Friday, August 20, 2010

Chronic Fatigue Syndrome Protocol "SHINE"

By Dr. Jacob Teitelbaum

We would be hard-pressed to find a person who hasn’t experienced exhaustion at one point in his or her life—whether you are a parent of a newborn, a college student working your way through school, or just suffering from a bad cold. Fortunately, this feeling is generally transient and can be relieved with rest. In contrast, people who suffer from Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS or CFS) experience severe, almost unrelenting fatigue, often associated with “brain fog”, widespread pain, and many other problems. CFS’s sister illness, fibromyalgia syndrome (FMS), is characterized by muscle pain. Oddly enough, despite their constant exhaustion, people with CFS/FMS typically find that they can’t sleep.

What Causes CFS?

CFS is thought to be an “energy crisis” associated with hypothalamic dysfunction. The hypothalamus can be likened to a circuit breaker/fuse in your home. This circuit regulates hormonal function (thyroid, adrenals, etc.), the autonomic system (body temperature and blood pressure regulation), and the sleep center. The hypothalamus can be suppressed by physical or emotional stress, which can cause you to “blow a fuse”.

The “SHINE” Treatment

In my 30 years of clinical experience treating CFS, I have found that the SHINE approach is successful in helping the large majority of CFS/FMS patients. The “SHINE Treatment Protocol” for treating CFS/FMS includes:

A Specialized Nutritional Program for Recovery

The reality is that most people don’t get the optimal amount of nutrients from their diets.1 In addition, many nutrients can be depleted as a result of CFS/FMS. Supplements can play an integral role, in conjunction with a healthy diet, in achieving optimal nutritional intake. Look for a powdered supplement that supplies a strong nutritional foundation, providing optimal and balanced nutritional support. By using a good vitamin powder, one can get the majority of nutrients in a single drink, instead of needing handfuls of pills. An ideal dietary supplement should include such key ingredients as:

Amino Acids—
Amino acids, as the building blocks of protein, are critical to every reaction that occurs in the body. Amino acid supplementation, especially with whey protein, has many benefits including maintenance of muscle tissue, energy levels, and brain function. They have also been shown to increase the production of glutathione, a potent antioxidant.2

Overall Vitamin and Mineral Support—
Vitamins C, D, E, K, and many minerals (e.g. zinc, magnesium iodine, selenium, etc.) are critical.

B vitamins—Nutritional deficits in B vitamins in CFS sufferers have been a subject of research for some time.3,4,5 B vitamins are especially critical for energy production.

Alpha Lipoic Acid—In addition to being an important antioxidant, alpha lipoic acid (ALA) helps recycle other important antioxidants, including vitamins C and E, CoQ10, and glutathione.

Energy Metabolites —Malic acid is critical for energy production.7, 8

In addition, you may also want to add a special nutrient called ribose. In a recent study of 257 people with CFS/FMS, conducted at 53 practitioner clinics, supplementation with ribose was shown to increase energy an AVERAGE of over 60% after three weeks.9

Natural solutions are available in the form of dietary supplements and when combined with different medical treatments,supportive therapies, and lifestyle changes, can be integral in the treatment of chronic fatigue syndrome.


1 White E, Patterson RE, Kristal AR, Thornquist M, et al. Vitamins and lifestyle cohort study: study design and characteristics of supplement users. Am J Epidemiol 004;159:83-93.

2 Krissansen GW. Emerging health properties of whey proteins and their clinical implications. J Am Coll Nutr 2007;26:713S-23S.

3 Jacobson W, Saich T, Borysiewicz L, et al. Serum folate and chronic fatigue syndrome. Neurology 1993;43:2465-2467

4 Puri BK, Counsell SJ, Zaman R, et al. Relative increase in choline in the occipital cortex in chronic fatigue syndrome. Acta Psychiartr Scand 2002;106:224-226.

5 Heap LC, Peters TJ, Wessely S. Vitamin B status in patients with chronic fatigue syndrome. J R Soc Med 1999;92:183-185.

6 Biewenga GP, Haenen GR, Bast A. The pharmacology of the antioxidant lipoic acid. Gen Pharmacol 1997;29:315-31.

7 Hendler SS, Rorvik, D., eds. Malic acid. In: PDR® for Nutritional Supplements. 2nd ed. Montvale, NJ: Physician’s Desk Reference Inc; 2008: 412-413

8 Russell IJ, Michalek JE, Flechas JD, Abraham GE. Treatment of fibromyalgia syndrome with Super Malic: a randomized, placebo controlled pilot study. J Rheumatol 1995;22:953-958.

9 Scripps Integrative Medical Center’s 7th Annual Natural Supplement Conference. La Jolla, CA. January 2010

1 comment:

  1. Anyway regarding the treatment, I went to a specialist in infectious diseases, and told about the study. It was a bit confusing at first, because he has never heard of anyone on Valcyte for 6 months, but after showing the line of study, became a little more comfortable with the idea. Then I was sent for blood tests and received a prescription for Valcyte shortly thereafter.

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