OVERVIEW OF THE DIAGNOSIS AND TREATMENT OF CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME ACCORDING TO TRADITIONAL CHINESE MEDICINE
Mary Helen Lee, Lic.Ac., Dipl.Ac. (NCCA)
White Moon Healing Center
1309 W. Albion Avenue, Chicago, Illinois 60626 U.S.A.
Abstract: Chronic fatigue immune dysfunction syndrome (CFIDS) is reviewed in terms of its possible causes, symptoms, diagnosis and treatment from both a Western and Eastern medical perspective. A summary of diagnoses and acupuncture and herbal treatments according to Traditional Chinese Medicine (TCM) are presented as well as information regarding patient support networks.
CHRONIC FATIGUE immune dysfunction syndrome (CFIDS) is the most recent official name for the illness which is also known in the U.S. as chronic fatigue syndrome (CFS). A major epidemic in the U.S. and around the world, CFIDS is known as myalgic encephanlomyelitis (ME) in the United Kingdom and Canada, and low natural-killer-cell syndrome in Japan. Many people in the U.S. know this condition as chronic Epstein-Barr virus (CEBV or EBV).
For some time EBV was thought to be the cause of CFIDS and , therefore, the names were used interchangeably. It is now known that not everyone who has CFIDS tests positive for EBV. Although most people who do have a high level of antibodies for EBV in their blood experience the symptoms of CFIDS, there are people with high EBV titers who are in good health.
CFIDS was officially defined by the Center for Disease Control (CDC) in Atlanta, Georgia in 1987 as follows:
People who truly have CFS are those who’ve suffered a debilitating fatigue (or easy fatigability) that’s lasted at least six months. They also must have ruled out (with their doctor’s help) any other physical or psychiatric diseases that may mimic CFS symptoms, like acute nonviral infections, depression, hormonal disorders, drug abuse, or exposure to toxic agents. Then they must have at least 8 of the following 11 symptoms recurring or persisting for six months or more: chills or mild fever; a sore throat; painful or swollen lymph glands; unexplained general muscle weakness; muscle discomfort; fatigue for at least 24 hours after previously tolerated exercise; a headache unlike any previous pain, joint pain without joint swelling or redness; complaints of forgetfulness, excessive irritability, confusion, inability to concentrate or depression; disturbed sleep; and quick onset of symptoms within a few hours or days.
Numerous other symptoms besides those named by the CDC have been reported. These include the following: dizziness; earache and ringing in the ears; heart palpations and chest pain; heat and cold intolerance; abdominal pain, nausea, vomiting, diarrhea and irritable bowel; jaundice; enlarged spleen and/or liver; alcohol intolerance; night sweats; difficulty speaking, writing, and reading; lack of coordination and loss of balance; spatial disorientation; hypersensitivity of skin and rashes; light sensitivity; dry and burning eyes; blurred vision; swollen eyelids and/or feet and hands; excessive thirst; respiratory problems; numbness in the face or extremities, especially the legs; loss of sex drive; menstrual problems including endometriosis; allergies and sensitivity to odors, chemicals, and medications; weight changes without changes in diet; hair loss; lightheadedness– feeling “in a fog”; muscle twitching and seizures; anxiety, panic attacks, and personality changes; and severe depression.
For many sufferers, the neuropsychologic symptoms are perhaps the most devastating aspect of the illness. Difficulty concentrating; mood disorders; depression; anxiety; photophobia; forgetfulness; confusion; irritability; spacial disorientation; panic attacks; dizziness; personality changes; and mixing up words when speaking, reading, or writing are some of the more prevalent conditions. Common problems include, e.g., entering a room and forgetting why, driving and getting lost, and bumping into walls that seemed to be farther away. Since many of these people were high-achievers before their illness the frustration of cognitive problems becomes even worse. Many patients report feeling like they must be going crazy; the last thing they need is someone telling them “it’s all in their mind.” Receiving assurance that these are commonly experienced with the illness and are not symptoms that will be permanent is a major relief.
Brain scans in some CFIDS patients show abnormally low blood flow to one of the two temporal lobes and a decrease in electrical activity in the temporal lobes and the hippocampus, which is important in the formation of memory. Therefore, some research is focusing on developing therapies which improve the capacity to restore cognitive functioning. After comprehensive neuropsychological evaluations, rehabilitation programs are designed for the individual patient. Unfortunately the cognitive dysfunctions tend to last longer than the physical symptoms, even when patients have gone into remission.
There are a number of related illnesses that effect a significant number of people with CFIDS, which include food and environmental allergies, candidiasis, endometriosis, and fibromyalgia.
