Detoxification: Body and Mind Pollution.
“Without doubt, the health of the intestine and large bowel plays an important role in the health of the patient with the chronic fatigue syndrome —the extent of which is yet to be fully appreciated.”
CHAPTER EIGHT
Body pollution detoxification
The main aim of any treatment programme should be to raise the patient’s vitality. This is basically what doctors of natural medicine have been doing for the last one hundred years. In the time of Hippocrates, over two thousand years ago, and also in ancient China, the role of the healer and physician was to cleanse the body. Many techniques have been devised for such ‘cleansing’ and ‘raising of the vitality’ with some being more popular and effective than others.
These concepts of detoxification, cleansing and elevation of vitality are foreign to most Western-trained doctors. They are also concepts that most of the population are either unaware of or ignore. Although the increasing pollution of our air, water and food has rung alarm bells in some sections of modern society, most people don’t realise the full impact that even small quantities of pollution have on the delicate machinery within the body’s cells.
Naturopaths have been talking for hundreds of years about the elimination of poisonous products in the system. These poisonous products include not only the toxic substances we receive from the external environment but also the elimination of toxic products produced by the body’s metabolism itself. The new field of environmental medicine encompasses all of those
factors in the environment which impinge on our health including chemicals, pesticides, herbicides, heavy metals, household chemicals, positive air ions, electromagnetic smog, air, pollution etc.
However, the concept of the large bowel being a part of the environment and having the ability to produce highly toxic substances because of the huge number of bacteria, fungi and micro-organisms present in it, is something that is only becoming more appreciated over the last couple years. According to the doctrines of natural medicine and healing, those pollutants — or toxins as they are commonly called —must be eliminated from the body and therefore reduce the total toxin load. As a part of a detoxification programme, one of the major approaches to treatment involves reducing exposure to various toxins, chemicals, allergens, drugs, food additives and the multitudinous collection of chemicals present in everyday household and workplace.
Detoxification also involves the elimination of toxins from within the body itself. This includes cleansing of the bowel and the placement in the bowel of micro-organisms that are beneficial to the host. Bacteria, fungi and Candida albicans are major allergens present in the bowel that can produce disease. The removal of heavy metals, such as mercury and lead, may be necessary, and this entails the use of chelation therapy. Chelation is the use of an intravenous agent which binds to heavy metals in the tissues, making them more water soluble and carrying them to the kidneys for excretion. As an integral part of a detoxification programme the use of antioxidant nutrients including vitamins A, C, selenium and zinc is mandatory.
These early steps in a treatment programme confer upon the sick person a degree of improved health without the use of toxic, synthetic drugs, drugs have the potential for symptom relief but disease promotion.
It must be remembered that although detoxification is a most essential step in the initial treatment of any disease, it may actually aggravate some of the symptoms of disease in the early stages. This probably occurs as a consequence of a change in metabolism and if there is sluggish functioning of the kidneys and liver, waste products may not be eliminated efficiently and quickly enough. These wastes form free radicals which have the ability to damage the cells and tissues of the body. This can further aggravate the disease process. Free radicals can be blocked by the use of
adequate antioxidant nutrients.
These antioxidant nutrients are discussed in Chapter 5 on free radical disease and antioxidants. To improve the effects of a detoxification and antioxidant programme, the patient must be encouraged to drink plenty of
fresh, pure water and to pass at least two well-formed bowel actions each day. A good detoxification programme therefore includes the stimulation of the organs of elimination including the kidneys, liver, bowel, lungs and lymphatics. This stimulation can be achieved with the appropriate use of exercise, herbal medicines, homeopathic medicines, diet, saunas and, if necessary, intravenous vitamin C.
In the chronic fatigue syndrome it appears that the nervous system, endocrine system, immune system, liver and lymphatics are the major organs under stress. It is therefore important to provide nutrients in the form of foods and herbal remedies for the various systems to enable them to recover sufficiently. Once these organs are functioning normally again, other treatments seem to have a better effect.
Detoxification of the liver
The liver is one of the largest organs in the body and it has many functions. The liver produces proteins, antibodies, anticoagulant factors, bile for fat digestion and it is intrinsically tied up with the metabolism of glucose for energy.
One of its major roles is as a detoxifying or cleansing factory. The action of the liver as a detoxifying organ is to make potentially toxic chemicals more water soluble so that they can be excreted in the bile or through the kidneys. These water soluble chemicals are produced by enzyme action in the cells of the liver and all of these enzymes are dependent on minerals, trace elements and vitamins acting as co-factors to make them work. The liver is responsible for the detoxification of chemicals obtained from the environment as well as those produced by the body’s metabolism. An overload of chemicals arriving at the liver from the environment, including the environment within the large bowel, may excessively stress the liver. An excess of alcohol or tobacco, an anaesthetic, antibiotic drugs or even a mild viral infection may be the straw that breaks the camel’s back. As a consequence, the liver begins to function in a sluggish manner in all respects. Until detoxification and elimination in the large bowel is improved suboptimal liver function is sure to retard a patient’s recovery.
A number of liver enhancing treatments are available in natural medicine to achieve better function. Briefly, the main liver treatments include the stimulation of bile production and bile flow, the protection of the liver cells from free radical damage and inflammation, the stimulation of the repair mechanism of the liver and the activation and modulation of the immune system cells in the liver known as the Kupffer cells. Briefly we mention here some of the various nutrients and herbs that act on the liver nutritionally.
Methionine is a sulphur containing amino acid that helps to prevent the accumulation of fat globules in the cells of the damaged liver. In fact, methionine can actually assist in the mobilisation of fat accumulation in the liver cells. To stimulate bile production and bile flow herbs such as the globe artichoke, dandelion root, greater celandine and golden seal have been scientifically demonstrated to be particularly useful. Carnitine is a complex molecule formed from the amino acid lysine. To form carnitine from lysine, it is interesting to note that vitamin C is essential for the converting enzymes. Carnitine is essential for the transport of free fatty acids into the mitochondria or power houses of the cells. Once carnitine has delivered the free fatty acids to the mitochondria of every cell in our body, the mitochondria can convert the fatty acids into carbon dioxide, water and energy. This is the basic way in which energy is produced for every cell, tissue and organ of the system. Therefore a lack of lysine, vitamin C, carnitine, essential fatty acids or enzymes involved in these processes may result in a reduction of energy production by the cells. If this occurs in the liver then we see a winding down of liver function and a patient showing signs of liver sluggishness.
Naturally occurring substances have been found in plants which actually protect the liver and cells from chemical and radiation damage. Milk thistle seeds, Catechin and dimethyl- glycine all protect the liver to some degree against chemical toxins. Milk thistle seeds and a herb called skullcap have an anti-inflammatory effect on the liver and reduce the inflammatory damage caused by viruses and chemicals. Licorice root and again milk thistle seeds help to regenerate a damaged liver. The liver is also a very important immune organ and it contains immune cells called Kupffer cells that are stimulated into performing immunological functions in the liver by such herbs as echinacea, wild indigo and golden seal. The use of a combination of these various herbs is invaluable in patients who have had acute viral infections, acute intoxications including alcohol, drugs and chemicals or even a very poor diet.
Improving lymphatic function
The lymphatic system of the body consists of hundreds of thousands of very fine tubes, much finer than arteries and veins, which carry waste material from tissues and organs back to a much larger tube called the thoracic duct which drains the lymph and all of its wastes into the blood vessels as they enter the heart.
The lymphatics also carry lymphocytes or white blood cells and they pass through the lymph nodes, liver and spleen where important immune system functioning is carried out. The very fine tubules that carry the lymph can very easily be blocked resulting in a build-up of waste materials in many tissues and organs of the body. For many decades natural medicine specialists and naturopaths have advocated various techniques to improve lymphatic flow. The stimulation of lymph flow and the prevention of lazy lymph vessels remains an essential part of the natural detoxification process.
