Chronic fatigue syndrome — more correctly called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — is one of the more frustrating chronic illnesses because most doctors don’t believe it exists or that it’s a psychiatric issue. Despite symptoms that completely debilitate its victims, ME/CFS is often the butt of jokes or medical ridicule because there is no lab marker to diagnose it even though it has been linked to inflammation of the nervous system.
However, that may change thanks to the invention by a father whose adult son has been bedridden with ME/CFS for the last 10 years.
The father, who is also a Stanford scientist, developed a simple blood test that measures the energy cells expend in order to maintain homeostasis after exposure to salt. Salt stresses cells, which must retain balance in sodium levels in order to function properly.
The researcher passed the cells exposed to salt through a small microchip that uses an electrical current to measure the energy exertion of the cells. Less exertion indicates the cells are able to easily maintain sodium balance, while more exertion meant finding balance required considerable effort.
The test was run on 40 people — 20 of whom suffer from ME/CFS and 20 healthy controls. In all 20 of the ME/CFS group, the cells expended significantly more energy in response to the salt compared to the cells of the 20 healthy people. This indicates the ME/CFS group had cells that were considerably less functional and more stressed.
Poor cellular function leads to poor function of the body and brain. Dysfunctional cells that can’t produce enough energy result in a body that is constantly fatigued and in poor health with multiple symptoms.
Although the test needs to be run on larger groups of people, if the research is able to replicate these results, it means conventional medicine will finally have the biomarker it needs to legitimize ME/CFS as a medical condition in the eyes of ordinary doctors.
Conventional advice for ME/CFS can be debilitating
One mistake many conventional doctors make when they examine a patient with ME/CFS is to assume they are lazy or hypochondriacs. As such, it’s common for doctors to tell ME/CFS patients to exercise to improve their symptoms.
This is bad advice for the ME/CFS patient whose cells are struggling to maintain just basic functions.
In fact, many patients with chronic fatigue are so severely fatigued they cannot work, have normal lives, or even leave their beds. Any exertion exacerbates their symptoms in what is called “post-exertional malaise.” For these individuals, exercise is an extremely inappropriate prescription.
ME/CFS affects several million people in the United States, although it’s estimated that as many as 90 percent of sufferers have not been diagnosed, due to the difficulty of receiving a proper diagnosis. It can take years and visits to multiple doctors to find one who will take the symptoms seriously.
Another difficulty in diagnosis is that patients suffer from multiple symptoms in addition to chronic fatigue, such as chronic pain, difficulties with memory and concentration, gut issues, and extreme sensitivities to light, sound, smell. Poor cellular function affects multiple organs so that symptoms can vary depending on the person.
ME/CFS can be diagnosed though a simple checklist of symptoms, however most primary care doctors are not aware of the list or adhere to the belief the disorder is imaginary. Conventional doctors also don’t like to diagnose ME/CFS because no drugs exist to treat it.
However, should the new testing prove to be accurate, it would give the millions of sufferers a diagnosis, thus eliminating the demoralizing mystery. This would also open the doors to new research into the condition.
Recent research into brain inflammation could also bring hope for ME/CFS
Fortunately, recent research breakthroughs in brain inflammation offer promise in not only validating ME/CFS but also its treatment.
Brain inflammation is more common than previously realized and is increasingly linked to myriad conditions other than ME/CFS, including depression, anxiety, childhood brain development disorders, and Alzheimer’s and Parkinson’s disease.
Immune cells in the brain outnumber neurons 10 to one and are vastly more important than previously realized. They are responsible for maintaining neuronal health and function and removing debris and plaque from the brain. However, when the brain is impacted by inflammation from dietary or lifestyle factors or a brain injury, the brain’s immune cells must abandon their jobs of supporting neuronal health and instead go into persistent warrior mode, damaging brain tissue in the process. Unlike the body’s immune system, the brain’s has no off switch.
There are no drugs to tame brain inflammation, however, it has been shown to respond to certain botanical compounds and functional medicine protocols that include dietary, lifestyle, and health interventions.
Ask my office for more advice on how we can help you with fatigue.
Fats are a hot topic of debate in the health-conscious community, and recent reports have made it hard to separate facts from fear-mongering. Canola and coconut oils are two popular fats that have received a lot of attention over the years, and thankfully recent studies are showing us more clearly which fats to embrace, and which to avoid.