CFIDS patients often report increased sensitivity to their surroundings; sometimes it can be mild, such as intolerance to heat or cold, photosensitivity, or allergies to excess mold or pollen. Many patients develop much more pronounced allergies, e.g., to dairy foods, yeast, or wheat; or to chemicals that occur in the workplace, cleaning products, cosmetics, or medications. Extreme cases are diagnosed with Environmental Illness (E.I.); some of those patients must wear gas masks before going outdoors, may need special air and water filters installed in their homes, or even require special homes constructed from allergen-free building materials.
Many patients develop cadidiasis. Common symptoms include chronic yeast infections, diarrhea or constipation, bloating, rectal itching, abdominal pain, and fungus of the nails. Candidiasis is exacerbated with antibiotic treatments, so for these patients, mild infections are best treated herbally. To control the yeast, diet restrictions are also common which may include no sugar, cheese, alcohol, yeast products, and refined carbohydrates.
Many female CFIDS patients have been diagnosed with endometriosis which can be progressive with symptoms of painful and irregular menstruation, pain during intercourse, abdominal pain, pain in the back and legs, infertility, heavy menstrual flow, swollen abdomen, nausea, dizziness, headaches, fatigue, and insomnia. Some women may have little or no pain. Treatment includes hormonal medication, laparoscopy, laser surgery, or even hysterectomy in severe cases.
Fibromyalgia is a chronic pain condition that is thought to affect three to six million Americans. It manifests many symptoms in common with CFIDS; some researchers think they are the same illness. Common symptoms are pain in the muscles, ligaments, and tendons; the muscles may twitch and burn or they may ache constantly. Patients report sleep problems and a lack of energy. Most of the pain occurs in the neck, shoulders, chest, hips, knees, and elbows.
For diagnosis there are 12 pairs of bilateral points on the body that are found to be tender; 70% of CFIDS patients manifest these tender points. These 12 tender points are located as follows: Splenius capitus muscle (near Anmian); upper middle trapezius muscle (the area of GB-21, TW-15 and SI-13); major rhomboid muscle at the medial scapula (from BL-14 to 17 and from BL-43 to 46); second costochondral junction (near CV-19 and K-25); just distal to the lateral epicondyle of the femur (one cun below and lateral to ST-34); proximal to the medial knee at the medial fat pad (around SP-9); just below the medial epicondyle of the femur (around LV-8); at the greater trochanter of the femur (near GB-29); the bicipital tendon (near HT-3); upper outer quandrant at the iliac crest (near GB-27); and the lumbar spine at L4-L5 interspinous ligament (around BL-25a and 26).
The sleep problems that occur are termed alpha-delta sleep anomaly; stage IV sleep is interrupted and patients report that upon waking they feel as if they’ve “been run over by a truck.” This sleep pattern has been found to occur in 80% of CFIDS patients.
The prevalence of CFIDS is widespread and effects people from all walks of life and all age groups. Most patients that have sought care are Caucasian women in their thirties although it has been found to affect a variety of age groups from elementary school children up to people in their sixties.
A typical patient seems to be a woman 25 to 45 years of age who is a type A personality career woman and who is under an extreme amount of stress from job, family, relationships, etc. It seems to prevail in hard-driving young professionals, which accounts for the popular name “yuppie flu.” According to a CDC public information publication, “CFIDS has been reported in many children, monogamous adults, and “clustering” in cases of families, workplaces, and communities also seems to occur. Anecdotal reports exist of pets of CFIDS patients getting unusual diseases. However, whether a person gets CFIDS is believed to be a function of how his/her system deals with the causative agents.” The large majority of people in close contact with persons with CFIDS have not developed the illness.
What Causes CFIDS?
The cause for CFIDS is not known. In the early 1980s many people thought it was caused by the Epstein-Barr virus. In the U.S., 80-90% of adults have EBV antibodies by age 40. In developing countries most people are host to the virus by childhood, where its symptoms are usually mild or non-existent. In the U.S. it often becomes apparent in adolescence where it may manifest as infectious mononucleosis. The virus remains in the body after the symptoms of “mono” are gone but can reactivate throughout life and be shed through the saliva. By the late 1980s several studies (Holmes, 1987 and Buchwald, 1987) showed that people with CFIDS were no more likely than healthy controls to have EBV antibodies. Although it is possible that reactivation of the virus could be a factor in the onset of CFIDS symptoms, to date there is no consistent link between elevated EBV antibody titers and the presence of CFIDS, and measurement of the titers is not of use in diagnosing or treating the illness.
Other viruses have been associated with CFIDS in some studies, however, none appears to be the specific cause. In 1990, researchers at the Wistar Institute discovered evidence of a retrovirus in more than 75% of 31 CFIDS patients studied. They also found the same viral sequence in about one-third of 20 healthy persons with CFIDS (PWCs) in close but casual, nonsexual contact. None of 20 other healthy, “non-exposure” controls showed the presence of such virus-positive cells in their blood. These findings suggest, but do not prove, that a retrovirus is associated with CFIDS and may be directly involved in causing the disease in many PWCs.