One of the main methods by which lymph flow can be stimulated is muscle action including exercise, yoga, stretching and rebounding. Massage is also another effective way of moving lymph through the tissues. Lymphatic massage is a special technique learned by specialist masseurs for the treatment of various conditions including acne, chronic pain and arthritis. The elevation of extremities and even the partial inversion of the whole body is another way of draining lymph and its wastes. Total inversion (i.e. with the head down and the legs up) for example standing on one’s head, is not recommended. Hydrotherapy and
spa-jets also provide a means of massage to the tissues and all of these methods are generally fairly safe and without untoward side effects. In fact, some of them can be fun and enjoyed by all the members of the family.
Exercise itself is a form of lymphatic massage and if it’s overdone in the unfit individual can result in a stirring up of toxins in the body and a general feeling of un-wellness, fatigue and perhaps even nausea after the exercise has been completed. Vigorous exercise and massage programmes should be avoided in preference to some gentler exercise such as stretching and yoga. As part of the lymphatic stimulation, improvement of spleen function and blood flow to the spleen is important. It has been shown that the herbs barberry and golden seal can stimulate these functions of the spleen which may then result in the enhancement of its immunological activities.
Detoxification by improving lymphatic flow.
Massage by special technique called lymphatic drainage.
Elevation of the affected parts and elevation of the foot of the bed.
Exercise such as stretching, yoga, tai chi and rebounding.
Spa jets and hydrotherapy including water aerobics.
Herbal therapies especially for patients with enlarged lymph
nodes (glands). These herbs include marigold, cleavers, poke root, fenugreek, wild indigo and queen’s delight.
6. Fasting
The prevention or treatment of certain diseases by abstaining from foods for a defined time and under optimal conditions has been practised for thousands of years. Fasting is actually defined as the total abstinence from all food and drink, except water, for a specific period of time; it differs from starvation which means death or dying from a lack of food.
Many illnesses and diseases have been treated successfully by the use of properly controlled fasts and patients suffering the chronic fatigue syndrome actually benefit from fasting. This suggests that foods, chemicals or their metabolites may be precipitating the fatigue syndrome.
People in both the east and the west have performed fasting as a religious observance from ancient times. Healers and physicians from these periods observed the therapeutic effect of religious fasts and adopted them into practice. Fasting was practised by the followers of Brahmanism and was adopted later by the Buddhists in India. In the fifteenth century, Buddhism was introduced to Japan and fasting was further refined into a Buddhist rite. Buddhism and its fasting rite then spread throughout Japan. It is interesting to observe that in India, fasting is an acceptable method of treating illness and the Japanese have probably done more scientific and medical investigation and research into fasting than any other country. Fasting therapies have also been exhaustively studied in the USSR. Published data in western scientific literature is scarce.
Voluntary or involuntary fasting has been a way of life since primordial humans first began to scrounge around for food. Athanaeus, the second century Greek physician, claimed that fasting ‘cures diseases, dries up bodily humours, puts demons to flight, gets rid of impure thoughts, makes the mind clearer and the heart purer, the body sanctified, and raises man to the throne of God’. Moses and Jesus fasted for forty days to bring on divine revelations, Tolstoy and his contemporaries in Russia fasted to divert the mind from materialistic concerns and ‘to give joy to the soul’, American Indians fasted to induce visions and dreams, and colonial New Englanders fasted to discipline them selves, save food, time and money. These are powerful testimonies to a very simple therapy and in modern day terms we can summarise this by saying that therapeutic fasting generally improves the well-being of the person fasting.
The Japanese, Russians and, more recently, the Americans have discovered fasting therapy can bring relief to patients suffering from psychosomatic disorders, gynaecological disease and even psychiatric disorders. They have been directing their attention not only to the clinical effects of fasting but also to identifying the neurological, physiological, hormonal, metabolic and psychological changes in the body which can be scientifically measured.
It has been found that patients who have some insight into their disease and an active desire for improvement generally benefit most from fasting — sometimes dramatically — including large numbers of schizophrenic patients who have now been studied in the east and the west. This also tends to support the accumulating evidence which shows that schizophrenia is a chemical disorder of the nervous system caused primarily from food derived chemical substances, or aggravated by these metabolites.
A common symptom running through nearly all physical, psychiatric and psychosomatic disease is that of fatigue. The postulation is that if the cause of the early fatigue is discovered the development of the physical or mental disease may be prevented. Why fasting should work is unknown. The Japanese and Russian scientists studying fasting believe that while it leads to a state of acute exhaustion, fasting actually serves as a powerful stimulus to subsequent recuperation. In the chronic fatigue syndrome, providing the patient is not overloaded with heavy metals and high levels of pesticide and herbicide residues, fasting one day a week or up to four days a month definitely helps in their recovery. Improvement generally occurs on each and every subsequent fast. Fasting ensures total rest of the digestive tract and the central nervous system. Large quantities of energy are required for the functioning of the digestive system, the production of its enzymes, absorbtion of food and the assimilation of food into the body. Simply giving the digestive tract a rest helps reduce the requirements for energy.
It is also known that the gastrointestinal tract and digestive systems relay messages back to the central nervous system when food is being processed. These relay messages may actually slow down some of the functions of the nervous system and induce a state of sleepiness or fatigue. Furthermore, food allergens have been shown to cross the gastrointestinal tract barrier and enter the bloodstream, causing allergies. These allergies are often associated with a severe state of tiredness and lethargy, apathy and fatigue. Hence, a fast rests the gastrointestinal tract, the central nervous system and possibly every other tissue and organ in the body. This rest may help to normalise function. It has also been suggested that the acidosis or increased acid in the blood provoked by fasting and its compensation reflect a mobilisation of detoxifying defence mechanisms which probably play an important role in the total metabolic process. There are quite a number of processes which occur in the body’s physiology during fasting. Acidosis occurs which increases over a period of time and then decreases due to the body’s ability to compensate. Proteins are mobilised from stores in the body and enter the blood in the first week of fasting. Enzyme levels also increase in the blood and tissues, as does cholesterol. However, the initial rise in cholesterol falls if fasting continues.
Interestingly, serotonin, a chemical derived from the amino acid tryptophan in the diet and which is responsible for the sleep- wake cycle actually increases in the early stages of a fast and then falls below pre-fast levels when the fast is broken. This may be one of the mechanisms by which the chronic fatigue syndrome actually improves after a series of fasts — the level of serotonin being set lower than it had prior to the fasting treatment. Another interesting neurotransmitter change is the level of catecholamine metabolites. The catecholamines include adrenaline and noradrenaline which are the fight and flight response hormones secreted by the adrenal glands. These catecholamines are also produced in the central nervous system and are responsible for increased alertness, reduced fatigue levels and generally an increase in the state of anxiety symptoms. These catecholamine metabolites rise during a fast and remain set at higher values after re-feeding.
The changes relating to the central nervous system, including the brain and nerves, are observed in the electroencephalogram (EEG). The EEG measures the brainwave activity in the form of electrical impulses which can be converted by the EEG machine to a graph. The waves that are seen on the graph are classified according to their frequency. The slow alpha waves are extremely prominent after a fast. These are the waves that are responsible for the relaxed meditative state. It has been shown that the beta waves of thirteen to twenty cycles per second — that is, faster waves than the alpha waves — are reduced significantly during and after fasting therapy. These beta waves are the waves responsible for anxiety states. It can be seen therefore that definite changes occur which can be measured during and after fasts and these changes may help to explain the clinical improvements seen in patients who undergo fasting therapy.
Coincidently, these measurable EEG changes persist for up to 3 months after the cessation of the fast.
There are certain conditions under which fasting therapy
should not be undertaken and these include an abnormality of the heart on the ECG or heart disease, pre-disposition to thrombosis, past history of a heart block or other serious disease, cancers of all forms, severe blood disorders, pregnancy, active lung disease except asthma and severely disturbed, unmotivated or psychotic patients. The fast should be broken if abnormal heart rhythms occur, rapid heart rates, rapid pulse rates, abdominal pains, persistent and severe hunger or a disturbance to a patient’s psychological and mental state occurs.
