Chronic fatigue syndrome
A service provided by mse Pharmazeutika GmbH
What is CFS?
Worldwide an estimated 17 million people, and up to 300,000 in Germany, suffer from chronic fatigue syndrome (CFS). Patients suffer from persistent physical and mental exhaustion of unknown cause, which cannot be improved, or only slightly, by periods of rest. Doctors define CFS as chronic exhaustion when performance is constantly reduced by more than 50 % compared with a healthy organism and this state lasts for more than 6 months.
Besides the main symptom, the persistent and disproportionate exhaustion and lack of strength, which can also appear with a delay on the following day after exertion, those affected suffer from a range of further complaints. These include, for example, sore throat, muscle, head and/or joint pain, gastrointestinal complaints, problems with concentration and memory loss, swollen lymph nodes, sleep disturbances, apnoea, muscle cramps and hypersensitivity to light, noise, touch, smells and stress. Depending on the severity of the symptoms, those affected are restricted in their everyday lives to differing degrees. While some people with CFS are still able to work to a limited extent, others cannot leave the house and, in particularly severe cases, cannot even leave their bed, because they simply lack the energy to do so. The situation of those affected is often made worse by sometimes drastic restrictions in working and family life and in contact with friends and acquaintances.
Causes
The cause of the illness has still not been conclusively clarified, which is why there is as yet no method of detection through a blood test or similar in order to diagnose CFS unambiguously. However, in many of those affected it appears abruptly after a severe viral infection, for example after glandular fever, influenza or a herpes infection. Chronic stress, contact with toxic chemicals, operations and traumas such as a serious accident are also described as triggers. In other cases no particular event from which the illness appeared can be defined and the course is described as rather gradual. A genetic component is also not ruled out, as the illness occurs in some families in the children of affected parents.
Diagnosis and therapy
As there is so far no direct proof of CFS, diagnosis is usually difficult and patients sometimes go through a lengthy process before they receive a definitive diagnosis. In the initial phase in particular, symptoms such as persistent tiredness (with no recovery even through sleep), sleep and appetite disturbances, headaches or gastrointestinal complaints can occur, which are frequently confused with depression. CFS is not a mental illness, however, but a neuroimmunological multisystem disease that therefore affects the immune system, the nervous system and also cellular energy metabolism. For the diagnosis, other causes of the exhaustion have to be ruled out and certain criteria have to be met, which are summarised in the guidelines of what is known as the “Canadian Consensus Document” (and which also take into account the somewhat older Fukuda criteria [1994]). In addition to the main symptom, “unexplained physical and mental exhaustion that considerably reduces the level of activity”, further criteria have to be present, such as a worsening of the condition after exertion, sleep disturbances, pain, cognitive impairment (confusion, memory limitations, difficulties with processing information), neurological symptoms (muscle twitching, ataxia) and breathlessness after exertion, nausea and irritable bowel syndrome, episodic sweating, flu-like symptoms and so on. The symptoms must have been present for at least 6 months, in children for at least 3 months.
There is as yet no specific therapy for CFS. Exercise therapy is highly controversial, as in some patients it only intensifies the symptoms. Antipyretics and painkillers can be used in order to attenuate some of the symptoms. In general, patients are advised to practise “pacing”. This means that they adapt their daily routine to their energy level and use the available energy as well as possible without overexerting themselves. Learning relaxation techniques and stress management can also be found helpful. A healthy diet and optimising the micronutrient balance can counteract the disturbed cellular energy metabolism.
MitoMedicine with CFS
In the mitochondria the energy from our food is converted into a form usable by our body, adenosine triphosphate (ATP). This takes place in what is known as the respiratory chain, in which five different complexes in the inner mitochondrial membrane are involved. As natural by-products, reactive oxygen species (ROS) can arise, above all the superoxide radical (O2-•). In a healthy body this is converted into water by antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT). Through an excessive formation of ROS, however, the antioxidant reserves can reach their limits and the superoxide radical can cause damage to proteins, lipids, the genetic material (DNA) and cell components such as the mitochondria themselves.
