Introduction - Unique Perceptions

Completing the Jigsaw Contents:
Introduction
1
Summary of Five Steps to Health
2
Five Steps to Health theory
3
Diagnostic Testing for M.E. / CFS
9
Detoxification:
Introduction
11
Far Infra Red Therapy
12
Lymphatic Therapy
15
Lymphatic Drainage Exercise
17
Sun Ancon Chi Machine
19
Dry Skin Brushing Technique
20
Avoiding further toxin build-up
22
Improving Oxygenation:
Introduction
24
Breathing Exercises
25
Activated Air Therapy
27
Optimising Airnergy
30
Diet and Supplementation:
Dietary Control and Supplementation
34
Supplements
38
Glyconutrients
42
Recondition Body:
Introduction
46
Stretching Exercises
47
Strengthening Exercises
49
Yoga
53
For a Better Night’s Sleep
54
Recondition Mind:
Introduction
56
Relaxation Exercises
57
Self Actualisation Learning Technology
60
Meditation
61
Summary
63
Tips for Managing Life with ME / CFS
63
Useful Websites
65
Appendix:
1. Canadian Criteria for ME / CFS
2. Evidence for Accelerated Oxidative Injury as a cause of ME / CFS
3. Technical Summary (for medical professionals)
4. Reference list
1
Introduction
I believe Myalgic Encephalomyelitis (M.E.) or Chronic Fatigue Syndrome (CFS) is caused by
system overload, through a toxic environment (bacteria, parasites, heavy metals etc) and stressful
life experiences (physical, mental and emotional) – leading to a process named accelerated
oxidative injury. This means that free radicals, which are damaging particles formed both outside
and within the body, cause damage to enzymes and structures within cells. This causes a deficit of
oxygen at a cellular level and prevents the process of energy production from working efficiently.
There is increasing evidence from numerous researchers providing evidence for this idea. When
occurring in cells throughout the body this oxidative injury (also called oxidative stress) can cause
the multitude of systemic symptoms such as fatigue, brain-fog, pain, loss of temperature control,
balance, blood sugar regulation etc that we have all come to know (but definitely not love!)
In order to address these symptoms and reverse the underlying disease process, I believe people
need an individualised, integrative programme of management, implementing changes where
necessary in five key areas. I think that, like a jigsaw, several different treatment strategies /
therapies / changes need to be put into place to complete a picture of health for the individual. Often
people try treatments in isolation and find them unhelpful. When combined with other measures, a
treatment may prove much more beneficial. I have designed a general management plan, to be
adapted for each individual, named Five Steps to Health.
The aim of Five Steps to Health is to empower individuals with M.E, by providing them with
knowledge and tools to help them on their personal quest for better health as and when they feel
able. Some aspects of the protocol will be more relevant than others to each person and different
methods may be appropriate for different individuals to achieve the aims stated below.
The five key areas addressed in Five Steps to Health are as follows:
•
Detoxification of the whole body and decongestion of the lymphatic system; including
•
•
•
•
treatment of latent bacterial / parasitic / viral / fungal infections and heavy metal
poisoning
Improving oxygenation to cells throughout the body
Diet and supplementation (when appropriate)
Reconditioning of the body
Reconditioning of the mind
Completing the Jigsaw includes further details and explanations of the theory laid out above and
specific factors that consistently seem to provide improvements in M.E symptoms and overall
health (when combined).
Over a period of several months, adapting Five Steps to Health for different individuals, I have
observed several people experience significant improvements in their health, including myself. At
the start of 2005, when I began to implement the Five Steps to Health in my own life, I had been
virtually housebound (sometimes bed-bound) for years, permanently exhausted and in constant
pain. In November 2005 I was well enough to start simple part-time work and in the summer of
2006 I was able to return to practising medicine within a busy district general hospital.
The main factors that brought about the massive improvements in my own health are activated
oxygen therapy, lymphatic therapy, glyconutrient supplementation, far infra-red therapy and the
utilisation of Self Actualisation Life Technology. For you the necessary changes may be the same or
a little different. I hope that within these pages you will find information and ideas to help you find
your own path to better health.
Dr Claire Bowen 2007
2
Summary of Five Steps to Health
Fibromyalgia Syndrome (FMS – as opposed to simple fibromyalgia), Chronic Fatigue Syndrome
(CFS), Myalgic Encephalomyelitis (M.E.) and Post Viral Fatigue Syndrome (PVFS) are all variants
within the same spectrum of disease. They all have the same underlying pathological processes.
Differences in diagnosis appear to depend on the most prominent symptoms at the time of
assessment and field of expertise of the diagnosing physician.
A genetic predisposition exists in ME / CFS patients, which causes cells to be more readily
damaged by oxidative (free radical) injury. This does not mean ME / CFS is an inherited condition,
but that genetics play some part in predisposing an individual to an ME / CFS experience.
Oxidants or free radicals (reactive substances which accept electrons from others) are produced
within the body, ingested by diet and taken in by other methods (e.g. antibiotics, pollution,
vaccinations). In health the anti-oxidant system neutralises and removes them, since they can
damage the body by breaking down tissues (through oxidation). In some individuals, the genetic
predisposition and excessive environmental oxidant exposure cause a build up of oxidants within
the body’s cells.
This is a pre-disease state of ME / CFS.
A “trigger event” then occurs (e.g. physical / emotional trauma / bacterial or viral infection) which
pushes the body system beyond the limit and manifests as ME / CFS, via the process described
below.
The oxidants, which have reached excessive numbers, begin to cause damage to cell structures
(such as cell membranes, enzymes and genetic material such as DNA within the cell). They do this
by reacting with molecules of the body itself, thus forming abnormal or dysfunctional structures.
They also “use up” oxygen within the cell (by their damaging oxidation reactions), thereby
depriving the cell of oxygen for essential processes. This results in inefficient energy production
and causes cells to regress to a more primitive form of being which does not require oxygen but
produces only minimal energy. This basically constitutes a state of oxygen deprivation at a cellular
level. The above situation causes an inefficient system overall and, by affecting different cells
throughout the body, causes the diverse and multiple symptoms observed in ME / CFS. There is
increasing, compelling scientific evidence in support of this theory.
A feedback cycle is formed, in which many effects of the ‘ME / CFS’ system perpetuate the
abnormal oxygen metabolism and prevent recovery. These effects include decreased circulating
blood volume, reduced red blood cell efficiency, build up of toxic metals and toxins in general,
break down of the detoxification system and immune dysfunction. Other negative effects of chronic
disease also come in to play, which exacerbate symptoms and perpetuate the damaging cycle.
In order to reverse the underlying pathology of ME / CFS and prevent recurrence, aims of treatment
for the condition are to: increase oxygen delivery to cells, improve oxygen utilisation within cells,
remove metabolic (body-produced), microbial (bug-produced) and man-made oxidants, increase
anti-oxidant defences and recondition the body and mind (addressing the biological and
psychosocial effects of chronic disease).
These aims are all met through the Five Steps to Health, which involves a personal programme,
tailored to the individual’s needs, addressing the following areas: detoxification of the entire
system, improving oxygenation, diet and supplementation and body and mind reconditioning.
3
Five Steps to Health Theory
Introduction
There has been much debate over recent years about the differences between Fibromyalgia, Chronic
Fatigue Syndrome and similar disorders. It is believed that the conditions known as Fibromyalgia
Syndrome (FMS), Chronic Fatigue Syndrome (CFS), Myalgic Encephalomyelitis (M.E) and Post
Viral Fatigue Syndrome (PVFS) are all variants within the same spectrum of disease. Individuals
with these conditions may suffer to differing extents with differing symptoms, but it is suggested
that the underlying disease process is the same for each and therefore a similar treatment protocol
can be effective in each. The different names seem to reflect the most significant symptoms present
at the time of diagnosis and/or the field of expertise of the diagnosing physician. For ease of
writing, the term ME / CFS will be used throughout this text to denote each of the above conditions
and any combination of them. A wide range of sources, from numerous authors, has been studied in
order to complete this piece of work. A full list of references can be found within the appendix at
the back of this book.
There is significant evidence to suggest that individuals with ME / CFS Complex have lower-thannormal levels of oxygen, both within their blood transport system and actually within their cells.
Studies have also shown that oxygen therapies and other forms of treatment which aim to increase
levels of oxygen levels in cells have a positive effect on ME / CFS patients.
Since oxygen is the most important nutrient for the body (humans can survive weeks without food,
days without water, but only minutes without oxygen), and is necessary for nearly all the body’s
processes, it is perhaps unsurprising that a basic lack of it can produce such a debilitating, systemic
disease.
It is thought that the underlying cause of all presentations of ME / CFS is an extreme lack of
oxygen within the body’s cells. Many factors come together to cause damage to cells and stop them
from working properly. This means that less oxygen actually gets to the cells, and what does get
into cells, is not used efficiently (is not ‘metabolised’ well). The consequence of this is that cells
cannot produce energy properly. Energy production within cells is essential for our bodies to
function normally. When this cell-damage and reduction in energy production occurs in cells
throughout the body, the individual suffers symptoms affecting many parts of the body, including
extreme fatigue, pain and brain-fog (major symptoms of ME / CFS).
A feedback loop then exists; conditions are created that further lower levels of oxygen within cells
and further impair the processes within cells. This prevents the body healing itself and perpetuates
the chronic ME / CFS condition.
It is concluded that if the damage to cells can be reversed and further damage prevented, the
condition of ME / CFS should be controllable and the body will be able to better heal itself.
Genetic Predisposition
It is suggested that some kind of genetic predisposition (as yet unidentified) exists in people with
ME / CFS. This does not mean that ME / CFS is an inherited condition. Just as inheriting a high
level of intelligence from our parents does not mean we will automatically become a lawyer or a
rocket scientist; we do not inherit any genes from our parents that mean we will definitely develop
ME / CFS. Although a higher basic intelligence perhaps makes it easier or more possible to us to
become a rocket scientist, many other factors such as environment, ambition, personality, finances
etc all have to come together in the right way for a career in rocket science to be achieved. In a
4
similar way, the genetic predisposition for ME / CFS may exist in many people; it is only when
combined with a multitude of other factors that the condition will actually develop. If these other
factors can be prevented or avoided, perhaps so can ME / CFS.
Pre-Disease State
A free radical is an unstable molecule, often a form of oxygen that reacts very easily with other
molecules. Inside the body, certain reactions involving free radicals are essential for production of
energy within cells. However, if not controlled, free radicals (also called “oxidants”) can cause
damage and breakdown to structures within the body (such as enzymes and cell membranes). This
damage is termed oxidative injury / damage.
Throughout our lives we are subject to high numbers of oxidants, both those produced within the
body, as well as those taken in from outside the body. Those produced within the body may be byproducts of normal chemical and biological (metabolic) reactions within cells, or toxins / waste
products produced by microbes (bugs e.g. bacteria, yeasts, viruses), which inhabit our gut. Those
taken in from outside (generally man-made oxidants) include those in cigarette smoke, food
additives, pesticides, certain medications and stimulants such as caffeine and narcotics (to name but
a few). In health, damage by free radicals is prevented by anti-oxidants. These are substances that
are capable of neutralising the oxidants (free radicals). They may be enzymes, vitamins or other
organic molecules. In essence, they absorb the oxidant’s extra energy and return it to a normal state
without harming the system.
In addition to high levels of oxidants, today’s society breeds a culture with poor anti-oxidant
activity. A diet low in foods full of nutrients and high in refined or processed foods is the norm.
This leads to low levels of anti-oxidants and allows levels of free radicals within the body to climb.
When there is a build up of oxidants within the body, or a lack of anti-oxidant activity, the reactions
of free radicals become uncontrolled, causing injury to many structures within the cell and
restricting use of oxygen for normal (vital) processes. This then creates a pre-disease state of ME /
CFS; an individual is effectively functioning normally without obvious symptoms, but all their
body’s resources (e.g. oxygen and anti-oxidants) are stretched to the limit; so much so that it only
takes a small amount of extra stress in terms of oxygen / energy demand, for the body to stop
functioning normally and exhibit the signs and symptoms we attribute to ME / CFS.
Trigger Events
Considering the number of people with ME / CFS Complex who report a sudden onset to their
symptoms, it seems likely that in the majority of cases a specific trigger event can be identified.
This is effectively “the straw that breaks the camel’s back” with regard to extra strain placed on an
already struggling system.
As previously described, a pre-disease state exists in ME / CFS, in which there are very high levels
of damaging free radicals, their reactions are uncontrolled and processes within cells are becoming
disrupted. It is suggested that a “trigger” event then occurs, which increases pressure on the cells
(pressure to produce more energy) to such an extent that the system cannot accommodate the extra
requirements and begins to fail. This failure is manifest as the clinical picture of ME / CFS.
The trigger event may either cause an increased demand on the system, or may increase the number
of oxidants to overwhelming levels.
5
Examples of trigger events that increase energy demands on the body:
 Physical trauma such as road accidents, surgical operations or other medical conditions such
as Rheumatoid Arthritis,
 Excessive emotional stress such as bereavement.
Examples of trigger events that cause extra-increased toxin levels:
 Bacterial infection
 Viral Infection
 Vaccinations (e.g. Hep B)
Whatever the nature of the trigger event, it has the same consequence: tipping someone from
functioning normally in life into a variably disabled condition.
One proposed theory regarding a “toxin-overload” trigger event for ME / CFS is that an infectious
agent, such as a virus, bacteria, or even a vaccine (e.g. Hepatitis B) stimulates the immune system.
This has various effects including a temporary but potentially significant “thickening” of the blood.
This has the effect of slowing down blood flow throughout the body, thereby decreasing the ease
with which oxygen can be transported to the tissues (and therefore the cells).
Explanation of ME / CFS Symptoms
As a result of the lack of oxygen, toxin damage and consequent acidic conditions described above,
cells within ME / CFS individuals undergo a transformation. They become simpler, more
‘primitive’ structures. These cells are able to survive in more acidic conditions but only very simple
reactions go on inside them (which do not require oxygen) and they produce relatively small
amounts of energy (compared to normal, healthy cells). Effectively, cells of the body change their
method of energy production from respiration to fermentation. When this happens to cells all over
the body, the overall production of energy is markedly decreased, major symptoms are produced
and without addressing the problem, an individual has little hope of functioning normally within the
world!
To explain the symptoms that result from this over-oxidised, oxygen-deficient system, several
disease processes must be described. Firstly in the blood circulatory system: red blood cells, white
blood cells and the walls of blood vessels become damaged by the free radicals, to form
microscopic blood clots and generally “sticky” blood. Although this doesn’t seem to produce heart
attacks and strokes as it may sound like, the overall effect of the damaged blood cells and damaged
vessel walls is that blood cannot flow as easily to the tissues, so not as much oxygen is delivered to
cells within the tissues, thereby decreasing energy production in cells – which has the effects on
organs and the individual as a whole as previously described.
The term “oxidative lymphopathy” was recently introduced to describe a similar state in the body’s
lymphatic system. The lymphatic system is a complex system of vessels and nodes that collect and
neutralise foreign proteins (bacteria / toxins) in the body (the detox transport system of the body).
Just as oxidative injury affects cells and structures within the blood circulatory system; it affects
cells and structures within the lymphatic circulatory system to produce collections of stagnant
toxins within muscles, tendons, and ligaments. These collections are believed to form the very
painful, tender “trigger points” often found in ME / CFS.
6
Oxidative cell injury is also believed to have significant effects on cells within the nervous system.
This has numerous consequences, including problems with control of blood sugar, adrenaline
levels, clear thinking and pain.
The processes above all combine to cause a state of chronic dehydration and high levels of acidity.
This not only directly causes symptoms (such as dry mouth, dry skin, hair loss and brittle nails), but
also reduces oxygen delivery to cells and increases oxidative injury, thereby forming a vicious
cycle of damage.
Put very simply, the previously described mechanism of oxidative injury causes the following:
 Affected cells in the central nervous system cause brain fog, memory loss and problems with
hormone regulation.
 Affected cells in the autonomic nervous system cause disruption to digestion, the urinary
system and the production and secretion of adrenaline and insulin (which controls blood
sugar levels).
 By affecting cells in the tissues, body wide, disabling fatigue is caused.
 By affecting cells in muscles, lymphatic system and other tissues, pain is caused.
 By affecting cells in the skin, cold sensitivity and skin changes, as well as nail changes are
caused.
 By affecting cells in the bowel, irritable bowel syndrome symptoms and poor absorption of
nutrients occur.
 By affecting cells in the liver, the body’s detoxification process is affected and toxin-build
up is increased.
Perpetuating Factors
Once in this state of excessive oxidative injury, lack of oxygen and high acidity levels, abnormal
biological processes initiated aggravate one another, creating a positive feedback loop (positive
only in the “cumulative” rather than “good” sense!). For example, often, the yeast-like microforms
(build up of bugs in our gut) which helped precipitate the condition flourish in the low oxygen
environment, producing greater numbers of free radicals, consuming greater amounts of nutrients
and thus exacerbating the condition.
The following are further examples which exacerbate the ME / CFS complex, and may
inhibit healing:
 Changes in the pH (acid-alkali) balance within the body.
 Alterations within the working of the immune system.
 Alterations in hormone and enzyme levels throughout the body.
 Seasonal Variation: reduced atmospheric oxygen levels, vitamin D levels, potential increases
in lymphatic congestion and increased primary pollutant levels in winter (more than half of
ME / CFS individuals experience worsening of symptoms during winter months).
 Excessive physical exercise, mental exertion and emotional exertion. All these require
increased energy production, causing increased metabolic processes. These extra demands
placed on an already-overstretched system result in either an inability to finish the physical
7
or mental task at hand, or allow completion of the task but afterwards then cause a “shut
down” of the bodily (and often mental) system in order to make up the energy stores that
have been totally depleted (this describing the post-exertional exhaustion characteristic of
ME / CFS).
Any chronic disease can cause additional difficulties for the individual. ME / CFS is no exception
to this and the following issues must also be addressed in order to regain full health. Not only can
these factors affect the overall well being of the individual; they may also exacerbate symptoms:
• Immobility, due to pain / fatigue etc. This can add to constipation, deconditioning of muscles
and joints etc.
• Deconditioning of muscles and joints through lack of use (often despite an individual’s best
efforts).
• Psychological distress; depression / anxiety etc due to physical pain, cognitive impairment,
as well as the loss of health, independence, employment, relationships etc.
• Social effects; isolation secondary to poor health limiting social activities and psychological
effects causing demotivation with regard to maintaining social contacts.
• Nutritional deficiency (e.g. B-vitamins, magnesium); this can be caused by digestive
dysregulation (the irritable bowel syndrome symptoms often a part of ME / CFS) as well as
poor or inappropriate dietary intake.
• Sleep disturbance. This has previously been cited as the cause of ME / CFS. It now seems
more likely that as in many chronic conditions (especially those in which pain is a significant
feature), the sleep disturbance is a consequence or symptom of the condition, caused by the
above factors.
Evidence for the Five Steps theory
A lot of studies have been done focusing on ME / CFS and oxygen. The majority provide strong
evidence for the above theory (that ME / CFS symptoms are produced because of damage by
oxidants and / or low levels of anti-oxidant activity). Other research has been carried out, which
demonstrates abnormally low levels and poor use of oxygen within cells of individuals with ME /
CFS. Results of studies have shown that compared with healthy people, individuals with ME / CFS
generally have a smaller circulating volume of blood, lower levels of circulating oxygen, less
efficient red blood cells (the cells responsible for oxygen transport in the blood), lower levels of
oxygen within their tissues, and decreased blood flow (and therefore decreased oxygen delivery) to
various parts of the body, including the brain (obviously quite an important organ!)
Aims of Treatment
Symptomatic treatment can be useful in any medical condition. However, addressing the underlying
cause of a disease will have a greater impact and obviously a more sustained effect on patients’
health. This means reversing the underlying problem as well as preventing further occurrence of the
problem. With any chronic disease, it is also important to address aspects that have resulted from
the actual state of ill health (such as those described above).
8
Taking into account the underlying problems in ME / CFS, the main aims of treatment are to
normalise metabolism within cells, promote repair of cellular structures and elimination of toxins
and prevent further oxidative injury. More simply, these aims can be stated as follows:
•
•
•
•
•
Remove toxins and prevent further build up
Improve oxygen delivery to cells
Improve oxygen utilisation within cells
Increase anti-oxidant defences
Counteract negative biological and psychosocial effects of chronic disease
It is imperative to carry out all the above in a controlled manner so that full health can be achieved,
without causing a relapse in the condition by placing demands which are too great on the
individual’s over-burdened body system.
Based on the above aims, using personal experience and research carried out by various
investigators, the following Five Point Management Plan has been compiled for individuals with
ME / CFS.
Five Steps to Health
1. Detoxification / Lymphatic
Decongestion
2. Improving Oxygenation
3. Anti-Oxidant Diet and
Nutritional Supplementation
4. Reconditioning of Body
5. Reconditioning of Mind
These steps are elaborated on over the following pages, with further explanation as to why they are
so important and suggestions of how to go about achieving them.
9
Diagnostic Testing for ME / CFS
There is currently no universally accepted diagnostic test for M.E. / CFS. However, various
investigations are now available (unfortunately rarely through the NHS) which can identify
abnormalities within an individual’s system; aspects of their M.E. / CFS. The results of these tests
can be used as a basis for tailored treatment as well as providing evidence for the individual’s very
real illness.
Many people diagnosed with M.E. / CFS undergo numerous medical investigations with either
totally normal or ‘borderline’ results; nothing to explain the debilitating and multi-system
symptoms they are suffering from. Results of the following tests can often provide individuals with
documented evidence that they are suffering from a very real, biological condition. This can be
useful documentation to show people around them that they ‘really are ill’. This is unfortunately
often necessary in order to obtain the support necessary to deal with the condition and all the effects
it can have on life.