Of the disorders listed below, 87% of 380 patients greatly benefitted from the fasting therapy. Interestingly, in this study, it was shown that the long-term results of fasting therapy also showed very similar effects. Excellent results in the long-term follow-up of these patients occurred in 22% and good results in 65% of patients. Even more interesting is the fact that those patients who did not benefit from fasting therapy immediately gained moderate clinical improvement up to three months after the fasting. This suggests that fasting therapy may not, in the short term, always produce results but some mechanism may continue to operate to the patient’s benefit after the fast. The chronic neurasthenia syndrome mentioned in the disorders included below is very similar clinically to the chronic fatigue syndrome and was one of the synonyms used for the chronic fatigue syndrome before its official recognition.
Disorders studied in fasting therapy
Migraine
Diabetes
Hypertension
Chronic neurasthenia
Irritable bowel syndrome
Arthritis
Anxiety and depression
Asthma
Hyperventilation syndrome
There are some basic rules that must be followed during a fast, whether it be one day a week or a four day a month fast. For the inexperienced, it is certainly not recommended that anything longer than a four day fast once a month be attempted. The fasting person must be out of bed and active during the fast. Hunger must cease within a short period of time. The fasting ideally must be absolute —that is, there should be no food intake
whatsoever. Fasting means the absence of all food and the use of water only. If juices are used during a fast then it is not regarded as a true fast but fresh fruit or vegetable juices, if diluted 50% with water, are suggested if a water fast is too difficult. The fruits and vegetables used in juicing should be organically grown and as free of pesticides and herbicides as possible.
Yoga, stretching or walking are ideal exercises to be per formed during the fast and encourage the bowels to remain active.
Hunger should diminish by the second or third day of the fast and at no times during the fast should it be severe. If it is, then the fast should be broken. At least two litres of purified and filtered water should be consumed daily. A daily weighing should be performed. It has been suggested that bowel cleansing enemas are of benefit. However, if the bowel has been treated properly prior to the fasting therapy and lactobacillus, bifidobacteria combinations used prior to the fast, the bowel should be reasonably clean. Drugs and medications that are not absolutely necessary should be reduced or stopped completely prior to the fast under appropriate medical supervision.
Smoking is also strictly forbidden, and the avoidance of other air pollutants is strongly advised because of the increased sensitivity to inhaled odours and smells whilst fasting. Fasting should be broken gently by the introduction of diluted fruit and vegetable juices and lightly steamed vegetables for the first few meals. Certainly heavy grains, animal proteins and dairy products must be avoided in the early stage of the ‘break fast’ and avoided completely if allergies to them are diagnosed.
Diseases responding to fasting therapies
Headache and migraine
Diabetes
Heart disease and Hypertension
Gout
Chronic neurasthenia (now called chronic fatigue syndrome)
Inflammatory disorders
Irritable bowel syndrome
Epilepsy
Obesity
Hypertensive heart disease
Hyperlipidaemia
Hypercholesterolaemia
Mild congestive cardiac failure
Low HDL cholesterol
Pancreatitis
Arthritis
Pain syndromes
Food intolerances and Food allergies
Glomerulonephritis
Autoimmune diseases
DDT poisoning (Caution — Chemicals may be mobilised
from fat tissues during fasting)
22. PCB intoxication (Caution — Chemicals may be mobilised from fat tissues during fasting.
23. Psoriasis, eczema
24. Varicose ulcers
25. Depression and anxiety
26. Asthma
27. Hyperventilation syndrome
All of the above diseases have been scientifically evaluated show a definite response to fasting therapy.
The cleansing diet
The dietary programme and food composition of the patient with the chronic fatigue syndrome represents a complicated aspect of their highly individualised treatment programme. Inappropriate eating habits over the whole of a lifetime, or for that matter a few weeks or months, are implied in the majority of degenerative diseases facing modern westerners. These inappropriate eating habits and nutrient depleted foods such as junk foods, fast foods and processed foods, account for a wide range of deficiencies and/or excesses which eventually lead to a weakening of the organism and finally a disease state.
Although many people with the chronic fatigue syndrome believe that they are consuming a well-balanced diet of good foods, on further questioning they are often found to be consuming empty calorie, high fat content, high sugar content products for up to 30% of their total food intake. Even CFS sufferers who eat a wide variety of foods that are fresh and unprocessed cannot assume that they are receiving optimum concentrations of nutrients required for their best health. It is under such conditions of imbalance and borderline deficiency states that unresolved viral infections and stress will result in damage albeit reversible to the main systems affected, that is nervous, hormonal and immune.
For the great majority of people with chronic fatigue syndrome and other nutritionally responsive diseases, dietary changes, corrections and nutritional manipulation will involve major lifestyle changes.
The practical aim of therapeutic nutrition is to help to bring the person back into a balanced state of body chemistry for the available dietary energy to be used for homeostasis and the healing process, and not for the fight against disease. To achieve this, a balanced diet containing all of the important nutrients is essential. In industrialised western society, it is virtually impossible for an optimally balanced nutritional programme to be attained without the use of some additional supplementation. This has been scientifically verified.
The three main killer diseases in western society are cancer, heart disease and stroke and it has been scientifically and medically demonstrated that these diseases are caused by a poor diet. It has also been demonstrated beyond any doubt whatsoever that people with these diseases and many of the other degenerative diseases in our western society have multiple nutritional deficiency states. The standard Australian diseases of heart disease, cancer and stroke, diabetes, arthritis and inflammatory bowel disease are strongly related to the standard Australian diet.
The issue of supplementation in the diet is covered in other chapters of this book.
Aims of the cleansing and rejuvenation dietary
programme
The replenishment of nutrients that are in short supply or deficient in fresh, natural, whole, unprocessed foods including raw vegetables, salads and juices.
To reduce the toxic, metabolic and chemical load on the nervous, immune and hormone systems.
To accelerate the detoxification processes and mechanisms
in the bowel, liver and kidneys
4. To provide antioxidant-dense foods that protect the cells
and tissues of the body against highly reactive free radicals.
5. To reduce the energy requirements of the digestive system
including the liver, pancreas and small intestine by decreasing the complexity of foods eaten, including animal proteins.
Note — Some metabolic types may do better on small regular snacks of animal protein. This is discussed elsewhere under metabolic types.
6. To reduce the toxic load, not only of chemicals but also artificial stimulants such as sugar, alcohol, tea, coffee, chocolate, cola drinks and of course drugs including tobacco, marijuana, cocaine etc.
7. To encourage the use of raw fruit and vegetable juices
diluted 50% in purified water to provide living enzymes, vitamins, minerals, trace elements and probably other life-giving healing factors that science has yet to isolate and define.
8. To restrict, or completely eliminate if possible, the following substances which have been demonstrated scientifically to retard the healing process:-
Cortisone
Anti-depressant drugs
Anti-anxiety drugs
Coffee
Beta-blocking drugs
Sleeping medications and other hypnotics including barbiturates
Some anti-inflammatory drugs
The oral contraceptive pill
Aspirin
9. To eliminate all additives including artificial colourings, flavourings, emulsifiers, preservatives, synthetic antioxidants.
10. No fried foods are allowed and fats and oils should be greatly restricted. This does not apply to the essential fatty acids which may be added to the nutritional programme as supplements. These essential fatty acids include the EPA of fish oil and evening primrose oil.
11. To encourage grazing on six to eight small meals per day rather than two or three mail meals.
12. Cleansing fruits
Natural medicine specialists the world over have learnt that the following fruits are very cleansing:-
Apples Avocado Cranberries Grapes Paw paw (Papaya) Pineapple Watermelon
Paw paw (papaya) is an excellent fruit because it contains high concentrations of digestive enzymes and it is very easily digested and assimilated. Oranges and lemons are also extremely useful in a general cleansing programme and they also contain a good natural source of vitamin C and the extremely important bioflavonoids.
Cleansing vegetables Avocado Beetroot and its leaves Carrots
The following vegetables, providing they are fresh and organically grown, are also regarded as very useful cleansing and healing foods:
Asparagus
Celery
Dandelion leaves
Green peppers
Horseradish (fresh)
Lentils (partially sprouted)
Lettuce
Onions
Parsley
Potatoes (in their skins)
Spinach and silverbeet
Turnip tops
Watercress
Of course if one is sensitive or allergic to any of these fruits or vegetables they must be avoided.
