Solutions for severe fatigue, brain fog, CFS/fibromyalgia, and even long COVID
We are in the middle of a perfect storm for a patient energy crisis. Even before COVID, 31% of adults suffered from severe fatigue.1 And who do you know or treat who doesn’t want more energy?
Several factors have combined to stress human energy production, including but not limited to:
- A major loss of micronutrients in the processed Western diet, including as much as an 85% loss of the key energy nutrient magnesium.2 It is likely that over 50% of vitamins and minerals are lost on average.
- Insufficient sleep.3
- The increased speed and stress of modern life.
- Infections triggering chronic fatigue and fibromyalgia.
Energy care
Optimizing energy is especially important in a chiropractic practice. Low energy is a major trigger for myofascial pain.
Although it may seem counterintuitive, it takes more energy for a muscle to relax than to contract, which is why your muscles feel tight after a heavy workout, instead of loose and limp. In addition to addressing structural components of chronic pain, treatment can be far more effective and enduring when the underlying energy deficiencies are addressed.4
You may wonder what a physician is doing addressing energy and myofascial pain? In 1975, I came down with a nasty viral illness that I call the “Drop Dead Flu.” It knocked me out of medical school and left me homeless for a good part of the year.
But it was as if the universe put a “Holistic Homeless Medical School” sign on my park bench. Chiropractors, naturopaths, herbalists, energy healers, nutritionists and a wide array of other healers found their way to my park bench. Sometimes they even had a pizza with them, and I ate. But this was the venue in which I learned the bits and pieces of what I needed to recover from my own post-viral CFS and fibromyalgia. I was able to return to medical school and get honors in medicine.
It also taught me how clueless standard medicine is for pain, fatigue and a wide array of problems. Because of this, I have spent the last 45 years researching, writing, treating and teaching about effective treatments for these conditions, using the entire healing tool kit. My work includes eight treatment studies for which I have been the principal investigator. Low energy, fatigue and pain, including post-viral issues, are incredibly relevant issues to me.
So how to proceed? People do best when we address structural, biochemistry, biophysics and mind-body issues in an integrated manner. Today, my focus will be on the biochemistry of low energy.
Energy production — the big picture
Want to organize your approach to fatigue, pain and fibromyalgia, including optimizing energy to eliminate myofascial pain? I use the acronym SHINE, where we address Sleep, Hormones, Infections, Nutrition and Exercise-as-able. My published randomized, double-blind, placebo-controlled study showed that this approach resulted in an average 90% increase in quality of life in those with CFS and fibromyalgia, with a dramatic decrease in pain.5
We will focus on the herbal nutrition component of SHINE, as two of my recent studies showed that with just a few tablets/capsules daily, energy and stamina can be easily increased by well over 60-80%. But first I want to start with two foundational areas that are critical for both energy and pain relief.
Poor sleep = low energy, continuing pain
Sleep is where we recharge our batteries. It is also where we make the growth hormone that results in tissue repair. The research has been clear for decades — it is very hard to eliminate chronic pain in the absence of good sleep.6
I begin with a sustained-release 10-mg melatonin. This can be augmented by a mix of the four essential oils: lemon balm,7 lavender,8 mandarin, and ravintsara.
Tired of being “hangry?”
Odds are, so is the person’s family. Being irritable when hungry, caused by drops in blood sugar, is enough for me to suspect adrenal fatigue regardless of the person’s testing.
These drops in blood sugar not only trigger fatigue and often severe irritability, but also will repeatedly throw susceptible muscles into tightening and recurrent pain. In addition to avoiding excess sugar and increasing salt intake, I recommend a mix of adrenal glandulars, pantothenic acid, licorice, tyrosine, rehmannia, DHEA and pregnenolone. This combination can be found in a single capsule daily.
Not only do I find it to be highly effective in supporting adrenal function, but also much cheaper than marriage counseling and divorce lawyers!
Double your energy in less than one minute a day?
It’s easier than you may think. Recently, I completed two studies looking at a unique form of red ginseng, and also another mix of six nutrients including ashwagandha and rhodiola.
The latter study is still being prepared for publication and showed an average 80% increase in stamina in fibromyalgia. It was based on several studies showing ashwagandha and rhodiola to be quite helpful for energy and stamina.
Red ginseng is what I take myself on days when I want more energy.
Ginseng — the Asian miracle recovers
For over a millennium, ginseng had been the most popular herb in China and much of Asia. Unfortunately, the overharvesting of wild ginseng led to it becoming insanely expensive. The newer-farmed ginsengs just didn’t work as well, so its popularity started to wane.
Old wild ginseng produced over 50 different ginsenosides as a protective response to the insect attacks and difficult weather. But these are usually not found in most farmed ginseng. And the ginsenosides currently produced are poorly absorbed unless converted into “rare ginsenosides.”
But now, a unique new ingenious hydroponic farming technique, which reproduces the challenges the plant faced in the wild, has allowed a unique cultivated ginseng to have the same active component profile as the 17-year-old wild plants.