Several subtle immune abnormalities have been found in patients with CFIDS, such as: low levels of specific gamma globulins (Straus, 1985), increased ratios of “helper/suppressor” T-cells (DuBois, 1984), and low numbers of natural killer cells(Caliginor, 1987). Nevertheless, most patients do not have these abnormalities.
Diagnosis of CFIDS
According to Western Medicine
In Western medicine CFIDS can be diagnosed in conjunction with the list of symptoms published by the CDC. Ruling out other diseases by a process of elimination is an essential part of the process. As of this date, there is still no test that can definitively diagnose CFIDS since the specific cause is as yet unknown. Typical lab tests would include viral titers for EBV and cytomegalovirus, as well as tests to rule out other illnesses including HIV, Lyme disease, lupus, and thyroid abnormalities. T-cell panels can determine if the immune system is activated, and sensitivity tests to antiviral drugs can be valuable. The cost for these tests can range from several hundred dollars to several thousand dollars depending on the extent of the screening.
Treatment of CFIDS
According to Western Medicine
The treatment of CFIDS in Western medicine is still in the experimental stages. Two drugs have yielded some promise: Kutapressin and Ampligen.
Kutapressin, an anti-viral, has been approved by the FDA. An older drug in use since the 1920s for treatment of skin disorders, acne, eczema, and herpes, it is contraindicated for pregnant women and people allergic to pork or liver. Patients diagnosed with EBV, CMV, HHVG, or HTCV2 and treated with this drug have been shown to have a 75% recovery rate. These viruses produce a hyperactive immune system and cause depressed T-lymphocyte functions and capillary leakage in the brain—symptoms for which Kutapressin is effective. Kutapressin was used on CFIDS patients after research demonstrated that 90% showed abnormal counts in single lymphocyte immune function (SILF) tests.15
Treatment with Kutapressin is preceded by a skin test for allergies and then followed by administration of daily injections of 2cc for 25 days, followed by 2cc every other day for 50 days, and 2cc three times a week for six months. Repeat SILF tests are preformed prior to the third and sixth month. If relapse occurs, the patient receives a 2cc injection daily for ten days and resumes treatment at 2cc every other day for 50 days, etc. In addition to the side effects for persons allergic to this drug (which can be severe), the patient faces a regimen of never ending injections. The cost of the drug is $70-$100 for 20cc; therefore, treatment can be expensive and seems only to mask symptoms in many patients who relapse and have to begin again on larger doses. 15
Ampligen is an anti-viral drug that is used to combat impairment of the cytotoxicity of natural killer cells. It was tested from June 1990 to July 1991 on 111 volunteers with good results (alleviation of most symptoms). However, the symptoms returned when the drug was discontinued. The first patient to use Ampligen in 1988 is still in the recovery process and requires three IVs a week to maintain her status. The drug could cost more than $20,000 a year for one patient.
As of this writing, allopathic treatment for CFIDS involves constant injections or IVs and is prohibitively expensive for most patients. Therefore, most CFIDS patients are not receiving allopathic treatment.
Diagnosis and Treatment of CFIDS
Traditional Chinese Medicine
For any ten patients, all receiving the Western medical diagnosis of CFIDS, a practitioner of Traditional Chinese Medicine (TCM) may formulate ten separate diagnoses based on Eastern medicine. This disparity between diagnoses in Western and Oriental medicine is even more challenging with CFIDS because it manifests so differently with each individual. Thus, there is no one way to treat someone with CFIDS using TCM.
Since CFIDS patients frequently have very complex cases with numerous patterns of disharmony, the TCM practitioner searches for the “root” cause of the disease and treatment is addressed in that context. Following this strategy, symptom patterns are eliminated and gradually the patient is put into harmony again.
According to TCM, the following are examples of some of the common root and branch patterns that are found in CFIDS patients. However, these are not inclusive of all the possible TCM diagnoses that may be formulated for someone with CFIDS since most patients tend to have symptoms from more than one root and/or branch disharmony.
Each pattern is followed by basic point prescriptions. An individual treatment would consist of a combination of points for the root and branch problems and points for specific conditions. Points where moxa is indicated should be treated with both acupuncture and moxibustion.
1. Kidney Yin Deficiency: Common symptoms include ringing in the ears, dizziness, poor memory, spontaneous or night sweats, dry mouth and excessive thirst, dry hair and nails, premature hair loss, chronic low-grade sore throat, constipation, leg weakness, weak and sore back, chronic low-grade sore fevers, loss of muscle mass, weight loss, insomnia, swollen lymph glands, and loss of sex drive.
Emotionally the patient may feel agitated, nervous, and fearful. The tongue has a red body with little fur and the pulse is thin and rapid. This can lead to Yin deficiency of the Liver, Heart, and Lung which become branch illnesses.