Nuts and seeds, provided they are not consumed in large quantities, are also helpful during a cleansing, detoxification programme. All nuts, except peanuts, providing they are fresh and not rancid are safe. Sesame seeds, pumpkin seeds and sunflower seeds are highly nutritious and fresh sesame seed paste is a good substitute spread for butter and margarine. Garlic, parsley and lemon juice can be added and blended to give it extra flavour.
Sprouts made from alfalfa, mung beans, lentils and clover are highly nutritious and contain living enzymes.
Drinks include 10 to 12 glasses of purified water every day and herbal teas are highly recommended. These include dandelion tea, peppermint tea, rosehips, chamomile and lemongrass.
Organically grown brown rice, millet and buckwheat are the most appropriate grains as they don’t provoke allergic reactions as frequently as wheat, barley, rye and oats. In fact, the gluten containing grains — wheat, barley, rye and oats are common offending foods in the patient with the chronic fatigue syndrome. Whether it is the gluten or gliadin or other components of these grains causing the fatigue, lethargy and weakness is unknown. However, it’s wise to avoid these grains and dairy products including milk, butter, cream, cheese and yoghurt, at least in the early stages of treatment.
Meat and animal proteins are generally banned completely in a strict detoxification and cleansing programme. However, animal protein in the form of yoghurt and fish may be permitted if the metabolic make-up of the individual warrants it. Even small quantities of red meat may be allowed in patients who are sensitive to grains, have difficulty gaining weight, and who generally feel better on a higher protein diet.
Other foods that are permitted in smaller quantities include rye bread, non-fat cottage cheese, stewed fruits in small quantities, boiled or poached free-range eggs, olive oil (maximum of 1 tablespoon per day), fresh fish (no other seafood including shellfish), Iambs fry, unsterilised yoghurt (unsweetened and unflavoured), all types of nuts, fresh and raw (exclude roasted, salted nuts and peanuts), chives, marjoram, thyme, sage, oregano, cumin, coriander, ginger, cinnamon, cloves, cardamon, horseradish and pollen.
From practical experience with hundreds of patients suffering from fatigue and the chronic fatigue syndrome, the most effective way of eating is through the macrobiotic approach. The macrobiotic diet and modifications of it cannot be covered in detail in a single chapter. It is recommended that if you are serious about consuming the best possible diet for the chronic fatigue syndrome you should attend macrobiotic cooking classes and refer to some of the references at the end of this book.
In brief, we obtain our energy from the sun through the foods that we eat. The various organic nutrients in our foods contain the energy information from the sun for our utilisation and it is basically through foods, nutrients and nutrient substances that we can improve the health of every living cell and tissue in the human body. The results of a cleansing, detoxification and rejuvenation diet do not occur immediately but may take three to six weeks before they are seen. What happens after that initial improvement is up to the individual. Nutrition and diet are with us for life — we eat food until the day we die. The way we feel is directly related to what we eat — a little self discipline is far less hampering than chronic ill health.
Colon therapy
The colon is another name for the large intestine. The large intestine is the organ which receives the remains of the food that has been eaten and digested in the small intestine. This food waste is referred to as the faeces which are eliminated via the colon and rectum and anus. In fact, the colon is part of an empty tube that begins at the mouth, passes through the gullet, stomach, small intestine then the large intestine and exits through the anus. This hollow tube is twisted and in places very narrow (intestines) or very swollen (stomach) and receives tubes from various glands including the liver and the pancreas. It may be regarded as a part of the external environment. Hence the contents of the colon are a part of the external environment and the waste material (faeces) is only temporarily carried there until it is expelled through the process of defecation.
The environment of the colon is extremely active biologically. It was once thought that the colon was simply an organ for the passage and removal of faeces. However, it is known that water is actively absorbed from the faeces in the colon into the circulation and many organic and inorganic substances are produced by the billions of bacteria berthed in the faeces. These substances can be absorbed through the bowel and pass into the liver via the bloodstream where they are meant to be inactivated. The types of microorganisms that make up the faeces determine the state of health of the individual. The correct type of bacteria are conducive to good health whereas the incorrect bacteria can actually contribute to poor health and may even cause overt disease.
Colon cleansing therapy has been used for centuries in natural medicine and it dates back to the time of the ancient Chinese. The highly controversial nature of colon therapy which persists until this day will eventually be quashed in the light of recent scientific evidence. Despite what many people believe as a crude and unclean form of therapy, colon treatments are relatively simple, safe, inexpensive and very effective. Colon treatment is more than just a simple enema or irrigation. It generally involves dietary changes, herbal medicines, fluid therapy, recolonisation procedures, all dependent on appropriate diagnosis of the physical, chemical and biological properties of the bowel and its faeces.
Types of colon therapy
Plain or herbal enemas
Colonic irrigation
Coffee enemas (not recommended)
Colectomy (surgical removal of the colon)
Recolonisation of the colon eg faecal transplants
Specific dietary fibre
Improving blood flow
A majority of sufferers of the chronic fatigue syndrome note that prior to their illness they had suffered from a viral or bacterial infection. Should the infection have involved the gastrointestinal tract with flu-like symptoms, abdominal pains, diarrhoea, nausea and perhaps vomiting the possibility of a disturbance in the balance of microorganisms in the bowel is very high. Treatment with antibiotics for the initial infection can further grossly disrupt the normal bacteria in the bowel and may even result in the overgrowth of fungi, yeasts and a particularly damaging organism
— Candida albicans.
Candida albicans is responsible for the disease known as oral
thrush, an infection which consists of a creamy white irritating discharge from the vagina, nappy rash in babies, skin rashes in adults and white plaque-like lesions on the gums of the mouth. Candida albicans is discussed in more detail in another section.
For centuries it has been known by lay people and healers, doctors of natural medicine and even orthodox physicians, that the large intestine plays a major role in a wide range of diseases. In fact this range is probably greater than most people appreciate. ‘Have the bowels opened, ‘cleanse the bowels’ and other similar phrases have resounded in the major healing centres and hospitals throughout the world since antiquity.
The health spas and centres of Europe emphasise fasting, juices and aperients as part of their basic programmes for the treatment of arthritis, migraine headaches and chronic un-wellness. Other diseases directly related to the diet and colon health include diverticulosis, irritable bowel syndrome, rectal polyps, appendicitis and even carcinoma (cancer) of the colon and rectum.
Colonic health is dependent on fibre in the diet and even minor changes to the amount or type of fibre can have a significant effect on the health of the bowel. The removal of fibre from the diet is associated with a large number of diseases including those of the large bowel mentioned above. These fibre deficiency associated disorders include high cholesterol levels, varicose veins, diabetes, gall stones, coronary heart disease and perhaps even stroke. Hence, plant food or dietary fibre as it’s more commonly known is intrinsically woven into the health, not only of the gastrointestinal tract, but of the nation as a whole.
The internal environment and metabolism of the contents of the colon is dependent not only on dietary factors but also the types of bacteria and other microorganisms present. In the following table we see the various influences on bowel health.
Factors determining the health of the internal environment of the colon
Allergenic and sensitising foods
Pesticide, herbicide and other xenobiotic chemicals in the diet
Abnormal pancreatic, liver and gall bladder functions
Poor quality or deficient dietary fibre (plant foods)
Disturbances in immunological function
Abnormal microorganisms in the faeces
Psychological stress factors
Inadequate exercise
Food allergies and foods to which a patient is sensitive may result in the fatigue syndrome.
However, allergenic foods can produce other problems including a suppression of liver, pancreatic and gall bladder functioning and an inhibition of intestinal enzymes also. The result is the incomplete digestion and breakdown of food components and their passage through the gastrointestinal tract undigested, resulting in direct entry of unassimilated food into the large intestine. It is here in the large intestine that these undigested food proteins, carbohydrates and fats are acted on by the microorganisms and bacteria in the bowel to produce a wide range of toxic substances including indoles, skatoles, spermine and putrescine. These compounds are absorbed through the bowel wall and enter into the bloodstream with effects that are potentially damaging. These toxic organic molecules have been shown to have an effect on liver function, immune function and the activity of the central nervous system. They may also interfere with the body’s hormones.
