AHMF: Conf 2001: R Cosford

Chronic Fatigue Syndrome Case Histories: a Complementary Perspective

Robyn Cosford MBBS(Hons) FACNEM

Director,
Northern Beaches Care Centre
Mona Vale
NSW 2103
Australia
Ph 612 9979 9444
Fx 612 9979 9016

Chronic Fatigue Syndrome (CFS) includes a spectrum of disease and clusters of predominant symptoms. Severity varies from mild to disabling, and predominant symptoms in addition to fatigue may be musculoskeletal, neurocognitive, gastrointestinal or infective.

Three case histories will be presented, who presented with CFS of varying duration and severity and differing symptoms. Symptoms were scored on a multi-system questionnaire (MSQ) and 'CFIDS Disability scale'. All patients were assessed with routine blood and biochemical parameters, in addition to urinary organic acids, faecal analyses and intestinal permeability testing. Each patient demonstrated abnormal urinary organic acids to varying degrees with raised markers of fibrillar and nonfibrillar catabolism and markers for dysfunction of the tricarboxylic acid cycle; abnormal gastrointestinal bacteria with varying degrees of loss of beneficial E coli and overgrowth of streptococcal/enterococcal species, and increased intestinal permeability. Some additional testing such as QEEG, Spect scanning, RNA-ase were performed on some of the patients.

Management in all cases was based on lifestyle change, with prayer/meditation, regular supportive counselling, regular graded exercise and dietary manipulation, with removal of wheat, dairy, artificial additives and other foods reactive for the individual (Elms TM et al 2001). Supplemental nutrients were added specifically directed to the abnormalities found in testing, but including broad-spectrum high potency multivitamin-minerals with additional magnesium and B6, and essential fatty acid supplementation. Nutrients to promote healing of gastrointestinal mucosa, probiotics to replace beneficial bacteria and combination 'antibiotic' herbs were added to eradicate pathogenic bacteria. One patient also had intermittent antibiotic courses administered by other practitioners. Treatment continued from 12 months to 5 years.

Progress was monitored with regular consultations and intermittent questionnaires and retesting of abnormal parameters. Each of the three patients discussed demonstrated measurable improvements and have been able to return to more normal lifestyles and work levels. Retesting of patients with previously grossly abnormal gastrointestinal bacterial flora, has demonstrated that it is possible to restore gastrointestinal flora to normal, and that concomitant improvements in patient health can be anticipated.