To understand which fats are healthy, it’s helpful to understand “good” HDL and “bad” LDL cholesterol, small fat and protein packages that transport cholesterol throughout the body.
High-density lipoprotein (HDL) or “good” cholesterol helps protect your arteries from cholesterol and removes excess arterial plaque.
Low-density lipoprotein (LDL) or “bad” cholesterol can accumulate in the arteries to form plaque that narrows them and makes them less flexible (atherosclerosis).
Triglycerides. Elevated levels are linked to heart disease and diabetes. Risk factors include smoking, physical inactivity, excessive drinking, overweight, and a diet high in sugars and grains.
HDL, LDL, and triglycerides come in small and large particles. While the large particles are practically harmless, the small, dense particles are more dangerous. They can lodge in arterial walls, leading to inflammation, plaque buildup, and damage that eventually leads to heart disease.
When considering test results, your doctor will note:
HDL levels versus LDL levels
The ratio between triglycerides to HDL
The ratio between total cholesterol and HDL
The size of the particles
Here’s where the former warnings about fats and cholesterol have been misleading: We now understand that more important than knowing your total cholesterol is knowing the ratio between your HDL and your LDL, and especially the size of the particles.
In addition, the Mayo Clinic says many doctors now believe that for predicting heart disease risk, total non-HDL may be more useful than calculating your cholesterol ratio. Non-HDL cholesterol is figured by subtracting your HDL cholesterol number from your total cholesterol number.
Finally, either option appears to be a better risk predictor than your total cholesterol level or simply your LDL level.
Note: In some cases, people have a genetic tendency toward extremely high cholesterol. In those situations, it may take more than diet to manage cholesterol levels.
Should I consume saturated fats?
Sourced from tropical oils and animal products, saturated fats are typically solid or semi-solid at room temperature. Common dietary sources include beef, pork, lamb, poultry skin, high-fat dairy, palm oil, and coconut oil.
Saturated fat sits at the forefront of the debate about dietary oils. Why? For years, we’ve been warned that it increases the risk for cardiovascular disease because it raises LDL, the “bad” type of cholesterol.
This recommendation was based on four hand-picked studies done nearly 40 years ago and doesn’t reflect recent studies that shine a different light on fat intake. What the studies didn’t do is take into consideration other things saturated fats do to help balance the equation:
Raise HDL (“good”) cholesterol.
Change LDL (“bad”) cholesterol from small, dense particles — dangerous for heart health — to large particle LDL, which does not increase heart disease risk.
Support brain health.
Possibly reduce stroke risk.
In fact, a recent meta-analysis of studies showed there is no significant evidence that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease.
For some people there are legitimate reasons to moderate saturated fat intake:
Saturated fat intake can be associated with lighter, less restorative, more disruptive sleep (yet increased fiber can help increase sleep quality).
ApoE4 carriers (increased Alzheimer’s risk) see a much higher spike in LDL cholesterol from high saturated fat in the diet, without a matching rise in HDL. They may benefit from lower intake of saturated fat which can lower LDL cholesterol and improve HDL/LDL ratio.
A small percent of the population does experience a skyrocketing increase in LDL concentrations along with increased inflammation levels measured by C-reactive protein.
Ask meabout a diet that is sufficient in healthy fats, void of bad fats, and customized to your dietary needs.
Many of us start the day with a small breakfast as we run out the door, followed by a medium sized lunch and a large dinner. We also tend to snack throughout the day and even grab a bite before bed. However, while what we eat is important, a growing body of research suggests when we eat matters too.
The digestive system’s circadian rhythm
While you have likely heard of the circadian rhythm, the master “clock” in the brain that governs our sleep-wake cycle, we actually have a variety of circadian clocks that govern the daily cycle of activity for every organ.
These rhythms exist because every organ needs downtime for repair and regeneration.
The digestive system is no exception. During the day, the pancreas increases production of insulin, which controls blood sugar levels, and then ramps it down at night.
Circadian clocks optimize our health by aligning our biological functions with regular and predictable environmental patterns. Disrupting our circadian clocks — such as by skipping breakfast or eating at midnight — can result in health issues such as weight gain, metabolic syndrome, cancer, cardiovascular disease, and more, and if you want to know more about YOU and YOUR health, schedule a FREE 15-minute consultation with Dr. Celaya.