These chemicals together with toxic amines can also cause local tissue damage which may explain why approximately 90% of patients with the chronic fatigue syndrome also suffer from abdominal bloating, intestinal gas and disturbances in bowel function generally. Diarrhoea may also occur in 40% of patients and up to 65% of patients will complain of abdominal pains and halitosis (bad breath). These symptoms can often be easily corrected by a change in diet, the removal of food allergens and correcting abnormal food combining patterns. The avoidance of combining foods such as proteins and carbohydrates, fruits and vegetables, and grains with citrus fruits relieves abdominal symptoms in more than half of patients suffering. It has been shown that the damaged lining of the bowel due to some of these chemicals and toxic substances will result in an increase in permeability of the bowel membrane. This allows the toxins, bacterial products and food components to enter the bloodstream directly. The blood then presents these unusual components to the liver which has to handle the increased load of toxins and allergens for detoxification.
Optimal pancreatic, liver and gall bladder function are very important for the health of the individual from the perspective of proper digestion, absorption and assimilation of nutrients. The adequate digestion and breakdown of food in the upper small intestine is also important from another point of view. That is, this process if adequate will reduce the load of undigested protein, carbohydrate, fat and other foodstuffs from entering the large intestine as discussed above.
Detoxification implants
It is extremely pertinent when discussing environmental medicine to keep in mind the internal environment of the large bowel. The health of this organ and its environment has been ignored by modern medicine. However, recent research shows that the large intestine is a dynamic organ and its contents may play a major role in the wellness of the individual. The aspects of toxin production by abnormal bacteria, fungi and spores the effect the liver and immune system are discussed in the section on toxaemia in the bowel.
For centuries people around the world have used some form of fermented food in their diet ranging from miso, kefir and various yoghurts. This fermentation process has been a means by which foods can be preserved in a healthy, nutritious and tasty state. Of great importance to the diets of many cultures are foods fermented with various bacilli (bacteria) which convert milk sugar or lactose to lactic acid. These lacto-fermenting bacteria are known generally as lactobacilli. Recent documented medical evidence has proven that the lactobacilli are not just simply symbiotic organisms that live in harmony with humankind but that they are actually bacteria which are important in the prevention and in the possible of some major diseases such as Crohn’s disease and ulcerative colitis. The actual culturing of milk and dairy products not only preserves the foods but it actually retains all of the original nutrients including proteins, fatty acids, vitamins, minerals and trace elements. It also converts some of the nutrients into more bioavailable forms and breaks others down into simpler compounds.
Our first exposure to this family of bacteria is through breast milk. Breastfeeding actually introduces lactobacillus bifidus into the gastrointestinal tract of the newborn infant. With continued breastfeeding the bifidus colonises the gut and becomes a dominant strain of bacteria in the faeces of the baby. Other bacteria of the lactobacillus family colonise the bowel and live in harmony with one another. Depending on various factors and dietary circumstances, these bacteria may be displaced by harmful organisms that are potentially toxic.
A poor diet high in sugar, alcohol drinking and the use of antibiotics either as medicines or in foodstuffs are the most common causes of a disturbed bowel flora. It is clear that lactobacilli are important in the chronic fatigue syndrome because of reasons of infection in the bowel or the use of antibiotics. As we have seen earlier, many patients with the chronic fatigue syndrome have had a viral or bacterial infection which may or may not have been treated with an antibiotic. These events result in the development of abnormal bowel flora and it is for this reason that lactobacillus plays an important part in the recovery of health of the CFS patient. One of the most significant therapeutic effects of lactobacilli is their antibiotic properties. Lactobacilli have been shown to inhabit the growth of other micro organisms in the bowel and vagina through competition for nutrients for survival, by increasing the acidity of the vagina or bowel and by utilising the available oxygen necessary for the growth and reproduction of disease causing bacteria.
Another very interesting antibiotic-like effect of lactobacilli is their ability to prevent the attachment of other bacteria to the lining cells of the bowel wall. This prevents the attachment of and subsequent penetration of these bacteria into the system. Antibiotic and antimicrobial substances are produced by the lactobacillus family and generally maintain a healthy environment within the large intestine.
An increase in the variety of foods containing lactobacilli organisms are appearing in the marketplace in addition to the pure lactobacilli supplements available in tablet, capsule and pure powder form. In clinical practice the choice of the form of lactobacilli is extremely important. Generally the most effective form is a powder called Lactobac which contains lactobacillus acidophilus and lactobacillus bifidus. The desirable actions of the lactobacillus family can be obtained by using a combination of these two formulas. Lactobacilli are extremely fastidious in their metabolic requirements and they are significantly effected by the diet, sugars, antibiotics and alcohol. Acidophilus and bifidus are normal inhabitants of the intestine and can adapt quite readily. They generally perform most of the functions which are advantageous to the host as mentioned below. The Lactobac powder that has been studied the most in the chronic fatigue syndrome is the ideal preparation for these purposes. One teaspoon two to three times per day prior to meals for one week reduced to one teaspoon daily thereafter is sufficient in most patients to recolonise the bowel with high quality acidophilus and bifidus organisms.
Many yoghurts do not contain the correct species of lactobacillus and when they do most companies sterilise the yoghurt and render the organisms inactive. A great many products on the market containing lactobacilli, for example yoghurt and cultured milks, contain added flavourings and sugars. Sugar is inhibitory to the activity and growth of lactobacilli and therefore these products are not recommended.
Lactobacillus supplementation should always accompany and follow the use of broad spectrum antibiotics. In the chronic fatigue syndrome group of patients most of these individuals have been treated unnecessarily with antibiotics for viral infections. Asa consequence the bowel flora and microorganisms are altered to the detriment of the patient. Cultures of lactobacilli should also be used for treatment of gastrointestinal disorders including viral gastroenteritis, food poisoning and severe gastrointestinal allergies. The majority of CFS patients who have symptoms in the gastrointestinal tract such as nausea, vomiting, diarrhoea, abdominal bloating, colicky abdominal pains and flatulence generally respond very well to useful preparations of lactobacilli. It is important to remember that the benefits obtained from supplementation using lactobacilli may only last for as long as the supplementation occurs. This is important in the early stages of treatment. If a chronic fatigue syndrome patient responds to lactobacilli and bifido-bacteria supplementation then a maintenance supplementation programme should be continued for at least six to twelve months after commencement. Generally recommendations for lactobacilli supplementation is advised in modern environments where the food chain contains deliberately added antibiotics. Also, sugar and alcohol in the diet can often rapidly modify the type of micro-organisms in the bowel and are absolutely contraindicated in the patient with CFS.
Beneficial effects of lactobacilli
Produces organic and inorganic antibiotics
Produces anti-cancer factors
Has positive effects on psychological state (e.g. anti-fatigue,
anti-anxiety and anti-depressant activity)
4. Neutralises cancer producing chemicals
5. Produces antiviral substances
6. Produces antifungal substances
7. Suppresses the growth of yeasts and thrush (Candida)
8. Partially digests foodstuffs (e.g. milk sugar and milk proteins are broken down)
9. Synthesises certain vitamins including B-complex, folic
acid, vitamin B12, vitamin K
10. May reduce the allergenicity of milk. Improves the quality of milk proteins
11. Destroys naturally occurring anti-nutrients in foods (e.g. phytate, antitrypsins.)
12 . Detoxification of metabolites in liver disease
13 . Reduces bowel symptoms of gastrointestinal allergies (e.g. pain, bloating, flatulence)
14. May reduce serum cholesterol
The family of lactobacilli have the ability to produce organic and inorganic antibiotic like substances and acids which inhibit or prohibit the growth and replication of other species of bacteria in the large intestine and vagina. Many of the pathogenic bacteria in the large bowel are inhibited by such antibiotics as acidophilin, acidolin and lactocidin. These antibiotics can suppress the activity of pathogenic bacteria that are responsible for food poisoning, gastroenteritis, abscesses, skin disease and even the organisms that cause typhus and cholera.