Up to a certain degree a person can compensate for such damage to the mitochondria. This damage becomes critical when the mitochondria no longer regenerate sufficiently and the number of healthy mitochondria falls below a certain threshold. In patients with CFS, 40 % or more of the mitochondria are in some cases damaged. Many patients also show reduced ATP and Q10 levels in their blood, which points to what is known as a bioenergetic deficit (BED). Damage to the mitochondria usually affects the entire organism and thus also explains the many different accompanying symptoms of CFS. In some CFS patients the bioenergetic deficit is also present because of a reduced activity of the mitochondria, which work less efficiently for example because of a gene mutation or are not sufficiently supplied with substrates for energy production because of an additional metabolic disorder. Carnitine, which brings about the transport of fatty acids into the mitochondria, plays an important role here, among others.
The relevant mitotropic substances with CFS
A large number of what are known as mitotropic substances, also called Mitoceuticals®, (see the consumer information on mitotropic substances) contribute directly and indirectly to maintaining the natural function of the mitochondria and to protecting them. These substances, mostly native to the body, play central roles in mitochondrial metabolism and are essential for many metabolic reactions. Avoiding, or compensating for, deficiencies of these substances can contribute to maintaining particularly energy-intensive bodily functions.
The following briefly explains the relevant mitotropic substances whose supplementation could be sensible with chronic fatigue syndrome, particularly as some patients have a deficiency of these substances.
Ubiquinol / ubiquinone Q10
Q10 occurs in all cells of our organism. It is a key substance in the mitochondria, in which the energy for our body is produced. As free radicals are formed in particular during energy production in the mitochondria, the Q10 within them contributes not only significantly to the energy supply but also to the protection of the mitochondria. Besides the biphenol structure in ubiquinol, it is above all the isoprene side chain that comes into play: isoprene is the most effective hydroxyl radical scavenger (OH-•). Ubiquinol/ubiquinone Q10 is also a component of the cell membranes, which are involved in the exchange of substances and information between the cells.
The product range of mse Pharmazeutika GmbH includes numerous Q10 products with individual advantages. We will gladly advise you on which product is the right one for you.
Vitamin B3 - niacinamide
Vitamin B3 (niacinamide) occurs in all cells of our organism. In the form of NAD(P)H it is a substrate for complex I of the respiratory chain and thus promotes a healthy energy metabolism. It is also valuable for a normal function of the nervous system and the psyche and supports the maintenance of healthy mucous membranes and skin. The mse product TriaMit-B® contains vitamin B3 as niacinamide. RiboMit® contains vitamin B2 and ubiquinol Q10 in addition to vitamin B3.
Vitamin B12 - cobalamin
Vitamin B12 (cobalamin) likewise contributes to a normal energy metabolism as well as a normal function of the nervous system and the psyche. It also promotes a healthy function of the immune system and a normal homocysteine metabolism. It supports a normal formation of red blood cells as well as the maintenance of healthy hair, mucous membranes and skin. Vitamin B12 mse contains this vitamin in the bioactive form as methylcobalamin, supplemented by biotin, folic acid and vitamin B6, biotin being fundamental for the uptake of vitamin B12. The folic acid is also present in the bioactive form as 5-methyltetrahydrofolate (5-MTHF).
Vitamin C - ascorbic acid
Vitamin C (ascorbic acid) stands for a normal function of the immune system and the protection of the cells from oxidative stress. It also supports a normal formation of collagen, which is valuable for a normal function of blood vessels, bones, skin, gums and teeth. It regenerates vitamin E and plays an important role in the amidation of the hypothalamic hormones, among them thyrotropin-releasing hormone (TRH), which regulates the immune system and is also found in the gut. In order to make vitamin C available to the body over a long period, a formulation with delayed release is advisable, as with Vitamin C mse matrix.