When I first heard about this, having given up on ginseng over the decades, my initial reaction was “whatever.” Until I tried one. Being fairly energy-sensitive, I could feel the effects quickly. So, I offered it to people I treat with the disabling fatigue of fibromyalgia. It was life-changing for so many people that I decided to do a study. I recruited 188 people with post-viral or other causes of fibromyalgia (which is what long COVID is) who had at least a 50% decrease in function and energy. They took just one or two a day of the unique red ginseng. I will let the published study results speak for themselves:
An Open-Label, Pilot Trial of [a unique] Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue. Pharmaceuticals 2022, 15, 43. 9
Results: 188 subject patients completed the one-month treatment trial. 60.1% rated themselves as improved, with 13.3% rating themselves as much better (p<.001), with a:
- 67% average increase in energy
- 44% average increase in overall well-being
- 48% average improvement in mental clarity
- 46% average improvement in sleep
- 33% average decrease in pain
- 72% average increase in stamina
Conclusions: The red ginseng root powder resulted in marked improvement in people with CFS and fibromyalgia. This included the subgroup with post-viral CFS/FMS.
ClinicalTrials.gov Identifier: NCT04599348
The form of ginseng matters
Red ginseng has shown increased effectiveness for fatigue and cognition relative to other forms of ginseng.10,11 It may be especially helpful for stress-induced psychological fatigue as well.12
Importantly, this may be via modulation of the cortisol stress response via the hypothalamic-pituitary-adrenal (HPA) axis,13 which is significantly impaired in CFS,14 showing decreased adrenal gland response to CRH stimulation. As I mentioned before, being “hangry” reflects adrenal fatigue. These are two of the key mechanisms by which the stress of modern life causes this.
I find these simple tools to be a powerful way to begin the healing process for not only people suffering fatigue and cognitive dysfunction from the “human energy crisis,” but also chronic pain.
JACOB TEITELBAUM, MD, is one of the most frequently-quoted integrative, energy, pain and fibromyalgia medical authorities in the world. He is the author of 10 books, including the best-selling “From Fatigued to Fantastic!” (Penguin/Avery 2021) and the popular free smartphone app “Cures A-Z.” He is the lead author of eight studies on effective treatment for fibromyalgia and chronic fatigue syndrome. He appears often as a guest on news and talk shows nationwide, including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and FoxNewsHealth. Learn more at Vitality101.com.
References:
1- Leven MJ, et al. Fatigue and CFS -like Complaints in the General Population. European Journal of Public health, volume 20, 3, 251 – 257. August 18, 2009
2- Swaminathan R. Magnesium metabolism and its disorders. Clin Biochem Rev. 2003 May;24(2):47-66. PMID: 18568054; PMCID: PMC1855626.
3- Chaput JP, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this? Nat Sci Sleep. 2018 Nov 27;10:421-430. doi: 10.2147/NSS.S163071. PMID: 30568521; PMCID: PMC6267703.
4- Travell JG, Simons DG. The Trigger Point Manual- Volume 1. Baltimore (MD): Williams & Wilkins; 1983.
5- Teitelbaum JE, Bird B, Greenfield RM, et al. Effective Treatment of CFS and FMS: A Randomized, Double-Blind Placebo Controlled Study, Journal of Chronic Fatigue Syndrome Vol. 8, No. 2, 2001. PP3-28 https://www.tandfonline.com/doi/abs/10.1300/J092v08n02_02
6- Bernd Kundermann, Jürgen-Christian Krieg, Wolfgang Schreiber, Stefan Lautenbacher, “The Effects of Sleep Deprivation on Pain”, Pain Research and Management, vol. 9, Article ID 949187, 8 pages, 2004. https://doi.org/10.1155/2004/949187 ).
7- Taavoni S, Nazem Ekbatani N, Haghani H. Valerian/lemon balm use for sleep disorders during menopause. Complementary Therapies in Clinical Practice. 2013;19(4):193-196.
8- Yıldırım D, Kocatepe V, Can G, Sulu E, Akış H, Şahin G, Aktay E. The Effect of Lavender Oil on Sleep Quality and Vital Signs in Palliative Care: A Randomized Clinical Trial. Complement Med Res. 2020;27(5):328-335. English. doi: 10.1159/000507319. Epub 2020 May 12. PMID: 32396914.
9- Teitelbaum, J.; Goudie, S. An Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue. Pharmaceuticals 2022, 15, 43. Https://www.mdpi.com/1424-8247/15/1/43/pdf
10- Lemerond T, Panossian AG. Panax ginseng Meyer Herbal Preparation HRG80 for Preventing and Mitigating Stress-Induced Failure of Cognitive Functions in Healthy Subjects. J Altern Complement Integr Med. 2020; 6: 100.
11- Mariage PA, Hovhannisyan A, Panossian AG. Efficacy of Panax ginseng Meyer herbal preparation HRG80 in preventing and mitigating stress-induced failure of cognitive functions in healthy subjects: a
12- Choi J.Y., Woo T.S., Yoon S.Y., et al. Red ginseng supplementation more effectively alleviates psychological than physical fatigue. J. Ginseng Res. 2011;35:331–338. doi: 10.5142/jgr.2011.35.3.331.
13- Lee S, Rhee DK. Effects of ginseng on stress-related depression, anxiety, and the hypothalamic-pituitary-adrenal axis. Journal of Ginseng Research. 2017 Oct;41(4):589-594. DOI: 10.1016/j.jgr.2017.01.010.
14- Demitrack MA, Crofford LJ. Evidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome. Ann N Y Acad Sci. 1998 May 1;840:684-97. doi: 10.1111/j.1749-6632.1998.tb09607.x. PMID: 9629295.