Treatment: K-3, Source point, to tonify Kidney Yin and Yang; K-7, Metal point, to tonify the Kidneys; BL-23, Shu point, to strengthen Kidney Qi; CV-4 and/or CV-6, to adjust Qi and tonify Kidneys; SP-6, to tonify the Kidney, Spleen, and Liver Yin; K-10, Horary point, to tonify the Kidneys; Anmian [N-HN-54], for insomnia; SI-19 for ringing in the ears; ST-25, for constipation; LI-4 with LI-11 and/or GV-14 for fever; LU-10 for sore throat; LI-4 with K-7 for night sweats; and HT-7 with ear Shenmen to calm the Spirit.
a. Kidney-Liver Yin Deficiency: May include headaches, blurred vision, loss of visual acuitym night sweats, dizziness, tired burning and itching eyes, photophobia, irregular menses, and irritability.
Treatment: Add LV-3, Source point, to balance the Liver and regulate the Blood: LV-2, Fire point, to disperse Liver Fire; LV-8, Water point, to tonify Liver Yin; BL-18, Shu point, to tonify the Liver.
b. Kidney-Heart Yin Deficiency: May include insomnia, dream disturbed sleep, restlessness, forgetfulness, disorientation, and palpitations.
Treatment: Add HT-7, Source point to tonify the Heart and calm the Spirit; HT-3, Water point, to calm the Spirit; CV-14, Mu point, to tonify the Heart; PC-6, to tonify Heart Yin and calm the Spirit; BL-15, Shu point, to tonify the Heart.
c. Kidney-Lung Yin Deficiency: May include a weak and dry cough, expectoration of blood, afternoon fevers, low voice, hot palms and soles, and flushed cheeks.
Treatment: Add LU-9, Source point, to tonify the Lungs; LU-7, Luo point, to open and strengthen the Lungs; LU-5, Water point, to expel Heat in the Lungs; LU-1, Mu point, to tonify the Lungs; BL-13, Shu point to tonify the Lungs; and LU-10 for sore throat.
2. Kidney Yang Deficiency: Common signs include aversion to cold, cold hands and feet, extreme fatigue, drained and white complexion, dizziness, ringing in the ears, weakness and pain in the knees and low back, irregular menses, frequent urination, getting up to urinate during the night, impotence, spermatorrhea, edema, diarrhea, low sex drive, loose teeth and dulling of the Essence or Spirit. Emotionally the symptoms are fearfulness, hopelessness, confusion, and indecision. The tongue is enlarged and pale with a moist white fur and the pulse is slow and weak. This can lead to, Yang deficiency of the Spleen, Lung, and Heart.
a. Kidney-spleen yang deficiency: May include edema, diarrhea, abdominal pain or distention which is relieved by warmth or pressure, leukorrhea, poor appetite, and trouble in absorbing nutrients.
Treatment: Add SP-3, Source point, to tonify Spleen; moxa SP-6 to tonify Spleen; moxa ST-36 to tonify Qi, regulate Stomach and Spleen; moxa BL-20, Shu point, to tonify Spleen Yang; moxa CV-12, Mu point for the Stomach, to regulate Stomach and Spleen, tonify Qi; moxa SP-15 for diarrhea and abdominal distention.
b. Kidney-Lung Yang deficiency: May include rapid breathing at the slightest exertion, lack of desire to talk, exhausted Spirit and appearance, shortness of breath, weak cough, and general weakness and lassitude.
Treatment: Add LU-9, Source point, to tonify the Lungs; LU-1, Mu point, to tonify the Lungs; moxa CV-17, Influential point of Qi, to tonify Lungs; LI-4, to tonify Wei Qi; LU-7, Luo point, to open and strengthen Lungs; moxa BL-13, Shu point, to tonify Lung Yang.
c. Kidney-Heart Yang deficiency: May include palpations, edema, difficulty breathing, and in serious cases, inversion frigidity [si zhijue leng] of the limbs and oily perspiration.
Treatment: Add BL-15, Shu point, to tonify Heart Yang; HT-7, Source point, calms the Spirit; PC-6, to tonify the Heart; moxa CV-14, Mu point, to tonify the Heart.
3.Spleen Qi deficiency: Common signs include either poor or excess appetite, cravings for sweets, lack of concentration, muscle weakness, whole body aching, abdominal pain and distention relieved by pressure, poor absorption of nutrients, intestinal gas, allergic reactions to foods, anemia, lassitude, edema, swollen lymph nodes, anorexia, diarrhea or thin stool, lusterless complexion, and exhaustion. Emotionally the patient may suffer preoccupation, chronic worrying, obsession, and indecisiveness. The tongue is pale with a thin, white fur and the pulse is soft and soggy. Some of the branch illnesses are Spleen deficiency with Damp encumbrance, Damp-Heat in the Spleen, and upper body harassment by Phlegm turbidity.
