Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis Second Edition: it’s mitochondria, not hypochondria

Anyone who has every had a mysterious or chronic illness probably knows that there are some things that modern Western medicine doesn’t handle very well. If you have the misfortune to suffer from some aspect of the FM/CFS/ME family, you may have discovered that doctors, far from being your trusted confidants, can be your worst enemies. The recent revelation about the flaws in the PACE trials, which recommended GET (Graded Exercise Therapy) for CFS sufferers, despite the copious evidence from the patients themselves that GET was making them worse, sometimes dramatically so, rather than better, is just part and parcel of willful misunderstanding of this debilitating illness among many mainstream medical practitioners, who, short on time and long on hubris, grasp at anything that they think will get these problem patients out of their hair.

In light of these background factors, Dr. Myhill deserves profound gratitude for her tireless crusading on behalf of the CFS/ME community, and even more gratitude for her work to help uncover the physiological processes behind the illness. Her hypotheses of mitochondrial function vis-a-vis CFS/ME, and the tests she helped pioneer to measure it, will, we hope, go a long way to clarifying some of the more mystifying and frustrating symptoms, particularly Post-Exertional Malaise. Having lab tests that medical professionals may be more inclined to trust than the anecdotal evidence of thousands of sufferers is an essential start towards treating this illness.

Unfortunately, there isn’t really a cure yet for failing or damaged mitochondria. Dr. Myhill does have an arsenal of treatment options for CFS/ME patients, which essential boil down to a ketogenic diet, massive supplementation, and various methods of attempting to balance thyroid and adrenal function, fight infection, and “detox,” which the book lays out in a fair amount of detail. If you want to try her methods and don’t have a helpful doctor to work with you, you should be able to do most of her suggestions on your own by following her instructions in the book.

She claims an impressive track record of improvements, much better than that of conventional treatments, and I have to say, without having tried her treatment regimen yet, that most likely it will do most people less harm and more good than GET. Of course, so would hitting yourself repeatedly with a hammer, so the bar is low. The reasoning behind the basics of her treatment program is sound: make sure mitochondria have all the nutrients they need to function, and try not to overload them with stress, exertion, toxins, or infections.

That being said, I do find myself somewhat skeptical about some of the things she suggests, which range from the above-mentioned ketogenic diet to buying over-the-counter cortisone cream and ingesting it in order to balance out adrenal function. Which I totally get as an idea, because part of her hypothesis is that one aspect of CFS/ME is that it is like low-grade Addison’s Disease, but it still makes me nervous to think of eating cortisone cream. I also have concerns about the long-term, heavy-duty supplementation she suggests, given the recents findings regarding the dangers of vitamin supplements, and while I do in fact share some of her reservations regarding vaccinations and hormonal birth control, these are still life-saving medical innovations that are currently under attack here in the US (Dr. Myhill is British), so I feel queasy about attacking them too vocally. It is unfortunate that the medical profession seems so determined to undo all the good it’s achieved with vaccines and antibiotics by taking such a blinkered, heavy-handed approach to illnesses such as AIDS, and now Lyme disease and CFS/ME, but it is up to us to try to sort out the good from the bad.

Anyway, the main question I have about Dr. Myhill’s methods is that she says you will feel substantially worse for the first few weeks after starting them, before then beginning to improve. So is it the methods themselves that are curing you, or the weeks of enforced rest? Having just come down with the latest crud floating around my campus, I was fascinated and horrified to realize that my walk time from my parking spot to my classroom had actually *improved* after a day home sick. Apparently the exertion of going into work is even more harmful to my body than a stomach flu. So could a lot of us get better(ish) on our own just by taking a vacation? But that, alas, is something is isn’t going to make anyone any money, so I doubt we’ll see any studies being done on that any time soon. In any case, if you have anything in the FM/CFS/ME spectrum, you would probably do well to read this book and consider the options it offers, even if you don’t end up taking all of them.

You can get your own copy here: Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis Second Edition: it’s mitochondria, not hypochondria

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