It has been demonstrated that abnormal bacteria and viruses can persist in the bowel of a chronic fatigue syndrome patient for more than twelve months. If this is the case and these bacteria have the ability to either produce toxin or, more seriously, to produce endotoxins on their own death, then the total toxic load on patients with this problem may render recovery an almost impossibility.
In women with the chronic fatigue syndrome another reservoir of abnormal bacteria, fungi and yeasts, is the vagina. Lactobacillus acidophilus is a normal constituent of the micro organisms in the vagina. Here the lactobacillus maintains a very acid environment by fermenting glucose to lactic acid. The amount of glucose in the vaginal cells is hormone dependent and the balance is aggravated by a high dietary intake of sugars. This fine balance if upset can result in the suppression of lactobacillus acidophilus with a consequent loss of vaginal acidity and the consequent overgrowth of abnormal bacteria, fungi and yeast. This is the ideal environment for the growth of the yeast Candida - the organism that causes vaginal thrush. Lactobacillus acidophilus is also suppressed by broad spectrum antibiotics, and most women who suffer from thrush know of the nasty, irritating, creamy discharge that results. In fact, Candida may be present in the vagina without producing a discharge and it can be partially responsible for chronic ill health.
Women have known for many decades that the use of yoghurt orally and as a vaginal douche helps to suppress the abnormal yeasts and bacteria and return the vaginal condition to normal. It has been recently shown scientifically that the introduction of lactobacillus into the vagina and bowel helps to suppress yeast infections. Hence, in the investigation of the female with the chronic fatigue syndrome, it must be remembered that not only the large intestine but the vagina can act as a harbour for abnormal micro organisms, yeasts and Candida.
It may be very difficult in some cases to actually show Candida and yeast growing in the vagina by normal laboratory methods. The organisms have the ability to penetrate the cells of the lining of the vagina and grow into the deeper tissues. This results in a situation where the tissues of the host eventually become sensitised or allergic to the microorganisms and antibodies to Candida and yeasts are made by the host’s immune system.
These antibodies react also with yeasts in the diet and can cause severe allergic reactions including many of the symptoms commonly found in the chronic fatigue syndrome. To assist in controlling these problems, a product (Lactobac) containing lactobacillus and bifido bacteria organisms must be taken orally — one teaspoon of the powder mixed in water three times daily before meals, to help alter the flora in the large intestine. To correct the vaginal problems the powder can be mixed with an aqueous (water based) cream and inserted high into the vagina at night. This cream should also be applied to the outside tissues of the vagina.
Many patients with the chronic fatigue syndrome carry abnormal enteroviruses in their gastrointestinal tract. In approximately one third of patients these enteroviruses persist for twelve months or longer. Generally the bowel flora of these patients is abnormal and the use of Lactobac in these people will reconstitute the normal flora. As mentioned earlier, lactobacilli produce organic and inorganic acids which inactivate or inhibit viruses either directly or by increasing the acidity of the environment. Some workers in this field have postulated that lactobacilli themselves can produce specific anti-viral compounds. Non specific antimicrobial substances produced by lactobacilli include hydrogen peroxide (common bleach), benzoic acid, acetic acid and lactic acid. Many other substances known to inhibit or suppress the overgrowth of bacteria, viruses and yeasts known to causes illness and disease are also secreted by lactobacilli. The environment of the large intestine, including its contents the faeces, is able to support the growth and reproduction of bacteria that both survive well in oxygen and others that are inhibited or killed in an oxygen rich environment. The great benefit of the lactobacilli is that they can survive under both oxygen-rich and oxygen depleted conditions. Under both these conditions, lactobacilli also secrete their anti-pathogenic substances. In practical terms this means that high concentrations of lactobacilli in faeces are able to suppress disease causing bacteria and harmful toxins in the large intestine.
It has been demonstrated that sufferers of the chronic fatigue syndrome have either low levels or deficiencies of one or a number of micronutrients including some of the B-group vitamins and ascorbic acid. Supplementation of these nutrients by mouth and injection is often necessary. As an adjunct to this supplementation, lactobacilli have been shown to synthesise a number of viruses including some of the B-complex and vitamin K. Lactobacilli can also increase the concentrations of B-complex vitamins in fermented milk products such as yoghurt. However, they also require a supply of B-complex vitamins for their own growth and development and dietary supplementation appears to facilitate this. Vitamin B12 is one of the more important of the B-complex vitamins in the chronic fatigue syndrome. Hence, the use of lactobacilli and injectable vitamin B12 as part of the therapeutic regime are extremely useful.
If dairy products are tolerated and the person with chronic fatigue syndrome can be shown not to be allergic to dairy foods, the safest of these foods are of course the fermented dairy products including yoghurt, kefir, acidophilis milk, bifidus milk etc. The lactic acid produced by the lactobacilli bacteria on fermentation of these products improves the digestibility and availability of the protein in the dairy foods and yields higher levels of free amino acids than the parent milk compounds. Many amino acids are of course the precursors to the neurotransmitters or nerve chemicals that transmit information from one nerve cell to another in the brain and spinal cord.
We know that chronic stress and acute viral infections can reduce the free amino acids in the bloodstream and thus decrease the availability of these amino acids for the central nervous system. This is an area that needs further investigation in the future.
Another important aspect of the digestibility of dairy products is that of lactose — milk sugar. Many people who are sensitive to dairy products react to the milk sugar (lactose) rather than have a distinct allergy to cows milk protein. This lactose intolerance is due to lack of the enzyme lactase. Lactose intolerance in individuals causes symptoms of abdominal pain, bloating and diarrhoea. However, these people are often quite tolerant of lactobacilli fermented dairy products.
In the chronic fatigue syndrome it has been demonstrated that most patients have a reactivity to cows milk proteins. Therefore in the early stages of treatment, they should avoid both fermented and unfermented dairy products. The use of pure lactobacillus acidopholis and bifidobacteria in powder form is the most efficient method of reconstituting the lactobacilli in the bowel. Even sufferers of cows milk allergy who have mild to moderate sensitivities to cows milk protein, can recommence the use of small but increasing quantities of yoghurt once their condition improves. The fermentation process produces greater acidity and this changes the structure and chemical composition of the cows milk proteins, reducing it’s allergenicity. Protein digestibility and availability are often improved. This has been proven in animal studies in which the animals have shown improved weight gain.
Lactobacillus supplementation has also been shown to reduce the symptoms of gastrointestinal allergies. These gastrointestinal allergies may manifest themselves in such diverse symptoms as indigestion, symptoms mimicking peptic ulcer, bloating, abdominal pain, flatulence, diarrhoea, itchy anus, mouth ulcers and nausea. The exact mechanism by which lactobacilli accomplish these marvellous symptom relieving properties is unknown. The symbiotic relationship between this organism and humans definitely requires further studies, especially in view of the fact that it appears so useful clinically. Epidemiological studies have even indicated that the consumption of high levels of cultured dairy products may reduce the risk of cancer of the colon.
Lactobacilli also secrete anti-cancer factors. A number of enzymes secreted by unhealthy bacteria in the bowel are known to stimulate the production of carcinogens. Two of these enzymes are called nitroreductase and beta-glucuronidase. Carcinogens can be formed from nitrites and nitrates in the food that we eat. These nitrogen containing compounds are converted in the gastroin testinal tract to nitrosamines which are known carcinogens. If this conversion can be inhibited, then fewer carcinogens are manufactured in the bowel and presented to the bowel wall. Theoretically, and to some degree practically, this can be achieved.
For example, the use of ascorbic acid or vitamin C in the diet can prevent the formation of nitrosamines from nitrites and nitrates. The use of lactobacillus can inhibit the activity of the abnormal bacterial enzymes which are responsible for the production of carcinogens. In fact it has been shown scientifically that after four weeks supplementation with lactobacillus acidophilis the activity of carcinogen promoting faecal enzymes can be reduced to as much as 25% of the original levels. Theoretically this may be sufficient to reduce the risk of cancer development. Blastolysins are complicated molecules which have been isolated from lactobacillus bulgaricus. These substances have been shown to have anti-tumour effects in animal cancers.