Treatment: SP-3, Source point, to tonify Spleen Qi; moxa SP-6 to tonify Spleen Qi, Yin of Spleen, Kidney, and Liver; moxa ST-36 to tonify Qi, regulate Spleen and Stomach; moxa CV-12 to strengthen and tonify Qi of Spleen and Stomach; moxa BL-20, Shu point, to tonify Spleen; moxa BL-21, Shu point for Stomach; moxa ST-25 to regulate Qi in the Large Intestine and Stomach; moxa SP-15 for diarrhea and abdominal distention; moxa GB-34 for muscle weakness and aches; and HT-7 with ear Shenmen to calm the Spirit.
a. Damp Encumbrance of the Spleen: May include loss of appetite; nausea; feeling of fullness or heaviness in the head, chest, and limbs; loose, watery stools; abdominal distention; indigestion; sickly, sweet taste in the mouth; foggy feeling as though there is a “bag around the head”; and edema. The tongue is thick and slimy, and the pulse is soggy and rolling.
Treatment: Moxa Sp-9 to transform Dampness in the Spleen; moxa ST-40 to transform Dampness; moxa CV-9 to regulate water retention and edema.
b. Damp-Heat in the Spleen: May include fever, pain and distention in the chest and lateral costal region, nausea and vomiting, thirst with little desire to drink, short urination with scant and/or dark yellow urine, chronic yeast infections, chronic urinary bladder infections, jaundice, and a heavy sensation in the body. The tongue has a red body with yellow, greasy fur or white and slimy fur.
Treatment: Add GB-34 to resolve Damp-Heat anywhere in the body; SP-9 to resolve Dampness in the Spleen; ST-40 to transform Dampness; LI_4 and LI-11 to drain Heat from the body; LV-5 for genital itching; CV-3, Bladder Mu point; and BL-28, Bladder Shu point.
c. Upper Body Harassment by Phlegm Turbidity: May include extreme dizziness, pressure in the head, heaviness in the head, insomnia, nausea, poor absorption of nutrients, restless, and a bitter taste in the mouth. The tongue is very slimy with either a yellow or white coat and the pulse is slippery or wiry.
Treatment: Add ST-40 to resolve Dampness; GV-20 to disperse dizziness and calm the Spirit; Sishencong [Ex-HN-1] to disperse dizziness and calm Spirit, increase oxygen to the brain; GB-20 to disperse Wind and head pain; treat local point for headache and balance, including GB-14, ST-8 and Taiyang [M-HN-9].
4. Liver Qi Stagnation: Common symptoms are premenstrual syndrome; headache; distention and tenderness in the hypochondrium, chest, and breasts; poor digestion; intestinal gas; hormonal imbalances; allergic reactions; irregular menses; formation of lumps and masses; feeling of a lump in the throat; and bitter taste in the mouth. [Unreleased] emotions are commonly a large part of Liver disharmonies, problems are depression, irritability, anger without a cause, impatience, hypersensitivity, and anxiety. The tongue is purplish and the pulse is wiry. Branch illnesses include Liver Yang ascending, deficient Liver Blood, and stirring of Liver wind.
Treatment: Moxa LV-3, Source point, to balance the Liver and regulate the Blood; LV-2, Fire point, “to course” [“shu” = to spread release and disperse] Liver Qi; moxa LV-8, Water point, to course liver qi and tonify Liver; moxa LV-14, Mu point, to tonify Liver, spread Qi in the hypochondrium; LV-1, Wood point, to move Liver stagnation; moxa GB-34, to course Liver and Gallbladder Qi; moxa SP-6, to open the Liver; moxa BL-18, Shu point, to tonify the Liver; HT-7 and ear Shenmen to calm the Spirit.
a. Ascending of Liver Yang: May include throbbing headaches, dizziness, ringing in the ears, blurred vision, anger, depression, insomnia, palpations, red eyes and ears, low back pain, and weakness in the legs. The pulse is fine and wiry and the tongue is red.
Treatment: Add GB-20, special point for headaches; LI-4 for headache and to pull Qi; K-3 to tonify Kidney Yin and Yang, support Liver and pull Qi; Anmian for insomnia; and GV-20 with Sishencong for dizziness and headache.
b. Deficient Liver Blood: may include dizziness, blurred vision, dry eyes, muscle spasms, numbness and inhibited movement in the limbs, irregular menses with reduced flow, pale and lusterless complexion, insomnia, excessive dreaming, and slow growth of hair and nails or hair loss in serious cases. The pulse is thin and the tongue is pale.
