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Herbs for Chronic Fatigue Keats Good Herb Guide Keville, Kathi. NTC Contemporary 9780879838096 9780071401302 English Chronic fatigue syndrome, Herbs--Therapeutic use. 1998 RB150.F37K48 1998eb 616/.0478 Chronic fatigue syndrome, Herbs--Therapeutic use.
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Nurture, Strengthen, Heal Are you "tired all the time" even after a full-night's sleep? Are you depressed and unable to concentrate? Do your muscles and joints ache and does even mild exercise make you feel worse? An estimated two percent of Americans suffer from this complex of stress-induced symptoms commonly called Chronic Fatigue Syndrome (CFS) or fibromyalgia. Herbs like ginseng, licorice root, astragalus, echinacea and St. John's wort have far-reaching healing benefits; they nurture and strengthen the body and mind, boosting energy and banishing pain and depression. Learn how to use these nourishing herbs and many others in the pages of this Good Health Guide.
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Herbs for Chronic Fatigue Keats Good Herb Guide Keville, Kathi. NTC Contemporary 9780879838096 9780071401302 English Chronic fatigue syndrome, Herbs--Therapeutic use. 1998 RB150.F37K48 1998eb 616/.0478 Chronic fatigue syndrome, Herbs--Therapeutic use.
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About the Author Kathi Keville is a prominent American herbalist who has been working with herbs since 1969. Her books include Herbs: An Illustrated Encyclopedia of Herbs, Herbs: American Country Living, Aromatherapy: The Complete Guide to the Healing Art, Herbs for Health and Healing, Pocket Guide to Aromatherapy and the Good Herb Guide Ginseng. She has also contributed to ten other herb books, written over 100 herb articles for national magazines, and was associate editor for Well-Being magazine. She has lectured throughout the United States, and has been on the staff of 10 teaching institutes. Kathi is director of the American Herb Association and editor of the AHA Quarterly, a founding member of the American Herbalist Guild and an honorary member of the National Association of Holistic Aromatherapy and the American Aromatherapy Association.
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A Keats Good Herb Guide
Herbs For Chronic Fatigue
Kathi Keville
Keats Publishing, Inc. New Canaan, Connecticut
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Herbs for Chronic Fatigue is intended solely for informational and educational purposes, and not as medical advice. Please consult a medical or health professional if you have questions about your health. HERBS FOR CHRONIC FATIGUE Copyright © 1998 by Kathi Keville All Rights Reserved No part of this book may be reproduced in any form without the written consent of the publisher. Library of Congress Cataloging-in-Publication Data Keville, Kathi Herbs for chronic fatigue / by Kathi Keville. p. cm. Includes bibliographical references and index. ISBN 0-87983-809-4 Printed in the United States of America Good Herb Guides are published by Keats Publishing, Inc. 27 Pine Street (Box 876) New Canaan, Connecticut 06840-0876 Website Address: ww.keats.com
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Contents Introduction
1
What is CFS?
4
Symptoms
7
Diagnosis
10
Fibromyalgia
13
Causes of CFS
15
Insomnia
34
Physical Fatigue
41
Heart and Circulation
47
Pain
51
Depression
57
Brain Function and Memory
62
Herbal Formulas for CFS
66
The Herbs
72
References
77
Appendix
80
Index
85
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Introduction ... In health, the genial pretense must be kept up and the effort renewedto communicate, to civilize, to share, ... to work together by day, and by night to sport. In illness this make-believe ceases. Directly the bed is called for ... We cease to be soldiers in the army of the upright; we become deserters. They march to battle. We float with the sticks on the stream; helter-skelter with the dead leaves on the lawn, irresponsible and disinterested and able, perhaps for the first time in years, to look round, to look upto look, for example, at the sky. Virginia Woolf, Collected Essays, vol. iv, 1925. There I was, successful at the work that I loveherbal medicine. I had two books and over 100 magazine articles published, plus a national herb newsletter and I was traveling throughout the country giving seminars. To top it off, I was in a wonderful relationship, lived in a beautiful rural area, was in good health and even had a great dog. Sure, I was pushing myself, but with so many opportunities on my doorstep, who could say no? Then one day, seven years ago, I got sick, very sick, I was so dizzy, I literally crawled around my house to keep from toppling over. I remember thinking that it was the oddest flu I ever had; it certainly must be that killer flu going around. I did not often get sick and I figured that I could suffer through it for a few days.
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The problem was, it did not go away. I tried to plunge back into my active lifestyle, but was dizzy, my sight was blurry and those headaches! Plus, an achey, flu-like feeling lingered in my muscles and intensified when I did anything even remotely active. I began to look wistfully at my skis and cross-country bike. Even more frustrating, I could not sleep. It finally dawned on me. I had a classic case of chronic fatigue syndrome, complete with 30 full-blown symptoms. A holistically minded doctor initially hoped that it was a case of low thyroid. So did I. But then he confirmed my suspicions. So I looked at my life. I lived in clean mountain air, ate healthfully, got plenty of exercise. I even drank burdock tea instead of coffee! However, I still had plenty of stress in my life. The obvious remedy was to eliminate stress. I quickly realized that this would not be easy. Sure, I could cut back on my work, but being afflicted with chronic fatigue syndrome brought a whole new meaning to the word stress. The first thing I did was to give myself a new assignment as a researcher and herbalist; to find out all I could to cure myself; a tough assignment, considering almost nothing was known about chronic fatigue syndrome at that time. I experimented with the herbal formulas I am sharing with you in this book; I took plenty of hot epsom salt baths; I did yoga and did spurts of dancing and hiking as my strength allowed. Now that I am healed, I would describe my experience as going to hell and back; I certainly am glad to be back. If anything beneficial resulted beyond my healing, it was the realization that I had the power to change myself. I no longer push myself at the crazy pace that once propelled me. If I should go back to my old ways, I do not know if chronic fatigue syndrome
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would once again engulf me. I do not care to find out. I thank God that I once again feel optimistic about life and have the energy to work and play. Chances are the majority of people reading this book have some form of chronic fatigue. The information in this book is geared to you, but will help those who have other fatigue disorders, especially the closely related fibromyalgia. I wrote this book for you because I personally discovered the power of herbs to heal me and I want to share what I learned. May it serve you well and help you along the path to natural healing and good health. Chronic Fatigue Syndrome This book describes natural treatments for a disorder that goes by many different names; most often it is called chronic fatigue syndrome, or CFS. Recently it has also been called chronic fatigue immune dysfunction syndrome, or CFIDS for short, to differentiate it from the general fatigue that results from many different disorders. "Immune dysfunction" also implies that we are not talking just about tiredness. In Great Britain, you may hear the disorder called "myalgic encephalomyelitis" or ME. However, this name suggests that it is caused by painful brain swelling, so it is being used less and less. Another outdated term is chronic Epstein-Barr virus (CEBV), now discarded because the connection of CFS to Epstein-Barr virus is questionable. I will use the term chronic fatigue syndrome or its acronym, CFS, in this book.
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What Is CFS? Feel tired? Can't seem to make it through the day without wearing out much less have time to enjoy the evening? If so, you are not alone. Fatigue seems epidemic in the Western world. Some say at the rate we are going, a quarter of the American population will develop some type of prolonged fatigue at some point in their lives. In a survey of almost a thousand patients visiting a primary care clinic, one-third complained of at least six months of fatigue severe enough to disrupt their lives. It turned out that many were diagnosed with the increasingly prevalent form of fatigue known as chronic fatigue syndrome or CFS. 1 CFS first came into public awareness in 1985 when a mysterious epidemic struck a couple of hundred residents of a small town near Lake Tahoe. The debilitating illness they contracted lingered for so long that it became apparent that these folks suffered from far more than simple flu. Researchers suspect that CFS was around long before this, but that it went by different names. There have been disorders that sound strikingly similar to our modern chronic fatigue syndrome, such as the "hysteria" experienced by 19th century womena form of exhaustion accompanied by dizziness, headaches and mental confusion. The fatigue disorder "neurasthenia" hit
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Germany in 1869, and Captain Cook's Resolution crew came down with a strange lingering flu-like illness after visiting New Zealand. What exactly is chronic fatigue syndrome? A good question, but unfortunately one not easily answered. In fact, much of the disorder is shrouded in mystery. The Centers for Disease Control defines it as ''unexplained and recurring fatigueone that is out of the ordinary for that individual. Unlike normal tiredness, rest does not relieve it.'' After researchers looked over 250 scientific papers on CFS in 1996, they observed that the "profound fatigue is made worse by minimal physical or mental exertion" and the symptoms typically last "at least six months." However, this fatigue is not simply feeling worn out by the end of the day. If you have chronic fatigue syndrome, you can literally be so exhausted that you barely have the energy to move. The telephone rings, yet even lifting a hand to answer it may require far too much energy. A CFS sufferer who does make it out of bed in the morning may get only as far as the couch before she or he needs to rest again. I know several people who spend most of their days in bed. A 1991 study in the Journal of Clinical Psychiatry reported that this fatigue can be even more debilitating than multiple sclerosis, lupus or Lyme disease. What is particularly devastating to the majority of CFS sufferers is that they were once exceptionally energetic. It is estimated that 96 percent of people with CFS actively exercised before they got sickmore than double the number in the general population. In fact, the syndrome was initially coined the "yuppie disease," because so many of the people it hits are energetic overachievers in the prime of their lives. As a result their lives drastically change. Many
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become so incapacitated they are forced to quit their jobs. This is reflected in disability claims, which shot up 500 percent from 1989 to 1993. In is now estimated that CFS affects at least 2 percent of the U.S. population, with this number predicted to grow as more and more people become ill. Although children and men get Chronic Fatigue Syndrome, the majority of its victims are women in their 30s and 40s. At least one survey observed that those who have had no children and/or have had a hysterectomy are at a higher risk. If women's hormones are a contributing factor, this area is still unexplored, although new research from McGill University in Canada indicates that women seem less able to produce the brain chemical serotonin, the lack of which may be directly linked to CFS. Whatever causes CFS, only about half of the people who come down with it are expected to improve. Many experts say that figure is overly optimistic. Moreover, the longer you have the disease, the harder it is to shake it. Only about 2 to 3 percent of people with full-blown cases fully recover. Even then, it likely to be years before they shrug off all the lingering effects. For that reason, most doctors specializing in CFS prefer to use the term remission rather than cure. If this sounds sobering, it is, but read on. I believe that the use of natural, body-healing herbs can vastly improve this statistic.
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Symptoms Debilitating fatigue is only one of many unpleasant symptoms that afflict Chronic Fatigue Syndrome sufferers. Unrelenting insomnia, low-grade fever, general pain, headaches, poor memory and concentration are landmark signs. These are usually accompanied by a sore throat and swollen lymph glands. Emotional breakdown, depression and feelings of despair are not uncommon, and the list of potential problems goes on and on. Some people with CFS lose their sense of balance, space and timing so much that they tend to misjudge distances. Simply closing their eyes while standing can make them lose their balance. Bright light strains and hurts their eyes, but it can be equally difficult to see in dim light. As you can imagine, driving at night against oncoming headlights is particularly hard for them, if driving is possible at all. There is also a tendency to put on weight; some people gain as much as 20 pounds when they get sick. At first it was assumed that this was because they were so physically inactive, but it now appears that several metabolic imbalances are responsible. Other possible problems are digestive upsets, recurring bladder infections, leg jerks during the day or nightall contributing to poor sleep. Some days are worse than others; the fevers come and go and, although they never rise very high, they
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usually mark a bad spell. The same is true of chronic muscle, joint and connective tissue pain, which has a strange inclination to increase and decrease and migrate from one area of the body to another for no apparent reason. As research into CFS continues, more obscure symptoms have cropped up. Oddly enough, about 80 percent of the people with CFS develop a distinct crimson crescent on the plate in the back of their mouths, much different from strep throat. Even more curious is the loss of fingerprints. According to police investigators, this phenomenon is very rare, yet almost 40 percent of people with CFS have exceptionally smooth fingertips and at least 4 percent cannot even be fingerprinted. (There, is no explanation, but one theory suggests that connective tissue cell deposits inflame the fingertips.) A relatively new finding in many people with CFS is an increase in their urine of a compound tagged CFSUMI, which peaks during infection or muscle or joint pain. Other compounds overly abundant in the urine include the amino acid tyrosine and aconitic and succinic acids. Substances called pro- and beta-alanine increase with indigestion or urinary tract problems. What all this means is still anyone's guess, but hopefully these new findings will increase our understanding of the disorder. CFS Symptoms Primary Fatigue after physical exercise (typically lasting 24 hours) Headache Joint pain (without redness or tenderness) Lymph node swelling (especially under arm or neck) Muscle aches Recurring sore throat Unrefreshing, poor sleep
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Secondary Balance off, especially with eyes closed Blurred vision Breathing difficulty Depression/emotional distress Digestive upsets Diminished libido Dizziness Involuntary eye movements Eye pupils of unequal size Heart palpitations Light sensitivity Low blood pressure Low-grade fever Poor memory and concentration Mental confusion Difficulty phrasing words and doing math Prostate problems Increased reflex reaction Skin rashes Poor spatial and timing judgments Temperature sensitivity Tender points Weight gain Other Characteristics Rapid destruction of antibodies Increased autoantibodies Poor blood flow to brain Brain changes Crimson crescent in mouth Fingerprint markings undefined Decline in muscles' energy storage (ATP)
Unregulated natural killer cells Aberrations in protein cells Increased urine compounds Adrenal dysfunction Allergies Alcoholism Anemia Brain tumor Cancer Chronic hepatitis Food poisoning Depression/anxiety disorder Environmental sensitivity Epstein-Barr virus Fibromyalgia Food allergies Gut toxicity
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Other Disorders That Cause Fatigue Heart disease Hyperglycemia Hypoglycemia Low blood pressure Liver disease Lyme disease Multiple chemical sensitivity Multiple sclerosis Pharmaceutical drug side effects Polio encephalitis Silicone breast implants Sleep apnea Thyroid disorders
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Diagnosis So, you're dog-tired and things are not quite right with your health. How do you know you have Chronic Fatigue Syndrome? You are immediately up against several problems. First, standard medical tests will probably come back showing you are just fine. The only problem obvious to others, including your doctor, is that you easily get confused and you may be depressed. This leads to another issue; many physicians still doubt Chronic Fatigue Syndrome exists. Instead, they chalk up its symptoms as simply "all in the head." Thus, CFS sufferers seeking help are routinely sent to a psychiatrist. In preparing this book, I read hundreds of articles on CFS in scientific journals. As recently as 1994, some still debated its existence. On top of all their unpleasant symptoms, it is especially difficult for CFS patients to have friends, family and doctors doubt their sanity. This attitude is improving, yet CFS is still misunderstood by many doctors and patients. To compound the problem, if you have CFS, you probably do not look sick. Sure, you may have bags under your eyes from far too many sleepless nights, but rarely do you appear to be suffering from chronic illness. In fact, you probably look great. This may seem a blessing, but it also means few people take
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your illness seriouslyespecially a year or two later when you are still complaining of a multitude of seemingly unrelated problems from some undetermined disease. No wonder it has been suggested that CFS be renamed "chronic frustration syndrome." In her book Running on Empty Katrina Berne, a clinical psychologist specializing in CFS, lists ways her patients describe their disease: My brain is on strike. I feel like a camera lens that can't focus. I've been short-circuited. I feel like there is an infection in my brain. It just isn't working rights. Considering all these road blocks, diagnosing CFS takes a last-ditch approach. Everything else that causes fatigue, such as low thyroid or Lyme disease, is eliminated first. Once disorders with similar symptoms are ruled out, the Center for Disease Control declares that if you have had serious fatigue for at least six months and experience four out of eight common symptoms (see page 8), you are a likely candidate. This is especially true if your symptoms are new ones that came on suddenly. Although the diagnosis may be upsetting, most people are glad finally to have their seemingly bizarre condition named. Even with these guidelines, not everyone fits the usual profile. Few people have all the symptoms, nor does everyone manifest the disease in the same way. Undoubtedly, some people who think they have CFS really have another ailment that causes exhaustion. Likewise, many people may blame symptoms of CFS
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on low blood sugar, candidiasis or anemia. Chances are we are looking at not just one disorder, but several that have similar symptoms. CFS researcher James F. Jones, M.D. says, "We may even find that what we now think of as chronic fatigue syndrome is actually more than one syndrome, with different triggers and different clinical courses."