Dr John Howard, former head of BioLab in London pioneered and developed an investigation
known as ATP Profiling. Although not yet widely accepted, this is considered a useful diagnostic
tool for M.E. / CFS. The investigation (a simple blood test) involves examination of different
aspects of the mitochondria within an individual’s cells. The mitochondria are the ‘batteries’ of the
cell; the site of energy production, where many important cellular processes take place.
The ATP profile test is a measure of how well mitochondria are functioning. The job of
mitochondria is to provide energy for cell processes in the form of ATP (Adenosine Triphosphate).
Mitochondria have the same structure and function in every cell of the body, even in cells which do
completely different things. It is believed that ‘mitochondrial failure’, caused by toxin overload and
consequent free-radical damage is an underlying problem in M.E. / CFS and this test of
mitochondrial function can therefore be used to confirm a diagnosis of M.E. / CFS, with the
specific parameters within the ATP profile providing further information about where there may be
a particular problem, such as a block in enzyme activity or deficiency of certain nutrients.
The ATP Profiling test is divided into various sections:
•
•
•
•
Absolute levels of ATP and ADP: giving information about the body’s ability to produce ATP from its
raw material: D-ribose. This also gives an idea of how well an individual is pacing themselves.
Release of energy from ATP: The rate at which ATP is converted to ADP (adenosine diphosphate) with
the accompanying release of energy; a magnesium-dependent process (obviously abnormal where an
individual is deficient in magnesium).
Movement of ATP and ADP across mitochondrial membranes: this process is dependent on
translocator protein. If this is malfunctioning it is likely to be due to a blockage by some kind of toxin
(either waste products from inside the body, or toxins taken in from outside, such as pesticides / heavy
metals).
Oxidative Phosphorylation: recycling of ATP from ADP: this essential process is particularly
complicated and abnormalities here may have various causes including low levels of Vitamin B3 or
Magnesium again.
Results from these investigations can not only provide the necessary evidence of organic illness but
can also give pointers as to the various treatments (such as Magnesium supplementation, high need
for detoxification through far infra red saunas etc) which will be particularly important for the
specific individual to incorporate into their management plan.
For further information on ATP Profiling; how to order tests and receive
interpretation of results, please contact BioLab on: 020-7636-5959/5905.
© Dr C J Bowen 2007
10
Detoxification
 Introduction
 Far Infra Red Saunas
 Lymphatic Therapy
 Lymphatic Drainage Exercise
 Dry Skin Brushing Technique
 Avoiding further toxin build-up
© Dr C J Bowen 2007
11
Introduction
Detoxification has become quite a buzz word these days. There are many detoxing diets around, as
well as various pieces of equipment and therapies which claim to detoxify the body. In the world we
live in today, full of environmental pollution, food additives and strong medications, it seems like a
good idea for everyone to attempt effective detox occasionally, but for individuals with M.E. / CFS
it is essential. However, it is equally essential that any detoxification process is carried out
appropriately for the individual; when dealing with a system as fragile as in those with M.E. / CFS,
it may be possible to detox too rapidly or powerfully, placing too much strain on the body, leading
to a worsening of symptoms rather than the positive effects one would hope for. It is important to
take account of this when following the suggestions made in the following few pages. Ideally, any
treatment programme is supervised by an experienced, empathetic practitioner. In the absence of
this, the patient themselves must take sole responsibility for the speed and extent of treatment. With
M.E. / CFS it’s always best to start off at the minimum and build up gradually; this applies to
bodywork therapies, medications, supplements and any other treatments. Writing this I recognise
that this goes completely against the grain with generally hardworking, intense, perfectionist-type
individuals with ME / CFS, who would generally prefer to try things one hundred percent
immediately!
More and more people with ME / CFS are being found to harbour latent infections: ‘stealth
organisms’ such as viruses, bacteria and parasites. When treated appropriately (i.e. when the bugs
themselves are got rid of, as well as all the toxins they produce), these people find a significant
improvement in their symptoms. In order to identify the relevant organisms, specific laboratory
tests carried out on blood, urine or saliva samples can be used to direct treatment programmes. The
most commonly found infectious agents include the following:
o Herpes viruses – such as Epstein-Barr
o Toxoplasma
o Aspergillus
o Legionella
o Borrelia Burgdorferi (causing Lyme)
o Brucella
Some clinics, such as The Breakspear Hospital in Hemel Hempstead, England, offer testing for
infectious agents, such as those above, as well as many non-infectious agents such as toxic metals
like mercury and lead. Examining levels of toxic metals in the tissues (via urine and blood tests) can
give specific information regarding an individual’s particular M.E. / CFS components. This
information can be combined with other results and a comprehensive medical history and
examination to produce an overall picture of someone’s M.E. / CFS and give an idea of how the
different aspects can then best be addressed.
Testing, however, can be very expensive. Although the information gained from results can be very
useful in guiding specific aspects of treatment, the same overall picture of a ‘toxic body’ comes up
again and again when assessing individuals with ME / CFS and a general, gentle detox of the
system consistently produces positive results as part of a management programme. The following
pages describe relatively simple and overall inexpensive methods of achieving this safely.
The lymphatic system (as described previously) is a complex system of vessels and nodes that
collect and neutralise the foreign protein or ingested bacteria in the body (the detox transport system
of the body). In the majority of ME / CFS individuals, toxic waste (oxidants, stagnant lymph etc)
builds up within their lymphatic system. Stimulating lymphatic flow expedites removal of toxins. It
will also disperse and eliminate trigger points: the toxic and painful accumulations of toxins
(stagnant lymph and blood products) within tissues. Gentle exercise such as brisk walking,
rebounding (controlled ‘bouncing’ on a small trampette), far infra red saunas, lymphatic massage
and dry skin brushing all stimulate the lymphatic system and aid decongestion (detoxification).
© Dr C J Bowen 2007
12
Far Infra Red Therapy
The health benefits of saunas have been acknowledged since Roman times, when the restorative
and health promotional effects were utilised by all classes in society, particularly by military
personnel, who had to maintain peak levels of fitness. Traditionally saunas have been used to
reduce pain, improve mental clarity and promote longevity. Recently, however, in the ‘age of
detox’, the hyperthermic effects (raising the core body temperature) of saunas, especially far infra
red saunas, have been studied and shown to provide a relatively simple and highly effective method
of detoxification of heavy metals and organic toxins such as pesticides, stimulating the circulation
and helping the body heal and prevent further disease.
The Physics of Far Infra Red:
Infra red (IR) rays are one form of energy given out by the sun (other forms include visible light
and ultra-violet rays). They have a wavelength longer than that of the spectrum we call visible light,
but shorter than microwaves and sound waves. The human eye cannot see IR rays, but heat-seeking
devices, some animals and night vision equipment can. Infra Red waves are what we feel as warmth
on our skin on a bright sunny day; which very quickly stops when cloud covers the sun.
Infra red waves can be divided into three groups: near, medium and far, depending on their
wavelength and their position relative to the red (visible light) spectrum. The longest (far)
wavelengths are those pertinent to Far infra red therapy, as it is these particular wavelengths which
penetrate the body an appropriate distance and cause the desired detoxification.
What is Far Infra Red Therapy?
The initial discovery of the effectiveness of Far Infra Red rays (FIR) came through work by NASA
to maintain the fitness of their astronauts during extended space missions. The requirement was to
replicate the muscle toning and detoxifying effects of exercise for the astronauts during missions
when physical exercise was impossible. Researchers recognised that sweating was one aspect key to
these positive effects and they found that by exposing bodies to the right FIR radiation they could
achieve the same health results without exercise.
FIR works because the billions of water molecules within the body will vibrate (resonate) when
exposed to a certain frequency (or wavelength). The wavelength for this natural vibration is around
10 microns (a micron is a millionth of a metre) and the FIR spectrum includes waves of this length.
Cells that are exposed to 10 micron FIR waves resonate (i.e. become excited). In this condition they
begin to release the toxins that have built up over many years of exposure to our modern
environment. In fact this excitement causes the cell material to warm up and then the released
toxins can be washed out. The displaced toxins can then either be removed via sweat, through the
skin, via the intestines (in faeces), or via the lymphatic system (the body’s own detox system).
Although sweating is the usual method of removal, it has been shown that even individuals unable
to sweat still detoxify well using FIR, through other bodily fluids.
Conventional saunas use high temperatures in order to induce high levels of sweating (often greater
than 80°c). Some individuals find the heat too difficult to tolerate, so FIR saunas provide a
comfortable alternative. Since FIRS rely on using resonance (molecule excitation) more than
general heating to produce the sweat, they typically run at much lower temperatures; between about
37°c and 50°c (100 -130°f). The FIR rays penetrate one to two inches into the subcutaneous layers.
This activation triggers release of cell toxins at this level.
© Dr C J Bowen 2007
13
As the FIR detoxification progresses, the toxins in the outer fat layers will be dislodged first. The
deeper ones will gradually move outwards and thence be expelled. The belief is that as the body
frees up these ‘safe storage’ areas (i.e. likely to cause less damage to the individual than those
lodged in more important places), it will cause the toxins stored in the ‘unsafe’ areas of the body
(the deeper tissues, such as the internal organs and the brain) to migrate into the subcutaneous
layers. As long as the FIR treatment continues, there they will be exposed to the 10 micron
wavelengths and a virtuous cycle of detoxification is set up.
What evidence is there that it works?
Far infra red therapy is already used extensively in Japan and is widely accepted as standard
treatment. Although not yet as widely used in the west, increasing numbers of clinics and
practitioners are starting to incorporate FIR treatments in their management plans.
Several studies provide evidence that the sweat produced from FIRS
use contains more toxins than that produced in conventional saunas.
One study reportedly examined the sweat from a conventional sauna
and from a FIR sauna. In the Swedish type the sweat contained 95 97% water. In the case of the FIR the water content was only 80-85%.
The remainder was cholesterol, fat-soluble toxins, toxic heavy metals,
sulphuric acid, sodium, ammonia and uric acid.
It has also been shown that levels of toxins such as volatile organic
compounds (VOCs) and toxic metals in fat cell biopsies have been
reduced in individuals following a course of FIR treatments.
Recent research carried out in Japan investigated the effects of FIR
therapy on two patients with Chronic Fatigue Syndrome. After twentyfive daily sessions of FIR, symptoms such as fatigue, pain, sleep disturbance and low-grade fever
were dramatically improved. The subjects showed no relapse or exacerbation of symptoms during
the first year after finishing the study.
How can individuals use FIR at home?
Several health clinics and treatment centres now have FIR Saunas installed, which individuals can
hire for sessions, with showering facilities available for afterwards. The ideal, however, is a unit
within the home, which can be used on a daily basis (and precludes the inconvenience of travel etc).
There are now a range of units on the market offering FIR treatments. These include wooden
cabins, portable ‘tent like’ (fabric) units (generally the cheapest option), as well as sleeping bags,
mattresses, pads and ‘dome’ units to cater for specific parts of the body. Prices start at about £100
and go on up to several thousands for large free standing multi person log cabins.
F IR B lanket /
In order to receive appropriate FIR therapy the body needs to be exposed to an energy field of the
correct wave length (around 1 to 20 microns). ‘All over’ body sleeping
coverage isbag
ideal. FIR waves travel
© Dr C J Bowen 2007
14
in straight lines and are absorbed by materials through which they pass (wood in particular).
However the waves can be reflected and focused to intensify the beam.
The stronger the output of 10 micron FIR rays within the unit and the closer the emitters are to the
surface of the skin the more powerful the treatment will be.
As described previously, it is essential to begin any detoxification programme at a rate and intensity
appropriate to the individual concerned. In the case of FIR therapy for a very ill individual, this may
entail only five minutes of treatment a day at first (possibly even less) and the incremental increase
in therapy according to response.
Following FIR therapy sessions it is important to wash off sweat produced, to prevent reabsorption
of toxins. If a shower is not feasible for the individual, wiping thoroughly with a damp face cloth or
towel is adequate. It is necessary to replace water sweated out as well as increase fluid intake to
help flush out the toxins displaced into the lymphatic system and bloodstream, so drinking more
water after treatments is recommended. It is also advised to rest after initial sessions and avoid
exposure to heavy meals, caffeine and alcohol.
There are a variety of FIR units available for purchase online. For further
information on specific, high quality, good value FIRS units or to arrange an
individualised treatment programme using FIR technology, please contact Get-Fitt
Ltd on 01923 855 588.
© Dr C J Bowen 2007
15
Lymphatic Therapy
Massage specifically aimed at drainage within the lymphatic system activates inhibitory cells whose
function is to dampen the sensation of pain. Furthermore, it’s believed that lymph drainage has
immunological benefits by increasing activity of macrophages (white blood cells which ingest
foreign nasties in the body), and stimulating the parasympathetic nervous system, causing calmness
and relaxation. This means that the right kind of massage can improve lymphatic function, thereby
assisting the body’s healing, detoxification, and pain relief.
A small pilot study in 2003 found improvement of M.E. / CFS symptoms (including pain, stiffness,
sleep disturbance and low mood) following four weeks of fairly intensive manual lymphatic
drainage covering the entire body. Five months after this period of treatment, pain levels and
fatigue remained improved (although the improvement was not sustained in other symptoms).
(HELTh) is a combined massage and mild moist heat
hyperthermia treatment. Its purpose is to stimulate the vascular circulation to enhance both the
movement of blood and lymph in the vascular and lymphatic systems to provoke beneficial changes
to the structure of the blood and lymphatic vessels.
HEAT ENHANCED LYMPHATIC THERAPY
HELTh is used to clear the superficial, mid and deep lymphatic vessels throughout the body, which
have become congested through trauma. When the body sustains any kind of damage or impact
(and this can be any time from birth onwards, including traumatic birth) an area of congestion
develops. Over time, this congestion becomes more solid and may hold fluid around the area, thus
giving an apparent increase in body size and blocking the natural flow of some body fluids.
HELTh is a gentle and safe treatment and is a suitable therapy for many illnesses. Though HELTh
does not purport to replace other treatments, nor does it claim to cure any diseases, it may be
helpful in: Diabetes, Immune weaknesses, peripheral oedema, injury rehabilitation, arthritis,
glaucoma, stress and atherosclerosis, as well as Fibromyalgia and ME / CFS.
HELTh is performed by specially trained practitioners. During an initial consultation, a full medical
history is taken and physical assessment carried out before treatment commences. Treatment
sessions may vary from one to two hours, during which time the body temperature, blood pressure
and skin temperature are monitored and recorded. The massage technique follows a systematic
pattern, including the use of gentle and deep strokes. Physiothermic Saturated Moist Heat
Technology is used to create a whole or part body temperature-controlled moist heat wrap. After
each session it is necessary to rest and re-hydrate.
Further to the positive detoxifying effects provided by working on the lymphatic system, as
described above, studies have shown how massage can produce other benefits in individuals with
ME / CFS, including the following:
 Massage reduces pain, lessens stiffness and fatigue.
 Massage improves the body’s natural ability to destroy invading organisms (such as bacteria)
and eliminate other negative substances and waste products.
 It seems probable that deeper tissue massage may cause the release of endorphins (the
body’s natural pain killing opiates) leading to an improved sense of well-being.
If HELTh is not accessible for individuals, any tissue massage, concentrating on lymphatic
decongestion, carried out by an appropriately experienced massage therapist can be very helpful for
individuals.
Due to the pain and tenderness symptomatic of ME / CFS, massage therapy for such individuals
may not be the pleasurable experience found by healthy people. However, if carried out gently,
© Dr C J Bowen 2007
16
increasing intensity only as and when appropriate; when easily tolerated by the patient, with good
aftercare advice, the benefits of regular deep massage should soon be apparent to ME / CFS
patients.
Use http://www.massagetherapy.co.uk to find a therapist in your area.
© Dr C J Bowen 2007
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Thermal Lymphatic Massage: Lymphatic Drainage Technique
The recommended, gold standard form of massage for lymphatic decongestion is HEAT ENHANCED
LYMPHATIC THERAPY (HELTh). However, if HELTh is unavailable, Thermal Lymphatic Massage is a
cheap and relatively easy method for individuals to stimulate their own lymphatic system; to encourage
dispersal of congestion and elimination of toxins. It also aims to stimulate the blood circulatory system and
encourage general relaxation. This is not a comprehensive detoxing treatment and wherever possible, an
experienced practitioner should be consulted by an individual. Despite being simple to carry out oneself (or
for a willing partner to oblige), the effects of the following may be quite powerful and it’s important to
recognise that the process of toxin elimination (as following various other treatments) may result in
temporary negative symptoms such as changes in bowel habit, runny nose, muzzy head etc. These
symptoms do show that the process is being effective however, and can be minimised by following standard
after care advice such as drinking adequate water, resting wherever possible, avoiding caffeine and alcohol
and eating a light diet.
In order to increase the effectiveness of lymphatic stimulation / drainage techniques, heat can be used; either
in the form of a warm bath, or by using heated wheat bags, placing a hot damp flannel between the bags and
the skin. Dry heat can be dehydrating, which is less beneficial than moist heat. Often people with ME / CFS
find hot baths uncomfortable and feel ill after them. This is likely to be due to various reasons, but if they
can be tolerated occasionally, and followed by a good intake of water and rest, they can aid the
detoxification process and thereby help to reduce symptoms.
The process described below can either be carried out in a deep warm bath, to combine the effects of heat
and massage, or on a bed, followed by body heating in some other way (such as the moist wheat bag method
described above). Like any therapy, the needs of the individual must be assessed before attempting massage;
carrying out the following may result in some detox symptoms, but should not cause someone to over-spend
their energy to too great a degree, or directly cause an increase in pain levels. This treatment should also not
be carried out in individuals who have known abnormalities in their lymphatic system (such as lymph nodes
removed via surgery or permanently blocked lymphatic vessels) or on broken or damaged skin. If in doubt,
consult a qualified and experienced lymphatic massage practitioner.
The therapy involves a systematic full body massage including work on face and scalp and consists of a
combination of light strokes and deeper massage movements, as feels appropriate for the individual.
Treatment Plan:
•
Face: Using the fingertips of each hand (one side at a time if necessary), starting in the middle of
the forehead, massage working out towards and then over the top of your ears, applying pressure to
the skin. Continue this motion, always moving from the centre outwards, above the eyebrows, under
the eyes, across the cheeks, under the nose, across the mouth and chin. Repeat this a few times.
Then place both hands over your face and making a movement similar to that used when washing
your face, but pressing more firmly, gently massage the entire face, keeping your face muscles as
relaxed as possible. I know this sounds like an odd instruction, but it can be surprisingly effective at
relaxing the facial muscles and stimulating lymph drainage.
•
Scalp: Using the fingertips of both hands (one hand at a time if necessary due to fatigue), place
your hands on top of your head and, applying pressure to the scalp (on top of hair), pull downwards
towards the back of your neck. Repeat a few times.
•
Neck: Place your fingertips at the base of the skull, at the top of your neck, moving hair out of the
way if necessary to really feel the skull. With short, downward movements, gently apply pressure to
the back of the neck towards the centre of the top of the back. Continue this downward pulling,
working outwards from the centre of the back of your neck.
Now use your fingertips to apply skin pressure in a downward motion from the line of the jaw-bone
towards the collar bones, particularly either side of the midline, where you may be able to feel your
cervical (neck) lymph nodes as you massage downwards.
© Dr C J Bowen 2007
18
•
Shoulders: With the flat of your right hand, reach as far as you can, comfortably, over your
left shoulder. Apply skin pressure and pull / massage forwards over your shoulder, towards your
collar bone and the centre of your chest. Repeat this a few times, continuing the movement over the
collar bone, towards the centre of the chest.
Repeat the above, using your left hand to reach over your right shoulder.
•
Arms: Using the thumb and index finger of your right hand, gently massage each finger and
thumb of your left hand in turn, working from the tip towards the palm. Then, using the fingertips of
your right hand, apply skin pressure and, starting on the back of the hand at the base of the fingers,
pull towards the wrist. Repeat this a few times. Do the same with your fingertips on the palm,
starting at the base of the fingers, moving towards the wrist.
Now raise your left arm slightly (just to be above the level of your heart if any higher is difficult).
Using the flat of your fingers on your right hand, massage / firmly stroke your wrist, forearm and
upper arm, moving towards your body, away from your hand, over all sides, aiming to drain the
lymph from your hand and arm towards your trunk.
Use circular-type movements and the flat of your right hand to massage your left under-arm, trying
to stimulate the lymph nodes there to aid drainage. Repeat this movement several times or as long as
is comfortable.
Repeat the entire arm-drainage using your left hand on your right arm.
•
Chest: Take some deep breaths in and out (not so deep you feel dizzy!). On each out-breath
gently beat the top of your chest with your fists (or with the flats of your fingers if more
comfortable). Repeat a few times, as is comfortable for you.
•
Abdomen: Using the flat of your fingers of your right hand, reach across your body, as far round
your left side as is comfortably possible. Apply skin pressure, pulling towards the centre of your
stomach. Repeat several times, in the same direction, massaging higher up, over your rib-cage and
lower down, over the top of your left hip.
Repeat the above using your left hand, working on the right side of your abdomen.
•
Groin: Lie or half sit-lie, so that the join between your thigh and your abdomen is flat and open.
Using the fingertips of your index, middle and ring fingers on your right hand, massage upwards and
outwards along your right groin crease, starting in between your legs on the right side and massaging
towards your right hip bone. You may be able to feel lymph nodes (glands) in this area and they may
be tender. If so, be quite gentle but massage the nodes particularly in the direction towards your
hipbone. Stimulating the lymph nodes can really help eliminate toxins, but it’s still important not to
overdo it! Repeat the right groin massage several times and then repeat using the left hand in the left
groin.