Vitamin D3 - cholecalciferol
Vitamin D3 (cholecalciferol) is the most important of the group of D vitamins. It has very varied functions, for example contributing to a normal calcium level in the blood and to the maintenance of normal bones. It also contributes to a healthy function of the immune system and the muscles. As an important step in the body's own production of vitamin D3 takes place in the skin and depends on sunlight, the importance of an external supply grows the less time a person spends in the sun. The final step of vitamin D3 synthesis takes place in the mitochondria.
The range of mse Pharmazeutika GmbH includes Vitamin D3 mse intense (10000 IU) as well as Vitamin D3 mse (2000 IU).
Selenium
The essential trace element selenium functions as a cofactor of numerous selenoproteins in the body. Among other things it is a component of antioxidant enzymes such as GPx and thus contributes to protecting the cells from oxidative stress. Selenium also supports a normal thyroid function. The thyroid enzyme deiodinase, for example, is selenium-dependent. A healthy immune system is also promoted by selenium.
The mse products SeleMit and Selen mse contain selenium in inorganic and organic compounds respectively (bound to Spirulina platensis) and can be used to raise and maintain the selenium level in the body.
Zinc
Zinc is likewise a cofactor of numerous enzymes, such as SOD, which catalyse important metabolic processes in the body. Zinc contributes, among other things, to a normal carbohydrate and fat metabolism, a normal protein synthesis, a healthy acid-base metabolism and a normal DNA synthesis. It also supports a healthy function of the immune system and the protection of the cells from oxidative stress. It further promotes a normal vitamin A metabolism, healthy vision and the maintenance of healthy skin, hair, nails and also bones. In addition it contributes to normal fertility and reproduction. For optimal uptake and biological availability in the body, the source of supply is decisive. ZincII biologically bound to the microalga Spirulina platensis (ZinkII mse) or in organic form as zinc bisglycinate (ZinkoMit) each represent a recommendable form of uptake.
Magnesium
Magnesium is a component of more than 300 enzymes. It promotes a normal function of energy metabolism and the reduction of tiredness and fatigue. Magnesium is not only needed for energy production but is also essential for the release of energy from the ATP molecule bound to magnesium (the body's energy currency), as it is required as a cofactor for ATPases. It is involved in ATP transport and in the recycling of ADP. It also supports a normal function of the muscles, the nervous system and the psyche and contributes to the electrolyte balance, a normal protein synthesis and the maintenance of healthy bones and teeth. In addition to the magnesium taken in with food, the product Magnesium mse offers the possibility of taking in magnesium in the form of magnesium oxide. This is a natural form of magnesium that is absorbed slowly by the body and can therefore act better in the body. Alternatively there is magnesium in the form of magnesium bisglycinate, which is distinguished by an organic chelate structure as well as a high and rapid bioavailability, as contained in the product MagnoMit.
Glutathione
L-glutathione is the naturally occurring biological form of glutathione. This substance native to the body consists of the three protein building blocks glutamic acid, L-glycine and L-cysteine. It occurs in all organs, particularly in the heart, brain, lungs, liver, kidneys, digestive tract, in immune cells and especially in the mitochondria. During energy production in the mitochondria, oxygen radicals also arise as unwanted by-products and, as a consequence, hydrogen peroxide, which is subsequently converted enzymatically into water via glutathione peroxidase with the consumption of reduced glutathione. The resulting oxidised glutathione disulfide is converted back into the reduced, bioactive form by glutathione reductase.
Glutathion mse contains 300 mg of reduced L-glutathione in enteric-coated capsules.
Omega-3 fatty acids
Omega-3 fatty acids are a component of our cell membranes and are found in our body particularly in the brain, heart, nerves and the retina. Here they contribute to maintaining a healthy brain function, above all by supporting the uptake of the thyroid hormone T3 by the brain, and contribute to maintaining healthy vision. A normal heart function can also be supported by the intake of omega-3 fatty acids.