Treatment: Moxa SP-10 to supplement the Blood; moxa BL-17 to supplement the Blood; moxa SP-6 to tonify Spleen, Liver, and Kidney Yin and Blood; moxa BL-20 to tonify Spleen and Liver; moxa BL-23 to tonify the Kidney and Liver; moxa CV-3, meeting point for Liver, Spleen, and Kidney; Anmian for infomnia; BL-1 and BL-2 for blurred vision and dry eyes.
c. Stirring of Liver Wind: Causes severe dizziness and headache, tension and stiffness in the neck, tingling and numbness in the limbs, muscle twitching, convulsive spasms and seizures, trembling limbs and fingers, inhibited speech, tightness or sudden paralysis of the facial muscles, and ringing in the ears. The pulse is wiry and the tongue is red or purplish with dry fur.
Treatment: Add GB-20 to pull Wind; LI-4 to expel Wind, especially in the face; GV-20 to extinguish Wind and calm the Liver; K-3 and/or K-7, and BL-23, to tonify Kidney and Liver; Taiyang, for headache and dizziness; GV-20 with Sishencong for dizziness and headache; SI-19 for ringing in the ears.
5. Other Treatment Points: Additional points useful for treating CFIDS patients include: moxa ST-36 to tonify Qi and strengthen deficiency (this point has been found to increase the levels of white and red blood cells in the body); LI-4 with LV-3 to open the Four Gates to course Qi through the body, good for pain; GV-20 with Sishencong to increase the level of oxygen to the brain, works well for the cognitive problems found in CFIDS patients.
Another treatment found to open the energy centers and course Qi through the body is to use a point combination to open the chakras: GV-20 with Sishencong for the crown; Yintang for the third eye; CV-23 for the throat; CV-17 for the Heart; CV-12 for the solar plexus CV-6 for the belly; and CV-4 for the root; these are used with LI-4 and LV-3.
Treatments are usually needed weekly for several months or up to several years, depending on how long the patient has been ill and the severity of the disharmony.
Herbal Treatment of CFIDS
In Traditional Chinese Medicine, acupuncture is combined with herbs to supplement the treatment. Many practitioners in the U.S. currently use a combination of Chinese and Western herbs, as well as vitamin supplements, diet counseling and homeopathic formulas.
Some of the more well-known herbs for boosting the immune system include ginseng, astragalus, and fo-ti-tien which can be taken alone or in commonly found formulas. Research has confirmed the immune enhancing properties of ganoderma (reishi mushrooms) and shitake mushrooms). Shitake mushrooms can be eaten fresh or taken as pills or tinctures. Reishi mushrooms are usually taken in pill form because they are too tough to eat.
As of this printing, Compound GL is the only formula manufactured specifically for CFIDS patients. It is prepared by Seven Forests Herb Company, which is affiliated with the Institute of Traditional Medicine in Portland, Oregon and formulated by Dr. Subhuti Dharmananda. Seven Forests also produces herbal formulas that are used in the HIV treatment centers utilizing Chinese medicine with acupuncture.
Seven Forests released Compound GL in the summer of 1991 after completing research specifically on CFIDS patients. Compound GL contains: ganoderma, isatis, zizyphus, astragalus, polygala, lithospermum, salvia, succinum, hu-chang, oldenlandia, lonicera, rehmannia, ligustrum, curcuma, atractylodes, ginseng, peony, epimedium, lyceum fruit, ophipogon, ho-shou-wu, tang-kuei (dan gui), schizandra, licorice, cardamom, and citrus. Compound GL can be combined with “Katsu,” an adjunct formula which contains garlic, pearl barley, natural mucopolysaccharides, and rice germ. This formula and others have shown very promising results for bringing about complete remission in CFIDS patients.
Although patent formula preparations imported from China can be prescribed, several companies in the U.S. produce similar formulas which they maintain are prepared with stricter quality control. K’an Herbal Company (Soquel, California) produces constitutional formulas developed by Ted Kaptchuk, OMD, which take into consideration not only the physical needs of the patient, but the emotional and spiritual aspects as well. These constitutional formulas are often needed for individual root problems. The following K’an formulas correspond to the previously discussed root illnesses frequently seen in CFIDS:
Kidney Yin Deficiency: “Quiet Contemplative” contains: Chinese foxglove, dogwood fruit, Chinese yam root, tuckahoe root, water plantain rhizome, tree peony bark, mulberry fruit bud, wolfberry fruit, fleece flower root, dodder seed, eclipta, and privet fruit.
Kidney Yang Deficiency: “Dynamic Warrior: contains: eucommia bark, morinda root, broomrape stem, bauchee seed, Chinese cinnamon inner bark, aconite root, schizandra berry, ox-knee, foxglove root, Chinese yam root, dogwood fruit, wolfberry fruit, dodder seed, dan gui root, and ginseng root.
Spleen Qi Deficiency: “Prosperous Farmer” contains: ginseng root, atractylodes, tuckahoe root, milk-vetch root, licorice root, Chinese yam root, ginger rhizome, mandarin orange peel, pinellia, grains-of-paradise fruit or seeds, costus root, magnolia bark, and hawthorne berry.