For all these reasons, lactobacilli are therefore an important aspect of total health care and the use of appropriate forms is critical to the welfare of the patient with chronic fatigue syndrome.
A further aspect of proper health maintenance and the role of the lactobacilli species of bacteria is the control of cholesterol and blood fats. There have been many conflicting studies conducted on the use of lactobacillus acidophilis and cultured dairy products in the control of blood fats and cholesterol. It could be said generally that the higher the blood concentration of cholesterol and fats (triglycerides) to commence with the greater the effect the lactobacilli have in reducing these raised levels. The reason for this is not completely understood. It has been suggested that the lactobacilli metabolise these lipids and cholesterol for their own energy and reproduction. It has also been suggested that lactobacilli may simply facilitate the excretion of cholesterol via the bowel. To reduce blood cholesterol and triglycerides using lactobacillus, high concentrations over a long period of time appear necessary.
There is no documented association between the chronic fatigue syndrome and high blood lipid levels but there certainly is a very strong suggestion that lipids peroxides and lipid free radicals are involved in the chronic fatigue syndrome. Organic reducing agents secreted by lactobacilli may, by this indirect mechanism lipid metabolism, have a beneficial effect in the CFS patient. It has been demonstrated in liver disease including cirrhosis, chronic hepatitis and portal hypertension that the bifidus form of lactobacilli decreases a number of oxidising chemicals in the blood, including phenols and ammonia. Again, it is not known why this happens. The production of toxins in the bowel may be inhibited by lactobacillus thus reducing the total toxic load on the liver. However, this does not readily explain the situation satisfactorily. But it has been observed in patients with the chronic fatigue syndrome who have evidence of viral disease affecting the liver (abnormal liver function tests) that the well-being of the patient, and the pathology tests, improve on lactobacillus supplementation. Much more research work needs to be done on the antigenic and immunological effects of lactobacilli in these conditions.
Patients with the chronic fatigue syndrome often suffer from nausea, epigastric discomfort and a tenderness of the liver. These symptoms, including the tenderness of the liver, respond to lactobacillus supplementation between three days and three weeks of commencement.
Occasionally, in approximately 20% of patients, a dieback or Herxheimer reaction occurs. This is the result of the lactobacilli inactivating or killing unwanted micro-organisms in the bowel and the subsequent release of endotoxins from the dead organisms. These substances are absorbed through the bowel wall and enter the bloodstream of the patient. Two and a half to three litres of water per day, and suitable natural cathartics to ensure optimal kidney and bowel function, reduce the severity of this problem.
Studies on the use of lactobacilli in impending hepatic encephalopathy have not been performed. Hepatic encephalopathy is a disease of the brain and nervous system due to liver failure. Although this does not occur in the chronic fatigue syndrome, it may be seen in a modified form in long term sufferers of the chronic fatigue syndrome who have developed severe liver disease as a consequence of alcoholism, drug addiction or psychotropic medication. Although these would be only a very small percentage of patients, it is mentioned here for the sake of completeness.
Lactobacilli destroy toxins in the bowel, inhibit anti-nutrients such as phytate and antitrypsin, neutralise sugars which produce gas and inhibit yeast infections.
Finally, and probably most importantly, through some unknown and definitely unappreciated mechanism, far away from the workings of the bowel and its contents, is an effect on the health of the nervous system and mind — lactobacillus supplementation results in an anti-fatigue, anti-anxiety and anti depressant effect on the central nervous system. The liver was believed by the ancient physicians to be the sight of melancholy (sadness and depression). Melancholy comes from the Greek which means black bile. With recent information on the health of the large intestine and its faecal contents and the effects of these toxins on the liver, emotional feelings may have some of their origins in this organ of elimination.
Factors involved in the determination of the health of the internal environment of the large bowel
Allergenic and sensitising foods
Pancreatic, liver and gall bladder function (abnormal, poor
quality or deficient functioning)
Dietary fibre (plant foods)
Immunological function in the wall of the bowel
Types of bacterial inhabitants and other micro-organisms
Stress
Exercise
Micronutrient supplementation (vitamin and mineral
therapy)
Colon therapies
1 Plain or herbal enemas
2 Coffee enemas
3 Colonic irrigations
4 Colectomy (removal of the colon)
5 Recolonisation with lactobacilli (oral or rectal implants)
6 Specific high fibre diets
7 Improved blood flow to bowel
8 Allergy treatments (elimination and rotation diets)
9 Pancreatic support (enzyme supplementation)
10 Liver support
Detoxification with vitamin C
No discussion on detoxification would be complete or even meaningful without vitamin C — ascorbic acid. This very important nutrient is discussed in detail in the chapter on vitamin C and the bioflavonoids. Ascorbic acid has a number of possible actions and a number of definite actions as a detoxifying agent. First, and foremost, it is the prime free radical scavenger in the water soluble compartments of the body. Second, ascorbic acid is essential for the proper functioning of some of the detoxifying enzymes in the liver including glucuronidase and various hydroxylases. Third, ascorbic acid has been shown to prevent conversion of harmless chemicals into carcinogenic substances, for example the conversion of nitrites to nitrosamines in the gut. Ascorbic acid also acts as a reducing agent to keep other substances such as vitamin E, glutathione peroxidase, catalase and other enzymes active and functioning normally.
There have been many studies to show that ascorbic acid can reduce the toxicity of inorganic poisons such as the heavy metals, mercury, arsenic, lead, chromium and gold and thousands of studies have shown that it can protect against organic poisons including drugs, anaesthetics, benzene, bacterial toxins and even snake bite and spider bite. Many more studies are needed on the effect of vitamin C in the chronic fatigue syndrome. However, at this point it can be shown that vitamin C is of definite benefit in the detoxification process when toxins, heavy metals, organic poisons, and by-products of bowel metabolism can be implicated in the cause of symptoms.
A detoxification programme using oral and intravenous vitamin C needs to continue for at least three months, preferably six months, in patients with severe chronic fatigue syndrome. It must be remembered that ascorbic acid is only one nutrient in the whole orchestra of substances that play a role in the maintenance of health.
By itself it may be effective but better clinical results are achieved if patients are also given synergistic nutrients such as vitamin E, beta carotene, B-complex vitamins, zinc, selenium and essential fatty acids.
The chemical pathways to disease
Xenobiotic (toxic synthetic) chemical
Attachment to D.N.A.
Cancer immunosuppression ? accelerated ageing
teratogenesis
mutagenesis
environmental illness
Attachment to reduced Epoxide
Glutathione
Vitamin B3 (NADH)
selenium
glutathione peroxidase enzume
Attachment to
tissues and
proteins glutathione
enzymes vitamin C
Excretion in bile
Chelation therapy
The word chelate is derived from the Greek word chele which refers to the claw of the crab. The word itself implies a firm pincher like action or binding effect. In biological terms, chelation is the binding of a metal to an organic or inorganic molecule. In chelation therapy we talk about the binding of a chelating sub stance to heavy metals such as lead, zinc, mercury, cadmium etc.
Chelation therapy involves the administration of a chelating substance, called EDTA or Ethylenediaminetetraacetic acid, usually by an intravenous infusion. It is not routinely used in orthodox medicine except for patients with heavy metal poisonings. In the chronic fatigue syndrome it can be demonstrated by full hair analysis that as many as 30% of patients have high levels of heavy metals in their system. The hair analysis is the most accurate method of measuring these heavy metals and an assessment of the total toxic load of heavy metals can be obtained from this test. If the levels are high, and there has been no response to any other form of therapy, chelation should be seriously considered. In the right hands, the use of intravenous EDTA, 2 to 3grams in 500-1000 mls of intravenous fluid twice weekly, is extremely safe. Providing the patient has good kidney function, and kidney function is monitored closely, the removal of heavy metals by this method can be extremely rewarding. Vitamins C, B-compIex and minerals are given simultaneously. Between three and twenty chelation treatments administered on a daily basis are generally recommended. Some patients may feel an improvement after only three or four chelations. In this group of patients it is recommended that a total of between ten and twenty treatments are given.