•
Legs: Using the fingertips of your dominant hand, start at end of your toes of your right foot,
apply medium skin pressure, and using short movements, away from the toes, massage all over the
top of the foot, in the direction of the body. Continue the same kind of skin movements, using the
fingertips of both hands, slowly moving up the leg to the knee, and covering all sides in turn. If
certain areas are particularly tender (for example the outside of the lower leg), it is likely that this is
an area of greater lymphatic congestion and requires more working on. Once the lower leg has been
worked on, move up to the thigh. Using the fingertips of both hands, apply skin pressure and
massage towards the body, from the knee up to the top of the leg. Repeat this movement several
times on top of the thigh, on the underside and on either side of the thigh.
Repeat the instructions for working on the groin above; so that the lymph you have encouraged to
drain up from your leg does not then end up congesting the groin area. Repeat the above steps for
Legs on the left leg and left groin.
Following treatment ensure an adequate intake of water, rest as and when your body feels it necessary,
avoid caffeine and alcohol for a few hours and try and eat a light diet rather than very large meals or hardto-digest foods.
© Dr C J Bowen 2007
19
The Sun Ancon Chi Machine
This is a device which enables the user to undertake aerobic exercise without doing anything more
than lying on the floor, resting their legs on a portable machine. The side to side oscillations of the
ankle rest on top of the Chi Machine cause the legs, trunk, arms and head to move in what is known
as the ‘body inherent eight’. In other words, like a fish or snake.
Doctor Shizuo Inoue, Chairman of the Japanese Oxygen Health Association, wanted to find a way
to make the human body oxygen-efficient without the need for time consuming meditation or
strenuous exercise, which consumes excess oxygen generated with movement. In the early 1950’s,
he theorised that Japanese Koi carp were always healthy and well toned due to the perpetual
movement of their spines. With a team of engineers and physiologists he then designed a device
which produced a precise rate of oscillation within a well-defined range of motion, which raised
both blood oxygen and levels of energy of the patient.
Clinical trial results show that the Sun Ancon is proven to improve lymphatic drainage, reduce body
fat and body weight and also provide pain relief.
Anecdotal evidence suggests that people with all kinds of conditions can find benefit from the Chi
Machine. As well as those with M.E. / CFS, they include individuals with:
• Arthritis
• Anxiety
• Sports injuries
• Menstrual problems
• Lymphoedema
• Osteoporosis
Today there are many imitation ‘Chi Machines’ on the market, which are generally cheaper and at
first sight appear no different from the original Sun Ancon machines. However, the Sun Ancon
device is the only one which has been clinically tested (in Southern Australia) and carries a unique
speed, height, angle, swing motion and motor, which is different from the imitation devices. It’s
believed that there is only one speed and swing motion suitable for the body’s physiology, so for
anyone pursuing this line of detoxification, this is worthy of note.
© Dr C J Bowen 2007
20
Dry Skin Brushing Exercise
The skin is the largest organ in the body and it’s believed that a quarter of our daily bodily
detoxification occurs via the skin. Dry skin brushing tones the immune and circulatory systems. It
can reduce the duration of infection and accelerate the clearing of toxins by stimulating the
lymphatic system. If skin hypersensitivity is a problem for an individual, skin brushing needs to be
carried out very carefully and gently so as to be tolerated. Ideally this exercise is carried out a few
times a week, but only if and when tolerable. Always try and brush towards the heart and avoid any
areas which are sensitive or have skin problems.
All that you need to effectively carry out dry skin brushing is a soft, dry, skin brush. Preferably a
brush with natural bristles is used, although this is not essential.
Caution: If you are severely unwell, even dry skin brushing may be too much for your system. If
your practitioner advises against it, or you experience increased M.E. fatigue and symptoms
following initial practice, please refrain until your system is more stable.
1. Using your right hand, gently slide the brush along your right jaw line starting from your
earlobe to the underside of your chin 7 times.
2. Place the brush at the hairline on your neck and gently pull around the right side of your
neck to the Adam's apple site 7 times.
3. Stroke your breastbone in a circular fashion to stimulate the thymus gland. Carefully brush
the right breast in a circular motion.
4. Repeat steps 1, 2 and 3 on your left side holding the brush with your left hand.
5. Hold the brush in your left armpit with your right hand and gently move it around in a tiny
circle counter clockwise 7 items, then clockwise 7 times. Repeat in your right armpit with
your left hand.
6. Brush upward 7 times from your upper right thigh to your right armpit. Repeat process on
your left side.
7. Brush back and forth over your belly button and around your waistline 14 times (like passing
a basketball behind your back).
8. Brush in a circular motion over your belly-button, counter-clockwise 7 times then clockwise
7 times. Finish brushing the front of your body in any direction starting at the bottom and
brushing all the way up 14 times. Very little pressure needs to be applied to the genitals and
women's breasts because the skin is sensitive and will redden if irritated.
9. Brush up and down your spine from the base of your neck and down as far as you can reach
14 times. Finish your upper back by stroking it from as near the spine as you can reach,
round to the front; towards your chest / stomach.
10. Brush your spine from tailbone up as high as you can reach 14 times, holding the brush with
two hands. Finish your lower back by stroking it around toward your sides from the spine.
11. Hold the brush in the right groin with both hands and brush upwards and outwards along
your right groin crease towards your hip bone. Repeat 7 times and then repeat in the left
groin.
12. Brush from right knee to right hip 7 times. Work all the way around your leg continuing to
brush upwards (towards the heart).
13. Brush up from right ankle to right knee and work all the way around your leg, brushing up
towards your heart.
21
14. Brush around your right ankle 7 times.
15. Brush back and forth over the top of your right foot from toes to ankle.
16. Brush across your right toes on top and underneath 7 times.
17. Brush the bottom of your right foot heel to toe 7 times.
18. Repeat numbers 12-17 for your left thigh, left leg and foot.
19. Brushing upward from right elbow to your armpit and shoulder, cover that entire area 7
times.
20. Brush from your right wrist to the elbow in the same manner 7 times.
21. Repeat numbers 19-20 for your left arm.
22. Brush each left hand finger individually back and forth 7 times on areas that have not been
brushed yet. Repeat for your right hand.
Other methods of detoxification
Many other methods of detoxification and lymphatic decongestion are also available fairly easily
these days. Those previously discussed are the methods I have found most useful and observed to
be most beneficial. Other ways to aid detoxification include the following:
Bowen Therapy: (A holistic body therapy, which uses gentle manipulation of muscles and soft
tissues to stimulate release of tension and stress, helping the body to use its own resources to detox
and heal).
Reflexology: This is a method of stimulating certain pressure points in the feet and sometimes in
the hands. Stimulating these pressure points is believed to result in a reflex action in the
corresponding area of the body. With controlled thumb and finger techniques, the entire body can
be encouraged to relax and repair itself. The theory is that reflexology enables the release of
blockages within the individual; physical, mental and emotional. This aids the overall detoxification
and healing process. As with many other therapies described here, reflexology can have very
powerful effects and it’s important to be treated by a sympathetic and experienced practitioner, who
will accurately assess how far to take your treatment and when you’ve ‘had enough’!
To book a reflexology session with a highly competent reflexologist, who has
excellent experience working with people with M.E. / CFS, please call Jane
Sheehan on +44(0)773-980-2175 or visit www.footreading.com/reflex.htm.
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Avoiding further toxin build-up
This should be accomplished to some extent by reducing oxidants (toxins) consumed via diet. (See
Diet and Supplementation pages). However, in order to fully achieve this aim, there are also other
considerations. The majority of these consist of avoidance. The extent to which it is possible to
avoid the following will vary between individuals, but acknowledging that exposure to these
oxidants may have an effect on ME / CFS, then aiming to at least reduce exposure, is a reasonable
start.
Avoidance of antibiotic abuse: If antibiotics are required to treat a significant
infection, obviously their use should not be avoided. However, if their use is not deemed essential
they should be kept away. This goes for other medications too; if a drug is considered crucial for
life or well being, it should be administered, but if effective alternative means of therapy can be
utilised, they should be used wherever possible. It is also important to note that due to toxin buildup and a hypersensitive system, individuals with ME / CFS often require much smaller doses of
drugs than other patients (levels considered sub-therapeutic by some physicians will often bring
about significant results in ME / CFS individuals) (and unfortunately often significant side effects
too).
Avoidance of synthetic hormones: this includes avoiding use of the oral
contraceptive pill (OCP) and hormone replacement therapy (HRT). If all aspects of Five Steps to
Health are adhered to, and full health is achieved and maintained, hormonal dysregulation is much
less likely to be an issue, obviating the need for synthetic hormones. Contraception, however, may
still be an issue; if other methods are not satisfactory to the individual, the OCP may be the only
option. However, it should be recognised that this may have a significant effect on health when
started / restarted.
Avoidance of pollutants such as cigarette smoke, exhaust fumes&
heavy metal compounds: Aside from moving to a remote area away from civilisation, this
is controllable only to a certain extent. However, avoiding smoke-filled rooms, wearing a scarf
across the face if walking along congested streets, and opting for non-heavy-metal dental work is a
reasonable course of action for most people. Individuals with ME / CFS who smoke have a great
opportunity to decrease the amount of man-made oxidants they inhale by giving up!
Reduced exposure to radiation: There is some evidence that a factor in the cause
of ME / CFS may be over-exposure to electromagnetic waves. Following studies in Japan, on
children with ME / CFS symptoms, Dr Ryoichi Ogawa states, “reduced cerebral (brain) blood flow
may possibly result from the influence of electromagnetic waves from IT equipment”. A link has
also been observed between individuals with ME / CFS and significant exposure to low level (50 60 Hz) electromagnetic fields (EMFs). Although evidence is still being gathered to support this
hypothesis, it seems logical to avoid exposure to EMFs wherever possible, as this avoidance will
certainly not have a deleterious health effect, and may have a beneficial result. Reduced exposure is
therefore advised regarding power lines and electricity power stations, as well as reducing use of
appliances such computers and mobile phones (as is reasonably possible).
23
Improving
Oxygenation
 Introduction
 Breathing Exercises
 Activated Air Therapy
 Optimising Airnergy
24
Introduction
Oxygen therapies include treatments with ozone (O3; an activated form of Oxygen), hyperbaric
(high pressure) oxygen and hydrogen peroxide. Oxygen therapies have been shown to help
individuals with ME / CFS. Since oxygenation deprivation is a major factor in the development of
the condition, this is perhaps not surprising (although other factors need also to be addressed in
order to achieve full health).
According to Frank Shallenberger, M.D, author of The Principles and Applications of Ozone
Therapy, oxygen therapies affect the human body in many positive ways, including the following:
1. They stimulate the production of white blood cells, which are necessary to fight infection.
2. They increase the delivery of oxygen from the blood to the cells.
3. They increase red blood cell membrane flexibility and effectiveness.
4. They increase the production of interferon and tumour necrosis factor, which the body uses
to fight infections.
5. They increase the efficiency of the anti-oxidant enzyme system, which scavenges excess
free radicals in the body.
Traditional oxygen therapies can be difficult to access, unpleasant to apply (e.g. hydrogen peroxide
drinks) and long term costs of treatment can be high. These therapies also have the disadvantage of
potentially giving the individual too much oxygen. This can then cause production of further free
radicals, causing greater oxidative stress (the damage caused by free radicals), thus undoing any
beneficial effect the treatment initially had.
Five Steps to Health, therefore, recommends use of a different type of oxygen therapy; use of an
Airnergy+ device that provides activated oxygen therapy. Although costing a significant initial
outlay, running costs (therefore long-term costs) are low. Very simply, the individual inhales
activated air through a tube (nasal cannula) connected to this Singlet Oxygen Energy Device. The
device pulls in environmental air through an air filter, and in an “activation chamber” energizes it
with Singlet Oxygen energy. This energized air is then passed through a humidifier and then
transported to the individual’s nostrils. No “extra” oxygen is breathed in, but the effects of the
activated oxygen prove very powerful.
A much cheaper and more simple way of improving oxygenation is to practise breathing exercises
such as those shown in the following few pages. Of course, sustained effort is required and the
effects may not be as noticeable or dramatic (at least initially) as they may be when using an
Airnergy+ device. However, only a couple of suggestions follow here; there is a plethora of
breathing exercises out there; in yogic traditions these exercises (or pranayama) are an important
part of daily routines to maintain physical and mental health. For people who are interested in
following this path further, the internet provides numerous resources, as do all good bookshops and
libraries.
25
Breathing Exercises
Because of our lifestyle, most of us use little more than 10% of our lung capacity and as a result we
are susceptible to all kinds of health problems. Breathing techniques such as those which follow
help to service the other 90% of our lungs.
Due to fatigue and pain, individuals with ME / CFS often develop poor breathing patterns. They
may take very shallow breaths and often enter a state of hyperventilation. In order to maximise the
amount of oxygen breathed in (and the amount of carbon dioxide breathed out) it is important to
regulate breathing; taking deep and slow breaths. This can be achieved to some extent by relaxation
therapies such as hypnosis, meditation and breathing exercises.
Why breathe through your nose?
When you breathe through your mouth, you only inflate the top area of the lungs, which is
connected to the sympathetic nerve fibres (that activate the fight or flight response).
When you breathe through the nose, you’re inflating the entire lung and lower lobes that connect
more to the parasympathetic nervous system. This helps to calm the body and slows the heart rate.
Basic Exercise: try this exercise sitting, standing or lying down.
1. Exhale deeply, contracting the abdomen.
2. Inhale slowly as you expand the abdomen.
3. Continue inhaling as you expand the chest.
4. Continue inhaling as you raise the shoulders up towards your ears.
5. Hold for a few comfortable seconds
6. Exhale in reverse pattern, slowly: release shoulders, relax chest, contract the belly.
7. Repeat.
This exercise will require gentle practice in order that inhalation and exhalation be smooth and
balanced. Beginners should only do it 2 or 3 times continuously.
Seagull Deep Breathing Technique:
Breathing through the nose, this technique can be done standing or sitting.
•
•
•
•
•
•
•
•
•
Interlace your fingers.
Lift your hands, palms together and place the knuckles firmly under your chin.
Keep the elbows together.
Keep the knuckles to the chin throughout the exercise.
Inhale slowly as much air as is comfortable; at the same time raise the elbows, like seagull
wings, on either side of the head.
Pressing the chin into the hands, do not bend forward.
When ready to breathe out bring your elbows back to the starting position.
Keep knuckles pressed into chin throughout the exercise.
Up to 10 breaths if possible.
This exercise can be done before any kind of physical activity because it expands the lungs and
increases circulation to the whole body. This helps by taking more oxygen into the bloodstream and
preparing the muscles for action.
26
Butterfly Deep Breathing Technique:
Stand or sit in a good posture. If standing, have your knees slightly flexed.
• Clasp your hands behind the neck, fingers interlaced.
• Inhale slowly through the nose, at the same time pulling your elbows back as far as
comfortable, like the wings of a butterfly.
• Now as you exhale through the nose, bend slowly forward bringing the elbows back together
and the chin to the chest.
• Begin inhaling again, pulling your elbows open and back until your butterfly wings are fully
spread.
• Repeat up to 12 times, breathing slowly and rhythmically through your nose, expanding and
contracting your chest with each in and out breath.
Move gently at all times, without jerking your head or neck.
Alternate Nostril Breathing (Nadi shodhana)
1. Close the right nostril by pressing against your nose with your right thumb and inhale
through the left nostril. Do this to a slow count of four.
2. Immediately close the left nostril with your right ring finger and little finger. At the same
time remove your thumb from your right nostril and exhale through your right nostril. Do
this for a slow count of eight, or as long as you can, without straining or becoming dizzy or
fatigued. This completes a half round.
3. Inhale through the right nostril to a slow count of four. Close the right nostril again with your
right thumb and exhale through the left nostril for a slow count of eight. This completes one
full round.
Start by doing three rounds, adding one per week until you are doing seven rounds. At first it may
be hard to make the out breath last for a count of eight. If difficult, don’t strain yourself, just breathe
out for as long as is comfortable and slowly build up as you continue to practice.
Alternate nostril breathing should not be practised if you have a cold or if your nasal passages are
blocked in any way. Forced breathing through the nose may lead to complications. In pranayama it
is important to follow this rule: under no circumstances should anything be forced.
27
Activated Air Therapy
Have you ever wondered why walking through woodland after a rainstorm can evoke such a great
feeling of well-being? The “connecting with nature” and distance from the hustle and bustle of
ordinary life may well be a factor. However, another factor may be that oxygen is entering your
body in a more energised, activated state, due to the effects of sunlight on leaves covered with
raindrops. This is the basis for a relatively new therapy, which provides the body with extraenergised or ‘activated’ air, boosting oxygen delivery and improving the process of energy
production in cells.
These are just a couple of the many studies in which researchers have found that oxygen therapies
have helped individuals with ME / CFS:
• Scholey et al (1998) found cognitive symptoms improved when oxygen was administered.
• In 2004, Yildiz et al found a decrease in tenderness of Fibromyalgia points, reduced pain
scores and an increase in pain threshold in a group of Fibromylagia patients after a series of
hyperbaric oxygen treatments (long term changes were not followed up).
• Ali (1999) found improvement in a variety of ME / CFS symptoms using various oxygen
therapies including ozone, hydrogen peroxide and nasal oxygen.
What is Activated Air therapy?
Activated Air Therapy is a new technology, developed in Germany over the past few years, which
helps the body make better use of the oxygen naturally
present in air. By means of a patented process, similar to
photosynthesis, oxygen in the air is momentarily converted
into a singlet state.
Singlet state is the active form of oxygen found within the
body for use in vital metabolic reactions.
Energy, released as the oxygen returns to its original state, is
absorbed by water molecules. It is these high-energy water
molecules (rather than actual singlet oxygen) which are then
inhaled through a lightweight nasal cannula (plastic tube). Once inside the body, the extra-energy in
these water molecules eases the transport of oxygen to cells and then facilitates the use of the
oxygen in basic metabolic processes. This then enhances the functioning of cells throughout the
body; improving performance of healthy individuals and kick-starting the healing process in those
who are ill.
Why do we need it?
Oxygen makes up around 21% of atmospheric air. Although this is what we inhale as standard,
even a very healthy person utilises only a small fraction of this. Advancing age, stress, sickness and
poor nutritional status (all common problems in today’s society) further decrease the proportion of
oxygen utilised. This means that our bodies are often struggling to maintain essential cellular
processes such as energy production, repair and protection of cells. This situation not only
contributes to many disease states, but also predisposes cells to damage by free radicals.
In order to improve metabolic reactions in cells and increase cellular defences against free radicals,
we need to improve the efficiency with which these processes are carried out. Activated air therapy
offers a method for doing this by providing the body with oxygen in a more ‘useable’ form (as
described above).
28
How does Activated Air Therapy compare to other ‘Oxygen therapies’?
Other oxygen therapies are based on the assumption that providing the body with more oxygen will
mean more oxygen is actually used by cells, so aerobic (oxygen-requiring) metabolic reactions will
work better. Although traditional oxygen therapies (such as Hyperbaric oxygen therapy and
hydrogen peroxide) have produced excellent results in a diverse range of applications, they are not
without problems. Aside from specific therapy-related complications (such as pressure-related
injury in hyperbaric therapy), oxygen toxicity is a significant concern. Toxicity results from the
formation of oxygen free radicals. As previously described, these are damaging particles that arise
within mitochondria (the ‘batteries’ of cells) as energy is produced. Injury caused by these free
radicals can result in variably severe diseases. Free radical damage is also thought to be the cause of
premature biological ageing. In health, the body uses its well-developed anti-oxidant enzyme
defence system to neutralise free radicals and prevent damage. But if the anti-oxidant system is
weak (as it often is in disease states), or the system is overloaded with free radicals (as can occur
with excessive oxygen inhalation), they can start to cause major problems for an individual.
Activated air therapy, such as provided by an Airnergy+ device, is free from these disadvantages,
but appears to offer all the benefits. The thought behind this technology is that the limiting factor
for metabolism is not the amount of oxygen, but rather the body’s ability to use it.
In terms of oxygen metabolism, it is an issue of quality and efficiency versus quantity. Traditional
oxygen therapies aim to increase the latter, whilst Activated air therapy, via an Airnergy+ device,
offers a highly convenient and accessible method of improving the former.
Maintaining physiological concentrations and proportions of oxygen not only prevents oxygen
toxicity, but activated air therapy has also been shown to help against free radical damage by
increasing production of anti-oxidant enzymes. This may have major implications in its own right,
in terms of reducing the effects of ageing and counteracting oxidative stress in modern diseases.
What evidence is there for Activated Air Therapy benefits?
Numerous testimonials show the dramatic effect activated air therapy has on a wide range of health
issues. For some of the conditions (such as M.E. / CFS) which have been helped, there are few
established treatments. For others (such as arthritis, bowel disorders, allergies, asthma, and cancer),
activated air therapy provides an excellent treatment to augment other therapies and provide
symptom relief and promotion of healing in its own right.
Several in vivo studies also demonstrate the effectiveness of this new technology: in a comparative
study with inhaled concentrated oxygen, activated air therapy resulted in significant improvements
in subjects’ peak flow rates (lung capacity) and other markers of metabolic efficiency including
pulse rate and breathing rate. Inhaling concentrated oxygen caused no significant improvements and
actually caused a decrease in peak flow rates immediately after treatment.
Of the various studies carried out, examining the effects of this treatment, an investigation done in
Finland with 10 high performance sportsmen (long distance runners) showed after only two weeks
treatment with activated air (10 treatments of 20 minutes each) the following results:
•
The blood absorbed 7% more oxygen.
•
Energy production increased by 8%.
•
After performance, 8% less lactic acid was found in the blood.
The results were all statistically significant. In another investigation done in Stockholm with 10
healthy individuals, after only 2 weeks of inhalation (totalling 6 treatments of 20 minutes each) the
following results were found:
29
•
The total antioxidant status (the capacity of the blood to cope with free radical production)
was increased by 20%.
•
Blood levels of cholesterol decreased by 10%
•
Blood levels of triglycerides (“bad” fats) decreased by 25%
Other studies have shown that activated-oxygen treatment decreases oxidative stress, produces a
powerful reduction of pain and a faster healing process.