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Fibromyalgia Fibromyalgia is either a type of chronic fatigue syndrome or closely related. The diseases share many symptoms, with a thin line distinguishing the two. As the name "myalgia" indicates, fibromyalgia's predominant symptom is pain, mostly in connective tissues, muscles and joints. For some reason, 11 to 18 tender points located at certain places on the body are particularly painful. Like CFS, fibromyalgia can also result in sleeplessness and mental confusion and, in slightly over half the time, it comes on suddenly with flu or viral symptoms. One theory is that traumatic incidents help trigger it, including physical and sexual abuse, since a history of these appear more often in people who have it. As in CFS, serotonin levels are low in fibromyalgia, blood flow to the brain is decreased and dysfunction of the hypothalamus, pituitary and adrenal gland axis may be involved. Disruption of this axis may be what produces the abundance of low-thyroid conditions in fibromyalgia; some experts estimate this occurs in about half the cases. Antidepressants, pain relievers and anti-inflammatory drugs are usually prescribed. Not only are there similarities in the two diseases, the treatments suggested in this book for CFS will also help anyone with fibromyalgia.
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Fibromyalgia Symptoms Primary Fatigue after exercising (lasting 24 hours) Muscle and/or joint pain (without redness or tenderness) Poor memory or concentration Unrefreshing, poor sleep
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Secondary Adenopathy Chronic cough Depression/emotional distress Headache Low-grade fever Pharyngitis Positive antinuclear antibodies Raynaud's phenomenon
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Causes of CFS It has been suspected for some time that chronic fatigue syndrome is caused by a virus, although this theory remains controversial. If true, the specific virus has not yet been discovered. However, the disease does have some characteristics of a virus. For example, it tends to linger on, it's difficult to identify and it causes excessive drowsiness as the body seeks sleep to regenerate the immune system. The same problem in pinpointing a virus is what hampered discovery of the HIV virus that causes AIDS; researchers did not know what to look for. So far, several families of virusesHIV, Epstein-Barr (responsible for mononucleosis), cytomegalovirus (source of herpes I and II and measles), intestinal and meningitishave been investigated to see if any may be related. To pursue the viral theory, researchers tested people with CFS for antibodies to these viruses. This would indicate that they had encountered the disease in the past. It seems that a higher percentage of people with CFS have antibodies to Epstein-Barr, cytomegalovirus (HHV-6) and intestinal viruses than the general population. This does not mean that these viruses are directly linked to CFS, especially considering most adults carry Epstein-Barr antibodies anyway. We can guess that people who get CFS are more susceptible to
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certain viruses. Also, scientists are learning that some diseases predispose us to others and can even affect brain chemistry. An example is rheumatic fever, a heart disease caused by strep throat. A high percentage of people who get rheumatic fever eventually develop obsessive-compulsive disorder symptoms. A lingering question for anyone with CFS is, ''How did I get it?'' Of course, that answer will have to wait until researchers determine exactly what CFS is. On the positive side, CFS appears relatively noncontagious. Only occasionally do members of the same family come down with it. If it is indeed a virus, something apparently makes one person more susceptible than another. Paul Cheney, M.D., the prominent CFS researcher who treated the first outbreak at Lake Tahoe, speculates that it may be a preexisting condition, perhaps a latent virus just waiting to be triggered. He feels that there may be several different triggers. If triggers prompt CFS, our next question is, "What are they?" There are plenty of suspects. Everything from childhood vaccinations to radiation to chronic candida have been blamed and all may be correct. The bottom line is either emotional or physical stress. The many chemicals that exist in our modern environment have been pegged as possible stressors. It is true that levels of chlorinated hydrocarbons, mostly HCB, are especially high in almost half the people who develop unexplained and persistent fatigue. 2 According to research surveys, a higher percentage of people with CFS were exposed to herbicides, pesticides or insecticides before they got sick compared to the general public. This would explain why the disease is so much more prevalent today. It also gives
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credence to the theory that the Gulf War Syndrome contracted by many soldiers who fought that war is related, although this disorder does involve more skin rashes, sinus congestion and diarrhea. Researchers at the University of Texas Southwest Medical Center in Dallas think the cause of Gulf War Syndrome might be stress combined with chemicals. Insecticides like malathion were sprayed on uniforms, mosquito repellents rubbed on skin and pyridostigmine ingested to safeguard against chemical warfare. Ironically, pyridostigmine inactivates enzymes in the blood that normally attack invading chemicals. The Immune And Lymphatic Systems Like most chronic disorders, CFS involves the immune system. Perhaps some weak link in the immune system makes it easier to get, or perhaps CFS occurs in an immune system weakened by trying to fight off the disease or a disease that preceded it. There is likely a direct connection to stress since nerves link the brain and nervous system to bone marrow, thymus and spleen, the places where immune cells are produced and educated. Years ago, Hans Selye, M.D., the researcher who first linked stress to illness, demonstrated that stress can damage the thymus gland, shrink lymph tissues and break up immune cells. Whatever the case, the immune system certainly is not performing up to par in CFS patients, who pick up practically every germ and virus that goes by and suffer with allergies and/or candida overgrowth in the intestines. The various parts of the immune system work as a team, so our first step in treating CFS is to determine which part is malfunctioning. Of special importance to
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CFS are natural killer cells. These cells cruise the body seeking invaders or irregular cell activity, especially viruses and cancer. A healthy immune system regulates killer cells by turning them on or off so they don't injure the body, yet many people with CFS have too few or too many natural killer cells. Obviously, in their case the immune system is not regulating these cells properly. This may also indicate that an infection is present. Other immune system irregularities recently observed in CFS patients were previously overlooked because they relate to areas of immunology just now being explored. Of concern are the immune antibodies, cells that remember characteristics of previous infections so they can quickly eliminate them if encountered again. These are destroyed far too rapidly in CFS patients. Normally breaking down in 20 minutes, they typically disappear in a rapid 20 seconds in CFS patients; that is 60 times faster than normal. On the other hand, autoantibodies, confused cells that attack the body itself, appear far too numerous. They are also seen in autoimmune diseases such as rheumatoid arthritis and lupus. One theory suggests that these autoantibodies injure parts of the brain. Dr. Cheney points out another immune system problem in CFS patients. The body produces interferon to fend off viral infections. Interferon's specific job is to prevent RNA (coded messages that tell cells how to work) in infected cells from spreading to healthy ones. However, it can also block messages of healthy cells if not held in check. Dr. Cheney theorizes that in CFS, something goes wrong with the system that transports RNA from one cell to the next (RNAse-L) and it rapidly spreads disease to healthy cells by mistake. This same problem is seen with the
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HIV virus and is one factor that makes it so difficult to control. While we do not know much about how RNA functions in CFS, Dr. Robert Suhadolnik of Temple University in Pennsylvania found that this transport system is more active in CFS than in most diseases. 3 It is possible that interferon also hinders serotonin. A common symptom of CFS is swollen lymph glands, especially those along the side of the neck. These glands, located throughout the body, produce antibodies and white blood cells called lymphocytes that flow through an extensive system of lymphatic channels that interweave into blood vessels and surrounding cells. The main role of lymphocytes is to collect garbage, i.e., pick up foreign materialsparticularly bacteria, cancer cells and cellular debris such as worn-out blood cellsand carry them to the nearest lymph gland. When a lymph gland swells from a toxin overload, you can be fairly sure infection lurks nearby. The lymph itself is a clear liquid produced by the spleen to carry lymphocytes and antibodies. The heart pumps blood through the body, but lymph relies on body movements to circulate. The once-active person, now slowed down by CFS, may move much too slowly to keep lymph moving at a sufficient pace even though the clean-up job is now more important than ever. Lymph flows in only one direction, from external parts to the center of the body, and doctors working with CFS patients note a predominance of lymphatic pain on the left side of the neck and the left front shoulder bone where the lymphatic system empties into the blood system. Herbs for the Immune and Lymphatic Systems Herbs can enhance the entire immune system, regulating its functions and helping it run efficiently.
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They go beyond simply handing the body a list of temporary instructions. They teach it how to operate better. Some of the most popular herbsechinacea, ginseng, shiitake mushroom, garlic and Chinese astragalus and ligustrumare good choices for treating CFS. Besides buffing up the immune system, they control production and activity of T-cells and natural killer cells. Scientific studies have found that garlic improves the efficiency of Tcells by preventing them from clumping and enhances natural killer cells by 145 percent in only three weeks. Most of these herbs probably also regulate white blood cell activity, including leukocytes. At the same time, echinacea, ginseng, Siberian ginseng, shiitake mushroom and garlic make healthy, uninfected cells more resistant to invasion. Ginseng offers other advantages, if Dr. Cheney's theories about RNA are correct since it regulates and improves the activity of RNA as well as the related DNA and cell division. Researchers conducting one study described the wide range of beneficial immune changes of ginseng dehydrated tea or extract as "drastic." 4 We can literally travel around the world to find other immune system herbs to help CFS. There is ashwaganda, an Ayurvedic remedy from India, pau d'arco from the Incas and uña de gato, or "cat's claw," from the Peruvian rain forest. Pau d'arco may boost the spirits, besides. When the award-winning Argentinian botanist Dr. Teodoro Meyer treated cancer patients with it, he noticed their outlook on life improved along with their general health. Chinese medicine uses astragalus and ligustrum in the traditional Fuzhung formula to promote vitality and healing. Astragalus is valuable for chronic disorders
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where the immune system does not keep up its normal pace and energy lags. As a testament to its ability, shiitake mushroom fights several viral infections more effectively than the powerful prescription drug amantadine hydrochloride. Teams of Japanese researchers in Tokyo have been investigating its antiviral properties. In one study, people with symptoms similar to CFS were selected. They had all tried an assortment of antibiotics and conventional fever drugs, but nothing worked until they were given lentinan, nicknamed LEM (Lentinus edodes mycelium), a powerful antiviral compound from shiitake mushroom. Not only did their fevers subside after two to four weeks, but their energy and feelings of wellbeing increased. After about six weeks, their natural killer cell levels returned to normal. 5 The recommended dose of LEM is 500 to 1,000 mg a day, although double that brings quicker relief. Whole shiitake mushrooms are not as powerful as the concentrated LEM, but I find people still benefit from adding them to food. I recommend tossing either fresh or dried mushrooms into soups and other dishes. Cooking is thought to enhance their benefits. Even if CFS turns out not to be viral, the above mentioned herbs will still boost a depleted immune system. They stop development of viruses and bacteria, thus lowering the numerous infections easily picked up with CFS. For example, ginseng and licorice diminish bouts of herpes. Pau d'arco and cat's claw treat a whole list of immune-related disorders, including herpes, shingles, candida, eczema, psoriasis, allergies, asthma and rheumatoid arthritis. Cat's claw helps heal the inflammation of stomach ulcers, colitis and Crohn's disease.