Georgio’s lead overload
Two years ago Georgio, a young foundry worker, was divorced. According to his GP, Georgio had a mild nervous breakdown following the stress of the separation from his family. The ’breakdown’ lasted longer than expected and after six months Georgio decided to seek help. Although an improved diet and vitamin supplements prescribed to him by a natural therapist helped, he continued to suffer periods of incapacitating fatigue.
After discovering that his body’s lead levels were extremely high, Georgio underwent intravenous chelation therapy to remove the lead. Before he had completed the course of 20 treatments, his health had remarkably improved, he was working as a building supervisor and he had developed a new and happy relationship.
The suspected source of Georgio’s poisoning was the lead contaminated air in the foundry where he previously worked, compounded by the lead from car fuels in the city air.
It is pointless giving chelation therapy if the source of heavy metal toxification persists. Nothing can be done about the leaching out of lead from the bones into the bloodstream during chelation therapy. However, something can be done about other sources of lead especially if patients live near^busy highways where the air is polluted from motor car exhausts.
Similarly, the patient with high levels of mercury will only benefit temporarily from chelation therapy if nothing is done about their mercury-silver amalgam dental fillings. Careful removal of dental amalgam fillings by a properly trained dentist using special dams and replacement with modern resins is recommended if mercury levels are high or mercury sensitivity can be demonstrated.
Other less significant heavy metals in respect to the chronic fatigue syndrome are cadmium, arsenic and aluminium. However, the presence of these toxic metals even in small amounts can add significantly to the total toxic heavy metal load.
Another very important aspect of chelation therapy in the chronic fatigue syndrome is the effect of EDTA on the mitochondria in muscle cells. Mitochondria are very small membrane bound organelles present in every cell of the body. They are basically the power houses of the cells and are responsible for transforming the energy in the foods we eat (glucose) into high energy phosphate bonds of a chemical called ATP. Estimations are that there are from between 200 and 2,000 mitochondria occur in every single cell. Within each mitochondria are as many as 10,000 complete sets of enzymes responsible for the oxidation processes which produce water, carbon dioxide and energy from our food fuels. Every living function and activity of the cell is dependent upon these mitochondria to release energy from food and transform that energy into a means by which the cell can use it. These energies may be present in the form of chemical energies, electrical energies (for example the nervous system) and transporting energies. ATP molecules produced by the mitochondria are the source of what is known as high energy phosphate bonds for the energy requiring-activities of the cells. EDTA has been shown to actually restore normal functioning of damaged mitochondria either partially or completely in damaged calf muscle cells. This is extremely interesting when considering the cardinal symptom in the chronic fatigue syndrome is severe muscle fatigue. Here we are considering the basic molecular units involved in the production of energy, that is mitochondria and ATP. The function of these units can be improved by the use of a chelating agent such as EDTA.
Ascorbic acid (vitamin C) has been demonstrated to also have moderate chelating activity and at the molecular level one may postulate that this is where it acts. In a few patients with extremely severe chronic fatigue syndrome, a synergistic effect between the use of ascorbic acid and EDTA together has been observed.
Although EDTA chelation therapy treatment is not a recognised form of medical treatment in this country for the chronic fatigue syndrome, it is being used quite extensively in America and Europe for many conditions, including syndromes associated with fatigue. EDTA is a drug and when used in skilled hands, it is very safe. Providing the patient has good kidney function and is monitored appropriately during treatment, no untoward side effects should occur. It is not to be regarded as a first line of treatment and it should be reserved for those patients with severe chronic fatigue syndrome who have not, or only partially, responded to the other therapies described in this book.
The integrity of the bowel
In the study of physiology in medical schools and science faculties it was taught that the large molecules in foods were broken down into their individual units by the process of digestion. These units were than absorbed across the membrane of the bowel into the body circulation. These large molecules include proteins, polysaccarides, nucleic acids, glycoproteins, and they are made up of amino acids, simple sugars such as glucose and fructose and other simple compounds.
However, it is now known that these large molecules are not necessarily broken down completely and that they can pass across the bowel membrane barrier into the circulation as whole molecules. Appreciable quantities of proteins, nucleic acids, poly peptides and glycoproteins can actually penetrate the normally protective intestinal barrier to enter the bloodstream and eventually evoke an immunological reaction. This may be the mechanism by which foods cause allergies and sensitivities in some patients.
In the chronic fatigue syndrome, there are higher levels of antibodies of the IgE and IgG4 classes against food antigens than there is in the normal population. In patients suffering from the chronic fatigue syndrome, severe lethargy, tiredness and fatigue, associated with muscular aches and pains or abdominal symptoms, occurring within 30 minutes of eating is highly suggestive of a food or chemical sensitivity reaction.
Another important aspect of the permeability of the intestine to substances is that of the absorption of bacterial proteins, endotoxins, bacterial toxins and breakdown products of poorly digested food in the large intestine. This chemical cocktail in the large intestine has the potential to cause immune reactions, hormonal actions, toxic effects and effects on the body’s pain relieving chemicals called endorphins. Interestingly, a breakdown product of some bacteria called muramyl dipeptide has been shown to enhance slow wave sleep. This dipeptide, produced in the bowel, has a number of other effects. These include the prevention of the effects of morphine withdrawal, elevation of the body temperature, interference with opiate receptors and it enhances the activity of some of the immune systems own chemicals (interleukin). It may be postulated that this dipeptide, or a similar substance, actually plays a role in the causes of the chronic fatigue syndrome. In some patients with CFS where bowel toxicity problems can be demonstrated, the sterilisation of the bowel using natural or synthetic antibiotics and the replacement of the flora with lactobacillus acidophilus and bifidobacteria can result in dramatic improvement in their condition. More research should be done in this area to define the actual mechanisms.
There is a wide variety of microorganisms in the bowel. Over four hundred species of bacteria and fungi have been isolated from the bowel; in fact, the faeces consist of approximately 10 billion bacterial cells per gram of weight. These microorganisms are alive and metabolically active. They can produce ‘allergies’ and they secrete chemicals that may be beneficial or harmful. The beneficial chemicals include antibiotic-like substances and immune modulating agents. Harmful chemicals include toxins to the liver, brain, nervous system, and hormone glands. Others have even been demonstrated to act as carcinogens and cancer- promoting factors.
Approximately 15% people with the chronic fatigue syndrome have moderate to severe sugar and/or alcohol cravings from time to time. These cravings usually correlate to the severity of the clinical illness. The test that is usually performed is a glucose tolerance test.
This demonstrates whether a patient has diabetes (high blood sugar) or reactive hypoglycaemia (low blood sugar). Neither of these conditions are usual in the patient with the chronic fatigue syndrome. However, abnormal sugar handling is usually demonstrated in the glucose test that is suggestive of borderline diabetes and/or reactive hypoglycaemia. The interpretation of the extended (6 hour) glucose tolerance test should be left in the hands of experts such as doctors who specialise in nutritional and environmental medicine. The point of the discussion here on blood sugar control and the micro organisms present in the bowel is not widely appreciated both by the lay public and healthcare professionals.
Blood sugar control is determined by the diet and a number of hormones including insulin secreted by the pancreas and glucagon secreted by the liver. Insulin reduces the blood sugar level. It has been shown that some bacteria in the large intestine can produce insulin-like molecules which interfere with the body’s normal insulin activity. If this insulin-like molecule disturbs blood glucose levels, then the delivery of glucose to the nerves, muscles and other tissues of the body is adversely affected. This may be one of the mechanisms by which the fatigue syndrome is produced but again more research work needs to be done in this area.
Other bacteria in the bowel can produce protein-like molecules that may stimulate the body to produce antibodies that can interfere with the normal functioning of the nervous system. Still other bacteria may interfere with the normal functioning of the thyroid gland.
“Without doubt, the health of the intestine and large bowel plays an important role in the health of the patient with the chronic fatigue syndrome —the extent of which is yet to be fully appreciated.”
Ian Brighthope 1990
Best chapter yet.