Liver Qi Stagnation: “Relaxed Wanderer” contains: hare’s ear root, dan gui (tang kuei) root, peony root, atractylodes, tuckahoe root, peppermint, licorice root, tree peony root bark, gardenia fruit, Szechuan lovage root, orchid bulb, nut grass rhizome, and ginger rhizome. (Numerous other Chinese herbs and formulations can be added for specific symptoms.)
Unlike many of their Chinese counterparts, most Western herbs are readily available in health food and herb stores throughout the U.S. and come in the same forms as Chinese herbs; teas, pills, and tinctures. There are several herbs helpful for specific symptoms common to CFIDS patients.
Gingko leaf and gotu kola increase the oxygen supply to the brain and are useful for relieving many of the cognitive problems of CFIDS.
Echinacea root and golden seal root are used as anti-virals. Other herbs that are used to stimulate immune function include: licorice root, borage leaf and flower, wild yam root, nettle leaf, wild indigo, burdock root, and dandelion root.
Depression: St. John’s wort (hypericum) works well for the depression often encountered in the patient with a chronic illness.
Candida: Pau d”Arco tea works well for candida. One of the more successful formulaes for candida symptoms is formulated by Dr. Max G. Barlow of Spice West Company (Salt Lake City, Utah). It involves two tinctures: Mycocyde I and II consisting of the following herbs: leptotaenia dissecta(lomatium), echinacea, desert globe mallow, fern bush, and cayenne pepper.
Many CFIDS patients seek out various treatments from alternative or holistic medicine. According to one report, “CFIDS is a multidimensional disease; any therapeutic strategy must match the levels of disruption or imbalance in order to strengthen and correct them so that the condition does not return. Any effective therapy must address the entire psychosomatic-spiritual being”—J. Stoff.
As patients become aware of the alternatives, many select treatment by a combination of methods including diet and nutrition, homeopathy, visualization, psychotherapy and lifestyle counseling, as well as through the Eastern approaches of acupuncture, herbs, bodywork, energy work,and magnet therapy.
Some patients report going to literally hundreds of doctors, many of whom dismissed their complaints as psychosomatic and referred them to psychiatrists. Many patients report being unable to get anyone to believe that something is wrong with them, including even family members and co-workers.
For this reason it is extremely valuable to help patients get in touch with local support groups and national CFIDS organizations. There are many groups around the country in which patients can talk with others who share the illness. Because the disease has only been recently recognized most people don’t really understand how debilitating it can become; sharing problems with other patients can provide assurance that nothing else can.
There are two main national support groups which can provide information on local support groups, research articles, newsletters, political action committees, vitamin and herbal products, and disability benefits: (1) National CFS Association, and (2) CFIDS Association, Inc. (see Resource Services listing following Bibliography).
It appears that there is more to CFIDS and all auto-immune disease than just the viruses that are thought to cause them. Some have suggested that these diseases are helping us realize the imbalances within ourselves so that we will become more sensitive to the imbalances between ourselves and the Earth. Perhaps these illnesses are part of the evolution of the human species and of the planet Earth itself towards greater spiritual growth and transformation. Health practitioners often note that as people become healed they enter into a more conscious state. Many CFIDS patients who have progressed to remission say that the illness has been a blessing in disguise.
In his report on “The Hidden Epidemic” Richard Leviton quotes William Collinge,
“…There is no turning back; only growth, renewed sensitivity to oneself, and vigilance toward maintaining one’s balance in living. You don’t have to be a helpless victim of this syndrome. CFIDS lends itself well to a mind/body approach of intervention. It’s an interaction process of ongoing reciprocal influence between organic and psychosocial factors. The people who have sustained remissions are those willing to accept this, to look inside and begin working on themselves.”20 (p.53)
Gilroy, D. (ed): Fatigue Free: Chronic Fatigue Syndrome. Emmaus, Pennsylvania, Rodale Press, 1990, p. 36.
[ii] Goldstein, J.: Chronic Fatigue syndrome: Limbic encephalopathy in a dysfunctional neuroimmune network. The CFIDS Chronicle. North Carolina, 1991, pp. 19-23.
Onischenko, T.G. (medical advisor to the CFIDS Association): Audiotape from August 1991 on CFIDS 900 telephone number (1-900-988-2343). CFIDS Association, P.O.Box 220398, Charlotte, North Carolina 28222-0398 U.S.A.
Goldenberg, D.L.: Simms, R.W., Geiger, A., et al: High frequency of fibromyalgia in patients with chronic fatigue seen in a primary care practice. Arth Rheum., 1990; 33(3)(March): 381-387
[v] Goldenberg, D.L.: Fibromyalgia and its relation to chronic fatigue syndrome—Viral illness and immune abnormalities. J. Rheumatol., 1989; 16 (suppl. 19): 91-93
[vi] Chencey. P.R. (ed): A Guide for PWCs (Persons With CFIDS). Charlotte, North Carolina, The CFIDS Association Press, 1990, p. 2.