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Omega-3 and GLA (gamma lineoleic acid), fatty acids found in evening primrose, borage, or black currant seed oils are thought to both inactivate some viruses and correct autoimmune disorders. These fats are noticeably deficient in people with viral infections and help relieve symptoms of autoimmune disorders like multiple sclerosis and lupus. Omega-3 fatty acids are found in the herb purslane, which grows as a weed in many gardens, as well as in nuts, soybeans and flaxseeds. They are especially abundant in fish. Since the body can not manufacture essential fatty acids, it relies on the diet to supply them. Herbs used to drain lymphatic flow and reduce swollen glands include cleavers, prickly ash and lemon. Echinacea stimulates the production and activity of lymphatic cells. Due to the berberine they contain, goldenseal, Oregon grape and barberry enhance blood flow through the spleen, probably also improving its function. There is evidence that astragalus and ligustrum improve spleen actions and thus aid the entire lymphatic system. Aromatherapy Lavender, tea tree, eucalyptus, bergamot, grapefruit and bay are essential oils that enhance immune activity. They also serve as potent antibiotics. Use them with other herbal therapies for best results. Similar properties are found in the essential oils of garlic, rosemary, black pepper, cardamom, ginger, thyme and lemon. A liberal dose of the leaves, roots or seeds of these herbs added to your food also packs an immune punch. Try chai tea flavored with cardamom, black pepper and ginger, an East Indian favorite. These herbs boost energy as well as the immune sys-
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tem. I avoid the traditional addition of black tea because of caffeine's adverse effects on the adrenal glands. For an aromatherapy body or massage oil, add three to six drops of lavender oil to your bath. Massage itself is very helpful, especially lymphatic massage with deep strokes that move in the direction lymph drains towards the heart. One caution: go easy adding hot oils such as black pepper, ginger and thyme into a bath or massage oil since they can burn the skin. Four drops per ounce in a massage oil or one drop in a bath is plenty. Even then approach them with caution. Nutrition and Lifestyle To increase immune system activity, eat extra amounts of foods rich in vitamin A, such as carrots, yams and any bright yellow foods, and vitamin C, such as citrus, and/or take supplements. Vitamin A, long known as the anti-infection vitamin, increases natural killer cells when their numbers drop. Since it is possible to take too much vitamin A, the best supplements to take are its precursor, betacarotene and vitamin C. The suggested amounts are 15 mg betacarotene and at least 500 to 2,000 mg vitamin C daily. The Importance of the Liver The liver is on the front line of immune defense. The immune cells in the liver (the Kupffer cells) clear viruses and the toxic by-products of inflammation from the blood. Researcher Paul R. Cheney, M.D. has found that the liver is easily overwhelmed in CFS patients. He suggests reducing protein in the
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diet, which places an extra burden on liver activity, and avoiding exposure to chemicals, including the pesticides in food. Thus, it is advisable to buy organic foods whenever possible. Of the herbs that enhance the immune system, licorice and the Chinese herbs bupleurum and schizandra are especially important for the liver. Both promote liver function, and bupleurum increases the blood flow to it. Ginger, garlic and rosemary increase production of beneficial liver enzymes. These are all potent antioxidants that protect against liver damage. Garlic, bupleurum and ginseng have even been shown to help safeguard the liver from toxic heavy metals such as the solder in tin cans, cigarettes, dental fillings and some cosmetics. Also drink plenty of water to help flush out toxins, taking some of the stress off the liver and kidneys. The Hypothalamus-Pituitary-Adrenal (HPA) Axis A complex disorder like CFS affects far more than the immune system. Three areas particularly impacted are the hypothalamus, pituitary and adrenal glands. Together they coordinate and harmonize body activities, including the immune system and hormones. Their work is so interconnected that together they have been dubbed the HPA axis and are considered the center of stress management. The pituitary and hypothalamus, both located in the brain, are designated the "master glands" because they literally rule the entire body by sending out hormonal messages. The hypothalamus oversees the pituitary's regulation of growth and its release of hormones from
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the thyroid, adrenal and sex glands. The adrenals (situated over the kidneys) release several hormones in response to physical and emotional stress, including adrenaline, cortisol and the closely related cortisone (which is converted into cortisol so the body can use it.). Cortisol reduces inflammation and is important in the body's use of fats, carbohydrates, sodium, potassium and protein. The role of the HPA axis is becoming more apparent in CFS as our understanding of the disease evolves. In fact, Dr. Mark Demitrack and colleagues at the University of Michigan Medical Center thinks the HPA axis may be the core problem in the disease. A 1991 study found most people with CFS are extremely low in adrenal hormones. This and the impact of stress on CFS convinced Demitrack to further investigate the role of this axis. It turns out that when constant stress overworks the adrenal glands, the pituitary and hypothalamus are impacted. Consequences can be far-reaching since there is hardly a system in the body that these glands do not influence. Defects in the axis, especially low cortisol levels, are seen in rheumatoid arthritis and other autoimmune conditions, chronic inflammation and fibromyalgia, as well in as CFS. One consumer advocate group, the CDS Foundation, even wants the name of the disease changed from Chronic Fatigue Syndrome to Cortisol Deficiency Syndrome. Some viruses apparently disrupt the HPA axis. Dr. William Jeffries, a Case Western Reserve University endocrinologist, thinks that ongoing suppression of the hypothalamus is to blame whenever a person remains chronically ill after an infection. It is Dr. Cheney's guess that problems with erratic RNA messages, the same scenario that suppresses the immune
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system, also subdues the HPA axis. In support of this, Dr. David Saphier from Louisiana State University found that excessive amounts of a-interferon injure the hypothalamus and then suppress the entire HPA axis, at least in rodents. It is also suspected that ACTH (adrenocorticotropic hormone), the pituitary hormone that stimulates adrenal activity, is chronically low in CFS. ACTH influences mood by attaching itself to brain cells so that we feel better and have more vitality when we have sufficient amounts. When ACTH is given to CFS patients as a prescription drug, some of their symptoms have been dramatically reduced. Herbs for Enhancing the HPA Axis Help for the HPA axis comes from herbs designated as ''adaptogens,'' so named because they normalize or "adapt" many different functions of the body. They also improve physical, mental and emotional health and resistance to disease. They help us work and think better and more efficiently and adapt to emotional and physical stress, including extremes of temperature and lightall important concerns with CFS. In fact, they work on the same conditions controlled by the HPA axis. This has led researchers to speculate that adaptogenic herbs like ginseng work primarily through this axis. It is certainly one avenue that would allow such far-reaching effects. This also makes adaptogenic herbs specific remedies for CFS. Ginseng is a classic example of an herbal adaptogen. Not only does it alleviate stress and fatigue, it improves immunity and sexual function, maintains blood pressure, blood sugar, water balance, body temperature and sharpens the senses. Other adapto-
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gens with similar properties are Siberian ginseng, schizandra from China and ashwaganda from India (sometimes called Indian ginseng). The Chinese herbs rehmannia and reishi mushroom also have adaptogenic properties, at least in regard to the adrenal glands. Stress The relationship of CFS to both the immune system and to the HPA axis brings us to the subject of stress. It is obvious to anyone who has CFS that stress precipitates the symptoms and it may trigger the disease in the first place. It makes sense, considering that stress lowers immunity and affects the HPA axis. Many people with CFS have experienced severe stress during the year before they get sick. According to a study reported in the journal Immunology Studies, if the disease comes on gradually, the patient is more likely to have had stressful experiences before getting sick. When the body floods with adrenaline in response to excitement, anxiety or a single stressful situation, such as a threatening dog or a near traffic accident, the nervous system reactions heighten: the heart pumps faster, blood rushes to the face, the eyes dilate, the digestion stops and muscles flood with energyall in the matter of a few seconds. The body even begins to sweat to keep cool during the crisis. After the crisis has passed, the body returns to normal. However, the continual everyday stress eventually drains and exhausts the adrenal glands. Once exhausted, they no longer produce enough adrenaline, cortisone or cortisol hormones. This can make itself
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known with a long list of seemingly unrelated symptoms, such as chronic back or headache pain, sugar cravings, feeling overly emotional, mental confusion, digestive problems and decreased resistance to disease, such as frequent colds and flus; however, the most common symptom is getting tired far too easily. It has been shown that even mild adrenal deficiency can cause a person to lose deep REM sleep and to develop low blood sugar, weakness and headaches. 6 Regular doses of adrenaline to the brain disrupt brain chemistry, specifically serotonin, which is responsible for promoting sleep, lowering sensitivity to pain, transmitting nerve impulses and even hindering aggression and depression. When serotonin levels drop, the result is insomnia, pain and depression. Prolonged stress also increases the hormone prolactin, which can also lead to pain and headaches. In a never-ending cycle, these brain chemical imbalances make a person even more prone to stress. Eventually, he or she becomes sluggish as enjoyment seems to literally drain out of life. People with adrenal exhaustion may even experience memory lapses or mentally blank out. The body seems to shut down in an effort to say, "enough is enough ... stop ... it's time to rest and recharge." Adrenal exhaustion and CFS are two separate disorders, but adrenal fatigue seems to be part of CFS. Although there are a few differences (adrenal exhaustion results in weight loss while CFS typically causes weight gain), they share many symptoms. Stress can also lead to heart disease, ulcers and increased allergies. It is possible to develop anemia or a blood pressure dip, causing even greater fatigue. One stress-related illness that often ensues is irritable bowel syndrome (IBS). A large percentage of people
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with CFS have it: 63 percent compared to 22 percent of the general public. IBS causes recurring pain in the large intestine, bloating and often fatigue, and is usually accompanied by low serotonin levels. 7 Stress itself is not the culprit; it is the reaction to it. Of course, avoiding stress is not easy and this is especially true for CFS sufferers. What may be considered small amounts of stress to a healthy person become major stumbling blocks for those with CFS whose capacity to deal with stress drops to less than 20 percent of what it was. Herbs for Stress Believe it or not, herbs can help in handling stress. Siberian ginseng, ginseng, licorice, schizandra, rehmannia, reishi mushroom and ligustrum are adrenal tonics especially helpful during bouts of stress. Schizandra is even reported to control anger and aggression. Ginseng strengthens the adrenal glands and regulates the adrenal hormones. ACTH and adrenaline, along with Siberian ginseng, increase resistance to disease during stressful times. Olympic-bound Russian athletes and cosmonauts regularly take Siberian ginseng to help maintain optimum health while being exposed to severe environmental and physiological changes. A good example of ginseng's ability to reduce stress was seen when it was given to British nurses in London as they switched from working a day to a night shift. While other nurses on the new shift complained of disrupted sleep and fatigue, those taking ginseng were more alert, tranquil and felt more psychologically balanced. Even though ginseng did not seem to improve their sleep, the nurses definitely
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felt less tired, and their competency, coordination and speed in their job improved. Ginseng also normalized blood sugar levels that had increased from the stress. 8 A Chinese medical journal tells the story of one woman who developed serious adrenal deficiency after a bout of major emotional stress, including a difficult pregnancy. Instead of the normal medical route of cortisone and ACTH shots, her doctors gave her the herbs licorice and ginseng. They successfully stimulated her own cortisone and ACTH so much that she quickly recovered. She had more energy, gained weight and her blood pressure normalized.9 The New Zealand Medical Journal printed a letter from a man with CFS who reported he tried licorice root after two years of unsuccessful attempts with other therapies. After only a few days on licorice root, he had more energy and mental stamina. Herbs that help relax and heal the nervous system also help to deal with stress. The British Herb Pharmacopoeia recommends linden or lime tree blossoms, and 19th century Eclectic doctors prescribed skullcap to calm nervous tension, anxiety and nervousness caused by emotional or physical exhaustion. In China, motherwort is used as a nervous system sedative to reduce anxiety, stress and nervous tension. Even garlic may quell the harmful effects of stress. Garlic researcher Dr. Richard Kuentansky of the Slovak Academy of Sciences says that, "In my own work with stressed patients, I have noted that those who use garlic regularly suffer much less from the effects of stress." Other appropriate herbs, such as valerian, are discussed in the section on insomnia (see page 33). Nervous system disorders involved with CFS can lead to eye problems. Various difficulties such as jig-
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gling eye and blurred vision are common complaints. Bilberry and other herbs that are rich in anthocyanidins and proanthocyanidins increase the blood supply to the central nervous system and the eyes. Bilberry jam was given to World War II pilots to improve their eyesight. Working with the Institute of Biologically Active Substances, professor Stchichenkov conducted 60 tests demonstrating that Siberian ginseng makes eyes more responsive to light and helps one see better in the dark, apparently by working on brain areas that control sight and hearing. 10 Aromatherapy for Stress An aromatherapy massage offers gentle and enjoyable stress reduction. Use relaxing essential oils like lavender, chamomile, sandalwood, orange, petitgrain and ylang-ylang individually or in combination. Take an aromatherapy bath by adding a few drops of one of these essential oils to the bath, hot tub or sauna, or treat yourself to a massage with aromatherapy oils. The added benefit is that just 20 minutes of heat in a sauna or hot tub or half an hour of deep massage has been found to change brain chemistry and deeply relax the body and mind. Nutrition and Lifestyle for Stress The major antistress nutrients are vitamin C (5002000 mg a day), the B vitamin complex, especially B2, pantothenic acid (250 mg) and niacin (200 mg). Zinc is also important (1215 mg). Vitamin C and pantothenic acid support adrenal functions and, when the body is under stress, they are soon depleted. Rosehips and bioflavonoids help with vitamin C as-
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similation. In three months, 300 mg daily of anthocyanidins from bilberry and other herbs or the closely related proanthocyanidins extracted from pine bark or grape seed increase vitamin C in the adrenal glands and liver. All of these supplements are available in natural food stores and many drug stores. Osteopathic treatments helped improve 40 percent of the symptoms in a study of patients with CFS. Two of the participants were symptom-free after a year of treatments. The treatments also improved circulation and digestion. 11 The control group did not fare so well, getting slightly worse as time went on. Osteopathy is thought to calm overly excited nerves, allowing the nervous system a break so it can heal. Stress Management There are many types of relaxing techniques you can try. Be sure to put aside time for yourself, then seek quiet, relaxing ways to spend this time. You may not have lots of energy, but chances are there is something you have always wanted to take up but never had the time before. Yoga, meditation, tai chi and biofeedback are just a few examples. These techniques have another advantage for CFS patients; they also gently stretch muscles and help eliminate pain. Acupuncture treatments can also unwind the nervous system and reduce the impact of stress. Be creative looking for anything that calms your mind and relaxes your body. Put up a hammock, porch swing or lawn chair and listen to the healing music of birds and crickets. Read positive, uplifting books. If that entails too much eye strain, listen to books on tape. Novels and self-improvement tapes, such as guided relaxations, are readily available at
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public libraries and bookstores. Creativity itself is not only relaxing, but boosts your self-esteem. Try your hand at knitting, crocheting, clay sculpture, or dust off that guitar you have not played for years. One thing that helps many people is to sit down with family or close friends and invite them to brainstorm ways to de-stress your life. You may be surprised at how many good suggestions even young children can offer. It helps them, too. Often the people closest to someone with CFS are frustrated because they want to do something positive for you, but don't know where to start. This gives them the opportunity to help. Counseling or self-help books can also help you relax. Three favorite books on eliminating stress from your life are Deep Healing: The Essence of Mind/Body Medicine, by Emmett E. Miller, M.D., in which he gently suggests how you can restructure your thinking and your life through simple visualization and other techniques; Stress and Natural Healing: Herbal Medicine and Natural Therapies for Depression, Anxiety, Insomnia, Heart Disease, by Christopher Hobbs and Successful Stress Control: The Natural Way by David Hoffmann.
