The treatment of conditions related to chronic inflammation response syndromes is challenging. Viruses such as Epstein-Barr or herpes, or bacterial infections including Lyme disease, can either trigger or contribute to inflammation syndromes such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia and neuropathy. Combination therapy has consistently been more efficacious than monotherapy. My multi-modal approach is to decrease inflammation and increase oxygen to the tissues.
Blood vessel health is as important to the body as nerve health. A few simple noninvasive tests to help you monitor vessel and neuronal progress include:
- The Barnes temperature test for the thyroid gland;
- The Ragland blood pressure test for the adrenal/kidney system; and
- The saliva test-strip check for deficiencies in nitric oxide (NO) levels
The thyroid, adrenals and endothelia (NO) have a relationship to blood vessel health, cardiovascular disease prevention and neuropathy. The inter-relationship of the neuro-vascular-gut-immune systems is increasingly being looked at to help resolve chronic inflammatory disease. Persistent neuropathy and ME/CFS-type symptoms (even months or years later) can’t always be evaluated or correlate with known tests. Conventional thyroid tests like TSH miss many cases of hypothyroidism. I prefer to look at a full thyroid panel, including reverse T3.
A host of symptoms are associated with ME/CFS and neuropathy. Most common are: not just tiredness but profound, persistent fatigue (“I’m exhausted all the time”); cognitive dysfunction (“brain fog”); dizziness; sleep abnormalities (poor total sleep, excessive movement and restlessness, poor REM and deep sleep); autonomic manifestations (digestion, hormone production, cardio symptoms, etc.); headaches; pain (usually widespread); and other symptoms that are made worse by exertion of any sort.
Chronic inflammation response syndromes: a multi-modal biohacking approach
Ongoing fatigue and chronic inflammation response syndromes deserves a proper diagnosis.
I take the “biohacking approach” to resolve symptoms. I attempt to implement as many of the biohacks as my patient will do for overall health optimization.
Here’s a sample list of my biohacks:
Exercise — I start with gentle movement to increase the blood supply and oxygen content to tissues. That could be as simple as “marching in place” for two minutes multiple times a day. The most important exercise for neuropathy patients is sensorimotor exercise. Months later we may begin to introduce light exercise with long-term goals of moderate intensity and high-intensity interval training (HIIT).
Blood sugar management — I like to keep tabs on this with off-the-shelf test kits that can provide A1C (glucose) levels. Everyone now has easy access to devices for finger-stick blood glucose/ketone monitors and continuous glucose monitors. As we age, we typically lose muscle mass, lung capacity, bone mineral density and other certain body processes, i.e., hormones decrease/slow down. After age 40 our risk of diabetes goes up and in general the older we are the higher our blood sugar rises.
Blood vessels — I use therapies such as Winback TECAR, shockwave, cupping and laser to help reduce enlarged and distended vessels and veins, to stimulate angiogenesis, and to improve stiff vessels and veins. I monitor the nitric oxide levels in the saliva during office sessions.
Manipulation — This is very individual and gets evaluated on a case-by-case basis. One thing for sure is that hands-on therapy with some techniques between high-low velocity treatments and the experience of joint mobilization and manipulation is helpful. Your skilled hands and the patient preference are what will guide this.
Weight management — I monitor body composition (e.g., fat mass and lean muscle mass) on each patient. The relationship to even just 5% more fat cells than your optimal body fat level is well-established to increased inflammation (cytokines) throughout the body.
Nutrition — There are so many ways to go here. Think about ruling out gluten, wheat and pasteurized dairy sensitivity. I start with recommending the removal of processed foods and talking about portion size and meal timing (no food three hours before bedtime). Based on body composition analysis done in my office, I’m able to offer macronutrient (fat, protein and carbohydrate) portions. The micronutrients I recommend most often include vitamin D, niacin, magnesium and chromium.
Other supplements — It helps to upregulate NAD and the B complex because this will improve mitochondria capacity.
Sleep — I need to see sleep data to help hack poor sleep and the associated fatigue. Wearable devices to monitor sleep are easy to implement. Certain herbs like lion’s mane can help improve REM sleep if that’s what a person needs. Getting patients into a nightly bedtime routine and eliminating electronics (i.e., light) that disturb hormones is important.
Stress — Patients need to talk about and release emotional stress — having a trusted listener about family problems, the illness itself and other physical stressors is helpful. To help reduce stress I encourage patients to nasal breathe only (not through the mouth) and meditate. Of late I am experimenting with vagal nerve tone stimulator devices. When you have loss of vagal tone you have imbalance in sympathetic and parasympathetic nervous systems. These devices hopefully help balance out the parasympathetic or the cholinergic tone to counterbalance the sympathetic dominance and the inflammatory response that’s going on with these patients. Think adrenal deficiency. Early reports from my patients on these devices are still out.
Hormones — Evaluating and optimizing testosterone and other hormone levels (i.e., thyroid disorders) helps things fall into place.
Environmental factors — Understanding exposure to pollution, toxins, molds, vitamin D via sunlight, altitude and ambient temperatures needs to be looked at.
Medications — Keep an eye on what patients are taking and the duration, e.g., steroids, antipsychotics, etc. Often, I need to look up various side effects of these medications. I am no longer surprised at the correlation between medications and side effects. On the other hand, there are times I’ll suggest intravenous vitamins to help patients overcome chronic fatigue.
Substances — Smoking, alcohol, excess caffeine — these are common contributors that you must see through your cells’ lens, as they contribute to poor health.
Allergies and allergic reactions — By the time I see a patient they usually have had allergy testing or know their specific allergies. I am more interested in food sensitivities than overt allergies. I am seeing positive results with the low-oxalate diets in reducing muscle and joint pain.
Be the doctor you want to be
I am very comfortable bringing awareness to patients about posture and positioning, proper belly versus chest breathing, nasal breathing, sleep hygiene, fat loss, movement and exercise. If we add even a few healthy practices for at home, i.e., establish better eating times, take out a possible food sensitivity, add some very gentle movement, patients may feel better.
I use modalities in the office that help “charge” the mitochondria and this allows some wonderful changes in these people’s lives. Since ME/CFS is rarely identified at onset, unfortunately the diagnosis of certain chronic inflammation response syndromes can take years to receive and even more time following for it be recognized by the medical community.