Eat breakfast daily
About 20 to 30 percent of American adults skip breakfast. Some do it to save time, many do it in an effort to lose weight. However, studies show that people who eat breakfast daily are less likely to be obese, malnourished, suffer from impaired blood sugar metabolism, or be diagnosed with diabetes.
They are also less likely to have the heart disease risk factors of high blood pressure and high cholesterol. Even the American Heart Association recently endorsed biologically appropriate meal timing to reduce the risk of heart disease.
Just eating breakfast isn’t the only important thing, however. It’s critical to start the day with a breakfast that provides plenty of protein and healthy fats, and a minimum of sugars. This helps support blood sugar balance and proper brain function throughout the day.
Make breakfast the largest meal for weight control and fat loss
The timing in relation to the size of our meals is also important.
Research shows having the largest meal in the morning appears to help with weight control compared to having a large meal in the evening.
In fact, a person eating the identical meal at different times of day might deposit more fat after an evening meal than a morning meal.
This is partially because insulin, a hormone that helps with blood sugar control, appears to be most efficient in the morning. In addition, we burn more calories and digest food more efficiently in the morning than later in the day when most of us eat our largest meal.
In one study, a group of overweight women with metabolic problems were put on a 1400 calorie-per-day diet. Half consumed 700 calories at breakfast, 500 calories at lunch, and 200 calories at supper and the other half reversed that pattern.
Women in both groups lost weight and experienced reduction in fasting glucose, insulin, and ghrelin (a hunger hormone), but in the same time frame the large-breakfast group experienced added benefits:
They lost 2.5 times the weight compared to those who ate the largest meal at dinner.
They had a significantly greater decrease in fasting glucose, insulin, and triglyceride levels.
Their satiety (sense of fullness) scores were significantly higher.
They also lost more body fat, especially in the belly.
According to the researchers, a high-calorie breakfast and a reduced calorie dinner is beneficial and might be a useful alternative for managing obesity and metabolic syndrome.
The body needs fasting periods for optimum health
Fasting signals to the body to start burning stores of fat for fuel. Most of us eat meals and snack from the time we wake up until shortly before bed — or even in the middle of the night. In fact, studies show the average person eats over a 15-hour period during the day. This short fasting time period may interfere with optimal metabolism and increase weight gain.
Researchers put a group of prediabetic men through two eating cycles. In one phase, they ate meals within a 12-hour window for five weeks.
Then in another phase, they ate the same meals in a time-restricted six-hour window starting in the morning.
They ate enough to maintain their weight, so they could assess whether the time-restricted regimen had benefits unrelated to weight loss.
In addition, the men who ate only one or two meals per day fared better than those who ate three meals.
A recent review of the dietary patterns of 50,000 adults over seven years provides added evidence that we should ingest most of our calories early in the day, including a plentiful breakfast, a smaller lunch, and a light supper.
The researchers said that eating breakfast and lunch five to six hours apart and making the overnight fast last 18 to 19 hours may be an effective method for preventing long-term weight gain.
Another recent study found that subjects who added snacks to their daily meals tended to gain weight over time, while those who had no snacks tended to lose weight.
Light exposure is key for proper metabolism
Sufficient exposure to natural light and darkness also play an important role in how we metabolize food for either energy production or fat gain.
At night, the lack of sunlight signals our brain to release melatonin, the hormone that prepares us for sleep. In the morning, the light stops melatonin production and we wake up.
When we change that signaling — whether from a late-night meal, artificial lighting at night (especially blue screen light), shift work, flying and travel, or changing our eating patterns — it confuses our bodies’ circadian clocks. Eating at the wrong time of day strains the digestive organs, forcing them to work when they are supposed to rest.
Shift workers, who account for about 20 percent of the country’s workforce, have a particular problem with disturbed circadian clocks. Many frequently work overnight shifts, forcing them to eat and sleep at odd times. Nighttime shift work has been linked to increased risk of obesity, diabetes, heart disease, and breast cancer.
Studies have linked poor melatonin activity and disrupted sleep-wake cycles with an increased risk of dementia and Alzheimer’s, cancer, autoimmune flare-ups, obesity, and more.