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Insomnia While a CFS patient may spend lots of time in bed trying to rest and is perpetually dog-tired, it is not easy to get enough sleep. Then, once he or she finally dirfts off to dreamland, the quality of sleep is likely to be very poor. Painful joints or ligaments, stiff muscles, excessive tossing and turning, bladder infections, low blood sugar and sluggish digestive activity may contribute to a restless night's sleep. Not only does the patient toss and turn all night, waking up often and then having difficulty going back to sleep, but little of the sleep he or she does get is the deep REM (rapid-eye-movement) type necessary for good physical health and emotional well-being. During this, the deepest stage of sleep, dreaming occurs as the eyes follow the movements of what is seen in the mind. The most restorative portion of sleep, this phase positively influences psychological health, enhances learning and memory and increases blood flow to the brain. With normal sleep, REM occurs several times a night, but not so with CFS. As quality REM time diminishes, so does the ability to enter other stages of deep sleep, especially the delta sleep where blood pressure, heart rate and body temperature all temporarily drop and the immune system is rejuvenated. Disruption of the sleep cycle can cause fatigue,
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weight gain, faster breakdown of protein and reduced immunity, bone density, thyroid function and protein synthesis. And, the more unrestorative the sleep, the harder it becomes to sleep at all. For one thing, low adrenal cortisol levels interfere with normal rhythms of sleeping and waking. Also, lack of sleep disrupts the HPA axis and sets up a vicious cycle of continued poor sleep. Levels of the pituitary ACTH and the adrenal cortisol drop. This was seen in a group of nurses after only five days of poor sleep following their switch to a night shift. After observing this, the researchers of this study concluded that problems with the nervous and hormonal systems in CFS may be the "consequence of disrupted sleep and social routine." 12 A trouble spot with CFS is the hormone melatonin, which promotes the onset of sleep. Produced by the brain's pineal gland, melatonin needs to correlate with time of day and lowered body temperature as a person drops into sleep. If this does not happen, sleep and waking time are thrown off as a person falls out of synch with rhythms of day and night. It is suspected that disruption in the HPA axis causes this in CFS. Since light hitting the retina signals the pineal gland to slow melatonin production, simply being less active or staying indoors out of the sunlight when feeling tired and sick can disrupt pineal gland actions and the sleep cycle.13 It may be that people with CFS do not produce enough melatonin in the first place. Its precursor is the brain chemical serotonin, which in turn is derived from the amino acid tryptophan. Unfortunately, several amino acids, especially tryptophan and phenylalanin, tend to be unusually low in those with CFS. Simply providing patients with a supplement of the eight essential amino acids improved CFS symptoms
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an impressive 50 to 100 percent in three-quarters of the participants in one study. 14 For tryptophan to reach the brain, it must compete with other amino acids for entry. As a result, the other, usually more abundant, amino acids found in protein-rich foods generally get priority. Taking tryptophan supplements does not always do the trick because much of it gets converted into other nutrients, such as niacin. Insomnia also greatly lowers the ability to deal with life in general. It is quite possible that many CFS symptoms are a direct result of insomnia. Problems such as dizziness, headaches, emotional instability and impaired concentration and memory go along with long-term sleep deprivation. Lack of sleep can impair driving ability more than being drunk. Sleeping pills may provide temporary relief, but not without pitfalls. The more they are taken, the greater the chance of developing liver damage, high blood pressure and further suppressing immunity. Besides, one can become dependent on them; the dose usually needs to be upped after only two to three weeks to achieve the same results. What's more, if trying to quit, the withdrawal symptoms (increased sleeplessness, agitation and foginess) can easily cause one to reach for the pills again. Herbs For Insomnia Herbs that promote relaxation and stress relief provide an important avenue to improve sleep. And, rest is essential in order for the energy level to return. Unlike drugs, herbs do not produce the morning-after effects of tranquilizers and barbiturates or impair dream recall. In one study on valerian, people who
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took it reported that they even felt better the next day. Several herbs (licorice root, the Polynesian herb kava, the Chinese formula Suanzaorentang and a compound in valerian) are comparable to the popular sedatives, benzodiazepines, Librium and Valium. 15 Double-blind studies from Germany show that both valerian and hops relax the brain waves of those having trouble sleeping and that valerian encourages the type of deep REM sleep so often seriously lacking with CFS. The result is sounder, more refreshing rest with fewer bouts of waking during the night. These herbs also go to work quickly; hops has been shown to directly affect the central nervous system in only 20 to 40 minutes. In one study on valerian, it improved sleep in almost all the insomniacs and almost half the group had a perfect night's sleep.16 Other sleep-promoters that calm the nerves at the same time are skullcap, chamomile, passionflower and kava. Kava has been used by the Polynesians to induce relaxation and a sense of mild euphoria for centuries. Strictly speaking, it is a muscle relaxant, not a sedative, but it does encourage sleep. Passionflower and kava are especially good when tight muscles, stress or an overactive mind prevent sleep. Combined with valerian, passionflower is one of European doctors' most recommended sleep aids. Ayurvedic doctors suggest ashwaganda and gotu kola. It is not known exactly how gotu kola works, but it does contain sedative compounds and an abundance of the anti-stress B vitamins. Indians use it to stay calm and serene and to improve their ability to practice meditation and yoga. Ginseng, licorice and St. John's wort, a popular herbal antidepressant, also encourage sleep by regulating brain chemistry, quite possibly by increasing serotonin. Siberian ginseng and ginseng are usually
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used as energizers, but along with valerian, they work both ways to help relieve CFS. They stimulate the nervous system when fatigued or sedate it when agitated. Studies show that St. John's wort is especially useful for disturbed sleep patterns in people who have trouble falling asleep or who wake up too early in the morning and are unable to doze off again. Since rejuggling brain chemistry does not happen overnight, it's important to be patient. Some people may need to take these herbs for several weeks before noticing an effect. The main ingredients in the Chinese formula Suanzaorentang are licorice and ligustrum. Chronic insomniacs in one study got a much better night's sleep when they took the herb 30 minutes before bedtime. Symptoms of sleep deprivation, including heart palpitations, weakness, irritability, anxiety, stiff necks, nervousness and lower back pain all greatly improved. Plus, they also felt an improved sense of well-being. Even after discontinuing the formula, they continued to sleep well for a week before returning to disturbed sleep habits. 17 Aromatherapy For Insomnia Even sniffing fragrant herbs can help to induce sleep. Throughout much of Europe, bed pillows are stuffed with dried hops for just that reason. Some people buy or make a small hops-filled pillow to tuck under their regular pillow at night. Other aromatic sedatives that promote sleep are ylang ylang, lavender and chamomile. One of the most relaxing ways to enhance sleep is to take a hot bath scented with at least a few drops of one of these oils. It will loosen sore, stiff muscles
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and lower body temperature, which encourages sleep. Hot water initially heats up the body, but after stepping out of the tub the body cools down. Nutrition And Lifestyle For Insomnia The hormone melatonin in supplement form does not work for everyone; in some cases it worsens rather than improves sleep. Although it may not resolve poor sleep patterns, taking 13 mg an hour or two before bedtime can increase time spent in the beneficial REM state. So far, melatonin seems a safer bet than sleeping pills, but its use is so new, we cannot be sure of potential side effects. A mere 40 years ago, its existence was unknown, and melatonin has only been used for a couple years as a sleeping aid. We know more about its safety for short-term compared to long-term use, so it's best to use it for only a few weeks at a time. Since it is a hormonal drug, it is important to discuss its use with a physician before taking it. More than one mg can increase symptoms of fatigue, depression and headaches in some, and continued use sometimes lowers sex drive and estrogen production. The best natural sources of melatonin are oats, sweet corn and rice. Ginger, tomatoes, barley, bananas and Japanese radishes are also good. You can also increase your intake of tryptophan to boost serotonin and melatonin. Cottage cheese, pumpkin seeds, turkey, chicken and especially soy foods are loaded with tryptophan, and eating carbohydrates at the same time assist its entry into the brain. Cow's milk, peanuts, almonds and brewer's yeast are other relatively good sources of tryptophan with spirulina the most potent (although it energizes many people too much
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for sleep). In addition, soy contains plenty of calcium, which works as a natural sedative. Meanwhile, it is important to supply the body with enough niacin so that tryptophan is not used up in order to produce it. Foods containing niacin include dried apricots, barley, brewer's yeast, sunflower seeds, chicken, turkey, halibut, salmon and swordfish. Drink a cup of ginger tea before bed or whip up a ginger-flavored sleepy-time smoothie with soy or cow's milk plus banana, almonds, sunflower seeds and brewer's yeast. If you do drink milk before bed, make sure it is lowfat, so that your digestive tract does not remain too active while you are trying to sleep. Enjoy this smoothie at least two hours before bedtime. Do not overeat before bed; a full stomach can keep you awake. Avoid sugary foods because they will wake you up in the wee hours of the morning when the blood sugar drops. Smoking, drinking and eating refined food use up vitamin B6 (as do birth control pills) which is vital for melatonin production. In addition, improve your sleeping environment; make sure that your bed, pillow and room temperature are comfortable and your bedroom is dark and quiet. Relaxing music, stretching, massage, or deep, rhythmic breathing help.
Spirulina Soy foods Cottage cheese Pumpkin seeds Turkey
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Sources of Trytophan Chicken Cow's milk Peanuts Almonds Brewer's yeast
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Physical Fatigue Stress and adrenal exhaustion lead to a lack of energy in anyone with Chronic Fatigue Syndrome. This causes problems with the manufacture, distribution, utilization and storage of energy in the muscles. There are also difficulties manufacturing sufficient amounts of protein to provide individual cells with energy; moreover abnormal proteins have been found in the spinal fluid of some CFS patients. The result is that simply taking advantage of a ''good day'' by going for a long walk in an effort to improve health can mean paying for it the next day with excessive tiredness, muscle or joint pain and a headache. Several things are going on. Too little adrenaline promotes fatigue, and cortisone is unable to properly regulate sodium, potassium, carbohydrates and protein, all of which play a role in energy production. Sodium and potassium work together to maintain body fluids, nerve impulses, muscle responses, especially in the heart, and a proper pH to aid cell metabolism. Oxygen is also vital for energy production. Yet, people with CFS typically have only about a 60 percent capacity for oxygen compared to the average person. The resulting lack of oxygen makes it impossible for them to perform healthful aerobic activity.
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Instead, they quickly convert to anaerobic (without oxygen) activity as the pulse races, the heart pounds and they pant trying to catch the breath while becoming fatigued from a lack of oxygen. The adrenal glands also manufacture the hormone corticosterone to help liver, muscles and other tissues make glycogen out of the carbohydrates we eat and then store it. Corticosterone is also responsible for breaking glycogen down into sugar and helping cells absorb it when energy is needed. Muscles burn glycogen to make energy, but use up oxygen as lactic acid forms in the muscles while they "burn." Oxygen is needed to convert leftover lactic acid back into glycogen for future use. Without enough oxygen, too much lactic acid remains in the muscles so they cramp and become stiff. That is not all. Metabolic wastes such as free radicals (molecular fragments that lose an electron during oxidation) cause harmful oxidation during strenuous exercise or physical work. If they kept to themselves, free radicals would not be much of a problem. However, they grab electrons from stable molecules and damage cells, enzymes, proteins and the DNA itself in the process. An excessive amount of free radicals are released by the immune system during a chronic disease or an infection to attack harmful organisms in the body, but they can also attack the body itself Physical and emotional stress, poor diet, toxic chemical exposure and drug use also increase their numbers. This ups your risk of illness, including cancer, and accelerates aging. To compound the problem, with physical fatigue several other mechanisms needed to provide the body with energy malfunction. For one thing, ATP (adenosine triphosphate), an enzyme produced in the cells and responsible for storing energy in muscles, is lost too quickly. This is a real problem since people with
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CFS already have insufficient ATP. One reason for low ATP could be magnesium and malic acid deficiencies. Another is that production of ATP declines whenever toxicity or a viral infection is present. It is estimated that about three-quarters of Americans are low in magnesium but this seems especially true of those with CFS. Magnesium plays many roles in energy metabolism There may be enough magnesium circulating in the blood, but adequate amounts of ATP are needed to transport it into cells. In a vicious cycle, low cellular magnesium causes ATP to drop even more. Magnesium is important to prevent fatigue, joint pain, muscle spasms and pain, heart palpitations, dizziness, headache, insomnia, irritability and fuzzy thinking. Malic acid is a component in fruit that is important for muscle health and pain reduction. It makes ATP more efficient even when only a little oxygen is present and is an integral component of the Krebs cycle winch transforms fats and glucose into energy. A group of neurologists working with CFS patients noticed that a large number of them did not walk properly. Instead, they had an unusual gait at various speeds; they did not flex their knees enough and had an extra-wide hip angle with a small stride. These idiosyncrasies can be caused by muscle weakness, poor balance or central nervous system problems, all of which are found in CFS. It came as no surprise that these patients also clocked a much lower running time than other subjects. 18 Herbs For Physical Fatigue When it comes to increasing energy levels, ginseng and Siberian ginseng are star performers. Ginseng, Siberian ginseng and codonopsis, called "poor man's
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ginseng," have long been used to decrease fatigue and improve strength and energy for those recovering from a debilitating chronic illness. They improve the entire spectrum of energy utilization, from breathing to storing energy for future use. They increase the rate of respiration, the amount of oxygen inhaled, muscle strength and endurance and cardiovascular health. The University of Munich in Germany found that daily doses of ginseng increase the lungs' capacity to fill with air as much as 29 percent after only one month. Ginseng also improves oxygen's absorption into the blood and increases the number of red blood cells which carry oxygen to its destination. This is especially important with long-lasting fatigue because stress wipes out extra red blood cells. Ginseng and Siberian ginseng help turn amino acids into protein and improve their utilization. Both herbs increase glycogen production and energy stored in muscles by almost one-third and encourage muscle gain. In addition, it was found that ginseng stimulates ATP more than 150 other herbs that were tested. It even contains a usable form of ATP to directly provide muscles with energy. 19 Following exertion, ginseng and Siberian ginseng help overtaxed muscles quickly recover. For example, numerous studies demonstrate how muscle tone, pulse rate and blood pressure bounce back to normal faster with ginseng intake. The Institute for the Prophylaxis of Circulatory Diseases at the University of Munich in Germany found that after nine weeks, the average lactate level (which determines the amount of lactic acid) dropped in half when athletes took a standardized ginseng extract. In two studies with Siberian ginseng, one with competitive cyclists at the Legraft Institute of Physical Culture and Sports and another with people participating in strenuous exercise,
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muscular vigor improved, they recovered their strength sooner and they slept sounder. 20 Antioxidant herbs, such as ginseng, hawthorn, ginkgo, milk thistle, rosemary and garlic, are important to stop free radicals from developing and injuring cells. However Cheney worries that large amounts could hinder rather than help CFS because antioxidants use up the nutrient glutathione as they work. Glutathione is needed to move oxygen into the cells but seems in short supply with CFS. The result is increased anaerobic activity (without oxygen) and decreased energy metabolism on a cellular level. To prevent this, Cheney suggests taking bioflavonoids, glutathione and minerals or eating plenty of mineral-rich green foods along with antioxidants. People with US complain that they always feel colder or hotter than everyone around them. Their inability to adjust to temperature can leave them weak and tired. The Chinese have several tea blends that are based on ginseng that prevent overheating. One formula also includes licorice and schizandra. When the Swedish Herbal Institute in Gothenburg gave seamen Siberian ginseng tonic while on a strenuous two-month voyage in the tropics, nearly three-quarters of the men did not experience the physical problems typical of working in extreme heat. Instead, their capacity for work, their heart function and breathing all improved. Siberian ginseng also maintained proper water, salt, blood protein and vitamin levels and kept blood vessels in good shape.21 Nutrition And Lifestyle For Physical Fatigue Dr. Daniel Peterson found that 40 percent of his patients benefitted from magnesium (50 mg) and
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malic acid (200 mg) on an empty stomach (or after food, if they got indigestion). Patients began with one or two capsules, then worked their way up to at least six a day. Another study found that pain and fatigue diminished in four weeks only when eight tablets were taken per day. It is best to take magnesium in a liquid form. 22 A limited amount of exercise is goodjust don't over do it. Muscle pain can be relieved by very light aerobic in addition to stretching exercises. Kenneth H. Cooper, M.D., well-known for his work in aerobics, says that exercise is "one of the most inexpensive treatment modalities for Chronic Fatigue Syndrome on record." For those who feel up to it, he suggests walking or stationary cycling, then graduating to a minimum amount of jogging in a couple months.
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Heart and Circulation Keeping the heart healthy is important with Chronic Fatigue Syndrome so that sufficient quantities of oxygenladen blood are pumped to all the cells, including the brain. A common problem with CFS, probably due to insufficient oxygen in the blood and possibly to adrenal and other imbalances, is heart palpitations. The heart can beat so fast it seems to jump out of the chest, especially during and after exercising, even when it is not strenuous. To someone with CFS that can mean no more than walking up the driveway to get the mail. A recent study conducted at Johns Hopkins found that a number of people with CFS had low blood pressure caused by a defect in how the nervous system regulates blood flow. The researchers think that this type of low blood pressure might be a previously unrecognized trigger for CFS. Adrenal hormones kick-start this response in which a confused nervous system tells the body to slow the heartbeat and lower blood pressure as if it is resting when it is actually standing upright. Thus the patient becomes dizzy and confused, especially after exercising, standing for long periods of time or feeling overheated. In the Johns Hopkins study, such symptoms were relieved in over three-quarters of the volunteers within a month when they went on a high-salt diet and took
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drugs to help their kidneys retain more sodium or to prevent their bodies from responding to adrenaline. 23 Stress, especially when persistent, can raise lowdensity blood cholesterol (LDL) levels. Cholesterol deposits diminish blood flow, and the resulting lack of oxygen can cause dizziness, confusion, turn the hands and feet numb and lead to serious heart problems. Of even more concern, it can lead to heart disorders such as angina pectoris, with its painful chest constrictions. Since people with CFS are already subject to most of these problems, constricted arteries can add insult to injury. There are drugs that lower the LDL cholesterol, but they can cause nausea, headaches, liver damage and vitamin deficiencies. Why bother with side effects like these when herbs are available? Numerous scientific reports show that herbs lower cholesterol about 16 percentalmost as much as prescription drugs but without the side effects. Herbs For Heart And Circulation Hawthorn, ginkgo, ginseng, Sanchi ginseng, motherwort and reishi mushroom are mild herbal heart tonics that encourage the heart to beat at a healthy low rate. At the same time, they increase blood flow to the heart and lessen its demand for oxygen while improving general heart activity. In doing so, they soothe chest pains and spasms and reduce shortness of breath. Hawthorn, ginkgo and Sanchi ginseng improve the heart's function even when it is not receiving enough oxygen, as is often the case with CFS. Their ability to reduce heart palpitations and blood pressure is comparable to drugs like diazepam. A
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popular European medicine, hawthorn has been studied for over 25 years and it is now used in over three dozen pharmaceutical preparations in Germany, where it is approved for treating mild heart conditions. Ginseng, Siberian ginseng and ginger raise or lower blood pressure, depending upon what the body needs. Shanghai's Hwa-san Hospital found that ginseng worked even better than drugs when given to patients with low blood pressure, irregular heartbeat and poor blood flow to the heart. And, unlike drugs used to treat these conditions, ginseng caused blood pressure to return to normal and remain there. A series of studies on Siberian ginseng conducted by the Soviet Academy of Sciences used only 20 drops of the tincture three times a day to improve low blood pressure in over 50 patients who had rheumatic heart lesions and were on conventional therapy. In studies from the Wu-han Medical College in China, Sanchi ginseng relieved angina spasms and heart pain in almost half the people who took it. 24 Still other heart-worthy herbs that make excellent companions to the herbs named above are astragalus, schizandra and the sedatives valerian and Chinese skullcap. They help the heart develop a more regular rhythm and frequency and stabilize nerve-related heart problems; they can calm a racing heart and also relieve dizziness. Ayurvedic medicine uses ashwaganda and spikenard, a relative of valerian, in a blend called abana which improves general heart function. Several herbs can keep cholesterol levels low, at a healthy level for the heart. Some of the best and tastiest are found right in the kitchen: onion, garlic, cayenne, rosemary, fenugreek, ginger and turmeric, the herb that gives curry its bright yellow color. These herbs may be added to meals or taken as pills,
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teas or tinctures. Garlic lovers will be happy to learn that areas of the world where people eat lots of this delectable herb have far fewer heart problems. For those who are not garlic fans, liquid and dried garlic in supplement form will also drop cholesterol. Linden tea is also a good choice. Bromelain enzyme derived from pineapple and anthocyanidins from bilberry and other dark fruits also break down cholesterol, even when it has already formed in the arteries.
