Our bodies need a steady supply of micronutrients — vitamins, minerals and essential amino acids— to operate properly. If you have a chronic illness like chronic fatigue syndrome or fibromyalgia, you’re especially prone to nutritional deficiencies; in fact, if you have any physical disability, you’re more likely to be deficient in vitamin C, for example.(1)
Most nutritionists would agree that even sub-clinical deficiencies — those at the bottom end of normal — can seriously effect your health.
“It’s likely that marginal deficiencies not only contribute to the clinical manifestations of [chronic fatigue] syndrome, but also are detrimental to the healing processes,” explains Melvin R. Werbach, M.D., a physician, psychiatrist and scientist from the from the UCLA School of Medicine who suggests CFS patients are deficient in many essential substances. Werbach’s monthly column on nutritional medicine appears in the International Journal of Alternative and Complementary Medicine in the UK and is reprinted in the U.S Townsend Letter for Doctors and Patients and the Australian Journal of Nutritional and Environmental Medicine.
Sometimes—not always— science can help you determine which supplements you need. Your physician can test how much iron is circulating in your blood; if you’re low, he can prescribe iron supplements. After you take them for awhile, he can measure how you’re doing with another blood test.
But it’s not always so simple. For example, doctors can test for magnesium levels in the blood, although most of the magnesium in your body is in bone and soft tissues.(2) If you have anemia, blood tests will show an obvious B-12 deficiency; but since some researchers believe even sub-clinical levels (those at the bottom of the normal range) can cause severe fatigue,(3) many CFS specialists recommend a trial of B-12 for most of their patients anyway.
The smart thing to do is enlist your physician and perhaps a nutritionist to help you figure out what your individual nutritional needs are and how best to meet them. It’s also helpful to have a pharmacist available who can tell you about any potential interactions between the herbs, supplements and prescription or over-the-counter medicines you take.
In your search for a balanced supplement regimen, take this advice from Jack Challem, The Nutrition Reporter™: “Vitamin supplements have their place, but they’re additions to a sound diet, not replacements for it. Instead of trying to compensate for what you do wrong, strive for balance. Eat a wholesome diet as consistently as possible, and then add supplements.”
How do you know which supplements to take?
Those of us with CFS/FM usually have deficiencies as a result of those illnesses— one study done in 2000 by Werbach suggests we’re low in the B vitamins, vitamin C, magnesium, sodium, zinc, L-tryptophan, L-carnitine, coenzyme Q10, and essential fatty acids “primarily due to the illness process rather than to inadequate diets.”(4)
Werbach suggests identifying deficiencies with objective testing when possible, treating them effectively, and testing again after treatment to ensure the deficiencies get resolved. But when that’s impossible, he suggests supplementing CFS patients with these nutrients, along with a general high-potency vitamin/mineral supplement, at least for a trial period.(4)
Why? “Because it’s often difficult to rule out marginal deficiencies, because serious adverse reactions are rare, and because nutritional supplements offer a therapeutic benefit,” he said in his study.
In other words, it probably won’t hurt and it’s likely to help.
But that doesn’t mean you should take every new thing that’s advertised as the next big cure. Instead, look at the science that’s being done and try those things that clinical research says might be helpful.
Dr. Darryl M. See, M.D, a CFS specialist from California, suggests that PWCs use “only those supplements that have been tested in a laboratory.”
Most long-term chronic illness patients have learned to try something for a relatively short period of time, gauge its effectiveness, and stop taking it if it’s not showing a clear health benefit.
“Sometimes it takes a few tries to be sure if something works —the benefit may be small but worth it; and sometimes you only realize something was helping you in retrospect,” says Connie Bladeo, a long-term PWC from Arkansas whose current regimen includes B-12 shots, a multi-vitamin and mineral mix and a powdered amino acid drink.
Because a number of recent studies have shown oxidative stress to be a problem for CFS patients,(5) antioxidants are an important treatment option. One study specifically mentions glutathione, N-acetylcysteine, alpha-lipoic acid, oligomeric proanthocyanidins, ginkgo biloba, and vaccinium myrtillus (bilberry) to be beneficial.(5)
Other studies show we’re deficient in growth hormone and NADH. We’ll take a detailed look at many of these substances later, but first let’s talk about proper dosing and efficacy.
