does Dr. Cathcart do for that? 

Again, the therapy is vitamin C to bowel tolerance. Same reasons, same procedure, same results. Dramatic response to aggressive vitamin C therapy has followed patients taking a tablespoon of vitamin C crystals every hour. That is close to 12,000 mg/hour, or about 150,000 mg/day. Dr. Cathcart reports cures of mononucleosis in a matter of a few days at this rate of intake. 

I have witnessed such swift recoveries myself.  And, I personally have taken 2,000 mg of vitamin C every 5 minutes when I had viral pneumonia.  You see, when you are sick, you need (and can hold) an awful lot of vitamin C without diarrhea. You take enough C to be symptom free, whatever that amount might be! Then, one's maintenance dose is just enough "C" to keep you well, but not enough to cause loose bowels. 

Magnesium is a catalyst for literally thousands of biochemical reactions in each of your body cells. Along with CALCIUM, magnesium is necessary for nerve conduction and muscular activity. Calcium deficiency is almost universal: according to the Arthritis Foundation, Americans consume only about 550 milligrams of calcium daily. This is one-third to one-half BELOW the modest US RDA! Magnesium deficiency may run as high as 99% among U.S. teenagers. (MRCA Census for the calendar year 1975, General Mills, Inc., Minneapolis, MN, 1980) These are reasons why a calcium-magnesium supplement should be included as a first-line measure against chronic fatigue. 800 mg calcium and 300 to 400 milligrams magnesium are common daily therapeutic levels. The dose should be divided among and taken with meals. 

Organic chromium supplements increase immune function in animals. Both stress and infection increase the amount of chromium required for good health. ("Chromium Improves Immune Responsiveness," Manitoba Co-Operator, December 2, 1993)  On top of that, the U.S. Department of Agriculture found that 90% of us are eating chromium-deficient diets. (Anderson, R. and Kozlovsky, A. "Chromium Intake, Absorption, and Excretion of Subjects Consuming Self-Selected Diets," American Journal of Clinical Nutrition, 41:6, pp 1177-1183, 1985)  High sugar intake  actually drains the body of chromium.  (Anderson, R. "Chromium Metabolism and Its Role in Disease Processes in Man," Clinical and Physiological Biochemistry, 4:31-41, 1986) Including what is used in food processing, Americans consume over 120 POUNDS of sugar PER PERSON per year. That is a third of a pound of sugar EACH DAY! And if you are not eating that much sugar, then someone else is eating more. 

200 to 400 micrograms of organic chromium daily is a safe and worthwhile measure to try. Chromium polynicotinate or chromium picolinate are probably the best forms to take as supplements. No fair nibbling on a car bumper, because that is the toxic, or hexavalent, form of chromium. 

Zinc may be "tail-end Charlie" of the nutritional alphabet, but it is near the top in importance. Of the trace minerals, only iron is found in you in greater quantity. Oddly enough, it is excessive iron consumption that can reduce your zinc absorption from food. Women, in particular, often need supplemental iron, for they lose iron in their menstrual flow each month. But a woman is more than a foundry, and merely giving her giant amounts of iron, in supplements or even iron-fortified foods, does not answer all her metallic needs. She needs zinc, too. (Incidentally, Vitamin C supplements substantially increase your iron absorption. Many anemic persons can get more iron just by taking more vitamin C. Isn't that ironic?  Ha!) 

So, have you seen many "zinc-enriched" foods lately? Neither have most Americans, for we do NOT even get the US RDA of zinc (which is a very low 12 to 15 mg/day). Nationwide zinc deficiency almost surely has contributed to CFIDS.  It is well known that zinc is needed for dozens of the body's enzyme systems. Reduced immune function follows zinc deficiency (Bogden, J. D. et al, "Zinc and Immunocompetence in the Elderly: Baseline Data on Zinc Nutriture in Unsupplemented Subjects," American Journal of Clinical Nutrition, 46:101, July 1987). Zinc is absolutely essential for lymphocytes, T-helper cells, T-suppressor cells, and natural-killer cells. Alcohol knocks zinc out of our bodies. Even if you have a blood test showing nearly normal plasma zinc levels, you may still have too little zinc in the cells themselves. This means your immune system may be seriously weakened and tests may not reflect it. Does this sound familiar to chronic fatigue patients? (Prasad, A. S. "The Role of Zinc in Human Health," Contemporary Nutrition, 16:5, 1991) 

How well does zinc work clinically? Zinc has been shown to  shorten the duration of the common viral cold by over 50% (Elby, G. A.; Halcomb, W. W.; and Davis, D. R. in Antimicrobial Agents and Chemotherapy, cited by Medical World, February 13, 1984). Zinc displays antiviral activity, according to B. D. Korant et al in Nature, vol. 248. Duchateau et al demonstrated improved immune response with about 400 mg/day. ("Beneficial Effects of Oral Zinc Supplementation on the Immune Response of Old People," American Journal of Medicine, Vol. 70, May 1981) Several clinical studies on zinc are well summarized by J. Challem and R. Lewin in Let's Live, June 1983 ("Fight Infections With Zinc") and by Frank Murray in Better Nutrition For Today's Living, July 1990, pp 12, 13 and 26.  At doses of 50 to 150 milligrams per day, zinc is completely safe to take. Long-term doses over 300 to 600 mg/day, especially of non-natural zinc sulfate, may cause copper or iron deficiency anemia (the reverse of what too much of THESE minerals do to zinc levels!) 

OK, here we go again. Here is yet another nutrient that is essential to the immune system, deficient in our diets, and available as a supplement. I think we are on to something here. 

The first rule of testing an electrical appliance is to be sure it is plugged in. You would be surprised how many service calls would be avoided if this were done first. The first rule of CFIDS should be to plug in the minerals and vitamins. 

If you are sick and tired of being sick and tired, knowing about therapeutic nutrition may perk you up.

A lot. 

One reader writes:


“I discovered the power of vitamin C early last year. I went to my family doctor in summer 1999 complaining of increasing drowsiness at work. His only answer was that I was just "getting old." I was 48.


“I started taking 3,000 mg/day of vitamin C, and other supplements. One day, After another 1 1/2 years of increasing frequency and level of this drowsiness (falling asleep at my desk almost daily), as well as declining cognitive ability (unable to concentrate more than 30 minutes at a time) and severe memory loss (could not remember names of 30-year neighbors), I felt a cold coming on, so I took 1,000 mg/hour of C.


“Next day – BAM! My energy level was back to my pre-teen level or better. I had that "spring" in my step that I had heard about, but had never experienced. I worked like a beaver for a full 8 hours, then studied on the computer at home for another 4 hours, and wasn't sleepy or tired then. Since then I have only had minor drowsiness maybe a half dozen times.”



Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at )

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Andrew W. Saul


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