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Pain Pain is all too familiar for anyone with chronic fatigue syndrome. Everything hurtshead, muscles, joints, tendons and ligamentswhile nerves send sharp shooting pains through the body. Even touching the skin lightly can irritate overly sensitive nerves. Unfortunately, while the nervous system is quick to respond to problems it is slow to heal once injured. Like so many other aspects of CFS, what causes all this pain is poorly understood, but several factors are probably responsible. The build-up of excess lactic acid that forms in the muscles as they burn glycogen for energy causes much of the stiffness and pain. Muscle cramps also serve as an outlet for the body to release stress. Another source of pain is hormone-like substances called prostaglandins that regulate inflammation, muscle contractions and blood vessel dilation. Produced from essential fatty acids in foods, some types of prostaglandins increase pain while others prevent it and keep pain-causing prostaglandins in check. The release of adrenaline and cortisone during continued stress impairs many cell functions, and one of these is the breakdown of essential fatty acids. As a result, fewer beneficial pain-hindering but more pain-producing prostaglandins are formed. Many CFS sufferers desperately turn to pharmaceuti-
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cal pain-killers and anti-inflammatories for relief. Drugs do lessen inflammation and the resulting pain temporarily, but they also can cause digestive upset and dizziness. Even more worrisome, the liver and kidneys must deal with their toxicity, an additional stress to these organs. In 1994 the National Kidney Foundation reported that kidney failure problems can occur from taking only one acetaminophen tablet a day for a year. Large amounts of other pain relievers, such as ibuprofen, naproxen and indomethacin, increase the likelihood of kidney problems as much as eight times. The anti-inflammatory drug phenylbutazone carries so many serious side effects that it must be closely supervised and it is almost never suggested for longterm use. Medical researchers say synthetic aspirin, the most widely-sold pain-killer and anti-inflammatory in the world, is so potent that the FDA would demand it be sold only by prescription if it were introduced today. The use of pain relievers such as codeine, acetaminophen, mepericine (Demerol), ibuprofen and even aspirin to relieve a headache may only make it worse. When the New England Center for Headache in Greenwich, Connecticut took patients off their daily dose of five to six painkillers, a surprising two-thirds of them had fewer headaches by the end of the month. After two months, four-fifths were more pain-free than when they were taking the pills. At least one study found that in the majority of cases, steroids like codeine also made people with CFS worse in the long run. Cortisone (Prednisone), taken as an anti-inflammatory and for pain relief, decreases the brain chemicals serotonin and ACTH. This can lead to depression and increased cholesterol, two ailments no one needs, especially someone with Chronic Fatigue Syndrome. In addition, taking corti-
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sone on a regular basis makes the adrenal and thymus glands ''lazy.'' The adrenal glands can actually shrink so much they no longer operate efficiently and barely function even after discontinuing cortisone. Herbs For Pain Most herbal sedatives that encourage sleep double as muscle and nervous system relaxants and pain-killers. These include valerian, hops, skullcap, chamomile, kava and crampbark. Herbs provide a solution to pain because they gradually heal the nervous system instead of just suppressing pain. While they do not provide the dramatic relief of pain-killers like morphine, they do offer a safer and more permanent approach, and often are even more effective in the long run. Compounds in kava have been found to stop muscle spasms up to ten times better than the common anticonvulsant drugs without dulling the mind. Turmeric, Chinese skullcap, African devil's claw and South American pau d'arco can reduce painful inflammation just as well as the potent drug phenylbutazone. Compounds in turmeric and licorice have proven even more effective than cortisone in reducing inflammation, and without unpleasant side effects. Ginseng and bupleurum gently stimulate the natural production of cortisone and make it longer-acting by slowing its breakdown and deactivation in the liver. While pharmaceutical cortisone shrinks the adrenal glands, licorice and buplueurum strengthen them and even slow the damage from taking cortisone. 25 Muscle, arthritic and headache pain are all reduced by inhibiting prostaglandins that cause pain with herbs such as turmeric, ginger, meadowsweet, GLA
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and bromelain, derived from pineapple. When Indian researchers gave ginger to people with muscle or arthritic pain, more than three-quarters felt considerable relief. Even after two years of constantly using herbs, no one had experienced any side effects. 26 Since 1957, bromelain has been used in hospitals, and over 400 scientific papers have discussed its ability to reduce inflammation. A traditional Ayurvedic blend of turmeric, ashwaganda and boswella (a relative of frankincense), with zinc gave arthritics substantial pain relief within three months during one study. Boswella enhances the supply of blood and fluids to joints, helps restore their function, improves blood vessel integrity and circulation, and shrinks inflamed tissue. It can be taken internally, but is also available in a cream. Turmeric and cayenne reduce substance P (short for "pain") that carries pain signals from nerve endings to the brain. Three-quarters of the people in clinical studies report substantial pain relief from using a cream of capsaicin, cayenne's active ingredient. Pain and nerve sensations are checked only in the area where the cream is applied. Capsaicin creams are now sold in pharmacies and natural food stores to help relieve nerve pain from diseases such as diabetes and shingles. To heal a damaged nervous system, turn to ginseng, St. John's wort, the essential fatty acids of omega-3 fish oils and GLA (from the oils of evening primrose, black currant seed and borage seed) and echinacea. They strengthen protective nerve cell membranes and connective tissue and lubricate painful joints. Ginseng improves nerve reflexes and the nerve growth factor to help rebuild nerve cells. Siberian ginseng, valerian and passionflower can also repair a damaged nervous system. Thanks to anthocyanidins and the
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proanthocyanidins they contain, grape seed extract, bilberries, blueberries and pine bark extract sedate the nervous system and successfully reduce pain, muscle spasms, nerve sensitivity and prickly skin and prevent legs from cramping at night. Dr. Peter Behan, M.D. and his colleagues at the Glasgow University in Scotland compared the effects of evening primrose oil and a placebo in clinical trials involving CFS patients. GLA relieved the symptoms of 33 to 39 of the participants far better than those who got a placebo, and with no adverse side effects. Most felt better within a month, but experienced even more pain relief after three months. It also alleviated their fatigue and depression so much that many were able to return to work. 27 Aromatherapy For Pain Essential oils that relieve inflammation and headaches include muscle relaxants such as lavender, chamomile, frankincense, ylang ylang, rosemary and marjoram. Physicians used lavender to relieve muscle spasms, nervousness and headaches until the 1940s and prescribed a lavender tincture called "Palsy Drops" for over 200 years. In a recent study, researchers showed that oils to increase circulation also relieve headaches. They sponged diluted oils of peppermint and eucalyptus on the foreheads of people with severe headaches, and their sensitivity to pain was reduced much more than that of people in a control group.28 If you are in pain and on the run, simply dab diluted essential oil or an aromatherapy massage oil on your temples or apply a compress to my pan of the body that aches. It is a snap to make: add four
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to six drops of one of the essential oils mentioned above to a cup or two of water. Soak a soft cloth in the water, wring out and apply over areas that hurt. One of my favorite headache remedies is to place a compress on the forehead and a second one under the neck. Most people prefer compresses cold, but you can use them warm or alternate cold and warm compresses, depending upon what feels best. St. John's wort and arnica relieve muscle tenseness, inflammation and nerve pain. An excellent way to apply them is in a massage oil rubbed directly into sore areas. For extra relief, mix in an essential oil. A heating liniment, such as Ben-Gay or Solarcaine, also relieves tight muscles. For an herbal alternative, turn to Chinese Tiger Balm or a similar formula, available at natural food stores, made from peppermint or menthol, eucalyptus or other heating herbs. The muscle relaxants dissipate blood and inflammation while heating oils in liniments warm the area by bringing blood to it. Experiment with both to see which works best for you. Two to five drops of relaxing essential oil can also be added to the bath. Most people with CFS find that hot water itself provides considerable pain relief. For added benefit, dissolve a half cup of muscle-relaxing Epsom salts in the water. And, while you are getting a massage or relaxing in a hot tub, listen to calming music that is 60 beats per minute, such as Brahms. It has been found to lessen pain, reduce anxiety and even lower blood pressure, according to research from Bulgaria. If you are prone to migraines or circulation headaches, try a hand bath with a couple of drops of lavender oil in it to short-circuit the pain by increasing the temperature of your hands by 15 degrees.
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Depression It is not unusual for chronic fatigue syndrome to lead to depression and even thoughts of suicide. About half the people with it show signs of some emotional disorder. Around 13 to 15 percent, slightly more than the general population, have a diagnosable psychiatric illness, especially anxiety. Of course, who would not get depressed while having such a devastating disorder? Certainly perpetual exhaustion, inability to think straight, weight gain and losing one's balance do little to nurture self-esteem. Top this off with the frustration of having an "incurable" disease while friends and family question your sanity. True depression is not based on how many distressing events fill your life. Surely you know people who go through one misfortune after another and still manage to stay afloat emotionally. Chronic depression is not easily resolved. No amount of constructive thought will do. It is a physical disease caused by chemical imbalances in the brain that must be corrected to resolve it. Dozens of studies have explored whether CFS might not be a type of depression. It is true that fatigue-related diseases often go hand in hand with depression, but the depression of CFS is not a textbook case of the disorder. How it differs from clinical depression is obvious in psychological testing,
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brain wave patterns, function and performance. Unlike clinical depression, the difficulty of processing information does not correspond to the degree of depression, and some people with CFS are not depressed at all. 29 Also, CFS tends to cause low cortisol and high prolactin, just the opposite of what is found in clinical depression. Antidepressants do relieve many symptoms, when taken in much lower doses than needed for clinical depression. CFS researcher J. Hicks, M.D. noted obvious differences in his patients' demeanor, "Chronic fatigue immune disorder syndrome patients in general are quite motivated to get well, whereas hopelessness, withdrawal, low self-esteem and suicide are more typical of depression."30 So, why do antidepressants such as Prozac and Zoloft work? The answer probably lies in their ability to increase the brain chemical serotonin. As already discussed, it seems in short supply in people with CFS. For some people, antidepressants make life worth living. Their down side is that instead of solving the brain's imbalances, they change it temporarily and are addicting in the long run. In some cases, they even prolong sickness. If you are already on medication, you might consider herbal alternatives. I know many people who have successfully gone off antidepressant drugs, in some cases after taking them for years, in favor of herbs. However, do not suddenly stop your medication unless you work closely with a health practitioner. Since some herbs affect the action of drugs, be wary about taking them at the same time as you are taking drugs. Herbs For Depression Herbs adjust brain chemistry in a nonaddictive and more holistic way than drugs. They do not impair
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attention, concentration or reaction time, but also are not as quick-acting or powerful. St. John's wort, in particular, is gaining popularity as a natural antidepressant after extensive 1997 media publicity as an alternative to Prozac. In several studies, it relieved the depression of over half of the people who took it. They also experienced less disturbed sleep and fatigue, usually within a month after starting the herb. 31 There are other herbs that help the mild to moderate depression of CFS. These are licorice, ginseng, Siberian ginseng and the GLA found in evening primrose, borage and black currant seed oils. Ginseng is widely used in Europe to treat depression and, according to ginseng researcher Stephen Fulder, Ph.D., works best to adjust mood disturbances rather than full-blown psychoses. In several Russian studies of individuals with various types of mental disturbances, the most improvement from Siberian ginseng was seen in those who had symptoms similar to CFS: exhaustion, insomnia, moderate depression, irritability and poor concentration. Almost all recovered, most slept better, had fewer headaches and less irritability and everyone felt more cheerful. Heart palpitations normalized in those having them. Along with other positive changes, their ability to do physical and mental work even improved.32 I find several relaxing herbs make good adjuncts to antidepressive herbs. Motherwort has been used to counter melancholy since at least the 17th century. German studies have found that it successfully treats anxiety, especially when associated with sleeplessness. A combination of valerian and hops relieves depression and anxiety faster than prescription drugs,
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taking only two instead of the usual six weeks. Another antidepressive contender is kava. In one of several German studies, over 50 people began feeling relief from depression and severe anxiety after only one week. Their alertness, attention, memory and sense of well-being all improved. A compound called kavain can work as well as benzodiazepine to relieve problems with memory, attention and reaction time resulting from anxiety. 33 Aromatherapy For Depression Just the aroma of some herbs helps lift depression. Some of my favorites are the citrus antidepressants, such as neroli or orange blossom, bergamot, orange and lemon (named roughly in order of their effectiveness). Some others are lemon balm or melissa, recommended for 2,000 years to make the heart "merry," and chamomile and lavender. Even inhaling the aroma of a cup of chamomile tea will relieve depression. When deciding which herb to use, choose the one you find most appealing. You should not expect aromatherapy to be as potent as antidepressant herbs taken orally, but you may be pleasantly surprised at how effective they are. Baths are an excellent way to use essential oils, and this is especially true for depression because hot water itself is therapeutic. Psychiatrists at Michigan State University discovered that 30 minutes of soaking in a hot bath helps dissolve melancholy, anxiety and hostility. Massage with aromatherapy oils is also helpful. For the very best results, combine both. In a study conducted by the Touch Research Institute of the University of Miami Medical School and funded by the National Institutes of Health, massage
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was found to reduce depression, anxiety and to improve sleep while regulating levels of the stress hormones cortisol and adrenaline. Nutrition And Lifestyle For Depression A diet low in sugar and refined carbohydrates with sufficient protein is recommended by the more enlightened mental health therapists to ease depression and related brain disorders. Since nicotine and caffeine overstimulate cortisone and adrenaline, they can trigger anxiety, panic attacks, depression, nervousness and heart palpitations and should be avoided. Dr. Michael F. Breslos, a psychiatrist at the University of Arizona, found that even a single cup of coffee or cola produced anxiety attacks in susceptible individuals and ten cups caused almost anyone to have an attack. Relaxation techniques like biofeedback, meditation, cognitive behavior therapy and visualization enhance the actions of herbs and aromatherapy. Exercise keeps anxiety in check, reported the University of Virginia in Charlottesville after looking at its effect on 10,000 people participating in aerobic exercise for 30 minutes three times a day. In another study, 60 minutes of weight training or swimming twice a week diminished depression, even if the exercisers did not show measurable improvement in their cardiovascular fitness. Just a short session each day of yoga or the Chinese exercises t'ai chi and qi gong can also shift you into better emotional well-being.
