Stress and Fatigue - Dr Myhill's Approach to CFS / ME Flashcards
Q: How does Dr. Sarah Myhill view CFS and ME?
A: CFS and ME are not diagnoses but clinical pictures. The role of healthcare practitioners is to identify the underlying mechanisms and contributing factors.
Q: What distinguishes ME from CFS?
A: ME involves an inflammatory process in addition to the poor energy delivery mechanisms seen in CFS.
Q: What causes poor energy delivery in the body?
A: Poor energy delivery occurs when mitochondria are overworked, run out of raw materials, or lack proper “shut down” time for repair during sleep.
Q: What are the effects of poor energy delivery on the immune system?
A: It reduces the immune system’s efficiency, leading to chronic infections, slow healing, and increased susceptibility to illnesses.
Q: What symptoms indicate poor energy delivery to the body?
A:
Physical fatigue and poor stamina.
Post-exertional malaise.
Muscle pain from lactic acid buildup.
Subnormal core temperature.
Variable blurred vision.
Q: How does poor energy delivery affect the brain?
A: It causes mental fatigue, brain fog, light/noise intolerance, and Postural Orthostatic Tachycardia Syndrome (POTS).
Q: What is the car analogy for poor energy delivery mechanisms?
A:
Diet: Fuel.
Mitochondria: Engine.
Thyroid: Accelerator pedal.
Adrenals: Gearbox.
Q: What is the first step to improve energy delivery mechanisms?
A: Start with the paleo-ketogenic diet (PK Diet) to provide “fuel in the tank.”
Q: Why is the PK Diet beneficial for CFS and ME?
A: It optimises mitochondrial energy production by using ketones, reduces inflammation, and decreases the toxic load on mitochondria.
Q: What foods should be avoided on the PK Diet?
A:
Gluten: Linked to intestinal permeability and systemic immune activation.
Dairy (except butter): Causes allergic reactions and magnesium deficiency.
Q: What are the three types of ketones, and how are they measured?
A:
Beta-hydroxybutyric acid: Blood (most accurate).
Acetoacetate: Urine (cheaper but less reliable over time).
Acetone: Breath (e.g., breath meters).
Q: What causes false positives in ketosis measurements?
A: Alcohol consumption, SIBO, or alcohol-containing products like mouthwash.
Q: How can false negatives occur in ketosis measurements?
A: Eating or drinking anything other than water 20 minutes prior to testing or the body’s improved efficiency at matching energy demands
Q: What are the raw materials mitochondria need daily?
A:
CoQ10: 100–300 mg.
Magnesium: 300 mg.
Niacinamide: 1,500 mg.
Acetyl L-carnitine: 500–2,000 mg.
Vitamin B12: 1–5 mg.
D-ribose: 5–15 g.
Q: Name some factors that inhibit mitochondrial function and their remedies.
A:
Lactic acid: Pace activity carefully.
Toxins: Use saunas and detoxify with multi-minerals and glutathione.
Mycotoxins and viral proteins: Investigate infectious causes.
Q: Why are the thyroid and adrenal glands important for energy delivery?
A: They ensure energy delivery matches demand and support circadian rhythms.
Q: How does circadian rhythm affect hormone production?
A:
Melatonin rises in darkness, stimulating TSH at midnight.
T4 peaks at 4 am and converts to T3 by 5 am.
Adrenal hormones peak at 6–7 am, waking you up.
Q: What does core temperature indicate about energy delivery?
A:
Average temperature reflects thyroid function.
Fluctuations reflect adrenal function.
Q: How can adrenal function be supported?
A: Use adrenal glandulars like Adrenavive II and adjust dosage based on temperature stability and symptom improvement.
Q: How is thyroid function supported in cases of low core temperature?
A: Use thyroid glandulars like Metavive I or II, increasing dosage gradually while monitoring symptoms, pulse, and temperature.
