Dealing With Chronic Fatigue After Environmental Illness

by Dr. Susan Tanner, MD

We have all experienced feeling tired. Whether related to not getting enough sleep, a passing illness, or a lot of stress, being tired is generally a passing feeling and one that after rest, rejuvenation, and healing, resolves with normal energy levels returning.  Fatigue, and especially chronic fatigue, is a different situation, though.  Individuals who experience chronic fatigue do not feel better; energy, even after substantial rest or sleep, does not return. For those with chronic fatigue, sleep is not restorative, nor is it the powerful antidote that it is for most people.

Chronic fatigue can vary in severity from simply not feeling very well and lacking the energy to complete day-to-day tasks to those who are practically bedridden.  Equally variable are the causes and reasons that one might develop chronic fatigue, and that is the subject that we will explore more in this article.

Defining Root Causes of Chronic Fatigue

Back in the 1980s, chronic fatigue syndrome was initially defined and was originally thought to have evolved as a group of patients who contracted the Epstein Barr virus and never fully recovered.  Epstein Barr is the causal virus for mononucleosis and, indeed, fatigue is one of the presenting symptoms.  The correlation was found because when blood was tested for Epstein Barr antibodies, many of the patients who had chronic fatigue were positive for these antibodies.  As time and research have evolved, however, we have found that chronic fatigue is quite a bit more complicated than a single virus.  Some patients who have had Epstein Barr simply remain chronically active with the virus and it continues to cause ongoing fatigue.  Others have had the virus but in taking a careful history are found to have other important contributors as well, including mold and mycotoxin exposures, chemical exposure, and other infections. This reiterates the importance of health practitioners taking detailed histories when dealing with complex patients! Determining if chronic fatigue is due to a single viral issue vs. an overloaded system from many different factors must be evaluated. All contributing factors should determine treatment because you cannot effectively eliminate symptoms if you are not addressing the root causes. However, whether fatigue results from a single viral issue or a system overloaded with toxins and other immune system challenges is difficult to pinpoint because symptoms can be similar. Here are some examples:

1. Disruption of hormonal functions, particularly thyroid and adrenal function.  Toxins and viruses both can cause loss of regulation and normal processing of these important glands resulting in irregular or deficient secretion of hormones both of which, when low, will result in fatigue.

2. Chronic inflammation/reactivity. Again, both toxins and infections can set into motion a cascade of immune complexes referred to as cytokines.  These cytokines cause inflammation in various body tissues, including the brain and central nervous system.  They also cause a decrease in circulation to tissues, leading to oxygen compromise in muscles and in organs.

3. Damage or oxidative stress( “rusting”) in the mitochondria of the cells. Oxidative stress can result from illness or toxins.  We all experience some of it just by our day-to-day living and aging, but when it is excessive, it interferes with the function of the mitochondria.  The mitochondria are the powerhouses, the gas tanks, of each and every cell.  Without proper function, there will be fatigue.

4. Interference with proper absorption of micronutrients from the digestive tract. Through inflammation, loss of the normal intestinal immune barrier, overgrowth of yeast/candida or other non-desirable bacteria, and loss of sufficient pancreatic enzymes through chronic physical or emotional stress, even with a good diet, can cause nutritional deficiencies to arise causing a host of complications in evaluating fatigue.

Chronic Fatigue and COVID

I would be remiss not to mention one of the issues that has arisen since the COVID-19 pandemic began– the development of chronic fatigue among survivors even those with relatively mild manifestations of the virus.  This “long-haul” symptom is a good example of the ongoing activity of inflammatory cytokines that may remain activated long after the acute phase of the illness has passed. One of the reasons that high-dose quercetin (500 mg, twice daily) and CDP choline (1000 mg, twice daily) have been recommended to treat chronic fatigue post-COVID, is that both nutritional supplements can help sequester these inflammatory cytokines and provide healing to the central nervous system tissues that have become damaged by their activity.  These same nutrients are helpful in patients recovering from mold toxicity and other post-viral syndromes. They can dampen the chronic immune response that prevents the body from proper detoxification and healing. A supplement especially helpful is Histamine Relief as it contains both quercetin and NAC which addresses respiratory health as well.

Mold, Mycotoxins, and Chronic Fatigue

With mold and mycotoxin illness, ALL of the items discussed as to causes of fatigue can apply.  Mycotoxins have been shown to interfere with proper hormonal function, including the pituitary gland.  Sustained exposure to mycotoxins can actually damage the gland.  Proper pituitary function and regulation are essential to energy production.  CellTropin has been very helpful in propping up pituitary function as well as all the downstream hormones, including thyroid, adrenal, and sex hormones.  Mycotoxins are chemicals and exposure to them disrupts cellular function, both by inflammation and by damage to the mitochondria.  Once the source of the mold is removed and remediated and exposure is no longer ongoing, the restoration of the mitochondria may be addressed by adding the appropriate nutrients to help these gas pumps of cellular energy regain function.  I often use the Organic Acids test to help me identify specifically in my patients where the nutritional deficiencies are occurring.  Carnitine, B vitamins, and Coenzyme Q10 are very often found to be lacking.  Mitigating oxidative stress with antioxidants, such as glutathione and Vitamin C not only restores function more efficiently but gives additional energy and allows proper healing. Addressing the adrenals with something like Adrenal Boost can also be helpful for patients as it has glandular support and B vitamins in the formula.

The use of probiotics and digestive enzymes can further support healing and nutritional absorption from the digestive tract.  It does go without saying, however, that diet plays an immense role in healing from any illness and in recovering energy levels.  It is sort of like trying to treat mycotoxins in a patient who still lives in a moldy environment, it doesn’t work to still have bad air or a bad diet and take meds or supplements to try to offset it.  The need for cleaning these things up must come first! Why? Because without breathing clean air or taking in clean food, the trigger or cause of the sickness is still very much in place and cannot be outdone or overcome. I often tell my patients that the best money they can spend is not on doctors, treatments, or supplements, but is on achieving a clean, mold-free living space, and eating high-quality, whole foods.

Can a Person With Chronic Fatigue Recover?

To what degree can and does healing of chronic fatigue occur?  That is a loaded question without a simple answer.  Much is related to genetics and how resilient the individual’s system is.  There are some patients who recover completely.  Those patients are ones that either find and address the root cause of the fatigue successfully or those who address many causes concurrently and continue to stay vigilant about the core triggers for their fatigue. These patients understand and accept that they do NOT have a free license to live anywhere, eat a bad diet, or not take care of themselves emotionally and physically, but live a pretty normal life because they choose to take care of themselves and their surroundings with that understanding.  Others may recover partially; they may have good days and bad days, but are doing much better.  Others continue to struggle no matter what is done. I believe those that still struggle just still have yet to find and fully address the cause, though.

In conclusion, while most articles about chronic fatigue will focus on controlling and mitigating symptoms with anti-inflammatory drugs, anxiolytics, and antidepressants, the real relief can only come from following the basic rules of clean air, clean water, clean food, and attending to the nutritional and hormonal needs of the sufferer. Attending to these crucial basics of healthy living are the things that allow for proper rest and relaxation. Focusing on the things that improve quality of life are preventive for the development of other chronic diseases as well.

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