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Brain Function and Memory Memory and brain power are adversely affected by low energy, tiredness, anxiety, stress and poor blood flow to the brain, all possible complaints with Chronic Fatigue Syndrome. When Paul Cheney, M.D. and associates looked at neuropsychological changes in CFS, they found verbal recall and the ability to scan visually were especially poor. People also had difficulty sensing space as they tried to fit blocks into a square box when blindfolded. They even performed poorly on the "draw-a-person" test, producing drawings with little detail, heads out of proportion and scribbled fingers that resembled the work of a four-year-old. One of the most consistent and frustrating problems encountered in CFS is the inability to process information correctly since memory, thought speed and attention are so poor. Related to this is difficulty in tracking or memorizing things in order, such as a sequence of events or a series of dance steps. Many people with CFS manage to do okay on standard IQ tests. Psychologist Curt Sandman, Ph.D. of the University of California thinks this is because they find retrieving already stored information is not nearly as difficult as recalling something freshly memorized. The more new information they try to
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pack in, the harder the task becomes. Plus, they are so easily distracted, just a few seconds of interference makes them forget what they were doing. It is not clear why all of this happens, but it certainly points to irregularities in the brain. The inability to get blocks into a box hints at a problem in the left frontal lobe, and poor drawing relates to the brain's right parietal lobe. Indeed, brain abnormalities have been observed through MRI (magnetic resonance imaging) and SPECT scans (Single Photon Emission Computerized Tomography), especially in the cerebral cortex and front temporal lobe. These irregularities are different from those seen in people with AIDS, Alzheimer's, Parkinson's, head injuries, lupus, or clinical depression. 34 The brain requires plenty of oxygen to function properly, demanding one-fifth of the total oxygen carried in the blood, so the lack of oxygen in the blood that is common with CFS does not help brain function. In some cases, blood flow specifically to the brain is down as much as 81 percent. The result is not too hard to figure out: fatigue, mental confusion and dizziness.35 Herbs For Brain Function Some herbs that help memory do so by sending more blood to the brain. Examples are ginseng, Siberian ginseng, gingko, hawthorn and gotu kola. In one study, a ginseng tincture increased the brain's blood flow an impressive 34 percent.36 Studies from the Chinese Academy of Medical Science in Beijing show that ginseng probably influences brain chemicals. This is probably true of gingko and Siberian
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ginseng, as well. These three herbs enhance mental abilities, including concentration, aptitude, behavior, alertness and even intelligence. They are especially effective for someone who has had a decline in mental abilities due to illness, stress or age rather than for a perfectly healthy person who simply wants to be smarter. Unlike stimulant drugs, ginseng and Siberian ginseng improve mental ability without disturbing sleep patterns, even when taken for long periods of time. According to ginkgo researchers, this herb has a specific effect on the memory process. Dozens of studies from Germany and France on a standardized ginkgo product during the course of the last decade confirm that it improves alertness, attention and reaction time. It may take one or two months for the effects to kick in, but it is well worth the wait. In a study with seniors, ginkgo not only improved memory and mental difficulties, it made them less moody and more sociable. An hour after taking ginkgo, alpha and beta brain waves increase and remain high for about four-a-half hours. A predominance of alpha waves means that the mind is resting, while beta waves are associated with normal mental activity such as concentration. This was seen when women took ginkgo an hour before sitting down to a battery of psychological tests. They performed better than those not taking the herb. 37 In studies by ginseng researcher Brekhman in Russia, proofreaders and radio telegraph operators had better concentration, coordination and reading speed, reacted sooner and made about half the mistakes if they took Siberian ginseng or ginseng, even though working under pressure. Ginseng is only a little less effective than Hydergine, one of the most commonly
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prescribed drugs to improve brain circulation. Ginseng and Siberian ginseng also quicken response time and make one more alert. This is without the overstimulation of the nervous system and adrenal glands that occurs with coffee, black tea or caffeine-loaded soft drinks. According to Japanese chemist Shibata, ''In comparison with the effects of usual stimulants, the antifatigue action of ginseng shows an essential difference. The stimulants give effects under most situations, whereas ginseng reveals its action only under the challenge of stress.'' Sweden's Health Ministry permits makers of ginseng products to declare that they produce antifatigue effects. 38 Aromatherapy For Brain Function One of the important uses of aromatherapy is to improve memory d brain function. The scents that help in this regard are lemon, rosemary, bay and, to some degree, lavender and jasmine. One way to help commit something to memory is to sniff one of these aromas while memorizing and then sniff it again when trying to recall it. The association should help spark recall. People with CFS tell me that just carrying around a sprig of rosemary or a bay leaf seems to help. It is certainly worth a try!
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Herbal Formulas for CFS Herbal formulas can be taken as tinctures, pills or teas. Most herbs are sold in natural food stores and in many drugstores. You can buy several kinds of herbs, already blended together or buy herbs separately and mix your own blends with the following formulas. The manufacturers of herbal products in the U.S. are limited as to what medical claims they can make and will rarely announce on the label that they are designed for fatigue or depression. Therefore, look for formulas that contain the herbs I suggest in this book. Dosage Guidelines If you want to mix your own formulas, buy the individual tinctures and combine them according to the following recipes. If you cannot get all the ingredients, then do the best you can to duplicate them. If you have had some experience mixing herbs, then you may want to use the information in this book to design your own formulas. Either way, the easiest way to keep your tinctures is in a one-ounce amber glass dropper bottle. This can be purchased at a drug store. Many natural food stores also carry empty bottles. Or, you can reuse the dropper bottles you bought
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your tinctures in. The following formulas make one ounce, which will last you about a week. (A dropper holds roughly 1/4 teaspoon of tincture or 25 drops, giving you 2024 doses in a one-ounce bottle.) If you want, make larger amounts. One advantage of tinctures is that they do not need to be refrigerated and they last for years. Dosages vary with the herb. A suggested daily amount for Chronic Fatigue Syndrome is: 36 pills 35 droppersful of tincture, or 46 cups of tea Occasionally even larger amounts are needed. This adds up to quite a lot of tea, so most people with CFS prefer either tinctures or pills for convenience and ease. It is perfectly okay to combine the use of pills, tinctures and teas. The best way to take most of the herbs suggested for CFS is throughout the day. Divide the dose and take 3 times a day at least 20 minutes before a meal. Many of the same herbsespecially ginseng, Siberian ginseng, licorice and astragalusare mentioned over and over again in this book. That is an indication of their importance in your formula. Other herbs that crop up often are echinacea, valerian and schizandra berry. I also find that St. John's wort is crucial to adjust brain chemistry. Of course, if you have specific symptoms, such as heart palpitations or low blood pressure, be sure to include herbs such as hawthorn and motherwort to address those problems (also, see Heart Ease tincture on page 69).
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Tincture or Tea for CFS 1 tsp. each tinctures of: Astragalus root Ginseng root Siberian ginseng root St. John's wort flowering tops
1/2 tsp. each tinctures of: Bupleurum root Echinacea root Licorice root Prickly ash bark
Combine ingredients and store in a dark glass dropper bottle. This formula can also be made into a tea using the same proportions of dried herbs and simmering them very lightly covered in 1 1/2 quarts of water for five minutes; steep mixture for 20 minutes, strain and drink. Store extra tea in the refrigerator. Relaxing Tea Blend 3 cups water 1 tsp. each: Chamomile flower Lemon balm leaf Peppermint leaf Bring water to a boil and pour over herbs. Let steep about 5 minutes, strain and enjoy. This makes a relaxing, good tasting tea, either hot or iced. Simply sitting down to enjoy a cup of tea goes a long way toward relaxation. Insomnia Formula 1 Tbs. valerian root tincture 1 tsp. each tinctures of: Hops strobiles Kava root Passion flower
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Combine ingredients. These dried herbs can also be taken as tea, although most people do not care for the taste. Take as needed to encourage sleep: 13 droppersful or 1/43/4 teaspoon. Anti-inflammatory and Pain Tincture 1 tsp. each tinctures of: Crampbark St. John's wort flowers Turmeric rhizome (if available) Valerian root
10 drops each tinctures of: Bupleurum root Ginger rhizome Licorice root Skullcap leaves
Combine ingredients. Take 2 to 4 droppersful a day or 1/21 teaspoon. Heart Ease Tincture 2 tsp. hawthorn berry tincture 1 tsp. each tinctures of: Chicory root Ginkgo leaves Motherwort leaves Reishi mushroom Combine ingredients. Take 12 drops 25 times a day on a regular basis if you experience a racing heart or heart palpitations. The same proportions can also be used to make a tea from these dried herbs. Place the dried herbs in a pan with 6 cups of water. Bring to a simmer, then turn off heat and let steep about 20 minutes. Strain and drink. Store extra in refrigerator for 12 days.
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Antidepression Tincture 1 Tbs. St. John's wort leaf tincture 1 tsp. each tinctures of: Ashwaganda leaf (if available) Ginseng root Licorice root Combine ingredients. Take 46 droppersful a day for 11 1/2 teaspoons. Relaxing Immune Enhancing Massage Oil 1 oz. St. John's wort or arnica oil 5 drops lavender essential oil 4 drops bergamot essential oil
3 drops lemon essential oil 1 drop marjoram essential oil (opt.)
Combine ingredients and use for massage. This is especially suitable to rub into tight muscles. Lavender Headache Compress 5 drops lavender essential oil 1 cup cold water Add essential oil to water and swish a soft cloth in it. Wring out the cloth, lay down and close your eyes. Place the cloth over your forehead and eyes. Use as often as you wish.
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Aromatherapy Oil for Relaxation and Easing Depression 1 oz. vegetable oil 4 drops lavender essential oil 2 drops bergamot essential oil
1 drop chamomile essential oil 1 drop ylang ylang essential oil
Combine ingredients. Use as a massage oil, 12 teaspoons in your bath, to rub on your forehead to relieve a headache or just to sniff out of the jar. Aromatherapy Oil for Memory and Fatigue 1 oz. vegetable oil 7 drops lemon essential oil 3 drops eucalyptus essential oil
1 drop peppermint essential oil 1 drop rosemary essential oil
Mix. Rub on the temples, use for neck massage or simply carry in a small vial and sniff. Hops Sleep Pillow 1/4 cup hops strobiles 1/8 cup chamomile flowers 1/8 cup lavender flowers (optional)
2 pieces of cloth about 8 inches square
Sew cloth together around the edges, leaving enough room to insert a tablespoon. Fold over so stitching is inside. Combine herbs and spoon them into the pillow, filling it up. Sew up the opening. Place the hops pillow under your regular sleeping pillow.
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The Herbs Ashwaganda (Withiania somnifea) Long popular in India, its adaptogenic properties give it a reputation similar to ginseng to treat fatigue, physical weakness, insomnia, impotence and lowered immunity. Small doses seem most effective. Astragalus Root (Astragalus membranaceus) Chinese tonic that builds the blood, spleen, kidneys, immune cells in bone marrow and provides energy. The Chinese add it to stews and soups. Barberry Bark (Berberis vulgaris) Substitute for endangered goldenseal to treat infection and indigestion. Interchangeable with Oregon grape root. Black Pepper Fruit (Piper nigra) Eating or sniffing energizes the body. Boswella Resin (Boswella serrata) Ayurvedic medicine uses this frankincense relative to reduce inflammation. Bupleurum Root (Bupleurum falcatum) Chinese herb important for liver and immune system. Cardamom Pods (Elettaria cardamomum) Use as tea mixed with other spices to aid digestion. Cat's Claw Bark (Uncaria species) Also called uña de gato and "claw of the cat," this South American vine treats infection, bladder problems and the immune system.
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Cayenne Pods (Capsicum frutescens) Promotes blood flow, stops pain and increases energy. Chamomile Flowers (Matricaria recutita) Soothes the nervous system and promotes sleep. Cleavers Leaves (Galium aparine) Also called bedstraw, promotes lymph drainage. Codonopsis Root (Codonopsis pilosula) Sweet-tasting, it is less stimulating and less expensive than ginseng. Enhances immunity and appetite; treats diarrhea, bronchitis and stomach ulcers; tones spleen and lungs. Devil's Claw (Harpagphytum procumbens) European physicians prescribe injections of this Southewest African herb for pain. It reduces uric acid, cholesterol and blood pressure (be careful if already low). The whole root is more active than the isolated compound harpagoside. Echinacea Root (Echinacea species) Nearly 400 studies support the actions of this immune herb. Can be used continuously, although it seems to work best when taken periodically. Take for a couple weeks, discontinue it for a week, then resume. Ginger Rhizome (Zingiber officinale) Versatile herb that enhances immune functions, fights infection, promotes circulation and eases muscle and joint pain. Ginkgo Leaves (Ginkgo biloba) By increasing circulation, Ginkgo brings oxygen to brain and muscles and relieves dizziness and some headaches. Ginseng Root (Panax ginseng) Adaptagen that balances many functions, including thyroid, adrenal glands, sex hormones, blood sugar and
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probably the hypothalamus. Sanchi ginseng is P. notoginseng. GLA (Gamma Lineoleic Acid) From the oils of evening primrose (Oenethera), borage (Borago officinalis) and black currant seed (Ribes species). It improves nerve and immune functions and lowers pain-producing prostaglandins. Hard to obtain enough from seeds, so buy it in capsules. Gotu Kola Leaves (Centella asiatica) Ayurvedic brain tonic that improves memory and circulation. Hawthorn Flowers and Leaves (Craetega laevigata) Very beneficial to heart and circulation. Hops Strobiles (Humulus lupulus) Relaxing, aids digestion and flavors beer. Kava Root (Piper methysticum) Polynesian plant relaxant and antidepressant. Licorice Root (Glycyrrhiza glabra) Popular in Germany, where doctors recommend taking it for no more than six weeks and supplementing the diet with potassium-rich foods, like bananas and apricots, because licorice root can increase blood pressure. Ligustrum Root (Ligustrum lucidum) Used in Chinese hospitals to enhance immune activity. Linden Flowers and Leaves (Tila europea) Also called time tree. Sore throat remedy and a relaxant. Motherwort Leaves (Leonurus cardiaca) Relaxant to uterus and heart. Passionflower (Passiflora incarnata) Sedative that also treats heart problems. Pau d'Arco Bark (Tabebuia altissima) South American immune herb.
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Pineapple (Ananas comosus) Its enzyme bromelain reduces inflammation. Prickly Ash Bark (Zanthoxylum americanum) Reduces inflammation and pain. Rehmannia Root (Rehmannia glutinosa) Chinese herb to enhance immune system. Reishi Mushroom (Ganoderma lucidum) Strong immune enchancer. Schizandra Berries (Schizandra chinensis) For immune system and respiratory tract. Shiitake Mushroom (Lentinula edudes) Immune stimulant. The extracted LEM is available in pills and tinctures. Whole mushrooms sold in grocery and natural food stores. Siberian Ginseng Root (Eleutherococcus sinensis) Siberian adaptagen with similarities to ginseng that works on many functions, including the HPA axis. Skullcap (Scutellaria baicalensis) Sedative, although the commercial herb is often poor quality. Spikenard Rhizome (Nardostachys jatamansi) Valerian relative that is a relaxant. St. John's Wort Flowers (Hypericum perforatum) Antidepressant that relieves pain, inflammation and tight muscles. Fears about it causing photosensitivity (a skin rash from the sun) were mostly dispelled years ago when antiviral studies showed it is nontoxic. Use products made from the fresh plant since it is not very effective dried. Turmeric Rhizome (Curcuma longa) Anti-inflammatory and pain reliever.
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Valerian Rhizome (Valeriana officinalis) A popular sedative for pain, insomnia and nervous-related heart problems. Aromatherapy Oils Bergamot Fruit (Citrus bergamonia) Popular antidepressant from an inedible citrus fruit. Eucalyptus Leaves (Eucalyptus globulus) Potent antibacterial and antiviral. Lavender Flowers (Lavendula angustifolia) Improve relaxation and mood. Lemon Balm Leaves (Melissa officinalis) Relaxant and pick-me-up. Lemon Peel (Citrus limon) Lymph cleanser. Orange Fruit (Citrus sinensis) Antidepressant, along with closely related neroli flowers and petitgrain twig (C. aurantium). Rosemary Leaves (Rosemarinus officinalis) Antioxidant and pain reliever that enhances memory Tea Tree Leaves (Melaleuca alternifolia) Antiseptic, enhances immune activity. Thyme Leaves (Thymus officinalis) Very antiseptic but can burn skin. Ylang-Ylang Flowers (Cananga odorata) Very sweet and relaxing.
