Sarah Myhill

Question 1

How does Sarah define CFS + ME?

Answer 1

Clinical pictures, not diagnoses
HCP must ID underlying mechanisms to be able to treat
CFS = poor energy delivery mechanisms
ME = CFS + Inflammation

Question 2

How does CFS develop into ME?

Answer 2

Eventual mitochondrial fatigue - chronic stress = CFS
Immune system lacks energy = chronic infection = ME

Question 3

What are the symptoms of poor energy delivery to the body?

Answer 3

Physical fatigue, poor stamina
Post-exertional fatigue
Weak muscles and pain
Blurred vision (ciliary bodies are muscles!)
Low core temp

Question 4

What are the symptoms of poor energy delivery to the brain?

Answer 4

Brain fog
Light and noise intolerance
Low mood feeling stressed and procrastination inhibit energy expenditure

Question 5

What are the symptoms of poor energy delivery to the heart?

Answer 5

HyPOtension, POTS (postural orthostatic tachycardia syndrome)

Question 6

What are the symptoms of poor energy delivery to the immune system?

Answer 6

Infection susceptibility
Inability to run a fever

Question 7

What other systems are involved in energy delivery - in addition to mito?

Answer 7

Nutrition (fuel) - Paleo Ketogenic diet
Mito (engine)
Thyroid (accelerator)
Adrenals (gear box)

Must be address in this order to support symptom alleviation

Question 8

What is the PK diet?

Answer 8

(Mito have evolved to use ketones and fibre - SCFAs)
Increases expression of energy producing genes
Decreases inflammation and toxic load

AVOID: gluten - common in CFS/ME, increase GIT disturbance and immune response. Dairy except fermented. Induces Mg deficiency and blood viscosity

Question 9

How do you know if your client is in ketosis?

Answer 9

Beta-hydroxybutyric acid - measured in blood

Acetoacetate - measured in urine, accurate but may show false negative as body normalises to ketone production

Acetone - on exhalation post meal to text for carbs - THIS TEST. 2-6ppm ketones

Question 10

What can cause ketones of >10ppm?

Answer 10

Stress - adrenaline stimulates fat burning
Fasting - all calories from fat when fasting so ketones higher
Over-dosing thyroid hormones

Question 11

What can cause a false positive result on acetone breath test?

Answer 11

Alcohol/alcohol wipes/SIBO
Household cleaners
Eating drinking 20mins prior to test

Question 12

How can you support the mitochondria (the engine)?

Answer 12

Magnesium, CoQ10, Acetyl-L-Carnitine, B3, B12, D-Ribose as emergency pick up

Question 13

What can inhibit mito function?

Answer 13

Lactic acide
SIBO -vit C kill off
Diamino compounds i.e. hairdye
Malondialdehyde (poor AO status) - Vit C and B12
Parabens, pesticides etc - detox with sauna/multimin, glutathione
Mycotoxins, viral proteins

Question 14

What do the thyroid and adrenals match?

Answer 14

Energy delivery with demand - is the thyroid under or overactive?
Circadian rhythm

Question 15

What time of the night is the thyroid active?

Answer 15

T4: 4am
T3: 5am - stimulates adrenals, waking at 6-7am

Question 16

How can you use core temperature to identify adrenal support?

Answer 16

Temp fluctuations by 0.6 degrees above/below average may indicate adrenal support via ‘Adrenavive I and II titrated for client tolerance

Question 17

What would you use to support the thyroid upon diagnosis via temperature?

Answer 17

Metavive I and II as per clients tolerance