Disclaimer. This web site is for research and educational purposes only. The information given in this site is not intended to replace a therapeutic practitioner relationship.
This site is written by Dr. David Bird who lives in Victoria, Australia. It is based on his clinical experience and research. He has a special interest in Chronic Fatigue Syndrome, Fibromyalgia and related disorders. It represents his personal opinions. In some ways this site is like a blog. I will likely update it frequently. If you want to know more about Dr. Bird check out his Bio page.
Some Basic Ideas

In medicine we use labels. Often these labels don't give any clues regarding the cause of a problem.

For example, if you have been diagnosed with chronic fatigue syndrome (CFS) this means that you have long term (chronic) fatigue associated with other symptoms (a syndrome). It is a label given when no other recognised label or condition seems to fit.

If you have been diagnosed with fibromyalgia this means that you have abnormal pain (algia) of fibrous tissues (fibro) and muscles (myo). Again, it is a label given when no other recognised label or condition seems to fit.

Some people are told that they have both CFS and fibromyalgia. Symptoms do overlap. Most CFS sufferers have aching muscles and most fibromyalgia sufferers have chronic fatigue.

Let's talk about a couple of other labels. If you are told that you have motor neuron disease (MND) this means that you have a problem (disease) of the nerves (neurons) that power muscles (motor). But this label gives you no clue regarding the cause of the problem. If you have a diagnosis of multiple sclerosis (MS) this means that you have lots of (multiple) areas of scar tissue (sclerosis) in the tissue of the brain or spinal cord.

If you have a problem with your health, the most important thing to know is the cause or causes of this problem. The next most important thing to know is what you can do to alleviate or fix the cause(s).

In my opinion, based on my clinical experience and research there are seven areas where the core issues are almost always to be found when it comes to what causes CFS or FMS:

Sick Buildings
Long term Infections
Mental/social/spiritual stress
Nutritional and gut problems
Hormonal problems
Sleep disturbances

A Systematic Approach

Intro: This approach can be used by people who have been diagnosed with CFS or FMS or who think they have some stealth bug like Lymes Disease. We are assuming that you have already addressed any major lifestyle problems like smoking, junk food diets, drinking inadequate water or lack of exercise. Read through all steps before starting. These steps are not set in concrete. They are designed for a guide to help sufferers get started and to help them not miss important things. Severe issues in any area will always need to be dealt with earlier in the treatment plan. On the subject of exercise, graded exercise therapy (GET) has been shown in studies to be of significant benefit to many patients with CFS (Larun L, et al, Exercise therapy for chronic fatigue syndrome, Cochrane Database Syst Rev. 2015 Feb 10). I have found GET to be particularly applicable to patients who are less than about 25 years of age. In commencing GET, it is most helpful to engage the services of an exercise physiologist experienced in treating patients with CFS.

Step one: Assess whether or not you are living or working in a sick building. Sick buildings are usually a problem because of mould from water damage, unhealthy electromagnetic frequency levels, toxic pollutants, poor hygiene, inadequate ventilation or adverse lighting. In most cases the most practical and cost effective way to assess the situation is to have a holiday away for about two weeks where you live in a place where you are confident you are not in a sick building. Take the mininum of stuff with you (in case, for example, your things are contaminated with mould). For more information see our Sick Building page.

Step two: Assess your sinuses and whether or not you have Staph Toxin Illness. I believe this area involves the most common causes of CFS and Fibromyalgia. There are three issues that I am aware of: (1) Mould or fungus colonisation (2) MARCoNS associated with Chronic Inflammatory Response Syndrome (3) MARCoNS or CoNS associated with Staph Toxin Illness. In Australia you can test for Staph and Mould by calling the lab called Nutripath and getting a kit sent out and do the swab yourself. There is also a US company called microbiologydx.com who do the same test. For more information please refer to our Sinus page.

Step three: Get checked out for metal toxicity. This can be more stricky. Hair testing needs an experienced person to interpret it as you can only find some toxicity issues by doing ratios between nutritonal elements and toxic ones. An alternative is a Comprehensive Urinary Elements Profile (CUEP). Check with Nutripath or Healthscope functional pathology to see if you can get a CUEP kit posted out. You may need a practitioner referral with Healthscope. To get more sensitive results you can modify the test by taking some chelating agents before you pass your urine sample. This should be done under medical supervision. For more information, see our Toxins page.

Step four: Assess your stress. Is there anything that you can do to reduce stress in your life? One way to reduce stress is to reframe our beliefs about traumatic events in our lives. This is one of the aims of Cognitive Behaviour Therapy (CBT). It is not traumatic events themselves that cause stress disorders but our beliefs about those events. Can you reframe the way that you look at the traumatic events in your life in order to reduce their negative impact or even change them to a positive influence? CBT has been shown to significantly help patients, particularly adolescents, suffering from CFS (Werker CL et al, Clinical Practice: Chronic fatigue syndrome, Eur J Pediatr. 2013 Oct) For a more general discussion on stress please see the page on Stress. If you would like to listen to a half hour MP3 talk on burnout and managing energy, click here.

Step five: Do you have a messed up gut? If so, make sure you have had a decent - I mean really good - stool analysis for parasites and pathogenic bacteria. This should include PCR analysis. When you have the all-clear on this, get a Faecal Microbial Analysis done by Bioscreen in Melbourne. If this is really mucked up, you need to consider a faecal microbial transplant. Moderated problems need intensive probiotic therapy with top quality (expensive) probiotics that really work. Please also see our Gut page.

Step six: Stealth bugs. It is important to remember that these bugs are like seeds. In dealing with the first five steps you will have got rid of or reduced things that fertilise them. Doing this can, in my experience, make the  bugs become dormant or less aggressive. I recommend dealing with these bugs in order of size, big to little. Larger parasites, including worms, are surprisingly common and hard to test for. In patients that I have dealt with it appears that if you eat meat, especially poorly cooked things and animals that are naturally scavengers, you have an increased risk. Also, if you have travelled to places where hygiene is compromised you are at increased risk. Due to space constraints, I refer you to our Lyme and Bugs pages for the rest of the story.

Step seven: Address hormonal imbalances. Of course, severe hormonal problems like very low or high thyroid or Addisons will have had to be dealt with already. I am referring in this step to the subtler imbalances associated with fatigue syndromes and muscle pain. Previous steps will have assisted already. For details, see the Hormones page.

Step eight: Sleep. Again, severe troubles will have needed emergency help earlier. If not dealt with earlier, now is the time to seek to optimise your sleep experience. See our Sleep page.

Step nine: Dental. Often expensive. Sometimes really needed. For details, please see the Dental page.
© May 2016