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References 1. Bates, D.W. 1993. ''Prevalence of Fatigue and CFS in Primary Care Practices.'' Archives of Internal Medicine 155:97103. 2. Dunstan, R.H., et al. 1996. "Bioaccumulated Chlorinated Hydrocarbons and Red/White Blood Cell Parameters." Journal of CFIDS 2(23):1089. 3. Suhadolnik, R. 1994. "Upregulation of the 25A Synthetase/RNAse L Antiviral Pathway Associated with CFS." Clinical Infectious Disorders 135(3):37479. 4. Scaglione, F., et al. 1990. "Immunomodulatory Effects of Extracts of Panax Ginseng." Drugs and Experimental Clinical Research 16:53742. 5. Aoki, T. 1994, "Immune Modulation Agents and Their Mechanisms." In Fenichel, R.L. and M.A. Chirgis, eds., Immunology Studies 26:6277. 6. Jeffries, W. 1991. "Cortisol and Immunity." Medical Hypothesis 34:194208. 7. Gomborne, J.E., et al. 1996. "Prevalence of IBS in CFS." Journal of the Royal College of Physicians 30(6):51213. 8. Hallstrom, C. et al. 1982. "Effects of Ginseng on the Performance of Nurses on Night Duty." Comparative Medicine East West Journal 6:27782. 9. Cheng-chia L. and T. Ching-chu. 1973. "Successful Treatment of Postpartum Hypopituitarism with Decoction of Radix Glycyrrhizae and Radix Ginseng." Chinese Medical Journal 11:156. 10. Brekhaman, I. I., ed. 1966. Eleutherococcus senticosus and Other Adaptogens among the Far Eastern Plants. Vladivostok,U.S.S.R. The Far Eastern Publishing House, pp.17378. 11. Perrin, R.N., 1993. "Osteopathic Treatment of ME (CFS)." British Osteopathic Journal 11:1523. 12. Leese, G., et al. 1996. "Short-term Night-shift Working Mimics the PA Dysfunction in CFS." Journal of Clinical Endocrinology and Metabolism 81(5):186770. 13. Williams, G., et al. 1996. "Dissociation of Body Temperature
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and Melatonin Secretion Circadian Rhythms in Patients with CFS." Clinical Physiology 16(4):32737. 14. Bralley, J.A. and R.S. Lord 1994. "Treatment of CFS with Specific Amino Acid Supplementation." Journal of Applied Nutrition & Lifestyle 46(3):748. 15. Mennini, T., et al. 1993. "In Vitro Study on the Interaction of Extracts and Pure Compounds from Valeriana Officinalis Roots with Gaba, Benzodilazepine and Barbiturate Receptors in Rat Brain." Fitotherapia 54(4):291300; Chen, H.D., et al. 1986. "Suanzaorentang versus Diazepan: a Control Double-blind Study in Anxiety." International Journal of Clinical Pharmacology, Therapeutics and Toxicology 24(12)64650. 16. Leathwood, P. D., et al. 1982. "Aqueous Extract of Valerian Improves Sleep Quality in Man." Pharmacological Biochemical Behavior 17:6571. 17. Chen, M.C. and M.T. Hsieh 1985. "Clinical Trial of Suanzaorentang in Treatment of Insomnia." Clinical Therapeutics 7(3):22427. 18. Boda, W.L., et al. 1995. Journal of the Neurological Sciences 131(2):15661. 19. Takahashi, M. and J. C. Cyong 1982. "Studies in Adenosine Triphosphate Activity in Ginseng Radix." Shoyakugaku Zasshi 36(3):177180. 20. Brekhman, I. I. 1957. Zen-shen. Leningrad, U.S.S.R.: State Publishing House for Medical Literature, in Fulder, S. 1990. The Tao of Medicine. Rochester, VT; Healing Arts Press, p. 118; Forgo, et al. 1983. "Effects of Drugs on Physical Performances and Hormone System of Sportsman." Mücnhener Medizinische Wochenschirift 125:8224; Lane, R.J. 1994. "Lactate Response to Exercise in CFS." Journal of Neurology 57(5):66263; Forgo, et al, 1980. "Effect of a Standardized Ginseng Extract on General Health, Reactive Capacity and Pulmonary Function." Proceedings of the Third International Ginseng Symposium. Seoul, Korea: Korean Research Institute. 21. Wikman, G. 1981. Use of Eleutherococcus for the Normalization of Condition of Seaman's Organisms While in the Tropic Zone. Gothenburg, Sweden: Sweden Herbal Institute. 22. Russel, I.J., et al. 1995. "Treatment of Fibromyalgia Syndrome with Super Malic." Journal of Rheumatology 22:95358. 23. Rowe, P.C., et al. 1955. "Is Neurally-mediated Hypotension an Unrecognized Cause of Chronic Fatigue?" The Lancet. 623(2):345. 24. Shi, L., et al. 1990. "Effects of Total Saponins of Panax Ginseng on Increasing PG2 in Carotid Artery and Decreasing TXA2 in Blood Platelets." Chung Kuo Yao Li Hsueh Pao 11:2932. 25. Finney, S.H. and G.F. Somers 1958. "The Anti-inflammatory Activ-
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ity of Glycyrrhetic Acid and Derivatives." Journal of Pharmacology and Pharmacodynamics 10(10):61320. 1984; Srimal, R. and Dhawan, B. 1973. "Pharmacology of (curcumin), a Non-steroidal Anti-inflammatory Agent" Pharmacological Pharmacy 25:44752. 26. Srivastava, K.C. 1992. "Ginger in Rheumatism and Musculoskeletal Disorders." Medical Hypothesis 39(4):34248. 27. Behan, P. and W. Behan 1990"Essential Fatty Acids in the Treatment of Post-viral Fatigue Syndrome." unpublished. 28. Gobel, H., et al. 1994. "Effect of Peppermint and Eucalyptus Oil on Headache." Cephalalgia 14(3): 22834. 29. Cleare, A.J., et al. "Contrasting Neuroendocrine Responses in Depression and CFS." 1995. Journal of Affective Disorders 34(4):2835. 30. Hicks, J., et al. 1995. "CFIDS: Strategies That Work." Patient Care 10(55):29. 31. Linde, K., et al. 1996. "St. John's Wort for Depression: An Overview and Meta Randomized Clinical Trials." British Medical Journal 313:25358. 32. Halstead, B.W. and L. L. Hood 1984. Eleutherococcus senticosus. Long Beach, CA: Oriental Healing Arts, pp. 4648. 33. Scholing, W.E., et al. 1977. "On the Effects of D.L. Kavain: Experience with Neuronika." Medica Klinica 72:130106. 34. Schwartz, R.B., et al. 1994. "Detection of Intracranial Abnormalities in Patients with CFS: Comparison of MRI and SPECT." American Journal of Roentgeneology 162(4):93541; Mountz, J.M., et al. 1995. "CFS." Arthritis and Rheumatism 38(7):92638. 35. Costa, D.C., et al. 1995. "Brainstem Perfusion Is Impaired in CFS." Quarterly Journal of Medicine 88(11):76773. 36. Quiroga, H.A. 1982. "Comparative Double-blind Study of the Effect of Ginsana G115 and Hydergine on Cerebrovascualar Deficits." Orientation Medica 1202:8687. 37. Vorgberg, G. 1985. "GBE Long-term Study Concerning the Major Symptoms of Age-related Cerebral Disorders." Clinical Trials Journal. 22:14957; Arrigo, A., and S. Cattaneo 1985. Hindermarch, I. and Z. Subhan 1988. "Activity of Ginkgo Biloba Extract on Short-term Memory." International Journal of Clinocal Pharmacology Research 4:88993. 38. Brekhman, I. I., ed. 1966. Eleutherococcus senticosus and Other Adpatogens Among the Far Eastern Plants. Vladivostok, U.S.S.R. The Far Eastern Publishing House, pp. 17378; Shibata, S., et al. 1985. "Chemistry and Pharmacology of Panax." Economic and Medicinal Plant Research, Vol. 1, London: Academic Press, 1985. p. 241.
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Appendix Suggested Reading Recovering from Chronic Fatigue Syndrome: A Guide to Empowerment by Colin William, New York, NY: The Body Press/Perigee, 1993. Running on Empty by K. Berne, Alameda, CA: Hunter House, 1995. Herb Books Aromatherapy, The Complete Guide to the Healing Art by Kathi Keville and Mindy Green, Watsonville, CA: The Crossing Press, 1995. Pocket Guide to Aromatherapy by Kathi Keville, Watsonville, CA: The Crossing Press, 1996. Ginseng by Kathi Keville, New Canaan, CT: Keats Publishing, 1996. Herbs: An Illustrated Encyclopedia by Kathi Keville, New York, NY: Friedman/Fairfax, 1992 and New York, NY: Barnes & Noble, 1997. Herbs for Health and Healing by Kathi Keville, Emmaus, PA: Rodale Press, 1996. (Instructions for making your own tinctures, etc.) Stress and Natural Healing: Herbal Medicine and Natural Therapies by Christopher Hobbs, Loveland, CO: Interweave Press, 1997. St. John's Wort by Roy Upton, New Canaan CT: Keats Publishing, 1997. Milk Thistle, the Liver Herb by Christopher Hobbs, Loveland, CO: Interweave Press, 1991. Valerian, The Relaxing and Sleep Herb by Christopher Hobbs, Loveland, CO: Interweave Press, 1993. Herbs to Relieve Stress by David Hoffmann, New Canaan, CT: Keats Publishing, 1997.
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Relaxation Books and Tapes Creative Visualization by Shakti Gawain, Berkeley, CA: Whatever Press, 1978. Deep Healing: The Essence of Mind/Body Medicine by Emmett Miller, MD., Carlsbad, CA: Hay House, 1996. Phone: 800-654-5126. Audio tapes available from Cassette Learning Systems, Inc., Menlo Park, CA, Phone: 800-528-2737. Guided Relation and Affirmations for Inner Peace by Sri Swami Satchidanarda (audiotape). Meditation by Sri Chinmoy, Jamaica, NY: Aum Publications, 1978. Newsletters Health Watch. CFIDS and FM Health Resources, 1187 Coast Village Rd. #1-280, Santa Barbara, CA 93108 1800-366-6056. Free. The CFIDS Chronicle, a quarterly published by The CFIDS Association of America. Annual $35 dues (Canada $45) includes membership and subscription. They also have an excellent and informative 16-page booklet on CFIDS for $1. Phone: 704-365-2343 CFS Organizations Center for Fatigue Sciences, 28240 Agoura Rd, Agora Hills, CA 91301, Phone. 818-991-9800 CFIDS Activation Network (CAN), P.O. Box 345, Larchmont, NY 10538, Phone: 212-627-5631. CFIDS Association of America, P.O. Box 220398, Charlotte, NC 28222-0398, Phone: 800-44-CFIDS. e-mail:
[email protected] Home page: http://www.cfids.org CFIDS Pathfinder, P.O. Box 2644, Kensington, MD 20891, Phone: 301-530-8624. CFS Crisis Center, 27 West 20th Street, New York, NY 10011, Phone: 212-717-1228
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Hotline The Media Hotline 704-369-0466 offers the CFIDS Resource Guide which lists regional support groups. Fibromyalgia Organizations Fibromyalgia Alliance of America, P.O. Box 21990, Columbus, OH 43221, Phone: 614-457-4222 FM/FMA, P.O. Box 8119, Minneapolis, MN 55408, Phone: 612-827-1941 National Fibromyalgia Research Association, P.O. Box 500, Salem, OR 97308, e-mail:
[email protected] Canada National CFS and Fibromyalgia Action Network, 3836 Carling Avenue, Highway 17B, Nephan, Ontario K2H 7V2. Fibromyalgia Association of BC, P.O. Box 15455, Vancouver, BC V6B 5B2, Phone: 604-540-0488. The ME Association of Canada, 246 Queen St., Suite 400 Otawa, Ontario KIP 5E4, Phone: 613-563-1565 Essex County Fibromyalgia Group, 977 University Avenue West, Winsdor, ON N9A 5S3, Phone: 519-2540417. Computer Resources CFS NEWSWIRE e-mail:
[email protected] Compuserve CFIDS Support Area: Section 16, Health and Fitness Forum (Good Health), Phone: 505-898-4635. World Wide Web Pages www.alternatives com/cfs-news www.nmia.com www.community-care.org.uk/ME/fag-html
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Natural Health Products CFIDS Buyers Club, 1187 Coast Village Road, # 1-280, Santa Barbara, CA 93108, Phone: 800-366-6056. (Part of proceeds goes to CFIDS reserach.) To Your Health, 11809 Nitengale Circle, Fountain Hills, AZ 85268,Phone: 800-801-1406. AHA Directory of Herbal Products, American Herb Association, P.O. Box 1673, Nevada City, CA 95959, Cost: $4. Also publishes a 20-page quarterly herb newsletter, $20/per year. Practitioners Naturopathic doctors, most acupuncturists and many chiroparactors use herbs in their practice and they can legally prescribe herbs to their patients. Physicians who practice holistic or preventive medicine often use herbs in their practice, sometimes along with drags. Contact the following groups for information on practitioners in your area who use herbs. American Association of Acupuncture and Oriental Medicine, 433 Front Street, Catasauqua, PA 18032-2506, Phone: 610-266-1433, FAX: 610-264-2768. American Association of Naturopathic Physicians, 2366 Eastlake Avenue, E, Seattle, WA 98102, Directory of members: $5. American Holistic Health Association, P.O. Box 17400, Anaheim, CA 92817, Phone. 714-779-6152. American Holistic Medical Association, 4101 Lake Boone Trail, Raleigh, NC 27607, Phone: 919-787-5181. Holistic M.D. directory, $5. American Preventive Medical Association, 459 Walker Road, Great Falls, VA 22066, Phone: 800-230-2762, Fax: 703-759-6711. Ayurvedic Institute, 11311 Menaul N.E., Albuquerque, NM 87112, Phone:505-291-9698. International Chiropractors Association, 1110 N. Glebe Road, Arlington, VA 22201. National Woman's Health Network, 514 10th A Street, NW, Washington DC 20004, Phone: 202-628-7814, FAX: 202-347-1168.
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Stress Reduction American Chronic Pain Association, P.O. Box 850, Rocklin, CA 95677, Phone: 916-632-0922. Biofeedback and Psycholphysiology Clinic, The Menninger Clinic, P.O. Box 829, Topeka, KS 66601, Phone: 913-350-5000. Chopra Center of Well-Being, 7630 Fay Avenue, La Jolla, CA 92037, Phone: 619-551-7788. The Fetzer Institute, 9292 West KL Avenue, Kalamazoo, MI 49009, Phone: 616-375-2000. The Mind-Body Medical Institute, 185 Pilgrim Road, Boston, MA 02215, Phone: 617-632-9525. Rise Institute, P.O. Box 2733, Petaluma, CA 94973, Phone: 707-765-2758. Stress Reduction Clinic, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655, Phone: 508-856-1616.
