Nutrition, Toxicity & M.E./C.F.S PDF Print E-mail

by Dr David Dowson

For nearly twenty years I have been treating patients with M.E. on a daily basis and have come to realise that the majority have a nutritional aspect to their illness, in addition to other problems. I now believe that up to ten problems can be present in a patient with ME and many of these need a nutritional approach as part of the treatment.

The ten problems are as follows:

  • Persistent viral infection.
  • Nutritional deficiencies, particularly mineral deficiency.
  • Yeast overgrowth in the intestine.
  • Allergies, intolerances and sensitivities (including food sensitivity).
  • Depression.
  • Exposure to toxic substance.
  • Electromagnetic sensitivity.
  • Back injury.
  • Low blood pressure.
  • Hormonal disturbance (thyroid, adrenal and sex hormones).

Of the above, 2, 3 and 6 all require nutritional aspects to be addressed.

It has long been held that M.E./C.F.S. is often a psychological problem. Psychological factors do exist, but this is hardly surprising in an illness which can persist for many years and is so poorly recognised and managed by the medical profession. However, laboratory tests can now be performed to show that there are biochemical changes in patients indicating that there are physiological and biochemical problems rather than psychological.

1. Minerals

Mineral deficiency is not new but is increasingly common in the western world:

“The alarming fact is that foods (fruits, vegetables and grains) now being raised on millions of acres of land, that no longer contain enough of certain minerals, are starving us - no matter how much of them we eat. No man today can eat enough fruits and vegetables to supply his system with the minerals he requires for perfect health, because his stomach isn’t big enough to hold them. The truth is that our foods vary enormously in value, and some of them are not worth eating as food. Our physical well being is more directly dependent upon the minerals we take into our systems, than upon calories or vitamins, or upon the precise proportions of starch, protein or carbohydrates we consume.”

This is a U.S. Senate document written in 1936!

A recent study has compared mineral levels in foods in 2002 with those in 1940 and shown that there has been a reduction in mineral levels of up to 70%. This has occurred because the soil on which crops are grown is now mineral deficient. Sadly there is little incentive for farmers to fertilise the soil with minerals as mineral deficient soil does not markedly reduce yield - it just creates nutritionally incomplete foods.

Further evidence of the endemic state of mineral deficiency in the U.K. is shown by studies on the tribes of the world known for their longevity and lack of ‘western’ diseases (particularly malignant disease and cardio-vascular disease). These are the Tibetans, the Azerbaijanis, Georgians and Titicacas. The only environmental factor common to these people is that they all live on land irrigated with glacial water, a water exceptionally rich in essential minerals, and which they also drink. Perversely in the U.K. the consumption of so-called ‘mineral’ water has dramatically increased, possibly increasing the prevalence of mineral deficiency as these waters often contain lower levels of minerals than hard tap water.

It seems quite possible that, if mineral deficiency is common in the U.K. population, as seems likely, that the accepted values for normal tissue levels of minerals may be substantially lower that the ideal.

The minerals which appear to be of particular importance in M.E./C.F.S. are Magnesium, Chromium, Iodine and Selenium.

• Magnesium

In 1990 I co-authored a paper published in the Lancet (Lancet. 1991 Mar 30;337(8744):757-60.) showing that magnesium deficiency was common in M.E. and that 80% of sufferers benefited from intramuscular magnesium injections. Unfortunately that has not been independently replicated, and hence this treatment remains controversial, despite the improvement many patients have experienced. At the time of publication the mode of action of magnesium in terms of energy production was unknown, but recently this has become clear - see Section 4

• Chromium

Chromium deficiency is relatively common in Chronic Fatigue. Chromium is essential for the correct utilisation of insulin, and deficiency causes wide fluctuations in blood sugar levels leading to a necessity to eat at frequent intervals. If food is not taken regularly, symptoms of dizziness, weakness and poor co-ordination can result.

The main dietary sources of chromium are whole unrefined grains and it seems likely that the increase in consumption of refined
carbohydrates in the Western diet may be the underlying cause for the high incidence of chromium deficiency.

• Iodine

Iodine is essential and forms part of the thyroid hormones (T3 and T4). Poor intake causes goitre (swelling of the thyroid gland) and low thyroid hormone levels. As this hormone is responsible for the rate and speed of metabolic processes in the body, deficiency causes fatigue, weight increase, lethargy and confusion.

The main dietary sources of iodine are fish and seafood. Because of relative poor quality and expense, seafood is consumed less in the UK than it was, and iodine deficiency is, therefore, becoming increasingly common.

• Selenium

Selenium appears to be a key mineral in that selenium deficiency causes deficiency of other minerals. However, one important function of selenium is the conversion of the thyroid hormone T4 into T3, and will result, therefore, in possibly normal levels of T4 and reduced levels of T3. As T3 is five times more powerful than T4 this causes symptoms of thyroid deficiency (see above).