With regard to Airnergy+ Therapy for ME / CFS individuals, it seems likely that beneficial results
are observed due to the following effects:
o Increased oxygen delivery into cells increases the amount of oxygen available for metabolic
reactions, thereby increasing energy production and consequently the efficiency of the
whole body.
o By improving intracellular oxygen metabolism, and thereby cellular function, the body’s
self-repair systems become better equipped to eliminate waste products, repair oxidative
damage and prevent further injury.
These (and maybe other) effects combine to reduce symptoms in ME / CFS individuals and begin to
return them to a state of health from within.
Are there any side effects from treatment?
This technology involves the inhalation of atmospheric air which has had no synthetic substances
added to it. The chemo-luminescence reaction that the air undergoes only alters its state for a
fraction of a second. The therapy cannot harm an individual. In a minority of cases, users
experience the symptoms of a healing reaction when undertaking treatment. As with other
therapies, these effects can be minimised by standard measures such as drinking water, rest,
avoidance of stimulants and gradual increasing of treatment duration.
For further information on activated air therapy in the UK, visit
http://www.biolifesolutions.co.uk or contact BioLife Solutions Ltd on 01938-556800.
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Optimising Airnergy+ Use in ME / CFS:
These are some suggestions for optimising the effects of your Airnergy+ device, to help you get the
most benefit from it. Airnergy+ is not a miracle cure, for any condition. However, it is believed to
help repair some of the organic damage suffered by individuals with illness, and to enable the body
to then use its own defences to reach an improved state of health. A large number of people have
found this treatment to be life-changing in a very positive way.
It appears (from collective experience) that there are two major issues likely to affect individuals
with M.E / CFS as they begin to use their Airnergy device regularly. These are the following:
1. Becoming disappointed when the Airnergy treatment has not cured everything within a
couple of weeks and feeling disillusioned with the whole process, believing it not to be
working, subsequently giving up on using the device.
2. Having more energy and feeling generally better due to the machine, and developing a sense
of invincibility, then increasing activity levels dramatically, causing a relapse in the
condition and consequent disappointment and disillusionment.
The fact is that every individual is unique and as such will have a different experience in terms of
noticing the positive effects from the device. In some people, effects may be noticeable
immediately, upon the first treatment. In others it may take days or several weeks before they notice
health improvements. Due to the cellular level that the activated oxygen is working at, positive
changes may be occurring within the body of which the individual is unaware of until these effects
combine with others to give them an obvious sense of improved health. Some people also find that
they experience positive effects each time they use the Airnergy device, but that these effects are
not sustained. Since this treatment has a cumulative effect, it is very likely that these positive effects
will eventually become more permanent, but this too will take varying lengths of time. For someone
who is able to give their body the chance to rest as necessary and is able to avoid stresses of work,
family etc, this period of time is likely to be a great deal shorter (perhaps weeks / months) than an
individual whose body and mind is continually under pressure – from work, family etc, whose
situation is effectively allowing fewer resources for the body to utilise the activated oxygen and
heal itself.
When the health improvements do begin, some people may not initially be aware of them,
particularly in relation to increased energy levels. This is because the majority of individuals with
M.E. / CFS are naturally active people, who will generally be doing all the activity that their health
allows. Although this is a commendable characteristic, it can also be very detrimental to health,
perhaps particularly during improvement phases of this condition. It may be of use to record daily
activity levels (i.e. how time has been spent during waking hours), to compare levels of activity
over a few weeks / months. Some people are surprised when doing this, how much more they are
actually doing compared to pre-Airnergy times, without really realising it. This is where issue
number two above can arise.
When considering increasing activity levels in an individual with M.E. / CFS, it may be a useful
idea to remember the 50% rule (for those who are very over-ambitious by nature, the 25% rule may
be more appropriate!) This states that someone works out what they would like to do and
reasonably think they would be able to do, then halve it (i.e. cut it by 50%, or 75% if necessary) to
work out the actual activity level to be attempted. This is one of the biggest challenges faced by
individuals with this condition, as it is often near impossible to stick to, but if carried out
appropriately, particularly during periods of improvement, as hopefully brought about by the Five
Steps to Health guidelines, it can speed up return to health and prevent relapses very effectively.
Doing too much appears to be a significant trap that many people fall into. The consequent relapse
is then associated with immense disappointment and demotivation, further worsening the situation.
31
The alternative is obviously more frustrating as it requires much more patience; it may mean
missing out on events and opportunities when you feel they may be a possibility, after having had
no choice about missing things in general for so long. However, sometimes, “Saying ‘No’ is the
achievement” and will result in a much healthier you, able to do a great deal more than if you are
continually “fighting” with your body.
In order to allow the Airnergy+ to help you return to health, you must acknowledge that this is a
“convalescence period”, in which you must allow your body the time and energy to heal itself,
rather than using up all your time and energy on external factors.
• Regime: Build up use of the Airnergy+ machine very slowly, according to your level of
health (the more unwell an individual, the more likely they are to require low intensity, low
duration treatments for longer). Most individuals aim to build up to 20-30 minutes (at 100%
intensity) twice a day. However, some may find that 3 sessions of 15 minutes or other
variations suit them better. Even if you have been using someone else’s machine a couple of
times a week, don’t rush into high intensity, high duration daily treatments; remember there
is a very big difference between 20-30 minutes twice weekly and 30 minutes daily. After the
first few sessions with the Airnergy+ device, some people find they experience a temporary
healing reaction. This is thought to be due to the powerful effects of the activated oxygen,
displacing toxins from within the body, as healing occurs. It may cause minor symptoms of
headache, dizziness or light-headedness, digestive or urination changes, increased sleepiness
or restlessness. In order to avoid or minimise these effects, follow the suggestions below. If
the symptoms develop during the Airnergy application, stop the session and follow the
advice below. If symptoms are at all intolerable, or remain after a couple of applications
despite the measures below, reassess the duration and intensity of treatment and cut down on
them as necessary for a while, allowing the healing to occur at a more gentle rate, which
should cause fewer symptoms. For a few individuals, it may be necessary to remain at low
duration and intensity for several weeks before building up, in order to prevent strong
healing reactions. N.B not all individuals experience a healing reaction and the lack of it
certainly does not suggest that no therapeutic action is occurring.
o Advice to minimise healing reactions:
 Drink plenty of water, especially during and after using the device (not
just the water from the device bottle).
 Allow the body to rest as much as possible when initially using the
device. Avoid heavy exercise (physical or mental).
 Avoid heavy meals, alcohol and caffeine in the early stages of using the
device. Aim for a light diet.
 Avoid stress wherever possible.
• Device Water: It is important to use good quality bottled water or properly purified water
(not just tap water or tap water filtered in a Brita-type jug). This is to ensure that no
impurities (such as heavy metals or bacterial contaminants) are being breathed in with the
activated oxygen. Approximately 50% – 65% of our bodies are made up of water and a lot of
individuals don’t take in as much water daily as their bodies could well use. Since the aim of
using Airnergy+ is to heal the body as much as possible, it makes sense to provide it with as
many of its essential nutrients as possible, and of the highest standards possible. Buying
bottled water (such as Evian or Volvic) from the supermarket in bulk, costs about £1 a week
if only one or two people are using the machine. Even with several people using the machine
regularly, it costs only a few pounds (sterling) a week.
32
• Water quantity: Fill the bottle (with bottled water) one third to one half full. The ideal
quantity of water is just to the top of where the machine obscures the bottle; so that the
bubbles are just visible when the machine is switched on.
• Cleaning: Clean the water bottle of the Airnergy+ device, including the element (the plastic
tubes and bottle top) regularly, as well as whenever the bottle begins to look cloudy. Use
vinegar to clean the bottle, and then rinse out thoroughly with filtered / bottled cold water.
You can also flush through the tubes with vinegar, to clean them, as long as they too are
rinsed well afterwards.
• Drinking water: As described above, drinking a lot of water can help to flush out toxins
and prevent symptoms from a healing reaction. It can also aid the chronic cellular
dehydration that many M.E. / CFS individuals suffer from. Unless you have a kidney
disorder in which you have been advised to restrict your fluid intake, it is advisable to drink
at least two litres of water a day (excluding any additional drinks of tea / coffee / juice). You
may find that using the device increases your thirst. As discussed below, listen to your body
and try and provide it with what it requires. Do not however, force your body into accepting
what it does not want; do not drink so much water that you feel ill because of it!
• Air Filter: Ensure that the air filter is properly screwed into the back of the device prior to
first use (with the “inlet” side facing the device). Be sure to follow the instructions (see the
device manual) for changing the air filter after fifty hours of use, even if the new air filter
appears to look identical to the old “dirty” one.
• Bed Time: For the first few weeks of using the Airnergy device, if possible, avoid
applications within an hour or so before bed time, as sometimes this can energise the body at
a time when relaxation is required to aid sleep. Within time, it seems that as your body gets
used to the healing effects of Airnergy, timing of use will be less significant; you will then
observe the positive effects of treatment, at whatever time of day the device is used.
• Nose Breathing: Ensure that whilst undergoing a treatment session, you regularly breathe
in through your nose. Do not attempt to breathe too deeply, just inhale and exhale gently, at
your usual rate, ensuring that at least your breathing in is done through your nose. This
means that at least initially (until you have got into the habit of always breathing in through
your nose), when attached to the device, try and avoid carrying out activities which will
reduce nose breathing or alter your breathing pattern and may potentially make the treatment
less effective. These activities include lots of talking (during which individuals generally
breathe through their mouth) and exercising etc. Small amounts of talking are not
detrimental, as long as you concentrate on regularly breathing in through your nose.
• Listen to your body: As your body starts to respond to the healing effects of the
activated oxygen, you may be more aware of feelings suggesting when you should eat, sleep,
drink etc. Many individuals find that the device may have different effects on them on
different days or at different times of day; this may involve someone feeling hungry when
they didn’t expect to, thirsty, sleepy or very active. Listen to what your body is telling you
and act accordingly (where possible): if you feel hungry, eat something. If thirsty, drink
(preferably water!), if sleepy, nap, if energised go for a short walk or carry out stretching and
strengthening exercises. If we give our bodies what they need, when they need it, the healing
process is likely to be much more efficient and recovery from illness much improved.
33
Diet &
Supplementation
 Antioxidant Diet
 Supplements
 Glyconutrients
34
Dietary Control and Supplementation:
This dietary advice is not compiled with any particular dietary or nutritional qualifications. It is
compiled as a result of personal research and experience and based on the previously discussed theory
of M.E. / CFS being caused by accelerated oxidative injury. The most significant aim of the diet is to
increase the body’s natural anti-oxidant defences and to prevent build up (i.e. excessive ingestion) of
foodstuffs that contain or cause production of damaging oxidants.
It is important in life to get a balance between behaving in the most “sensible” way, which will
supposedly prolong a healthy life, and actually enjoying the current life we have. The following
dietary guidelines, therefore, are provided as just that; guidelines. The aim of which is to help you
achieve and maintain full health. However, if all components of Five Steps to Health are being
implemented (and the reasons for each aspect are understood and accepted), it seems unlikely that
occasional ingestion of the “Avoid these…” foods (such as chocolate and biscuits!) will result in
significant negative effects. If this appears not to be the case, then listen to your body; by now you
are the best expert on your own body and your own health; if there are some foods that definitely
seem to worsen your condition, avoid them!
In 1993 a review was undertaken of several diet therapies recommended for individuals with M.E. /
CFS (Morris and Stare, 1993). Various dietary regimes were evaluated on the basis of nutritional
adequacy and scientific rationale. The diet therapies examined included royal jelly, elimination,
avoidance and rotation diets. So far, claims that any specific dietary regime is beneficial in M.E. /
CFS are anecdotal and have not been substantiated by scientific research. For example, the above
report concluded that rotation diets are often not balanced and do not meet current recommended
dietary intake levels. They also reasoned that diet strategies that call for the strict avoidance of food
additives, preservatives, sweeteners, and other ingredients are not supported by available evidence
and are not practical for all patients with M.E. / CFS. The authors recommended that a diet plan for
patients with M.E. / CFS should be based on sound nutritional principles and common sense. They
suggested that “until the results of studies demonstrating the benefits of particular diet therapies in the
management of M.E. / CFS are available, individuals are advised to eat a varied diet selected from among and within
the basic food groups to ensure an adequate nutrient intake and to reach and maintain a reasonable body weight”
(Morris and Stare, 1993).
It is suggested that individuals implementing the Five Steps to Health keep this advice in mind.
However, in today’s society of fad diets and contradictory nutritional advice, the following general
aims and recommendations are provided in order to assist the individual in optimising their
nutrition and digestion in general. It is also highly recommended that individuals undergo some
form of metabolic typing or similar nutritional assessment through an experienced nutritionalist or
Ayurvedic practitioner, in order to establish their own specific dietary requirements, in addition to
the general guidelines laid out here.
Main Points:

Eat regularly; don’t miss meals and snack when you need to!

Eat lots of Fruit and Vegetables (especially vegetables!)

Water Water Water – Ensure an adequate intake!

Eat Organic Produce wherever possible.

Take in low levels of refined sugars (e.g. sweets, cakes, biscuits, jams)!

Avoid alcohol, caffeine and other stimulants!

Avoid artificial sweeteners and foods high in additives and colourings!

Avoid foods that seem to affect YOU badly!
35
Anti-Oxidant Diet Rationale
Eat regularly: As you may already be aware, M.E. / CFS often affects hormonal regulation
within the body and this can include the control of blood glucose levels. A reactive hypoglycaemia
condition can develop. This means that although blood sugar levels do not drop to “dangerously”
low levels, as can be the case in Diabetic individuals after insulin administration, within a short
while of ingesting food, the body has “over-reacted” and caused blood sugar levels to drop to the
levels you would expect after having had no food or drink for many hours. This can cause excessive
fatigue very easily, as well as brain-fog and other symptoms. The necessary aim in treating this
particular condition is to regulate blood sugar levels, to keep them stable, without the big
(symptomatic) dips that hypoglycaemia causes. In order to combat these, it is necessary to eat very
regularly (even if only a few mouthfuls at times) perhaps even every couple of hours initially. The
aim is to eat (something appropriate) every time M.E. / CFS symptoms start to worsen during the
day. This may be an exacerbation of fatigue, pain, brain-fog or other symptoms. Taking chromium
as a supplement can also be helpful to stabilise blood sugar levels. It is also important to try and
stick to foods with a low glycaemic index (this means those foods which are converted into energy
more slowly than others, so giving you a more sustained release of energy). See the table below for
more details about glycaemic index. In time, as health improves, the symptoms of hypoglycaemia
should diminish and individuals become less reliant on regular eating. However, while your system
is still trying to overcome the enormous pressure it is under from the oxidative stress, it makes
sense to help it out by giving it enough fuel regularly!
Examples of glycaemic index table:
Low Glycaemic Index
Foods: (Good)
Medium Glycaemic Index
Foods:
High Glycaemic Index Foods:
(Limit intake)
Apples
Cherries
Dark chocolate (<70% cocoa)
Onions
Red Peppers
Tomatoes
Apricots (fresh)
Grapefruit
Cabbage
Plums
Quinoa (cooked)
Milk (semi-skimmed)
Peaches
Raw carrots
Grapes
Orange Juice (freshly pressed)
Buckwheat (black wheat flour)
Rye (wholemeal bread)
Peas (fresh petit pois)
Sweet Potatoes
Kiwi Fruit
Basmati Rice
Rice (long grain, white)
Bananas
Jam (traditional)
Melons
Raisins
Cereals (sugared)
Chocolate bars (e.g. Mars Bars)
Cola drinks
Rice cakes
Honey
Potatoes / Potato crisps
Pumpkins
Beer
Broad beans (cooked)
If reactive hypoglycaemia seems to be a particular problem for you (if you have widely fluctuating
energy levels throughout the day and seem to get improvement with eating or drinking high sugar
foodstuffs), the following is a brief list of “good” and “bad” foods in helping you control this aspect
of the condition:
BAD
Alcohol
Fruit juice
Pasta
Sweets / Biscuits
GOOD
Fresh vegetables
Oily fish
Oat cereals
Extra virgin olive oil
36
Lots of fruit and vegetables: Most vegetables have a low glycaemic index, so this
suggestion follows on from the previous. Fruit and vegetables are also excellent sources of many
vitamins and minerals. Particularly significant are “phytonutrients” These are nutrients concentrated
in the skins of many vegetables and fruits, and are responsible for
not just their colour, but scent, and flavour as well. Phytonutrients
are the best antioxidant foods that exist in nature. Lots of vegetables
such as broccoli and tomatoes (especially high in phytonutrients)
should be included in a good anti-oxidant diet. Fruit and vegetables
are also high fibre foods. As constipation and other irritable bowel
symptoms are a common problem in M.E. / CFS, a high fibre diet
(as long as accompanied by sufficient water intake) can be helpful.
Vegetables (and some low sugar fruits such as tomatoes and
avocadoes) are thought to be the most alkalising foods available to us. Since an aim of the Five
Steps to Health is to reduce acidity levels within the body, ingesting a diet which is potentially more
alkalising than acid-forming is a positive step. For more information regarding a strongly alkalising
diet, please refer to “PH Miracle”, Robert Young and Shelley Redford Young, Time Warner
Paperbacks, 2002.
Lots of water: As mentioned previously, part of the process causing M.E. / CFS is a state of
global cellular dehydration. Maintaining a high water intake goes some way to addressing this.
During treatment with the Five Steps to Health, a detoxification state may exist, which requires
large volumes of water to “flush out” toxins. It is also suggested that as a system becomes more
hydrated, the thirst centres are activated more easily i.e. the more you drink, the more you are likely
to want to drink, and hopefully the better you will feel for it. It is recommended that everyone who
is able should aim to drink at least eight to ten large glasses of water a day (about 1.5 to 2 litres), as
well as another glass of water for every drink you consume that contains caffeine (e.g. tea or coffee)
or alcohol. If your current intake of water is significantly less than this, it may be necessary to build
up gradually to this level. If you suffer from a renal impairment or similar medical problem, and
have been advised to restrict your fluid intake, please consult your physician before following this
advice.
Avoid stimulants: Alcohol, caffeine and similar stimulants act as oxidants. In order to
decrease the oxidant load on the body, it is necessary to cut down consumption of these toxins.
If you have a dip in your blood sugar, there are two ways to increase it. One is to take in glucose
(see previous section), the other is to increase the levels of stress hormones (cortisol and adrenaline)
within your body. Levels of stress hormones are increased either by consuming a stimulant such as
those found in tea / coffee / chocolate or tobacco, or by reacting stressfully to a situation. It is very
easy to get into a vicious cycle of stress, sugar and stimulants, but understanding the effect that
these factors have on your blood sugar levels and overall health is a start in trying to take back
control.
As a good alternative to highly caffeinated tea or coffee, try Rooibosh or Red bush tea. This is a
naturally caffeine-free drink also low in tannins. It is available from most supermarkets and health
food shops. There are also reports of individuals using red bush tea in their baths to effectively
improve skin conditions such as eczema and psoriasis. A wide range of herbal and fruit teas to
accommodate most palates is also available.
It is also advisable to reduce intake of foods containing acetaldehyde or alcohol such as tofu, bean
curd, soy or black sauces, pickles, vinegar, blue veined cheeses and cheeses with mould, fermented,
brewed and alcoholic products. Alcohol is broken down to acetaldehyde in the liver, which
increases free radical production and depletes levels of Vitamins B, C and E.
37
Avoid additives: Additives act as oxidants within the body. Ingestion of foods containing
large amounts of synthetic preservatives, flavour-enhancers and colourings (such as “E-numbers”)
increases the oxidative stress within the body, thereby perpetuating the M.E. / CFS complex.
Therefore these foods should be avoided or at least consumed in moderation. Foods in this category
include soft drinks, especially cola and lemonade, cordials/fruit syrup drinks (“squash”), chocolate,
sweets, ice-cream, biscuits, tomato ketchup, mayonnaise, processed cheese, processed meats,
artificial sweeteners, highly processed, “convenience” meals, highly coloured curries and Chinese
food (those dishes high in the “flavour enhancer” monosodium glutamate).
Snack healthy: Following the above advice, this is a logical progression and includes eating
fruit, yoghurt, carrots, celery sticks and hummus, fromage frais, nuts or similar, rather than crisps or
biscuits throughout the day. Although simple natural yoghurt or fromage frais is a very reasonable
snack, be careful of yoghurt-related products high in sugars and flavourings. For those who have a
sweet tooth, or for some variety, “9 bars”, containing a variety of seeds and hemp (covered in
carob; a good chocolate substitute) are a good choice, containing less refined sugar than similar
snack bars and manufactured in easily portable packaging. 9 bars are available from supermarkets
and health food shops.
Low sugar: Large amounts of refined sugar are likely to worsen the state of reactive
hypoglycaemia commonly found in M.E. / CFS, which causes even greater problems with fatigue
and brain-fog. Sugar overload will also sustain the negative microbial population within the gut,
causing them to flourish and produce more toxins within the body. In order to break the cycle of
microbial growth and regain control over symptoms, it is necessary to consume a minimal amount
of sugar.
Organic Food: Pesticides and other chemicals used on crops and in the manufacture of meat
products are recognized causes of free radicals within the body. Eating organic food allows the
individual to avoid exposure to those pesticides and all other chemicals routinely used on most
produce. The soil organic plants are grown in is usually less depleted than that undergoing harsh
treatment on standard farms, which means that organic produce is as much as 300% higher in
nutrients than non-organic food. Although often a more expensive alternative, eating organic food
is significant in both the “avoiding excessive oxidants” aim as well as the “optimise nutrition”
aspect. Many organic farms throughout the country operate a “box scheme”, in which you can order
specific, fresh organic produce to be delivered weekly or fortnightly, often with no additional
delivery charge.