Low blood sugar may require a before-bed snack
One important exception to the “don’t eat right before bed” rule is for those who have chronic low blood sugar. For these people, keeping blood sugar stable throughout the day — and night — is critical for brain health, energy level, and more.
If you suffer from the following chronic low blood sugar symptoms, it may be best to take a small, high-protein low sugar snack just before bed:
Constant sugar cravings
Nausea or lack of appetite in the morning
Irritability, light-headedness, dizziness, or brain fog if meals are missed
Craving caffeine for energy
Eating to relieve fatigue
Afternoon energy crashes
Waking around 3 a.m.
Daily habits to maximize your dietary rhythm
To help maximize your meal timing and metabolism, incorporate the following habits into your day:
Make breakfast your largest meal and make dinner your smallest. While this may prove difficult for those with a busy social life or family that sits down to a big dinner every evening, make the evening meal smaller whenever possible.
Prioritize protein and healthy fats with breakfast, and minimize sugar and caffeine intake especially before lunch, to stabilize blood sugar and regulate metabolism.
Avoid between-meal snacks and bedtime goodies. The exception is for those who have chronic low blood sugar as mentioned above.
Try a time-restricted eating pattern, or intermittent fasting, to maximize weight management.
Manage exposure to blue light at night:
Avoid screen light in the evening
Install the f.lux app on your phone and computer
Read a book
Wear blue-blocker glasses at night
Install amber or red light bulbs for evening use
If you have chronic low blood sugar, a small before-bed snack with plenty of protein may be a good idea to keep your blood sugar stable all night and prevent that 3 a.m. wake-up.
While studies suggest that prioritizing larger meals early in the day helps support metabolic health, it does not necessarily mean that you should skip dinner. Instead, have your dinners earlier and make them relatively light.
The take-home message here is like the old proverb, “Eat breakfast like a king, lunch like a prince and dinner like a pauper.” Schedule a FREE 15-Minute Consultation with Dr. Celaya.
While the eight-to-five workday may suit a man’s physiology, female researchers are finding women can capitalize on periods of heightened creativity, productivity, enhanced communication, and reflection depending on where they are in their menstrual cycle. We tend to think of female hormonal cycles as problematic or negative, but the truth is they can facilitate different aspects of productivity once you learn how to use them to your advantage.
Understanding your hormonal cycles of productivity can help you learn the best time to launch or finish a project, brainstorm a creative endeavor, meet with a boss or coworkers, or step back and reflect on operations.
Looking at a functional medicine view of female hormones — aiming for optimal functional and balance instead of just focusing on when things go wrong —can help you plot your course through each work week. Women can look at their cycles as offering four different periods of enhanced performance, with day 1 representing the first day of your period:
Days 1-5, Intuition and Reflection: During your period, your left and right brains are communicating more efficiently, allowing you to better access intuition, analytical thinking, and long-range visionary thinking. This is the time to reflect on past and future endeavors, re-evaluate whether your course aligns with your vision, and consider which relationships need attention.
Days 6-14, Creativity: During the follicular phase, which actually begins day 1, estrogen is increasing and you are at your creative peak. This is a good time to start new projects, plan, strategize, and brainstorm.
Days 15-17, Communication: During the ovulation phase your communication skills and magnetisms are at their height. This is a great time for negotiations, meetings, and pitches.
Days 18-28, Power: During the luteal phase you are primed to power through project completion, take care of all those administrative tasks, and follow up on meetings.
When your hormones are out of balance
Unfortunately, thanks to stress, unhealthy diets, environmental toxins, and other facets of modern life, it’s easy for your cycles to become unbalanced.
One of the most common causes of hormonal imbalances in women is chronic stress and poor blood sugar balance (another form of stress).
Eating a high-carb diet of pastas, breads, and other processed carbohydrates, eating too many sweets, drinking too many sweetened coffee drinks, not sleeping enough, being too stressed out, not getting enough physical exercise — all these things can drive both estrogen and progesterone out of whack and give you miserable hormonal symptoms.
PMS, irregular periods, infertility, hair loss, overly heavy periods, and other symptoms of hormonal imbalance are signs you need to bring your diet and lifestyle habits more in line with nature’s design.
Through functional medicine protocols of anti-inflammatory diets, blood sugar balancing, gut healing and repair, liver support and detoxification, and stress-reduction, our office can help you better balance your hormones so you can function at your best.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.