[vii] Holmes, G.P., Kaplan, J.E., Stewart, J.A., et al: A cluster of patients with a chronic mononucleosis-like syndrome. J. Am. Med. A., 1987; 57: 2297.
Buchwald, D., Sullivan, J.L., Komaroff, A.L.: Frequency of chronic active Epstein-Barr virus infection in a general medical practice. J. Am. Med. A., 1987; 257: 2302.
Holmes, G.P., Kaplan, J.E., Gantz, N.M., et al: Chronic fatigue syndrome: A working case definition. Ann, Int. Med., 1987; 108:387.
Dale, J.K., Struss, S.E., Ablashi, D.V., et al: The Inoue-Melnick virus, human herpes virus type-6, and the chronic fatigue syndrome. Ann, Int. Med., 1987; 110:92.
De Freitas, E. et al: Retroviral sequences related to Human T-lymphotrophic virus type-III in patients with chronic fatigue immune dysfunction syndrome. P. NAS. U.S. (Proceedings of the National Academy of Science in the U.S.), 1991; 88: 2292-2926
Struas, S.E., Tosato, G., Armstrong, G. et al: Persisting illness and fatigue in adults with evidence of Epstein-Barr infection. Ann. Int. Med., 1985; 1: 7.
Dubois, R.E., Seely, J.K., Brus, I., et al: Chronic mononucleosis syndrome. South Med. J., 1984; 77: 1376.
Caligiuri, M., Murray, C., Buchwald, F., et al: Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. J. Immunol, 1987; 139: 3306
Steinback, T., Herman, W.: Audiotape in August 1991 on CFIDS 900 Telephone Number (1-900-988-2343). CFIDS Association, P.O. Box 220398, Charlotte, North Carolina 28222-0398
Carter, W. et al: A controlled clinical trial in chronic fatigue syndrome using a specifically configured RNA drug, poly (1): poly (C12U), Conference Journal of the American Microbiology Society and 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois, September 29-October 2, 1991; 12:2.
Sone, Y. et al: Structures and antitumor activities of the polysaccharides isolated from the fruiting body and the growing culture of the mycelium of ganoderma lucium. Agricultural and Biological Chemistry, 1985; 49(9): 2641-2653.
Aoki, T. et al: Low natural killer syndrome: Clinical immunological features. Natur. Immun. (Natural Immunity and Cell Growth Regulation), 1987; 6: 116.
Dharmananda, S: Chronic Fatigue Immune Dysfunction Syndrome. Portland, Oregon, Institute for Traditional Medicine Press, 1991.
Leviton, R: The hidden epidemic. East/West Journal, 1989; January: 50, 53.
Cohen, M.: Chinese medicine in the treatment of chronic immunodeficiency: Diagnosis and treatment. American Journal of Acupuncture, 18 (2), 1990.
Cowley, G., Hager, M., Joseph, N.: Chronic fatigue syndrome: A modern medical mystery. Newsweek, November 12,1990.
Kaptchuk, T.J.: Chinese Herbal Product Guide. Soquel, California, Ming-men Design, 1989.
Leviton, R.: Environmental illness: A special report. Yoga Journal, November/December 1990, p.44-100.
Mena, I., Goldstein, J.et al: Chronic Fatigue: Brain SPECT Findings: Comparison with Late Life Depression. Manuscript in preparation. Contact Dr. Ishmail Mena at Harbor UCLA Medical Center, 1000 W. Carson St., Torrance, California 90509. Tel: (310) 533-2345.
Stoff, J., Pellegrino, C.: Chronic Fatigue Syndrome: The Hidden Epidemic. Random House, 1998.
The Chronic Fatigue Syndrome: An Information Pamphlet Produced by the Centers for Disease Control. Atlanta, Georgia, CDC, 1990.
CACTUS,(CFIDS Action Campaign for the U.S.- a political action group that lobbies for disability rights, research funding, insurance coverage, etc. They train PWC’s to be activists) P.O. Box 2578 Sebastopol, California, 95473
CFIDS Association, Inc. PO Box 220398, Charlotte, NC 28222, Tel: 1-800-442-3437.
CFIDS Buyers Club, (1-800-366-6056).
Institute for Traditional Medicine (I.T.M.), 2442 S.E. Sherman, Portland, Oregon 97214. (1-800-544-7504).
Kan Herb Company, 2425 Porter Street, ##8, Soquel, Calf. 95073, (1-800-543-5233).
National CFS Association, 12106 E. 54th Terrace, Kansas City, MO 64133.
Spice West Company, Dr. Max G. Barlow, Salt Lake City, Utah, 84170