Personal aversions: despite the underlying pathology of M.E. / CFS believed to be the same,
we are all unique and the experience of each individual will vary. If there are foods that you have
found (or subsequently come across) that do seem to worsen symptoms, avoid them! Listen to your
body and remember that these are general guidelines. Find your own balanced diet that works for
you, keeping in mind the above aims.
Many individuals suffer from food allergies or sensitivities as they develop or deal with M.E. /
CFS. It can be extremely helpful to identify these intolerances and treat them where possible. The
most effective method of doing this is via low dose immunotherapy (or Provocation and
Neutralisation techniques), provided at a few clinics throughout the UK, such as Breakspear
Hospital, Hertfordshire.
38
Supplements
When someone’s body is deficient in certain nutrients, or requires more than usual in order to
maintain ‘normal function’, dietary supplements (usually in the form of tablets, capsules or drops)
can be extremely helpful in supplying the necessary vitamins and minerals. However, many people
with M.E / CFS find they are unable to tolerate supplements; they actually feel worse taking them.
It may be that if this is the case, the body is so ‘toxic’ (with metabolic pathways slow or blocked),
that the system is unable to absorb and assimilate the nutrients effectively and taking supplements
simply adds to the toxic load – causing further problems and not doing any good (and often costing
considerable money!)
It may be that it is necessary for someone to attain a certain degree of health – get their own
detoxification system working better etc, before the majority of supplements will be helpful
(particularly with regard to those which are taken in through the digestive system rather than others
such as drops under the tongue / injections). Currently there is no documented evidence to support
this suggestion, but individuals with M.E / CFS may wish to reflect on this idea and may decide to
focus specifically on detoxifying their system (e.g. with far infra red therapy) with an
accompanying antioxidant, alkalising diet, prior to beginning / restarting a supplement regime.
Once someone is able to properly absorb and assimilate nutrients, the following are recommended
as useful general supplements (although ideally some form of specialist assessment will be carried
out to determine which nutrients the individual particularly needs) for people aiming to recover
from M.E / CFS:
Multivitamin/Mineral Complex including Zinc
Vitamin B Complex especially Vitamin B3 - Niacin
Vitamin C
Vitamin E
Magnesium
Co-Enzyme Q10
N-Acetyl-Cysteine
Vitamin D (for certain individuals)
There are many brands of supplements available for purchase today. They vary considerably in packaging,
price, and in actual formulation. Not all vitamins and supplements are created equally. There are currently
no standards that require the ingredients in the bottle match what is written on the label. The following are
also factors to consider when deciding on a supplement brand:
•
•
•
•
•
Ingredients for the supplements should be from organic sources whenever possible.
Nutrients should be tested for toxic substances and any kind of contamination.
No artificial ingredients should be used in manufacturing.
Look for hypoallergenic products if you have sensitivity problems. Avoid those which contain
wheat, yeast and corn.
Look for an expiration date and make sure the product is fresh. If there is no expiration date on the
label, buy something else.
Also keep in mind that when it comes to a supplement, cheaper often means poorer quality. Unfortunately
this means that in order to ingest a supplement that is actually going to have a positive effect, and avoid any
negative effects caused by contamination or inappropriate “bulking” agents, greater expense may be
required.
39
The following list may seem excessive to some (although probably not excessive to those who have
previously been advised to take up to fourteen different supplements a day!). However, each is included for
good reason and this is explained below.
• Vitamin E and Vitamin C
These are both excellent anti-oxidants (as well as having numerous other benefits) and will help
keep up your anti-oxidant defences as your body returns to health. Vitamin E has also been
found to be beneficial within the immune system. Further to specific supplements, eating foods
high in these vitamins will also be beneficial. Particularly good foods include:
Vitamin C:
Grapefruit
Peppers
Broccoli
Cabbage
Tomatoes
Vitamin E:
Oily Fish
Nuts & Seeds
Egg Yolk
Avocado
Brown rice
• Magnesium
The chief function of magnesium is to activate enzymes, especially those related to the storage
and release of energy (reactions involved with energy production within cells). As with the other
supplements recommended, extra magnesium ingested has a positive effect on cell energy
metabolism. M.E. / CFS patients have often been found to be deficient in this mineral, which
adds support for its inclusion in these dietary guidelines. The best food sources of magnesium
are:
Cereals
Milk
Fruit
Nuts
Vegetables
Seeds
• Zinc
Zinc is needed to make insulin, to boost the immune system and to help make certain
antioxidant enzymes. It also has a significant role in the metabolism of essential fatty acids.
The main function of this mineral is protection and repair of DNA. Stress, alcohol
consumption, a high sugar intake and smoking all deplete zinc levels. Good food sources of
zinc include the following:
Ginger Root
Lamb
Egg Yolks
Rye
Oats
Brazil Nuts
• B-Complex
Specific derivations of B-vitamins (NAD and FAD) are an essential part of the final pathway
of energy production within the body (electron transport chain). Many individuals with M.E. /
CFS are found to be lacking in B-vitamins and their derivatives. By taking this supplement
you are hopefully improving your energy production at a very basic level.
Good food sources Vitamin B Complex:
Asparagus
Broccoli
Cabbage
Cauliflower
Green beans
Green peas
Kale
Leeks
Lentils
Onions
• Vitamin D
Vitamin D supplementation is recommended for those individuals who observe a significant
deterioration in health and increase in symptoms during winter months. This is thought to be
caused by lack of Vitamin D synthesis from (UVB) sunlight in winter combined with poor
stores of Vitamin D in individuals with M.E. / CFS. Only a few foods naturally contain
significant amounts of vitamin D. These include the following:
Parsley
Salmon
Mackerel
Sardines
Eggs
• Co-Enzyme Q10
This substance (also called Ubiquinone) is a powerful antioxidant, like vitamins E & C.
However, it has another important role within cells, by serving as a coenzyme (“assistant”) for
several of the key steps in the production of energy within the mitochondria of the cell.
Dietary supplementation with Coenzyme Q10 has been shown to increase the concentration of
mitochondria in the brain (the energy-production factories within the cell). Increasing the
mitochondria concentration within cells implies increased cellular production of energy and
therefore improved cellular (and organ) function.
• N-Acetyl-Cysteine
N-acetyl cysteine (NAC) is an anti-oxidant molecule which helps to neutralise free radicals
within the body. NAC is believed to work by increasing the level of glutathione in cells.
Glutathione is a substance that helps cells produce energy and helps to protect them against
oxidative damage through involvement in detoxification processes. NAC may also act as an
immunomodulator, stimulating activation of the T-cells of the immune system. Glutathione is
poorly absorbed from the gastrointestinal tract and increasing foods that are rich in glutathione
(such as asparagus and watermelon) don’t seem to actually increase levels of production
within the body very much. Glutathione is made up of three amino acids: glycine, glutamic
acid and cysteine. Cysteine is usually the limiting amino acid in its production, which is why
supplementation with NAC is most appropriate.
Other Suggestions to Optimise Nutrition
• Oats are one of the best sources of slow-release energy. If reactive hypoglycaemia
symptoms are a particular problem for you, oats may help! Oat porridge at the start of the
day can help give sustained energy for most of the morning. However, some individuals
find that reducing consumption of ALL grains initially can help their symptoms. See what
works for you.
• Try and eat a heaped tablespoon of either mixed seeds (such as flax / linseeds / sesame and
pumpkin seeds) or cold-pressed flax oil daily. This will give you a good dose of essential
omega 3 and omega 6 oils and will aid digestion, helping to prevent constipation. The
seeds or oil can be mixed into your breakfast (after soaking in good quality water
41
overnight), sprinkled over salads or mixed into soups or sauces (after cooking has been
completed; heating damages the good stuff inside the seeds). Occasionally people may
find they are intolerant of seeds; it is thought that seeds may sometimes catch in
diverticular pockets in the gut and cause problems. In this case, avoiding seeds and
choosing oil alternatives is a preferable alternative.
• Where possible, eat fruit and vegetables raw, or lightly steam them, in order to retain as
many of the natural beneficial enzymes and other nutrients within the food. Steaming is
believed to produce virtually no free radicals at all, but cooking to high temperatures in
conventional or microwave ovens is thought to considerably decrease the nutritional value
of food. There is also increasing evidence that microwaves may cause further health
problems than simply destroying nutrients in food. If digestion problems are significant, it
may be better to avoid raw vegetables. Lightly steaming instead starts to break down the
cell walls within the vegetables, making them easier to digest (without losing too many
nutrients) and can make a big difference to how well someone tolerates their greens!
• Chewing food very well (“drinking your solids and chewing your liquids”) starts off the
digestion process well, by helping digestive enzymes do their work. It’s also important to
take small bites when eating, as properly chewed food expands considerably, and if a
larger bite has been taken, at least part of the food will have to be swallowed before
appropriate mixing with secretions (those containing the important enzymes).
• Wheat contains gluten, a protein that many people find hard to digest and which can cause
bloating and wind and exacerbate other symptoms of irritable bowel syndrome. This is a
mild sensitivity rather than a true gluten allergy (coeliac disease), but some individuals
with M.E. / CFS find a wheat free diet greatly improves their digestive symptoms. If you
are going to try a totally wheat free diet, give it at least one month before deciding whether
or not it is making a difference. Most supermarkets (particularly Sainsburys) now provide
a Free From range of gluten free goods, including bread, cakes, biscuits, flour and many
more. The most common products to avoid if you wish to follow this path, include:
Bread
Wheat-based breakfast cereals
Wheat flour
Oats
Cous Cous
Cakes
Biscuits
Pasta
As health improves and the underlying problem within the body is corrected, the intolerance
to wheat may be greatly reduced. As an alternative to wheat products, try rye bread, pasta
made from quinoa (pronounced keen-waa) or millet, soba (buckwheat) noodles and muesli or
porridge made from millet flakes rather than wheat-based (high sugar) breakfast cereals.
• Similar to the wheat intolerance, many people have intolerance to lactose (“milk sugar”).
Some individuals may find that avoiding dairy products such as milk, cheese, butter and
cream, can reduce symptoms of irritable bowel syndrome, as well as improving congested
sinuses or a persistent runny / stuffy nose. Organic goat’s or sheep’s milk products may be
tolerated better, but if following the path of dairy avoidance, it is preferable to cut out all
dairy for at least a month to observe any effect. Possible alternatives to dairy products are
rice / almond or sesame milk (available from most health food shops) and hummus / tahini or
guacamole instead of butter or cheese.
42
Glyconutrient Supplementation
The current state of our nutrition:
The human body requires water, vitamins, minerals, enzymes, proteins, fats and carbohydrates to
function properly. The foods we eat supply these nutrients and come from a variety of sources.
However, over the last few decades the quality and quantity of nutrients we can obtain from food
without supplementation has become less and less.
There is increasing scientific evidence markedly validating the lack of nutrients in our food and the
need for supplementation. In July 2002, the Journal of the American Medical Association reversed
its stance that supplementation was not necessary. Studies in the UK and Canada have reported
significant losses of vitamins and minerals in many fruits and vegetables during the past fifty years.
In 2003, Scientific American and Newsweek published a new food pyramid, which actually includes
supplements, along with the recommendation for different types of foods.
Reasons for decreased nutritional content of our food (and consequent increase in health problems)
include soil depletion, commercial farming methods (such as green harvests and increased use of
toxic pesticides etc), preservatives added to food and methods of preparation we use more these
days, such as irradiation in microwaves and cooking at high temperatures.
What are glyconutrients?
There are over 200 carbohydrate monosaccharides (“sugars”) in nature. Research has shown that
only eight of these are specific, “biologically active” sugars, essential to humans, which do not
convert to glucose when consumed (i.e. we don’t use them as an energy source), but go directly to
the surface of cells, attach to proteins and other molecules (such as lipids) to form structures which
construct a complex system for communication between every cell in the body. As your cells touch
each other, they communicate over this ‘sugar code system’ everything a cell needs: nutrition,
repair, hormones etc.
The 1999 Nobel Prize in Medicine was awarded for this discovery. The essential sugars described
above are known as glyconutrients.
In 1996, Harper’s Biochemistry, a prominent medical textbook added a new chapter called
Glycoproteins. The content of this chapter described the established fact that all mammals must
synthesise glyconutrients as a normal function of life. It is believed that those who do not produce
all eight glyconutrients correctly will develop disease.
Of the eight essential sugars, only two are readily available in our modern diet – these are glucose
and galactose. The other six (mannose, fucose, xylose, N-acetylgalactosamine, N-acetylglucosamine and N-acetylneurominic acid) appear to be significantly lacking.
Human breast milk though is actually a good source of several glyconutrients. This is one reason
why breast-fed babies are protected from gastrointestinal and other infections; the glyconutrients
may actually prevent infectious organisms from sticking to intestinal cells.
Making the Glyconutrients inside the body:
The process necessary to make the eight essential glyconutrients is very complex and requires many
enzymes and other micronutrients to complete. It is believed that our modern, nutrition deficient
diet, along with toxins and stress interferes with this process, leaving us lacking in these life-giving
substances.
43
Without these surface sugars, your body’s “operating system” breaks down. This means that your
body’s cells fail to communicate effectively. Consequently cells within your immune system may
decide to attack healthy good cells, resulting in autoimmune diseases such as Systemic Lupus or
Rheumatoid Arthritis or Multiple Sclerosis, while bad cells like cancer are left to grow and multiply
because your ‘killer’ immune cells are confused. Hormones could be misdirected, leaving you with
physical and emotional problems, whilst cells may not receive the vitamins and minerals they need,
resulting in all kinds of disease conditions.
All health, or lack of it begins at the level of cells. This is why treatment of any condition should
ideally be aimed at improving the health and function of cells within the body, not just the overall
symptoms which an individual experiences.
More specifically for individuals with ME / CFS, lack of glyconutrients and the glycoproteins they
form may leave cells more open to damage to attack from free radicals, viruses and bacteria. The
logical solution to this is to replace the glycoforms on the surface of cells and thereby improve
protection.
Glyconutrients found in nature:
Studies have demonstrated that these biologically active sugars can have the following effects:
 Dramatically raise natural killer cell and macrophage counts (immune cells) against
infectious organisms.
 Decrease cell death in ME / CFS.
 Protect the body against toxin and pollutant exposure.
 Decrease inflammation in conditions such as arthritis.
Scientists working in Dallas, Texas discovered that certain plants contain these essential sugars;
glyconutrients. They patented a process to extract and stabilise these unique carbohydrates. These
sugars are not digested as energy for the body, but go directly to the cell surfaces to form
glycoproteins, the same as if your body had made them.
The plants that contain some glyconutrients are often considered ‘healing plants’. They include aloe
vera, garlic, certain mushrooms, echinacea and coconut meat. Although it is theoretically possible
to obtain reasonable amounts of glyconutrients by consuming large volumes of the appropriate
plants, it is considered by many to be much easier; cheaper and convenient to simply add
glyconutritional supplements to the diet.
Glyconutritional Products:
A range of glyconutritional products are now on the market. Mannatech Inc produce the following
high quality products:
Ambrotose: a powder or capsule blend which provides the body with all eight essential
glyconutrients, combined in such a way to ensure they will be properly absorbed into the system to
improve cellular communication and immune system support.
Ambrotose AO: capsules containing an antioxidant formula to protect cells against the onslaught
of free radical damage and aid repair from oxidative injury. Glyconutrients are combined with this
formula to aid absorption and functioning.
Plus Classic: tablets containing the raw materials for formation of hormones; nutrients to support
the endocrine system, combined with the glyconutrient blend.
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For further information and pricing details of these products please go to www.mannatech.com
45
Recondition
Body
 Introduction
 Stretching Exercises
 Strengthening Exercises
 Yoga
 For a Better Night’s Sleep
46
Introduction
The aim of Body Reconditioning in the context of Five Steps to Health is to achieve appropriate
periods of rest and activity or exercise to enable effective healing and strengthening of the body at a
suitable rate which prevents recurrent relapse.
Any individual with a chronic disease is likely to require body reconditioning as part of their
treatment, since lack of use renders muscles and joints less able to cope with the demands of living.
It is important to start any reconditioning programme very gently, as overworking muscles and joints can
result in further damage. The aims of body reconditioning in the context of this M.E. / CFS protocol, are to
regain and maintain ranges of movements at all joints, strengthen the body’s major muscle groups,
and gradually increase stamina and physical activity levels to approach those of full health. Balance
and co-ordination may also be issues that need addressing in some individuals.
Many M.E. / CFS individuals will have been told by traditional physicians that “graded exercise
regimes” are the best treatment approach for this condition. Unfortunately, these regimes are often
poorly understood and their implementation often ineffectual or damaging, as enthusiastic or
unsympathetic practitioners (and desperate patients) attempt to increase activity levels too quickly.
Although the strategies suggested here promote a form of graded activity, it may be different from
that experienced previously by M.E. / CFS individuals. A combination of personalised pacing
(balancing rest and activity levels so that optimum activity levels are achieved without
overspending energy and requiring excessive rest afterwards) and an individualised exercise
programme are advocated.
The true interpretation of “graded exercise” is all about a baseline. No matter what state M.E. / CFS
has caused an individual to get into, there is still a daily baseline of exercise (activity is perhaps a
more helpful word) that they can achieve, even on a bad day. This may be a 1km walk around a
park, or it may be the straightening and flexing of fingers on one hand. More likely, it is somewhere
in between these two examples. It is up to the individual concerned (preferably with the guidance of
an understanding health care provider) to identify this baseline exercise, and then stick to it.
Although the activities of daily living are still carried out, no further exercise is attempted on good
days. As health stabilises and improves, this base-line activity is very slowly increased, ensuring
that it is still achievable on a bad day. In this way, levels of activity (and stamina) can hopefully be
built up.
With this idea in mind, it is important that specific muscle stretching and strengthening exercises
need to be included in a daily routine (when appropriate for the individual), in order to regain
strength and stamina. The major muscle groups needing to be addressed after a period of decreased
activity, as happens with chronic illness, are:
• Quadriceps (front thigh)
• Hamstrings (back of thigh)
• Biceps and Triceps (arms)
• Calf muscles (back of lower leg)
• Abdominal and back muscles involved in core stability (those muscles which are important
in balance and maintaining stability whilst sitting and standing).
Other muscles may also be affected and require attention.
In order to strengthen these muscles, exercises need to be carried out daily. However, the needs and
ability of each individual vary, so this should be a personalised exercise programme, preferably
overseen by an understanding physiotherapist or similar health care provider.
47
Stretching Exercises:
In order to maintain full ranges of movement at joints throughout the body and reduce general
stiffness, it is important to carry out regular stretching exercises as well as the strengthening
exercises recommended in the Five Steps to Health.
It is suggested that the following stretching (or warm up / cool down) routine is carried out daily
or twice daily by all those able to do so.
Neck:
•
Stand or sit up straight, facing forwards. Keeping shoulders facing forwards, turn head to
the right, as far as is comfortably possible. Hold the neck stretch for a few seconds then
relax head back to centre. Repeat, turning head towards the left.
• Stand or sit up straight, facing forwards. Keeping eyes facing forwards and shoulders still,
lean head to the right, trying to make right ear touch right shoulder. Hold the stretch for a
few seconds. Repeat, with left ear trying to touch left shoulder.
Shoulders:
•
Sit or stand straight. Roll shoulders backwards in large circles. Repeat ten times. Roll
shoulders forwards. Repeat ten times:
•
Sit or stand. Reach right arm over left shoulder. Use left hand to gently push right elbow to
create the stretch. Hold for a few seconds. Relax. Repeat with left arm over right shoulder.
Rotations:
• Sit on a chair and cross your arms over your chest, clasping the opposite shoulder.
• Bend your upper trunk forward while at the same time rotating to one side. Keep your hips
facing forward. Let your eyes follow the movement. Breathe out during the stretch. Hold
for a couple of seconds then relax. Repeat, rotating to opposite side.
48
Side Bends:
• Standing, bend to one side at the waist as far as is comfortable, by letting your hand slide
down the side of your thigh. Hold the stretch for a few seconds then stand up straight
again. Repeat, bending towards the other side.
Legs:
•
Stand with one foot in front of the other. Keeping the back leg straight, bend the front leg
so that you can feel the stretch down the back of your back leg (hamstrings). Hold for a
few seconds, and then relax. Swap legs and repeat to stretch the hamstrings of the other
leg. If necessary, hold on to a support whilst carrying out leg stretches.
• Stand with one foot in front of the other. Keeping the front leg straight, bend your back leg
until you can feel the stretch in the calf of your front leg. To encourage the stretch, pull the
toes of your front leg towards you. Hold the stretch for a few seconds then relax. Swap
legs and repeat to stretch the calf muscles of the other leg.
Heel Toe Moves:
• Stand with feet together (or slightly apart if balance necessitates). Holding support if
necessary, keep left foot still and touch a point on the floor with your right heel. Quickly
touch the same point with the toes of your right foot. Repeat this several times to give a
“heel-toe movement”. Repeat with left foot, keeping right foot still.
49
Strengthening Exercises:
Chronic disease and other causes of body deconditioning often result in weakness or poor stamina
in the major muscle groups of the body. When attempting to recondition the body, the major
muscles to address are the following:




Quadriceps Muscles (front thigh)
Hamstrings (back of thigh)
Biceps and Triceps (arms)
Calf muscles (back of lower leg)
 Abdominal and back muscles involved in core stability.
In order to strengthen these muscles and thereby improve the body’s overall stamina, it is
recommended that an individual should try and carry out daily or twice daily strengthening
exercises covering all these areas. The aim is to build up the number of exercise repetitions very
gradually, so as not to overwork or exhaust the body, but gently improve aspects of strength and
stamina. Ideally these exercises will be overseen by an understanding health care professional
such as a physiotherapist, who will suggest which exercises to focus on, and give advice
regarding the number of repetitions to attempt. The exercises below may also seem rather
ambitious for some individuals initially; a healthcare provider will be able to suggest more
appropriate alternatives until the following are possible.