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Index A abana, for heart and circulation, 49 acetaminophen, side affects of, 52 ACTH, 26, 29, 30, 35, 52 acupuncture, 32 "adaptogens", 26 adenopathy, as symptom, 14 adrenal glands and blood pressure, 47-48 caffeine affecting, 23 drugs affecting, 52-53 fibromyalgia affecting, 13 herbs for, 29-30, 32, 53 role in depression, 61 stress affecting, 24-25, 27-30, 41, 48 AIDS, 15 allergies, 17, 21, 28 amino acids 8, 35-36 anemia 12, 28 anthocyanidins for eye problems, 31 for heart and circulation, 50 for stress, 32 anti-inflammatory drugs, 13 antibiotics, herbs as, 22 antidepressants for depression, 58 for fibromyalgia, 13 antioxidants, 24, 45 anxiety. see also stress
effects of, 27 causes for, 61 herbs for, 30, 59 as symptom, 57 arnica, for pain, 56 aromatherapy for brain function, 65 for depression, 60-61 for immune/lymphatic system, 22-23 for pain, 55-56 for relaxation, 71 for sleep difficulties, 38-39 for stress, 31 arthritis, 18, 53 ashwaganda for depression, 70 for heart and circulation, 49 for immune system, 20 for insomnia, 37 for pain, 54 for stress, 27 aspirin, 52 asthma, herbs for, 21 astragalus for heart and circulation, 49 for immune system, 20-21 for lymphatic system, 22 in teas and tinctures, 68 ATP (adenosine triphosphate), 42-44 autoimmune disease, 18 Ayurvedic remedies, 20, 37, 49, 54 B back pain, see also pain, 28 balance difficulty, as symptom, 7
barberry, for lymphatic system, 22 baths for depression, 60 with Epsom salts, 2 essential oils for, 23 hand baths, 56 for pain, 56 bay, 22, 65 behavior therapy, 61 Ben-Gay, 56 bergamot for depression, 60 for immune system, 22, 70 for relaxation, 71 bilberry for eye problems, 31 for heart and circulation, 50 for nerves, 55 biofeedback, 32, 61 bioflavonoids, for stress, 31 black currant seed, 22, 59 black pepper, for immune system 22 bladder infection, as symptom, 7 blood cleansing. herbs for. 20 blood pressure, 29, 36, 47
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blood pressure regulation, herbs for, 26, 30, 44, 48-49, 67 blood sugar levels affect on CFS, 12 herbs for, 26, 30 blueberry, for nerves, 55 body temperature, herbs for, 26 borage, 22, 59 boswella, for pain, 54 brain disease affecting, 16, 18 fibromyalgia affecting, 13 serotonin affecting, 28 brain function. see also mental confusion aromatherapy for, 65 CFS affecting, 62-63 herbs for, 63-65, 67 bromelain, for pain, 54 bromelain enzyme, 50 bupleurum for liver, 24 for pain, 53, 69 in teas and tinctures, 68 C caffeine, avoidance of, 23, 61, 65 cancer, 42 candidiasis, 12, 17, 21 capsaicin, for pain, 54 carbohydrates, 41-42, 61 cardamon, for immune system, 22 cayenne, 49, 54 CFSUMI, 8 chai tea, for immune system, 22
chamomile for depression, 60 for insomnia, 37 for pain, 53, 55 for relaxation, 68, 71 chicory, for heart and circulation, 69 chlorinated hydrocarbons, 16 cholesterol, 49-50, 52 Chronic Fatigue Syndrome (CFS) causes, 15-33 described, 4-6 diagnosis of, 10-12 names for, 3 symptoms, 8, 9 circulation, enhancing, 32 citrus antidepressants, 60 cleavers, for lymphatic system, 22 codeine, side effects of, 52 codonopsis, for fatigue, 44 colitis, herbs for, 21 compresses, 56, 70 concentration difficulty causes, 36 herbs for. 63-64 as symptom, 7 connective tissue pain, see also, inflammation; pain as symptom, 8, 13 corticosterone, 42 cortisol affect on inflammation, 25 role in depression, 58, 61 stress affecting, 27-28 Cortisol Deficiency Syndrome, 25 cortisone and fatigue, 41-42
herbs for, 30, 53 side effects of, 52 stress affecting, 27-28 cough, as symptom, 14 crampbark, for pain, 53, 69 creativity, 33 Crohn's disease, herbs for, 21 cytomegalovirus, 15 D Deep Healing (Miller), 33 Demerol, 52 depression aromatherapy for, 60-61 chronic, compared to clinical, 57-58 drugs affecting, 52 herbs for, 58-60 nutrition and lifestyle affecting, 61 as symptom, 7, 14, 57 diabetes, 54 diazepam, 48 digestion, enhancing, 32 digestive difficulty causes, 28, 52 as symptom, 7 disease resistance. see also immune system factors affecting, 28, 29, 42 dizzyness causes, 47, 52 herbs for, 49 as symptom, 1-2, 36 dosage guidelines daily amounts, 67 for herbal formulas, 67-72 driving, difficulty with, 7, 36
E echinacea for immune system, 20 for nerves, 54 in teas and tinctures, 68 eczema, herbs for, 21 emotional problems causes, 28, 36 as symptom, 7, 57 energy levels herbs for enhancing, 22-23, 30, 37-38 stress affecting, 41 environmental stressors, 16 effect on liver, 24 Epsom suit baths, 2, 56 Epstein-Barr virus (CEBV), 3, 15 essential oils, 55-56 eucalyptus for brain function, 71 for immune system, 22 for pain, 55 exercise affecting lymphatic system, 19 for anxiety, 61 dizzyness from, 47 fatigue following, 14
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for muscle pain, 46 oxidation in, 42 by pre-CFS sufferer, 5 eye problem, herbs for, 30-31 F fatigue disorders causing, 9, 28, 34, 41 herbs for, 26, 43-45, 59, 71 nutrition and lifestyle affecting, 45-46 fenugreek, for cholesterol reduction, 49 fever, as symptom 1-8, 14 fibromyalgia, 3, 13-14 fingerprints, loss of, 8 fish oils, for immune system, 22 flu-like symptoms, 1-2, 13 foods For cholesterol reduction, 49-50 for enhancing immune system, 23 for enhancing sleep, 39-40 frankincense, for pain, 55 free radicals, 42, 45 Fuzhung formula. for immune system, 20 G garlic antioxidant effects, 45 for cholesterol reduction, 49-50 for immune system, 20, 22 far liver, 24 for stress, 30 ginger for cholesterol reduction, 49 for hem and circulation, 49
for immune system, 22 for liver, 24 for pain, 53, 54, 69 for sleep management, 39. 40 ginkgo biloba antioxidant effects, 45 for brain, function, 63-64 for heart and circulation, 48, 69 ginseng and antioxidants, 45 for brain function, 63-65 for depression, 59, 70 for fatigue, 43-44 for heart and circulation, 48-49 for immune system, 20, 21 for insomnia, 37-38 for nerves, 54 for pain, 53 for stress, 26-27, 29-30 in teas and tinctures, 68 GLA for depression, 59 for nerves, 54 for pain, 33-54, 55 glutathione, 45 glycogen, 42, 44 goldenseal, for lymphatic system, 22 gotu kola for brain function, 63 for insomnia, 37 grape seed extract for nerves, 54-55 for sum, 32 grapefruit aced oil, for immune system, 22 Gulf War Syndrome, 16
H hawthorn antioxidant effects, 45 for brain function, 63 for heart and circulation, 48-49, 67, 69 headache causes, 28 compress for, 70 herbs for, 53, 55, 56 pain relivers affecting, 52 as symptom, 7, 14 heart and circulation, herbs for, 48-50, 69 heart disease angina pectoris, 49-49 stress affecting, 28 heart palpitations causes for, 61 herbs for, 59, 67 as symptom, 47-49 heavy metals, haft for, 24 herbicides, 16 herpes, herbs for 21 HIV virus, 15, 19 hops for brain function, 71 for depression, 59 for insomnia, 37, 68-69 for pain, 53 hormones, stress affecting, 24-26 Hydergine, 64 hypothalamus gland 13, 25-27 hypothalamus-pituitary-adrenal (HPA) am 24-26, 35 herbs for, 26-27 hysterectomy, CFS risk increased by, 6
I ibuprofen, side effects of, 52 immune system CFS affecting, 17-24, 35, 42 drugs affecting, 36 herbs for, 19-22, 26, 70 stress affecting, 27 infection, symptoms of, 8, 18-19, 43 inflammation. see also pain herbs for, 53, 53 sources of, 51 tincture recipe for, 69 treatments for, 51-52 insecticides, 16-17 insomnia. see also sleep difficulties tincture recipe for, 68-69 intestinal difficulty. 17 irritable bowel syndrome (IBS), 28-29 J jasmine, for brain function, 65 joint pain, 13, 14, 54 K kava for depression, 60 for insomnia, 37, 68-69 for pain, 53 kidneys, drugs affecting, 52 killer calls. 18, 20
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L lavender for brain function, 65 for depression, 60 for immune system, 22, 23, 70 for pain, 55, 56 for relaxation, 71 leg cramps, herbs for, 55 leg spasm, as symptom, 7 lemon for brain function, 65, 71 for depression, 60 for immune system, 22, 70 for lymphatic system, 22 lemon balm, for relaxation, 68 lentinan (LEM), 21 licorice for depression, 59, 70 for immune system, 21, 24 for insomnia, 37, 38 for pain, 53, 69 for stress, 29, 30 in teas and tinctures 68 lifestyle for correcting insomnia, 39-40 for depression, 61 for fatigue, 45-46 for stress management, 31-32 light sensitivity, as symptom 7 ligustrum for immune system, 20 for insomnia, 38
for lymphatic system, 22 for stress, 29 lime tree blossom, for stress, 30 linden for heart and circulation, 50 for stress, 30 liver drugs affecting, 36, 52 herbs for, 32 role in immune function, 23-24 LDL cholesterol, 48 lung capacity, herbs for enhancing, lupus, 18 Lyme disease, 11 lymph gland swelling, as symptom, 7, 19 lymphatic system CFS affecting, 17-24 herbs for, 19-22 massage for, 23 M magnesium, 43, 45-46 malic acid, 43, 46 marjoram, 55, 70 massage, 23, 60-61 massage oils, 23, 56 meadowsweet, for pain, 53 meditation, 32, 61 melatonin, affecting sleep, 35-36, 39 memory difficulty causes, 28, 36 herbs for, 64, 71 as symptom, 7, 14 mental confusion causes, 28
herbs for, 30, 59, 64 as symptom, 7, 13, 14, 62 metabolic imbalance, role in CFS, 7 metabolic processes, 42-43 migraines. see also headache herbs for, 56 milk thistle, antioxidant effects, 45 mood disorders, herbs for, 64 motherwort for depression, 59 for heart and circulation, 48, 67, 69 mouth, inflamation in, 9 muscle cramps, 51, 55 muscle pain exercise affecting, 46 herbs for, 44-45, 53 as symptom, 8, 13, 14 treatments for, 32 muscle spasm, 7, 53, 55 music, for pain relief, 56 N neck, lymph gland swelling in, 19 neroli, for depression, 60 nervous disorders, 30-31, 32 nervous system, herbs for, 54-55 ''neurasthenia'', 4 niacin, for sleep management, 40 nicotine, avoidance of, 61 nutrition for depression, 61 for enhancing immune system, 23 for fatigue, 45-46 for insomnia, 39-40 for stress management, 31-32 O
Omega-3, 22, 54 orange, for depression, 60 Oregon grape, for lymphatic system 22 osteopathic treatment, for stress reduction, 32 oxygen in energy production, 41-42 requirements for, 63 oxygen absorption, herbs for, 44-45 P pain. see also inflammation aromatherapy for, 55-56 in fibromyalgia, 13 herbs for, 53-55 sources of, 51 as symptom, 7 tincture recipe for, 69 pain relievers for fibromyalgia, 13 side effects of, 52 passionflower for insomnia, 37, 68-69 for nerves, 54 pan d'arco for immune system 20-21 for pain, 53 peppermint for brain function, 71 for pain, 55 for relaxation, 68 pesticides, 16, 24
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pharyngitis, as symptom, 14 phenylbutazone, 52, 53 pine bark, 32, 55 pineal gland,s 35 pineapple, for heart and circulation, 50 pituitary gland, 13, 25-26 positive antinuclear antibodies, 14 prickly ash for lymphatic system, 22 in teas and tinctures, 68 primrose, for depression, 59 for immune system, 22 for pain, 55 proanthocyanidins, 31, 32 prolactin, role in depression, 58 prostaglandins, 51, 53-54 protein effect on liver, 23-24 metabolism of, 35-36, 41, 61 Prozac, 58, 59 psoriasis, herbs for, 21 purslane, for immune system, 22 pyridostigmine, 17 Q qi gong, 61 R Raynaud's phenomenon, as symptom, 14 rehmannia, for stress, 27, 29 reishi mushroom for heart and circulation, 48, 69 for stress, 27, 29
relaxation aromatherapy for, 71 for depression, 61 for sleep, enhancement, 40 for stress management, 32-33 teas for, 68 rheumatoid arthritis, 21, 25 rheumatic fever, 16 RNA/DNA, 18, 20, 25-26 rosehips, for stress, 31 rosemary antioxidant effects, 45 for brain function, 65, 71 for cholesterol reduction, 49 for immune system, 22 for liver, 24 for pain, 55 S St. John's wort for brain function, 67 for depression, 59, 70 for immune system, 70 for insomnia, 37-39 for nerves, 54 for pain, 56, 69 in teas and tinctures, 68 Sanchi ginseng, for heart and circulation, 48 schizandra for heart and circulation, 49 for liver, 24 for stress, 27, 29 serotonin effect on brain, 28, 35, 58 disease affecting, 19, 29
drugs affecting, 52 in fibromyalgia, 13 herbs for, 37, 39 in women, 6 sex glands, 25 sexual abuse, role in CFS, 13 sexual function, herbs for, 26 shingles, herbs for, 21, 54 shitake mushroom, for immune system, 20-21 Siberian ginseng for brain function, 63-65 for depression, 59 for fatigue, 43-44 for heart and circulation, 49 for immune system, 20 for insomnia, 37 for nerves, 54 for stress, 27, 29 in teas and tinctures, 68 skullcap for heart and circulation, 49 for insomnia, 37 for pain, 53, 69 for stress, 30 sleep difficulties affects of, 34-35 aromatherapy for, 38-39 herbs for, 29-30, 36-38, 59 massage for, 61 nutrition and lifestyle for, 39-40 and REM, 34, 37 as symptom, 7, 13, 14 sodium/potassium balance, 41 sore throat, as symptom, 7 soy foods, for sleep management, 40
spikenard, for heart and circulation, 49 spirulina, 39 spleen, herbs for, 22 stamina, enhancing, 59 strep throat, 16 stress effect on adrenal glands, 24-25, 27-28, 41, 48 effect on immune system, 17, 51 elimination of, 2 environmental factors for, 16 herbs for, 26-27, 29-31, 65 stress management aromatherapy for, 31 for HPA axis, 24-27 nutrition and lifestyle affecting, 31-32 relaxation techniques for, 32-33 Suanzaorentang, for insomnia, 37, 39 sugar, avoidance of, 40, 61 sugar cravings, causes, 28 T tai chi, 32, 61 tea tree oil, for immune system, 22 teas, 68 tension, herbs for, 30 thinking ability, herbs for, 26 thyme, for immune system 22
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thyroid gland, 25 tinctures CFS tincture, 68 for depression, 70 for heart and circulation, 69 for insomnia, 68 for pain and inflammation, 69 tranquilizers, 36 trauma, role in CFS, 13 tryptophan for sleep management, 35-36, 39 sources for, 40 turmeric for cholesterol reduction, 49 for pain, 53, 54, 69 tyrosine, in urine, 8 U ulcers herbs for, 21 stress affecting, 28 uña de gato, for immune system, 20-21 V valerian for depression, 59 for heart and circulation, 49 for insomnia, 36-38, 68-69 for nerves, 54 for pain, 53, 69 for stress, 30 viral infection, role in CFS, 13, 15-16, 18-19 visualization, 61 vitamin C, for stress, 31-32
vitamin B6, impacts to, 40 vitamins, 23, 31 W water, benefits of, 24 water balance, herbs for, 26 weight gain causes, 28, 34 herbs for, 30 Y ylang ylang, 55. 71 yoga. 32, 61 "yuppie disease", 5 Z zinc, for stress, 31 Zoloft, 58
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