The mse product EnzOmega® contains 750 mg of omega-3 fatty acids per capsule, of which 500 mg eicosapentaenoic acid (EPA) and 250 mg docosahexaenoic acid (DHA) in the physiological ratio of 2:1.
Summary and conclusion
The effects of chronic fatigue syndrome (CFS) represent a great burden for those affected, as the patients are considerably restricted both personally and professionally. A large number of clinical investigations and scientific papers show that the needs-based use of Mitoceuticals® can positively influence the natural functions of the mitochondria and thus of the body. The supply of micronutrients is therefore also a promising possibility for accompanying medical treatment of CFS in a supportive way. As the energy deficiency is directly or indirectly a consequence of exhausted mitochondria, including selected food supplements according to the MitoMed concept appears advisable in many cases.
Omega-3 fatty acids
Omega-3 fatty acids are building blocks of the membranes (cells, mitochondria, red blood cells and others) and starting substances for the formation of tissue hormones, which play an important role as local messengers in signal transmission. They have an important function with regard to the correct composition of the blood lipids and thus the flow properties of the blood as well as the blood circulation (through the formation of vasodilating tissue hormones). Omega-3 fatty acids are also needed for blood pressure, the flexibility of the cell membranes, the immune system, our skin metabolism, the cardiovascular system and brain and memory performance.
The mse product EnzOmega® contains 750 mg of omega-3 fatty acids per capsule, of which 500 mg eicosapentaenoic acid (EPA) and 250 mg docosahexaenoic acid (DHA) in the physiological ratio of 2:1.
Ubiquinol / ubiquinone Q10
Q10 occurs in all cells of our organism. It is a key substance for energy production in the mitochondria and is vital for the entire organism. Coenzyme Q10 is the only lipophilic (fat-soluble) antioxidant produced by the body itself and plays an essential part in protecting the cells from free radicals. As free radicals are formed in particular during energy production in the mitochondria, the Q10 within them contributes not only significantly to the energy supply but also to the protection of the mitochondria. Coenzyme Q10 also fulfils further important functions. It keeps the cell membranes fluid and functional and is involved in the exchange of substances and information between the cells. Q10 is barely metabolised in the body and is excreted intact in the stool. An external supply therefore places no additional burden on the liver or kidneys. The product range of mse Pharmazeutika GmbH includes numerous Q10 products with individual advantages. We will gladly advise you on which product is the right one for you.
Vitamin B3 – niacinamide
Niacinamide, like Q10, occurs in all cells of our organism. As a coenzyme building block of nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) it is involved in numerous enzymatic reactions of the metabolism and plays a significant part in energy production in the mitochondria. Its function is, among other things, closely linked to ubiquinol/ubiquinone Q10. It also plays a role in the defence against reactive free radicals and takes part in the regeneration of Q10 into its active form.
The mse product TriaMit-B® contains vitamin B3 as niacinamide and can be used to compensate for a bioenergetic deficit in the body. In addition to vitamin B3, RiboMit® also contains vitamin B2 and ubiquinol Q10.
Vitamin C - ascorbic acid
The importance of vitamin C for our defence system is widely known. However, the substance performs numerous further functions in the body. Among other things it is indispensable for the formation and function of collagen (an essential component of the connective tissue), and it is involved as a cofactor in the formation of hypothalamic hormones, messenger substances and detoxification processes. Beyond this, vitamin C is regarded as one of the most important antioxidants and as a very effective radical scavenger in our organism. It should be emphasised that vitamin C protects against reperfusion injury (reduced blood flow) during operations. It also regenerates vitamin E.
As excessive doses (more than 50 to 80 mg) are excreted via the kidneys, it is important to use a product that releases vitamin C evenly over a long period (6 to 8 hours) without burdening the kidneys. Vitamin C mse matrix 500 mg meets these requirements.