Initially, the number of repetitions possible may be very few. The individual should aim to do the
same number of repetitions every day (i.e. start with a number that is achievable even on bad
days; this may be only one or two to begin with, but this can gradually be built up as health and
fitness improve).
Initial exercises:
Static Quads (Quadriceps):
Lying on your back with legs straight.
Bend your ankles and push your knees down firmly against the
bed. Hold for 5 seconds and relax.
Repeat as appropriate.
Leg Curls (Hamstrings)
Stand. Hold onto a support and bring one leg slightly
backwards.
Bend your knee and lift your foot off the floor.
Hold for a couple of seconds. Relax.
Repeat with other leg.
Repeat as appropriate
50
Bicep Curls: (Biceps)
Stand (or sit if necessary) with arms hanging down.
Turn your palms forward and make fists.
Bend alternate elbows so hand moves towards face, then lower
slowly.
Repeat as appropriate.
For advanced strengthening, hold hand-weights or small fruit
in hands.
Transversus Abdominis: (Abdominal Muscles)
Crawling position.
Pull your belly button into your spine, arching your back
slightly and at the same time contracting your pelvic floor
muscle. Hold for a few seconds.
Repeat as appropriate.
Arm Raises: (Triceps and Biceps)
Sit or stand, holding your hands on your chest.
Lift alternate arms from your chest straight up and down.
Repeat as appropriate.
For advanced exercises, hold hand-weights or fruit in your
hands.
Straight Leg Raise: (Quadriceps)
Lying on your back with the one leg straight.
Exercise your straight leg by pulling the toes up, straightening
the knee and lifting the leg up to 20cm off the bed, as possible.
Slowly relax.
Repeat with both legs individually, as appropriate.
51
Pelvic Tilt: (Core stability)
Lying on your back with knees bent.
Tighten your stomach muscles by pushing your back down
and curving your bottom up. Relax.
Continue the exercise by pushing your bottom down and
tightening your back muscles to arch your lumbar (lower)
spine up. Relax.
Repeat as appropriate.
Bridging: (Core stability)
Lying on your back with knees bent and feet on the floor.
Lift your pelvis and lower back (gradually vertebra by
vertebra) off the floor. Hold the position. Lower down slowly,
returning to starting position.
Repeat as appropriate.
Incline press-ups: (Triceps)
Stand facing a wall with your arms straight and hands on the
wall, shoulders’ width apart.
Do push-ups against the wall, keeping your body in a straight
line.
Repeat as appropriate.
Advanced exercise: Do push-ups against a work surface (i.e.
lower than a wall).
Squats: (Quadriceps)
Stand up with your back against a wall, but not leaning against
it, as shown in the picture.
Squat down to as far as is comfortable, and come slowly back
up.
Repeat as appropriate.
52
Heel Raises: (Calf muscles)
Stand supported by a chair / bar.
Push up on your toes. Hold for a few seconds.
Repeat as appropriate.
Advanced exercise: Repeat as above standing on one leg and
repeat (with both legs) as appropriate.
Step downs: (Quadriceps)
Stand on one leg on a step facing down.
Slowly lower yourself by bending your (standing) knee to 30
degrees.
Return to starting position.
Repeat using other leg, then repeat both as appropriate.
Ball Exercises: (Core stability, Balance)
Sit on a large ball. Shift your body weight to maintain balance.
Gradually build up balance ability; initially by sitting on ball
with feet flat on floor, holding on to support, through releasing
hold of support, to lifting one foot at a time off the floor, and
raising arms into air etc.
Ideally, a personalised exercise programme should be established for each individual, with the
help of an understanding health care professional. The above exercise suggestions should be used
as a guide for a tailored programme and may also be useful for those who would like to improve
their muscle strength and stamina but currently do not have access to appropriate health care
providers.
As with all aspects of the Five Steps to Health, it is important to begin and continue a
reconditioning programme very gently, to ensure that it produces only positive consequences.
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Yoga
The word Yoga means ‘unity’ or ‘oneness’ and is derived from the Sanskrit word
meaning ‘to join’. This unity or joining relates to mind, body and spirit and combines
physically held postures with gentle stretching, relaxation and breathing exercises to
promote balance, health and energy. For thousands of years this ‘science of living’ has
been practised and passed on generation to generation in the East. In recent years the
practice of yoga (particularly the aspect of physical yoga postures – asana) has become
more commonplace in the West, usually as part of a general fitness regime. It is also
increasingly recognised to improve quality of life at all levels; physical, mental,
emotional and spiritual.
Although it can be very helpful to find an experienced and supportive yoga teacher, it is
not always necessary to attend a regular yoga class or residential course in order to
benefit from the effects of yoga. Resources abound, online, in books and magazines
these days, to teach individuals about different methods of practising yoga, including
how to develop your own routine to practise daily at home.
One particular asana (posture), relatively simple to hold and highly effective at
encouraging relaxation of the whole body and mind, is Savasana, or corpse pose. See the
instructions and picture below:
1. Lying on your back, either flat on the floor / bed or with your head resting on a
thin pillow, relax your legs and, keeping them as straight as is comfortable let
your feet flop gently outwards.
2. Relax your arms and, keeping them also straight, turn your wrists outwards, so
that your palms are facing upwards and your arms are not touching the sides of
your body.
3. Tuck your chin in slightly, towards your chest to elongate your neck and softly
close your eyes and your lips.
4. Breathe in and out slowly, through your nose, focusing your awareness on your
breath.
5. Every time you breathe out, imagine tension leaving your body and worries
leaving your mind. Feel yourself sinking further into the bed or floor that you are
lying on.
For further information on Yoga for M.E. classes or advice, visit http://www.angelastevens.co.uk, email [email protected] or read Beat Fatigue with Yoga by Fiona
Agombar, a book ‘designed to help with all degrees of fatigue – from general tiredness to long-term
exhaustion’.
54
For a Better Night’s Sleep
• Sleep in a comfortable, quiet environment
 Use heavy curtains to block out light to help regulate circadian (daily) rhythms of
wakefulness and sleep.
 Use gentle music or relaxing nature sounds to block out distracting outside noise.
 Make sure your mattress and pillow are comfortable. Check your mattress for signs of
wear at least twice a year and replace it as soon as possible if it is too hard, too soft or too
lumpy or bumpy.
 Try and use your bedroom only for sleeping not for other activities such as working,
watching videos or using a computer.
 If you find a cool pillow helpful for getting to sleep, place a hot-water-bottle filled with
cold water on your pillow for a while before bed-time. Then either keep it on hand to recool your pillow during the night, or turn your pillow over if you awake in the night, to
regain some coolness.
• Stick to a regular exercise programme (even if very gentle!)
 Regular exercise is one of the best ways to get rid of the energy produced by stress.
 Exercise stimulates the immune system and produces endorphins (“good feeling
chemicals”).
 Exercising at the end of the day may disrupt sleep, so ensure your exercise is not within
the last couple of hours before bed-time.
• Cut down on caffeine and alcohol, especially in the evening
 Alcohol or caffeine-containing drinks, such as tea, coffee and hot chocolate will all act to
stimulate the body and mind, while you are trying to get your body into a more relaxed
state for sleep.
 Avoid other stimulating drinks and foods such as those containing ginseng, cinnamon or
ginger, which will have a similar effect to caffeine.
 As an alternative, drink calming and relaxing drinks during the evening, such as
chamomile or fennel tea or another (non-stimulating) fruit or herbal tea.
• Spend the last hour before going to bed winding down
 Try a relaxing bath / reading a good book / watching relaxing television - get your mind in
the mood for rest and sleep.
 Lavender is recognised to have good relaxing and sleep-inducing properties. Perhaps try
lavender-based bath salts / bubbles, lavender sleep stones (from major health shops or
alternative therapists) in a bowl near your bed, or a lavender candle burning for a while
before bed-time (please do not leave candles burning when you go to bed).
 If you often lie awake with thoughts and worries rushing around your head, before going
to bed, take time to write a list of all the thoughts and worries that could potentially keep
you awake tonight. When written, place the list in a room other than your bed-room and
try and mentally leave the items on it away from your bed too.
• Take time to play
 Make sure you have enough fun in your life; relaxation and good times are therapeutic and
rewarding.
• Temporary Sleep inducing agents
55
 If sleep continues to elude you, try a course of melatonin or valerian root extract (either
as tablets or as a tincture); discuss other measures with a pharmacist, doctor or other
practitioner.
Recondition
Mind
 Introduction
 Relaxation Exercises
 Self Actualisation Learning Technology
 Meditation
 Summary
56
Introduction
Five Steps to Health aims to help the body into a state where healing is better able to occur, then
to provide it with all the tools and building blocks necessary (such as oxygen, vitamins etc) that
will enable healing to be carried out from a very cellular level. This final aspect of the protocol is
aimed at trying to combat the negative effects that chronic disease has on the mind, and achieve
an optimal mental and emotional state for recovery to health.
Mind reconditioning also includes other aspects of emotional and psychological support, which I
believe are essential in management of M.E. / CFS. In some individuals, psychological and
emotional support may be of utmost significance, in getting through the day-to-day experience of
living with the consequences of a severe, chronic disease, often misunderstood by medical
practitioners. For others, this aspect may involve the alteration of beliefs regarding their role in
life and achievements necessary to be the person they feel obliged to be.
Many individuals with M.E. / CFS can derive benefit from Neuro-Linguistic Programming (NLP)
(a form of applied psychology). Under the guidance of an experienced practitioner, techniques
can be learnt and applied to encourage and enable healing to occur. For some individuals,
Cognitive Behavioural Therapy (CBT; a form of psychotherapy) techniques may be useful.
However, improvement from this form of therapy will depend on the extent of M.E. / CFS and
how affected they are by brain-fog. Useful CBT needs to be carried out by a well-trained
practitioner who has good experience and understanding of working with M.E. / CFS individuals
and acknowledges the many different and physical aspects of the condition.
The aim of Five Steps to Health is to help individuals live the healthy life they want to live. It is
important for individuals to decide what kind of life they want to lead. So often (at least when
healthy), we end up rushing through life, swept along from one situation to the next; obligations
and “important opportunities” controlling our actions and decisions, often concentrating on the
next or next but one matter in hand, never really living in the moment and making decisions
about how we want to spend our time, or what we want from our lives: at this particular moment
and in this particular situation.
The truth is that all we have is now! We cannot predict what will happen in the far-off future
within our lives, or even in the near future, so it is important to get the most from the current life
experience, making it as good (productive / enjoyable / peaceful / easy) as possible. This may
sound impossible when experiencing body-wide pain, completely immobilised by exhaustion and
totally dependent on others for even the most basic of tasks, but even a situation like this can be
optimised. I believe that (although again, it may be hard to comprehend), M.E. / CFS can provide
an individual with an opportunity to really examine their true desires (when brain-fog and
depression allow!) and explore the actual essence of one’s being. With appropriate emotional,
practical and spiritual support, this can be a life-enhancing experience.
The following pages contain a few ideas to aid the mind reconditioning portion of Five Steps to
Health. They are far from exhaustive and some will be much more relevant and appealing to
some individuals than others. Use this book as it is intended: a resource to stimulate your interest
and enthusiasm for following up a treatment or lifestyle change that catches your attention.
57
Relaxation Exercises:
Everyone needs to be able to relax, in order to allow batteries to be recharged and to halt the
effects of stresses and strains on the body. Sometimes individuals with M.E. / CFS find it
particularly difficult to relax properly, and unfortunately often need that relaxation even more
than others. Poor breathing patterns are also sometimes a problem in these individuals and
retraining of breathing or breathing exercises can have a positive effect on symptoms.
What follows are just a couple of basic ideas to try, when sleep is not forthcoming or desired, but
which will hopefully allow your body (as well as your mind) to enter a greater state of relaxation.
See which, if any work for you and use them as often as is helpful. If you find that none of them
are helpful initially, try them again gently, slowly willing your body and mind to relax. If after
this, you are still feeling unrelaxed and unrefreshed, ask your GP or other healthcare provider for
further help with relaxation techniques and management.
Simple Breathing Focus:
Sit or lie with your back straight, as comfortably as possible. Close your eyes and concentrate
your mind on your breathing. Take a slow, comfortably deep breath in through your nose, for a
slow count of five, and then very slowly breathe out through your mouth for a count of eight. Do
not force the breath out, just try and exhale slowly enough to make it last to eight. Hold your
breath out comfortably for a few seconds, then, when you feel the need, again inhale slowly
through your nose for a count of five, and exhale very slowly through your mouth, counting to
eight in your head. Repeat this for as long as you feel comfortable, or until you are feeling totally
relaxed. The breaths should not be so deep as to make you feel light-headed, but should be deep
enough and slow enough for the whole process to be smooth and relaxing.
Autogenic Training:
This technique is basically a form of self-suggestion, where you place yourself in a relaxed state
by repeating and concentrating on feelings of warmth and heaviness in the arms and legs.
Sit or lie as comfortably as possible. Close your eyes. Try and make your whole body, including
your legs, arms, head and neck go relaxed and floppy. The aim of this exercise is to relax each
part of your body in turn, without tensing up the previous areas when moving on to the next.
Throughout, try and ignore any pain and discomfort and other sensations in your body and focus
on the weight of the specific body part.
First concentrate on your right leg. Without tensing up the rest of your body, try and make your
right leg go even more floppy. Don’t worry if this seems very difficult. Simply continue with the
following instructions. Focusing on your right leg, imagine it is made of lead, heavier than
anything else around. Concentrate on its heaviness and your inability (or desire) to lift it or move
it at all. Say to yourself slowly, “My right leg is very heavy”. Repeat to yourself twice more “My
right leg is very heavy”, “My right leg is very heavy”, the whole while concentrating solely on
your right leg and its incredibly relaxed and heavy state.
After three repetitions, transfer your focus to your left leg. Do not move either your right or left
leg – just leave your heavy right leg and move to concentrating on your heavy left leg. Again,
imagine it is so heavy that even if you were to try, you would not be able to move it at all, as if it
is practically welded to the bed or chair. As you focus on it, slowly say to yourself, “My left leg is
very heavy”, “My left leg is very heavy”, “My left leg is very heavy”. Now keep your heavy legs
still and gently start to focus on your right arm in the same kind of way. Imagine it is incredibly
heavy; all of it, from the shoulder down to your fingers; too heavy for you to move. Say slowly to
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yourself, “My right arm is very heavy”. Repeat this, slowly, a couple more times, until you
truly believe it, and can really feel that your arm is no longer a part of your body, but a lead
weight attached to you. Slowly repeat this process with your left arm, and then with your head
and your neck.
Now use the following repeated affirmations as slowly and gently as those above, each time
focusing on the relevant body part and feeling the truth of the words:
Heart: "My heart is calm and regular." Repeat four times.
Breath: "My body breathes itself." Repeat four times.
Abdomen: "My abdomen is warm." Repeat four times.
Forehead: "My forehead is cool." Repeat four times
By this stage your entire body should be feeling much more relaxed, hopefully your heart rate and
breathing have slowed down and you will either be a lot closer to getting to sleep or at least to
having a proper rest.
Four-Seven-Eight Exercise
This exercise is very simple, takes very little take, requires no equipment and can be done
anywhere. Although you can do the exercise in any position, ideally sit with your back straight
when you start to do it. Place the tip of your tongue against the ridge of tissue just behind your
upper front teeth, and keep it there through the entire exercise. You will be exhaling through your
mouth around your tongue; try pursing your lips slightly if this seems awkward.
• Exhale completely through your mouth, making a whoosh sound.
• Close your mouth and inhale quietly through your nose to a mental count of four.
• Hold your breath for a count of seven.
• Exhale completely through your mouth, making a whoosh sound to a count of eight.
• This is one breath. Now inhale again and repeat the cycle three more times for a total of
four breaths
Note that you always inhale quietly through your nose and exhale audibly through your mouth.
The tip of your tongue stays in position the whole time. Exhalation takes twice as long as
inhalation. The absolute time you spend on each phase is not important; the ratio of 4:7:8 is
important. If you have trouble holding your breath, speed the exercise up but keep to the ratio of
4:7:8 for the three phases. With practice you can slow it all down and get used to inhaling and
exhaling more and more deeply.
This exercise is a natural tranquilizer for the nervous system. Unlike tranquilizing drugs, which
are often effective when you first take them but then lose their power over time, this exercise is
subtle when you first try it but gains in power with repetition and practice. Do not do more than
four breaths at one time for the first month of practice. Later, if you wish, you can extend it to
eight breaths. If you feel a little light-headed when you first breathe this way, this is very likely to
pass after a few breaths, but be careful not to engender dizziness which causes you a real
problem.
Once you develop this technique by practising it every day, it can be a very useful tool that you
will always have with you. Use it whenever anything upsetting happens; before you react. Use it
whenever you are aware of internal tension.
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Digestive Breathing
Digestive breathing is a simple but effective breathing exercise that can help promote digestion. It
is based on using your hands to stimulate energy points related to the spleen and stomach
meridians (energy pathways described in Chinese medicine), while you simultaneously direct
your breathing deep into your belly.
To undertake this exercise, sit on a firm chair with your spine straight and relaxed, and your feet
flat on the floor in front of you. Place your hands on your knees with the heel of your hands
above your kneecaps and your fingers pointed downward. Use your fingers, especially your index
finger, middle finger, and ring finger, to find three indentations in your knee where the fingers
can comfortably fit. Your middle finger will be over the centre of the kneecap. Now simply keep
your hands there, using just a slight pressure to stimulate the meridians running through the knee
area. Sense the warmth going into your knees from your hands. As you breathing in, sense that
you are breathing energy gently into your expanding belly. As you are breathing out, sense your
belly naturally contracting. Do not use force. Work in this way with your breathing for at least
five minutes after each meal, or any time you have digestive problems. (This breathing exercise is
from The Tao of Natural Breathing: For Health, Well-Being and Inner Growth.)
Dis-identification and recognition of the self:
Sit or lie quietly and relax the body.
Slow the breathing down to a gentle, easy rhythm.
Repeat these words to yourself, or have them recorded on a tape to listen to and repeat mentally.
1. I have a body, but I am not my body. With my body I relate to the world around me,
but I am not my body. My body may be tired or rested, sick or well, wakeful or sleeping,
but it is only a house in which I dwell and through which I work and express myself. I
have a body, but I am not my body.
2. I have emotions, but I am not my emotions. They are forever. I may feel happiness or
sadness, joy or despair, anger or peace. I can watch and judge my emotions: I can control
them to a limited degree. With my emotions I relate to those in the world around me, but
they are not myself. I have emotions but I am not my emotions. I also have desires, likes
and dislikes. They too are fluctuating and changeable, but they are not myself. I have
emotions, but they are not myself.
3. I have a mind, but I am not my mind. I can control and direct my mind. It is unruly,
but it is teachable. It is an organ of consciousness both of the world within and the world
without, but it is not myself. I have a mind, but I am not my mind.
I am neither my body, my emotions nor my mind. I am a centre of pure consciousness. I am a
centre of will. I am a centre of light, the pure, unchanging self that lives within.
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Self-Actualisation Learning Technology
We come onto this planet in awe and wonder, full of curiosity and trust. As we grow up, we
become enculturated to exist in a very different state – one involving fear and guilt, stress and not
much fun! Self-Actualisation Learning Technology (SALT) reconnects people to the sensational
world we all knew when we were young and assists them in living happier, more authentic and
fulfilled lives. The curiosity-based system provides the tools to live life more consciously, to be
able to choose how to respond rather than react to situations and people. It’s not entirely clear
how the process succeeds in improving the physical health of individuals, but this is a recurrent
consequence of utilising the technology!
Where is your life currently on a scale of one to ten?
A ten would be that you have all the health, money, love, fun, opportunities and whatever else
you desire and a one would equate to you looking for the nearest bridge to throw yourself off.
What is your honest answer? If, like most people’s, your score is not as high as you’d like, SALT
may be helpful to you!
Looking for a life manual?
The human spirit comes without a guide or owner’s manual. So, for most people, the course of
life is left to fate and logic – with the mind taking over our reality. However, your mind is
designed to keep you “safe”, which means keeping you stuck in the familiar comfort zone, where
you’re used to operating, but probably not fulfilling your potential for magnificence. SALT is not
designed for your mind; it’s for your Self. Its aim is to literally take you out of your mind, so you
can experience who you really are and wake you up to your authentic self, thereby allowing you
to get more of what you really want, leading a more magnificent life!
Experiential Process
The process of SALT coaching can take place through individual sessions or in group workshops.
Within a very safe environment, without any criticism, judgement or conclusion, you have an
intentional conversation with the coach or trainer. Although the conversation itself may appear
relatively trivial and involve laughter (and sometimes tears), the process provides the opportunity
for you to stop your world for a little while, to look at what really matters to you and to give your
body and mind the chance to be all that they can be; all that you want them to be.
Although no claims are made about the effectiveness of SALT at treating conditions such as M.E.
/ CFS, there are numerous testimonials describing how coaching has had dramatic positive effects
on individuals’ health, creating long-lasting improvements in severe and chronic illnesses.
To find out more about SALT, visit http://www.micpeakperformance.com
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Meditation
While meditating, we simply observe all thought patterns. When a thought arises we may take
note of it, but there is no need to become emotionally involved. We let go of it just as we might
release the string attached to a helium-filled balloon and let the balloon drift away. Then we
gently guide the mind back to the object of meditation. Gradually the mind becomes empty of all
thoughts apart from the object of meditation. When this occurs we can experience a mental state
diametrically opposed to stress; one free from worry, concern, conflict, and pressure.
The meditative state also has profound physiological effects. Mental activity always precedes and
directs physiological activity; we think about doing something and then fractions of a second later
we do it physically. In fact, all thoughts create a physiological response even if we merely think
about throwing a ball; there is a slight but definitely measurable response in the arm muscles. If
we think about something that angers us, a subtle echo of this takes place throughout the muscles
and the nervous system.