2. Essential Fatty Acids

Omega 6, Omega 9 and Omega 3 are the range of essential fatty acids. Omega 9 can be metabolised in the human body and is not, therefore, necessary as a nutritional supplement. The end essential fatty acids cannot be taken as supplements and do not appear in the diet as they are unstable (react when exposed to air) and these essential fatty acids have to be manufactured from ingested basic fatty acids. Sometimes, although there is adequate intake the manufacturing process is inadequate and faulty and, therefore, essential fatty acids are not present in sufficient amounts.

It appears that the primary role of essential fatty acids is maintenance of the integrity of the cell wall and a deficiency can lead to a fragile and permeable cell wall allowing the passage outwards of essential nutrients such as minerals. In normal health, magnesium is maintained inside the cell and calcium outside the cell. This difference is maintained by an electrical potential difference between the interior and exterior of the cell and also by the integrity of the cell wall. If the cell wall is inadequate, magnesium can permeate out into the serum and so be excreted and calcium can penetrate to inside the cell. As already described a deficiency
of magnesium (intracellular) causes symptoms of fatigue.

The main nutritional items containing the base fatty acids are nuts, seeds, shellfish and fish. The western diet does not often contain much in the form of seeds and nuts and intake of oily fish in particular is commonly low. Incidence of deficiency is becoming increasingly common.


3. Nutritional Aspects in Yeast Overgrowth

Probably 60% of patients with M.E./C.F.S. have excess yeast in the intestine. This is often an effect of the inappropriate use of antibiotics whereby the commensal bacteria in the gut are eradicated allowing yeast to develop. Symptoms of yeast overgrowth are excessive flatulence, altered bowel action, abdominal distension, and a craving for sweet things with an intolerance to alcohol. In females there is often a history of thrush and/or of taking the contraceptive pill.

In yeast overgrowth syndrome, carbohydrates in the diet are fermented into alcohol and gas. The former adds to the “brain fog” which patients with M.E. experience and the gas production causes the flatulence.

Whilst antifungals are usually necessary to eradicate the yeast infection, dietary exclusion of food items which encourage yeast overgrowth is to be encouraged. This means that patients have to avoid sugar (refined) and yeast in their diet. However, this alone, without medication in addition, and contrary to the opinion of some practitioners, is not sufficient to eradicate the yeast.


4. Toxicity in Chronic Fatigue

In our now more environmentally polluted world toxicity is an increasing problem. Foods are often contaminated with chemicals such as pesticides, and exposure to heavy metals such as lead, cadmium and mercury is more common than in previous centuries.

Many pesticide products which were previously thought to be harmless have subsequently been banned, but nevertheless are still present in the environment. An example of this is DDT which was withdrawn in the 1950s but is now in the food chain to the extent that it is present in the blood stream of 100% of the UK population. It would seem quite logical that there are pesticides in use now that will be subsequently found to have dangerous effects on human health.

Heavy metals and pesticides have their effect on the ADP - ATP synthesis. ATP is the fundamental chemical in every cell in the body which produces energy by its conversion into ADP (adenosine triphosphate into adenosine diphosphate). This reaction creates energy and needs magnesium as a catalyst. In normal health adenosine diphosphate is then transported into the mitochondria of the cell where it is reconverted by a process known as phosphorylation back to ATP and is excreted from the mitochondria, so becoming available to produce more energy. The process of phosphorylation needs the nutritional items of carnitine, Vitamin B3 and Co-Enzyme Q10. Deficiencies of these can, therefore, lead to poor reconversion of ADP back to ATP.

Furthermore, the ingress and egress into and out of the mitochondria of ADP/ATP can be impaired by toxic chemicals such as pesticides and toxic metals. This leads not only to fatigue but also to a situation where there is very poor recovery from physical activity as because ADP is not being reconverted to ATP, new ATP has to be formed from glucose in the diet and this process takes many days.

There are now tests available to examine the level of ATP, together with the rate of ADP to ATP conversion, and as to whether there is a block or a deficiency of the essential nutrients necessary for reconversion. This is making it much easier to target the exact problem present in patients with Chronic Fatigue as almost all patients with Chronic Fatigue/ME show an abnormality in this test.

Attached to this paper are examples of tests indicating toxicity, mineral deficiency and abnormal ATP/ADP metabolism:

  • Toxic Effects Screen of patient demonstrating exposure to a toxic metal (nickel).
  • ATP test on the same patient showing a block on the mitochondrial membrane.
  • Translocator studies on the same patient, again showing nickel(only a trace as this was after treatment).
  • ATP test before treatment - abnormal.
  • ATP test for the same patient after treatment - normal.
  • Serum and red cell elements test showing low red cell magnesium (the most accurate method of assessing magnesium status).

5. Conclusions

Up till now the direction of research into M.E./C.F.S has been considering psychological approaches in treatment, using methods such a cognitive behavioural therapy and graded exercise programmes. It is now clear that
these can be detrimental unless biochemical abnormalities are first addressed.

Now that there is ample evidence for these biochemical changes, research needs to change direction and look at physical factors in the causation of the illness. One area vital to be investigated is the nutritional aspect and the importance of toxic exposure. It is my contention that the poor nutritional - and deteriorating - value of the average U.K. diet is largely to blame, together with increasing exposure to environmental toxins.

 

© David Dowson MMVI