Not surprisingly, many people claim they attain a state of total muscular relaxation when they
still the mind. There are no thoughts and feelings dashing about on the field of consciousness.
Because the mind is calm during the meditative state, there is an opportunity for relaxation of the
muscles and a balancing of the nervous system. The body achieves a state of physiological
quietness, and these physiological changes are far-reaching, involving muscles, blood chemistry,
brain waves, breathing, the cardiovascular system, and metabolism. Thus, harmony is established
at all levels of the body.
In addition, the effects of meditation tend to persist throughout the day: we retain some awareness
of a peaceful state within and are able to choose to recreate aspects of that state during the day.
We are no longer slaves to our own responses, but have the ability to modify our reactions. We
can recall the peace of our last meditation and can look forward to the next. Thus, meditation
becomes a peaceful cause in the otherwise hectic flow of life.
Five Natural Stages of Relaxation / Meditation:
1. Stillness
Select a posture for relaxation or meditation. Allow yourself to rest in it, gradually
experience a sense of stillness that rises naturally in you. Settle in to that stillness and let it
support you.
2. Diaphragmatic Breathing
Feel the flow of your breathing, in and out through the nose. The exhalation is cleansing,
the inhalation nourishing. Let the abdomen rise and fall with each breath. Let the breath
flow without pause.
3. Systematic Relaxation
Use a systematic relaxation method (see previous autogenic training exercise) to release
tensions. At the end of the method, bring your whole body into your awareness, breathing
as if all the cells are cleansed and nourished with each breath.
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4. Breath Awareness
Bring your attention to the touch of the breath into the nostrils. Feel the breath; warm as it
flows out and cool as it flows in. Maintain your awareness through each change in
direction. Let thoughts come and go without judging or criticising them. Simply rest your
attention on the breath and relax. Your awareness can be just like sunlight on fog; just by
being aware that your mind has wandered onto thinking / planning / remembering, the
thought may then be dissolved and allow you to return to the concentration on the breath;
the emptying of the mind.
5. Mental Focus
Continue feeling the breath and at the same time begin to think about the natural sound of
the breath in your mind. Think ‘So’ on the inhalation and ‘Ham’ (hum) on the exhalation.
Let this sound become the focus of your awareness, gently bringing yourself back to it if
your attention wanders. Relax your body, breath and mind, maintaining the focus.
Soham Mantra
This is a philosophical or ‘Vadantic’ Mantra. The words may be roughly translated to mean ‘I am that’, meaning
that no limitations can be put on the divine. The syllable ‘so’ representing the universal spirit, and the syllable
‘ham’ representing the personal spirit. Soham is the natural sound of the breath being inhaled and exhaled.
Meditation, Grey Matter and M.E. / CFS
In 2005, a team of researchers in the Netherlands reported results of a study showing that
individuals with M.E. / CFS have reduced grey (brain) matter volume compared with healthy
individuals (NeuroImage 2005; 26: 777–781). They found a (statistically significant) 8% drop in
grey matter volume compared to those who didn’t have symptoms of M.E. / CFS. This reinforces
other research results which have demonstrated changes within the brain tissue of M.E. / CFS
patients: a reduction in grey matter volume, the extent of which seems to correlate with the level
of fatigue and disability experienced by the individual.
The cause of this grey matter volume reduction is not yet certain, although it is suggested that it
may well be due to oxidative stress (free radical damage), as discussed earlier in this book.
Although this specific ‘loss of brain tissue’ may sound a little alarming, a very interesting paper
was published shortly afterwards in 2005, entitled ‘Research shows meditation is associated with
increased grey matter in the brain’. (NeuroReport 16: 1893-1897). This study, carried out by
investigators in Massachusetts General Hospital, showed that meditation can not only alter resting
brain patterns, but can also cause increased cortical thickness – literally increasing grey matter in
the brain!
The conclusion of the researchers was that “forms of yoga and meditation are likely have a similar
impact on cortical structure, although each tradition would be expected to have a slightly different
pattern of cortical thickening based on the specific mental exercises involved.”
This study looked at the effects of ordinary people (with jobs and families and so on; not
Buddhist monks!), meditating for on average forty minutes a day. Although this may seem
excessive and very difficult to a beginner, perhaps even a shorter duration of meditation can
positively affect our brain tissue and further counteract the negative, organic aspects of ME /
CFS!
For further and extensive information regarding biomedical research into M.E. /
CFS, visit ME Research UK at: http://www.meresearch.org.uk
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Mind Reconditioning Summary
 The suggestion that Mind Reconditioning is necessary in management of M.E. / CFS in no
way implies that the condition is a psychological illness. The mind and body are
inextricably linked and this is simply part of a necessary holistic approach to treatment in
order to obtain optimal health.
 The following may be useful:
Validation of individual and situation and appropriate emotional support.
Meditation and relaxation exercises.
Self Actualisation Life Technology.
Practical coping strategies for achieving a positive state of mind and raising pleasure
and enthusiasm levels, such as planning regular activities to bring enjoyment and
acknowledging all achievements, no matter how small.
NLP and CBT: formal therapy or techniques to be practised by the individual alone,
such as identifying negative thought processes and considering alternatives that may be
more positive and helpful.
Emotional Freedom Technique / Thought Field Therapy may be useful for many
individuals in dealing with various aspects of M.E. / CFS (and other issues in life). Go
to http://www.emofree.com/ for further information.
Other aspects of support relevant to the individual, including elements of counselling
and open dealing with depression and suicidal thoughts.
Tips for Life with M.E. / CFS
Most people with any chronic condition will have discovered ways of managing the changed life
that they have to deal with, and the following ideas may seem extremely basic to some. Some
individuals, however, may find them useful. This is not intended to patronise, purely to share a
few thoughts suggested by individuals with M.E. / CFS which have proved helpful in their lives.
Some of them may not be relevant to you, but others may be.
 Have three extra pillows on your bed. One to put between your knees and two for either
side of you – either to rest in the small of your back, or to rest your arms above and
beneath; stops bony body parts leaning on each other and increasing pain!
 Write or type lists wherever possible. Although brain-fog, poor concentration and poor
memory is due to the M.E. / CFS and can be so frustrating, the effects of them can be
alleviated a little by making lists of things to do or other things to remember, and keeping
a pen and small pad or notebook with you.
 Remember that you have a highly sensitive system. Avoiding medication in general is the
best option, but when this is not feasible, ensure that your prescriber is aware of your
condition, so that you can be given a low dose of a drug, at least initially.
 Be aware that just as you have only a certain amount of money in your wallet, you only
have a certain amount of energy within you too. This energy may be spent on physical
exertion, mental activity or emotion. Be aware of how mental and emotional activity /
stress can use up a great deal of energy, as much or more than physical exertion. Try and
avoid “overspending”
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 Fibre-tip pens and felt-tip pens require a lot less strength and pressure to write with
compared to biros or hard pencils.
 Wheat bags (available on-line or from health shops such as Boots) that you put in the
microwave can be a great source of comfort; similar to a hot water bottle, but without the
potential for scalding and softer to hold near the body. The heat acts as a muscle relaxant,
as well as increasing blood flow to the area, improving oxygenation and normalising pain
signals to a certain extent, thereby acting as good natural pain relief, to pretty much any
part of the body.
 A large glass of water first thing in the morning (preferably before you actually get out of
bed) helps to combat dehydration after a night without drinking, as well as kick-starting
the digestive system.
 Eating breakfast within half an hour of getting out of bed helps combat reactive
hypoglycaemia (low blood sugar). It gives your body a good boost of fuel after its
overnight fast, and can help to sustain your energy levels for longer during the day.
 Get as many plants for your living and working space as possible. This is so important, not
only for oxygen, but also for the cleanliness of the air, as plants are nature's air purifiers.
They have been shown to eliminate a large number of common air pollutants. Plants also
add a wonderful decor to anywhere and looking upon pleasing things is healthy as well!
 An empty dozen egg-box makes a very good container for either 12 daily medications and
supplements or 6 twice-daily meds; sorting out 12 days’ supply at a time can save time,
and having all your “breakfast meds” or “dinner meds” in one place can make it easier to
remember them all.
If You are Especially Unwell:
 An extra quilt / duvet on the bed, under the sleeping sheet adds softness that can improve
comfort for hypersensitive bodies.
 A quilt / blanket made into a dome (by a carer) over very tender feet can prevent the
painful weight of bed coverings and improve rest.
 T shirts or soft rugby-type shirts and loose drawstring jersey trousers make very
comfortable, soft nightwear, but are also acceptable day wear for individuals spending
most of their time in bed.
 If someone is in bed most of the time, enhance the light in the room wherever possible,
especially using mirrors and uplighters, which can provide more gentle light.
 Try and regain some degree of normality by ensuring day is day and night is night; aim for
a light (and airy) room during daytime hours and darkness during night. For example,
opening curtains in the morning and closing them in the evening, even if they are closed
for some times in the day when napping.
65
Useful Websites
• Self Actualisation Learning Technique (SALT): Peak performance, vitality and
happiness using curiosity and non-judgmental awareness! "This new learning method can
help you catapult yourself to higher levels of happiness, satisfaction and productivity." If
you’re curious about finding out more, go to: http://www.micpeakperformance.com
• Yoga for M.E / CFS: Angela Stevens has developed yoga techniques and classes
specifically addressing the needs of individuals with M.E / CFS. She has produced CDs
and tapes so that people can practise this very relaxing and gentle exercise at their own
pace and in their own home. Visit http://www.angela-stevens.co.uk/me.html for more
details.
•
Get-Fitt Ltd: An innovative and friendly London-based company offering an array of
high quality, thoroughly tested wellness products such as personal ionisers, glyconutrients
and water purifying systems. They offer fully supported individualised far infra-red sauna
programmes as well as hiring out various equipment for trial prior to purchase. Contact
them via http://www.get-fitt.com
• BioLife Solutions Ltd: UK suppliers of Activated Air Therapy Devices: Airnergy+.
Also offer a range of other technologies including pain relief devices. Find out more at
http://www.biolifesolutions.co.uk
•
Jane Sheehan: International reflexologist and footreader. By combining footreading
with her extensive experience of reflexology, Jane is able to address her clients’ physical
and emotional problems really effectively. Visit http://www.footreading.com.
•
Dr Sarah Myhill: A medical doctor who has been successfully treating M.E. / CFS
patients for over twenty years. Her website: http://www.drmyhill.co.uk is a wealth of
useful information.
• The Spoon Theory: A useful way of explaining how M.E. / CFS often affects
individuals’ lives, to people who are finding it hard to understand. Visit:
http://www.butyoudontlooksick.com/2006/02/the_spoon_theory.php
•
Holosync Meditation Technology: “A sophisticated form of neuro-audio
technology that produces many desirable cognitive, emotional, and spiritual states —
states usually only available to experienced and dedicated practitioners of meditation.”
Go to http://www.centerpointe.com for further information, a free CD and an interesting
free monthly newsletter.
66
Appendix
 Canadian Criteria for diagnosis of M.E. / CFS
 Evidence for Accelerated Oxidative Injury as a
cause of ME / CFS
 Technical Summary (for medical professionals)
 Reference List
Checklist of ME / CFS Criteria
67
(Canadian Clinical Criteria (abbreviated version) 2003)
1) Post-Exertional Malaise and Fatigue (these criteria must be met)
a) The patient has a marked degree of new onset, unexplained, persistent, or recurrent
physical and mental fatigue that substantially reduces activity level
b) Post-exertional fatigue, malaise and/or pain, and a delayed recovery period (more
than 24 hours to recover)
c) Symptoms can be exacerbated by exertion or stress of any kind
2) Sleep Disorder (this criterion must be met)
Unrefreshing sleep or altered sleep pattern
3) Pain (this criterion must be met)
Arthralgia and/or myalgia without clinical evidence of inflammatory responses of joint
swelling or redness, and/or significant headaches of new type, pattern or severity.
4) Neurological / Cognitive Manifestations: (2 or more criteria must be met)
a) Impairment of concentration and short-term memory
b) Difficulty with information processing, categorizing, and work retrieval, including
intermittent dyslexia
c) Overload phenomena: information, cognitive, and sensory overload (e.g. photophobia
and hypersensitivity to noise) and/or emotional overload which may lead to relapses
or anxiety
d) Perceptual / sensory disturbances
e) Disorientation or confusion
f) Ataxia (loss of balance / co-ordination)
5) Autonomic / Neuroendocrine / Immune Manifestations:
(at least 1 symptom in at least 2 of the following 3 categories must be met)
Autonomic Manifestations:
1) Orthostatic intolerance
2) Postural Orthostatic Tachycardia Syndrome
3) Vertigo and/or light-headedness
4) Extreme pallor
5) Intestinal or bladder disturbance, with or without IBS
6) Palpitations, with or without cardiac arrhythmia
7) Vasomotor instability
8) Respiratory abnormalities
Neuroendocrine Manifestations:
1) Loss of thermostatic stability
2) Heat / Cold intolerance
3) Anorexia or abnormal appetite or weight change
4) Hypoglycaemia
5) Loss of adaptability and tolerance for stress, worsening of symptoms with
stress and emotional lability
Immune Manifestations:
1) Tender lymph nodes
2) Recurrent sore throat
3) Flu-like symptoms and/or general malaise
4) Development of new allergies or changes in status of old ones
5) Hypersensitivity to medications and/or chemicals
6) The illness persists for at least 6 months: (this criterion must be met)
68
Evidence for Accelerated Oxidative Injury and
Consequent Oxygen Deprivation as a Cause of ME / CFS:
There follows a summary of medical papers published over recent years, the results of which
provide further evidence for the theories discussed in this book regarding the cause and
symptomology of M.E. / CFS.
Oxidative Stress and Poor Anti-Oxidant Activity:




Vecchiet et al, 2003, concluded that “increased oxidative stress and decreased antioxidant defences are
related to the extent of symptomatology in CFS”.
Fulle et al, 2000, detected oxidative damage to DNA and lipids in muscle specimens of CFS patients as
compared to age-matched controls. Their data “support an organic origin of CFS, in which muscle suffers
oxidative damage”.
Behan et al, 1999, demonstrated that significant numbers of myoblasts (muscle fibre precurser-cells) from
M.E. / CFS patients had defects in aerobic metabolism.
Richards et al, in 2000, showed that oxidative stress, as measured by methaemoglobin, malondialdehyde
and 2,3 diphosphoglycerate levels, was significantly raised in CFS patients compared to controls. These
data suggest that “oxidative stress due to excess free radical formation is a contributor to the pathology of
CFS and is associated with symptom presentation”.
Oxygen Deprivation:










Costa et al, 1995 found that patients with M.E. / CFS have a generalized reduction of brain perfusion, with
a particular pattern of hypoperfusion (reduced blood flow) of the brainstem.
Ichise et al, 1992 also found areas of hypoperfusion within brains of M.E. / CFS individuals (using SPECT
scans).
Alvarez et al, 1996, examined arterial oxygen saturation levels. They found that patients with M.E. / CFS
showed overnight falls in SaO2% and spent more time during the night with SaO2% below 92% than did
the control group. They suggested that “These alterations could be important in FMS musculoskeletal
pathophysiology”.
Farquar et al, 2002, demonstrated that patients with M.E. / CFS have significantly lower peak oxygen
consumption with a trend towards lower blood volume.
Van Ness et al, 2000, described significantly impaired oxygen delivery and consumption levels in muscle
in patients with M.E./CFS. They concluded that “what may be an aerobic exercise regimen for healthy
individuals could actually be an anaerobic activity for CFS patients”
Results obtained by Lund et al, 1986, suggest, “in patients with primary fibromyalgia, the muscle
oxygenation is abnormal or low, at least in the trigger point area of the muscles.”
In a study by McCully et al, 1999, oxygen delivery to muscles and the oxidative metabolism in M.E./CFS
patients after exercise, were significantly reduced compared with controls. There was a significant
correlation between oxidative metabolism and recovery of oxygen, which is consistent with abnormal
autonomic control of blood flow in these individuals.
An abnormally low circulating red blood cell volume and / or plasma volume has been identified in M.E. /
CFS patients by a number of investigators, including Streeten & Bell, 1998. They found that red blood cell
mass was found to be significantly reduced. Plasma volume was subnormal in 52.6% of patients and total
blood volume was below normal in 63.2%. “The high prevalence and frequent severity of the low RBC
mass suggest that this abnormality might contribute to the symptoms of CFS by reducing the oxygencarrying power of the blood reaching the brain in many of these patients.”
Simpson, (1989), describes how, compared to healthy controls and patients with Multiple Sclerosis, M.E. /
CFS patients showed the lowest percentage of normal red blood cells and the highest incidence of cup
forms (abnormal red blood cells). These changes in the shape of the red blood celll may plausibly make
them less flexible, thereby impairing their ability to enter the capillaries. This may reduce blood flow and
delivery rate of oxygen and metabolic nutrients into the tissues, and inhibit metabolic waste from being
carried away.
Results from Peckerman et al, 2003, provided initial evidence of reduced cardiac output in severe CFS.
They suggested that in some patients with CFS, blood pressure is maintained at the cost of restricted flow,
possibly resulting in a low flow circulatory state. Thus, “there might be periods in daily activities when
demands for blood flow are not adequately met, compromising metabolic processes in at least some
69

vascular compartments. If confirmed, this finding would signify that some cases of CFS might be
explained and potentially treated as low circulation problems.”
De Lorenzo et al, 1998 found that both maximum and minimum diameters of carotid arteries were smaller
in M.E. / CFS patients, compared to healthy controls. This suggests that overall blood flow to the brain
may also be reduced.
Objective Evidence of Physical Abnormalities in Patients with M.E. / CFS:
Autonomic Nervous System Dysfunction:
•
•
•
•
•
•
•
increased incidence of abnormal tilt table response in CFS (30 - 95%) (Bou-Holaigah et al, 1995; Freeman
& Komaroff, 1997; Gibson et al, 1993; Stewart et al, 1999; De Lorenzo et al, 1997)
increased resting heart rate (Duprez et al, 1998; LaManca et al, 1999)
decreased vagal power (i.e. parasympathetic activity) (Freeman & Komaroff, 1997)
decreased sympathetic activity response to physical (Stewart et al, 1999; Freeman & Komaroff, 1997;
Duprez et al, 1998) and mental stress (Soetekouw et al, 1999)
decreased nocturnal systolic BP (van deLuit et al, 1998)
increased postural drop in BP (Soetekouw et al, 1999)
increased HR and sympathetic activity after tilt table testing (De Becker et al, 1998)
Immune Dysfunction:
•
•
•
Patarca et al (2001) demonstrated that most M.E. / CFS patients undergo a shift to over-produce Th2 cells
and under-produce Th1 cells. This means that, rather than being able to “switch” between producing Th1 or
Th2 cells depending on which is the most appropriate response, individuals’ immune systems get “lockedinto” producing Th2 only, whatever the immune insult.
M.E. / CFS individuals are often found to have high levels of antibodies of many kinds; particularly types
of auto-antibodies such as anti-nuclear antibodies (Von Mikecz et al, 1997; Nishikai M et al, 2001).
Behan et al (1991) identified specific damage to mitochondria in the muscle cells of M.E. / CFS
individuals.
Effectiveness of Oxygen Therapies:
•
•
•
Scholey et al (1998) found a reversal of cognitive deficits associated with chronic fatigue syndrome when
oxygen was administered.
In 2004, Yildiz et al found a decrease in tenderness of Fibromyalgia points, reduced pain scores and an
increase in pain threshold in a group of Fibromylagia patients after a series of hyperbaric oxygen
treatments (long term changes were not followed up).
Ali (1999) found improvement in a variety of M.E. / CFS symptoms using various oxygen therapies
including ozone, hydrogen peroxide and nasal oxygen.
70
Aetiological model of Chronic Fatigue Syndrome: proposed
pathophysiological process underlying ME/CFS and implications for treatment.
(aimed at medical professionals)
Dr C J Bowen, July 2005.
Abstract
M.E. / CFS is a debilitating systemic disorder about which little is conclusively understood. There is a
great deal of evidence to support the theory that M.E. / CFS symptom complexes result from accelerated
oxidative injury. This evidence is discussed. Necessary aims of treatment are suggested as repairing
damage caused by oxidants and preventing recurrence. An integrative management plan for the condition
is proposed, addressing relevant biological and psychosocial factors. The areas addressed by this
individualised protocol include treatment of latent infections / management of heavy metal poisoning
(detoxification), improving oxygenation, diet and supplementation, reconditioning of body and
reconditioning of mind.
Introduction
Chronic Fatigue Syndrome (CFS) or (M.E.) Myalgic Encephalomyelitis is an often poorly-understood, debilitating
neurological condition (as classified by the WHO in ICD10) affecting at least 0.4% of the population of the UK (Chief
Medical Officer’s Working Group Report on CFS/ME, 2002). It is a growing problem worldwide, with tremendous costs
to the individual as well as enormous economic costs to society. A study released in 2003 by Sheffield Hallam
University on behalf of Action for M.E., a U.K. charity, estimated the cost of M.E. to the U.K. economy at £3.46 billion
per year. In 2004, the annual total value of lost productivity due to M.E. / CFS in the United States was estimated at $9.1
billion (Reynolds et al, 2004). This is not including medical and disability costs to the state.
The Canadian Expert Consensus Panel Clinical Case Definition of ME/CFS (Carruthers et al, 2003) is now widely
accepted as the most appropriate diagnostic criteria for this condition, as they incorporate dysautonomia, cardiac and
immune symptoms as a key feature of the condition, when other diagnostic criteria focus only on the fatigue
experienced, thereby broadening the diagnostic group to include those suffering from chronic fatigue or other conditions.
Individuals meeting these criteria may be diagnosed with Fibromyalgia Syndrome (FMS), Chronic Fatigue Syndrome
(CFS), Myalgic Encephalomyelitis (ME) or Post Viral Fatigue Syndrome (PVFS). Patients with these conditions may
suffer to differing extents with differing symptoms, but it is proposed that the underlying pathological process is similar
for each and therefore a similar treatment approach / protocol, tailored to the individual will be effective. The different
names seem to reflect the most significant symptoms present at the time of diagnosis and/or the field of expertise of the
diagnosing physician. ME/CFS is a useful term to encompass all the above diagnoses, covering those individuals who
meet the Canadian criteria.
There is significant evidence to suggest that individuals with ME/CFS Complex have lower-than-normal levels of
oxygen (O2), both within the circulatory system (Alvarez et al, 1996) and intracellularly (Lund et al, 1986). Studies have
also shown that oxygen therapies and other forms of treatment, which aim to increase intracellular oxygen levels, have a
positive effect on ME/CFS patients (Scholey et al, 1998; Ali, 1999; Yildiz et al, 2004).
Since oxygen is the most important nutrient for the body (humans can survive weeks without food, days without water,
but only minutes without oxygen), and is necessary for nearly all metabolic processes, it is perhaps unsurprising that a
basic lack of it can produce such a debilitating, systemic disease.
It is proposed that the underlying cause of all presentations of ME/CFS is accelerated oxidative injury to biological
structures throughout the body. It is suggested that many factors combine to cause cells immense oxidative stress. This
greatly decreases oxygen delivery to cells and impairs oxygen metabolism within the cells. This causes severe oxygen
deprivation at an intracellular level. When this impairment of vital metabolic processes occurs systemically, it is believed
to cause the symptom complexes seen in ME/CFS. A feedback loop then exists; conditions are created which further
impair O2 delivery and metabolism and increasing the oxidative injury. This perpetuates the condition, worsening
symptoms and preventing return to health.
It is concluded that if the oxidative damage can be reversed and further damage prevented, the condition of ME/CFS
should be controllable; a state should be attainable in which the affected individual’s own body system is able to heal
and maintain itself to prevent all signs and symptoms of this condition.
Genetic Predisposition
There is believed to be a genetic predisposition to development of ME/CFS, which manifests as cells more easily
damaged by oxidative stress. This may be quantifiable as an “inferior anti-oxidant system” (i.e. reduced levels /
mutations of enzymes such as superoxide dismutase, catalase or glutathione peroxidase), another specific inborn error of
metabolism (relevant enzyme mutation) or alterations in cell mitochondria (Behan et al, 1991).
71
It is considered that this genetic predisposition is the first in a series of events that eventually culminate in the
potentially debilitating ME/CFS complex.
Pre-Disease State
Throughout life, human beings are subject to high numbers of endogenous and exogenous oxidants (free radicals). A free
radical is a cluster of atoms (or a single atom), one of which contains an unpaired electron in its outermost shell. This is
an extremely unstable configuration, so free radicals react easily with other molecules to achieve greater stability: an
outermost shell containing a full complement of electrons.
The term reactive oxygen species (ROS) is also used to describe free radicals and other molecules that are themselves
easily converted to free radicals or are powerful oxidising agents. Sequential reduction of molecular oxygen (i.e.
sequential addition of electrons) leads to formation of the following ROS: superoxide anion, hydrogen peroxide and then
hydroxyl radical (OH⋅) (most reactive).
ROS are formed via several different mechanisms; endogenously and exogenously. These can be categorised into three
groups of oxidants: metabolic (unavoidable by-products of cellular respiration), microbial (toxins and waste products
generated by microbes and via the destruction of microbes by immune system cells) and man-made (such as those
formed through exposure to ionising radiation, pesticides, cigarette smoke, synthetic hormones, antibiotics and other
medications) (Ali, 1998).
By reacting to gain a stable configuration, free radicals convert their target species into a radical. So a chain reaction
begins that will propagate until two radicals react with each other and each contributes its unpaired electron to form a
covalent bond. This chain reaction can result in damage to innate / biological molecules. The resultant damage is termed
oxidative stress.
In order to prevent oxidative injury, the body utilises its anti-oxidant system. Antioxidants have been defined as “any
substance which delays or inhibits oxidative damage to a target molecule.” (Gutteridge and Halliwell, 1994).
The exact activity of an antioxidant depends on the ROS involved, the area of the body affected and the exact molecular
target of attack. Oxidative stress (injury) occurs when there is either a decrease in anti-oxidant defences or an
overwhelming increase in generation of ROS (or both).
Cellular components especially vulnerable to oxidative injury are lipids (via peroxidation e.g. in cell membranes),
proteins (e.g. enzymes, cell receptors) and DNA. Free radicals can cause fragmentation of DNA within cell nuclei.
Among the most important damaging actions of free radicals, is that done to fatty acid side chains of lipids in
mitochondrial membranes (directly exposed to the superoxide anions produced during cellular respiration).
In those genetically more susceptible to oxidative injury, the following may be a consequence of rising free radical
levels:
•
•
•
Structures of cellular components become altered and dysfunctional (due to radical chain reactions).
Mutations occur, producing dysfunctional enzymes.
Numbers of oxygen molecules within the cell are exhausted by damaging oxidation reactions, leading to
decreased levels of O2 available for cellular metabolism.
The human cell is believed to be able to withstand certain levels of uncontrolled oxidation. In health it is estimated that
an intracellular partial pressure of oxygen as low as 1-3 mm Hg is sufficient to support cellular metabolism (Coher,
1984). This indicates a substantial reserve under physiological conditions, since the average partial pressure value is
estimated at 23 mm Hg (by direct measurement in lower animals) (Coher, 1984). However, it is not known whether such
conditions can support active cellular metabolism in a state of accelerated oxidative injury.
It is suggested that, with certain levels of uncontrolled oxidation, cells within the human body are able to function
adequately due to the large reserve of oxygen and other cellular resources. However, this is considered to be a premorbid state of ME/CFS. If the high levels of oxidants are not addressed at this point, a trigger event may precipitate
ME/CFS Complex.
Trigger Events
With such high rates of oxidation, it takes only a small amount of extra stress (a “trigger event”) in terms of radical
generation or O2 demand, for cellular respiration and other metabolic processes (and consequently cellular function) to
become impaired. When this occurs systemically, the body begins to exhibit the signs and symptoms attributed to
ME/CFS; a state of accelerated oxidative molecular injury (Ali, 1993).
The trigger event causes either:
 Increased energy (ATP production) demand,
 Reduction in O2 levels,
 Further increase in free radical numbers,
 A combination of the above factors.
72
Examples of trigger events involving increased energy demand are physical trauma such as musculo-skeletal injury
and surgery, or excessive emotional stress such as bereavement. Examples of trigger events involving generation of
increased radicals include bacterial or viral infection. One theory regarding trigger events is that an infectious agent, such
as a virus (CMV / EBV / HHV6) (Cheney, 1999), bacteria, or vaccine (e.g. Hepatitis B) stimulates T-cell proliferation,
producing large numbers of cytokines, which consequently increase blood viscosity, thereby resulting in a temporary but
potentially significant decrease in oxygenation of tissues (Berg et al, 1999). This is an example of a “combined effect”
trigger event, since the above pathway causes reduced availability of O2, plus the infectious agent is likely to increase
free radical generation through production of toxins and waste products.
A second trigger event theory starts with the observation that infections which precede and may therefore precipitate
ME/CFS act to induce production of inflammatory cytokines (as above) that induce, in turn, inducible nitric oxide
synthase (iNOS). This enzyme then synthesizes excessive amounts of nitric oxide, which reacts with superoxide to
produce the potent oxidant peroxynitrite. Excessive peroxynitrite levels in an anti-oxidant-deficient system cause
accelerated oxidative injury, thereby initiating symptomatic ME/CFS Complex. Once produced, peroxynitrite also acts
via biochemical mechanisms to increase the levels of both nitric oxide and superoxide, which react to produce more
peroxynitrite. In this way, once peroxynitrite levels are elevated, they may act to continue the elevation, thus producing a
self-sustaining vicious cycle (Pall, 2001).
Nitric oxide (NO) is known to stimulate the nociceptors that initiate pain perception; high nitric oxide levels may
therefore be associated with the body-wide pain observed in ME/CFS (Pall, 2000). NO has a central role in learning and
memory and excessive production may also provide a partial explanation for the cognitive dysfunction in ME/CFS (Pall,
2000). Other symptoms potentially explained by NO excess include immune dysfunction, fatigue and post-exertional
malaise (Pall, 2000).
Not only infections but also instances of severe physical or psychological trauma may produce a similar NO vicious
cycle effect via activation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis and consequent cytokine production (Pall,
2000). Pesticide and organic solvent exposure has also been reported to cause accelerated oxidative injury via the
cytokine pathway described above (Pall and Satterlee, 2001), and in some individuals this may be the trigger event
precipitating ME/CFS (Behan and Haniffah, 1994; Behan, 1996).
The consequence is the same for each type of trigger event; an individual moves from the pre-morbid state into
symptomatic ME/CFS. This occurs because cells are unable to function normally in the anaerobic, structurallydeforming conditions of accelerated oxidative injury; they are forced to exist in a more ‘primitive’ state, able to sustain
very limited function via anaerobic fermentation rather than aerobic respiration (Ali, 1998).
Symptom Complex Explanations
As described above, there is significant evidence to suggest that accelerated oxidative injury to biological structures,
with consequent defects in aerobic metabolism may be a major causative factor in ME/CFS (Behan et al, 1999; Fulle et
al, 2000; Richards et al, 2000 A; Vecchiet et al, 2003;)
Extensive evidence also exists supporting the proposal that the ME/CFS symptom complex is associated with decreased
levels of oxygen. In ME/CFS individuals, studies have demonstrated hypoperfusion and poor O2 delivery (Ichise et al,
1992; Costa et al, 1995; Alvarez et al, 1996; Van Ness et al, 2000;), abnormal erythrocyte function (Simpson, 1989) and
reduced plasma volume and red blood cell mass compared with healthy controls (Streeten and Bell, 1998; Farquar et al,
2002).
It is proposed that, as a result of the above state, excess reactive oxidative species, progressive anoxia and accumulation
of organic acids create cellular ecologic conditions that closely resemble a primordial state (Ali, 1998). The enforced
anaerobic conditions in cells body-wide causes a respiratory-to-fermentative (RTF) shift in terms of ATP production.
Inefficient and subsequently dysfunctional cells then produce the symptom complexes of ME/CFS (Ali, 1998).
The Krebs (Citric acid / Tricarboxylic acid) Cycle is the final common pathway for oxygen-driven breakdown of sugars,
fats and proteins to produce usable energy for the body. If the enzymatic pathways of Krebs Cycle are impaired (e.g.
secondary to the oxidative damage previously described), the cycle is effectively blocked. This causes a build up of
metabolites, which are then excreted. It has been demonstrated that individuals with ME/CFS excrete increased levels of
Krebs Cycle metabolites (organic acids) (Ali, 2003). This accumulation predictably results in intracellular acidosis,
which further impedes oxygen metabolism (see below).
Ali (1998) describes how the oxidative regression to a primordial ecology of cells (ORPEC), as described above, results
in rapid multiplication in blood and tissues of pleomorphic anaerobic organisms with yeast-like morphological features.
These are designated primordial life forms (PLFs), due to lack of precise nucleotide sequence and taxonomic data. PLFs
are readily observed with high-resolution phase-contrast and dark field microscopy in freshly prepared and unstained
smears of peripheral blood. Strong homology (up to 40 percent) among yeast and mammalian DNA sequences has been
reported (Altschul et al, 1990; Botstein et al, 1997). Such homology indicates that the genetic codes for PLF growth may
already exist in human cells and that organisms observed may not indicate an infection from an outside source. Organic
acids such as tartaric acid and carboxycitric acid and other toxins produced by the growing number of PLFs worsen
73
acidic conditions and generate oxidative cycles that feed upon each other, causing further damage to antioxidant
systems and oxygen metabolism within the body.
If it is agreed that ME/CFS Complex is due to abnormal oxygen metabolism at a cellular level, causing significantly
reduced levels of ATP production and other disrupted intracellular processes, the diverse, variable and often debilitating
ME/CFS complex symptoms can perhaps be better understood.
Novel Coagulopathy
There is strong evidence for a novel coagulopathy in ME/CFS individuals. This is caused by a host of oxidative
phenomena, leading to structural damage to erythrocytes, polymorphonuclear cells, and abnormal micro-clot and microplaque formation (Ali, 1993B; Ali, 1997). The micro-clotting process can be reversed using antioxidants such as
vitamins E or C (Ali, 1990), demonstrating the oxidative nature of such changes. This hypercoaguable state has also been
documented in ME/CFS patients using markers such as fibrinogen, thrombin-anti-thrombin complexes and soluble fibrin
monomer (Harrison et al, 2004). The phenomenon, which effectively increases blood viscosity, decreases delivery of
nutrients (including oxygen) to tissues, thus further decreasing tissue oxygenation.
Lymphopathy
A state of oxidative lymphopathy in ME/CFS is also proposed, similar to the oxidative coagulopathy described above
(Ali M, 1999). It is suggested that oxidative denaturation of proteins, lipids and sugars occurs within the circulating and
stagnant lymph, as has been demonstrated in the blood of ME/CFS individuals. Myofascial trigger points (the tender
points included in the American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia) are
believed to develop as a result of accumulation of oxidised and stagnant lymph components within muscles, tendons and
ligaments (Ali, 1999).
Autonomic Dysfunction
Signs and symptoms reflecting autonomic dysfunction occur frequently in patients with ME/CFS (Gibson et al, 1993;
Bou-Holaigah et al, 1995; De Lorenzo et al, 1997; Freeman & Komaroff, 1997; De Becker et al, 1998; Stewart et al,
1999). These include delayed gastric emptying, urinary frequency, neurally mediated hypotension and other forms of
orthostatic intolerance. Oxidative stress has been linked to development of autonomic dysfunction (Demir et al, 2005).
Autonomic nervous system changes (autonomic dysfunction) in ME/CFS may develop due to “channelopathy”.
Abnormal ion channel functions as the mechanism of neurological disorders (including epilepsies and migraine) now
constitute a new group of diseases termed channelopathies (Chaudhuri and Behan, 1999). Accelerated oxidative injury
may alter the configuration of plasma-membrane receptors and neurotransmitters. These alterations may lead to
abnormalities in the normal receptor and ligand-gated ion channel function, causing perturbations of cell transport
mechanisms and the action of neurotransmitters. Evidence of a cell membrane transport defect (Watson et al, 1997) and
alterations in neurotransmitter activity (Spence et al, 2000) has already been demonstrated in individuals with ME/CFS.
It is proposed that Neuropeptide-Y (NPY) is amongst the neurotransmitters affected. NPY co-exists with norepinephrine
in the sympathetic nervous system. Released by sympathetic activity, NPY is a major mediator of stress, responsible for
prolonged vasoconstriction via Y1 receptors (Zukowska et al, 1993). Studies have shown that NPY levels are
significantly elevated in individuals with ME/CFS (Anderberg et al, 1999). It has also been demonstrated that, in female
patients, during the luteal phase of the menstrual cycle (between ovulation and onset of menstruation) levels of the
peptide were higher than during the rest of the cycle. This correlates with a worsening of symptoms observed in female
ME/CFS patients during this phase of their cycle (Anderberg et al, 1998). NPY is also believed to have considerable
immunoregulatory effect on natural killer (NK) cell activity (Nair et al, 1993). Dysfunction of this may explain some of
the immune system abnormalities observed in ME/CFS (Patarca et al, 2001).
Pain
Dysregulation of Substance P (via neurotransmitter oxidative injury as described above) is proposed as a contributing
factor to the multi-organ pain commonly experienced in ME/CFS. Substance P (SP) is a short-chain polypeptide that
functions particularly as a neurotransmitter in pain transmission. Higher levels of SP cause increased pain. Levels of SP
in cerebro-spinal-fluid (CSF) in individuals with ME/CFS are three times higher than in healthy controls (Russel et al,
1994; Larson et al, 2000), and also higher than in Rheumatoid Arthritis patients (Vaerov et al, 1988). Oxygen deficit
triggers the release of SP (Kim et al, 2001; Chen et al, 2001). Since it is proposed that individuals with ME/CFS have a
global oxygen deficit, this, combined with the oxidative SP dysregulation described above, may go some way to
explaining the non-specific, body-wide pain experienced in this condition.
SP levels tend to have an inverse relationship with norepinephrine (noradenaline), in part (or entirely) as a result of
neuronal competition for nerve growth (Davis et al, 1994). This is consistent with findings of hyposecretion of
norepinephrine in ME/CFS patients (Goldstein, 1996) and consequent high pain levels and adrenergic dysfunction.
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Hormonal Dysregulation
Oxidative injury to cell membrane receptors, hormones and neurotransmitter substances within the hypothalamopituitary-adrenal (HPA) axis may cause dysregulation of several hormones. Biochemical evidence for hypothalamic
dysfunction in ME/CFS complex is rapidly accumulating (Demitrack et al, 1991; Bou-Holaigah et al, 1995; De Becker et
al, 1996; Suhadolnik et al, 1996) with the following hormonal deficits (and consequent symptom complexes) commonly
observed in ME/CFS: dopamine (Moorkens et al, 2000), serotonin (Dinan et al, 1997) and human growth hormone
(HGH) (Moorkens et al, 2000; Allain et al, 1997).
The mechanisms of oxidative injury described previously are thought to cause a state of chronic, global, cellular
dehydration (Ali & Ali, 1997). This not only directly causes symptoms but in turn increases the degree of oxidative
damage, anoxia and acidosis.
Acidosis
In ME/CFS, there is chronic and unremitting intracellular acidosis, caused by the build up of organic acids secondary to
anaerobic metabolism. The body compensates for this acidosis by increasing renal bicarbonate resorption, and
developing tissue alkalosis (Ali, 1999). Extracellular alkalosis decreases levels of 2,3-diphosphoglycerate (2,3 DPG).
Since this substance lowers the affinity of haemoglobin for oxygen, the effect is inhibition of oxygen transport to tissues
and organs, constriction of blood vessels, and reduction of overall circulating blood volume. This increases tissue
hypoxia and a vicious cycle is created: hypoxia increases acidosis, causing greater blood alkalosis, which lowers 2,3
DPG even further, worsening hypoxia.
Seasonal Variation
Between 43% and 79% of ME/CFS patients report increased symptoms during winter (Terman et al, 1998). This may be
due to a variety of reasons including the following:


Lower levels of oxygen in the atmosphere, secondary to the loss of leaves from deciduous trees and decrease in
herbaceous plants (Keeling and Shertz, 1992).
Increasing vitamin D hypovitaminosis.
Low levels of vitamin D are a common finding in individuals with ME/CFS (Al-Allaf et al, 2003). This may be linked to
winter exacerbations, as wintertime supplies of Vitamin D depend on the previous summer’s exposure creating adequate
stores in the liver, or on dietary sources (Webb et al, 1988). One study of 504 patients with ME/CFS found that 97.8%
had a vitamin D deficiency (Hock, 1997). The cause of this is not currently understood, but may be due to enzymatic
mutations (caused by oxidative injury) preventing production of active vitamin D (Calciferol) from precursors. Another
possibility is pancreatic enzyme insufficiency (also driven by accelerated oxidative injury), causing malabsorption of fats
and consequent malabsorption of dietary vitamin D (ergocalciferol); a fat-soluble “vitamin”. Deficiency may also be
linked to illness preventing ME/CFS individuals from being out in the sun as much as their healthy counterparts.
Aims of Treatment
Symptomatic treatment can be useful in any medical condition. However, addressing the underlying cause of a disease
will have greater impact and a more sustained effect on patients’ health. This entails reversing the underlying problem as
well as preventing further occurrence. With any chronic disease, it is also important to address biological and psychosocial aspects of the condition that have resulted from the illness state.
Additional factors come into play when dealing with any chronic disease. ME/CFS is no exception to this and the
following issues must be recognised when formulating a treatment plan for the condition, as they affect the overall wellbeing of the individual and can exacerbate symptom complexes, thereby inhibiting recovery.
•
Deconditioning of muscles and joints, due to lack of use, fatigue and pain (Donald et al, 1996).
•
Psychological distress; depression / anxiety etc due to physical pain, cognitive impairment, as well as the loss of
health, independence, employment, relationships etc.
•
Social effects; isolation secondary to poor physical health and psychological effects.
•
Nutritional deficiency (e.g. B-vitamins); this can be exacerbated by digestive dysregulation and poor /
inappropriate dietary intake.
•
Sleep disturbance; this has previously been cited as the cause of ME/CFS. However, it is suggested that as in
many chronic conditions (especially those in which pain is a significant feature) the sleep disturbance is a
consequence or symptom of the condition, caused by the above factors.
Combining consideration of these factors with the previously discussed theory of aetiology, the proposed aims of
treatment for ME/CFS are to normalise cellular metabolism, promote repair of cellular structures and elimination of
toxins and prevent further oxidative damage. More simply, these aims can be stated as follows:
•
Improve oxygen delivery to cells
75
•
•
•
•
Improve oxygen metabolism
Increase anti-oxidant defences
Remove toxins and prevent further build up
Counteract negative biological and psychosocial effects of chronic disease
It is imperative to carry out all the above in a controlled manner so that full health can be achieved, without causing a
relapse in condition by placing demands which are too great on the individual’s over-burdened, often hypersensitive
body system.
Based on the above aims, using personal experience and research carried out by various investigators, the following
Management Plan has been compiled. The plan covers five areas that need to be addressed to differing extents by
individuals with ME / CFS. Each individual will require a tailor-made programme of treatment dependent on his or her
personal needs and situation. Research is currently underway to establish effectiveness of this regime.
Five Steps to Health
Areas to be addressed:
 Detoxification / Lymphatic Decongestion
 Improving Oxygenation
 Diet and Appropriate Supplementation
 Reconditioning of Body
 Reconditioning of Mind
© Dr C J Bowen 2005
76
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