What is chronic fatigue?

fatigueThere is a great deal of confusion and disagreement in the medical world about how to diagnose and treat chronic fatigue. Chronic fatigue is characterised primarily by low energy levels (poor stamina) and slow recovery after exertion. Secondary symptoms are feelings of ill-health, muscle pain and weakness, sleep disturbance, recurrent infection, hypersensitivity e.g. to chemicals, drug and alcohol intolerance, gut symptoms, headaches, and mood swings. Inflammation, joint pain and depression are further symptoms that occur in some but not all cases (Myhill 2014). Chronic fatigue is essentially a fault in the energy production system in the body. As most symptoms mirror those of other conditions such as Myalgic Encephalopathy (ME) and fibromyalgia it is likely that the underlying issues are similar.

How does it arise?

Chronic fatigue arises because of a sudden serious depletion of the body’s energy resources in cases where resilience was already low (Myhill 2014). It affects people of any age and generally those that tend to strain their bodies to the limit. While the body can maintain energy levels despite a certain amount of mineral depletion, when there is a sudden shock like a virus, toxic exposure or similar, a tipping point is reached. The body enters a new state of lower energy production maintained by low mineral and cell oxygen levels.

What role does breathing play?

Healthy breathing has three important roles to play:

  1. Breathing affects mineral levels. Good breathing helps to restore mineral levels while continuous overbreathing, i.e. breathing in excess of metabolic requirements, depletes mineral levels even further.
  2. Breathing provides necessary oxygen. Healthy breathing, i.e. breathing that ensure CO2/O2 balance, ensures optimal oxygen delivery to cells required for energy production.
  3. Dysfunctional breathing can cause or worsen all secondary symptoms listed.

cfscycleIn fact quite a number of experts argue that chronic fatigue is not just worsened by breathing dysfunction but at least in part caused by it. Unfortunately, in the case of chronic fatigue, mineral depletion causes overbreathing as the body tries to maintain pH balance by breathing faster. Hence, the two aspects of the condition – mineral depletion and breathing dysfunction – reinforce each other in a vicious cycle and this is what makes chonic fatigue very slow to shift. When breathing habits are ignored, low energy production is maintained and doctors and sufferers naturally despair.

What are these minerals important for energy creation and transport?

Minerals for energy creation and transport are called electrolytes. CFS is maintained by chronic electrolyte imbalance via increased breathing volumes. The body’s breathing reflex is driven in response to arterial CO2 levels. One of CO2’s main function is to maintain proper pH levels in bodily fluids. This is a very carefully regulated system. There are two ways of maintaining pH balance in the body: by adjusting the breathing reflex and by the kidneys releasing electrolytes into urine. The former is a short-term working in minutes, the latter a medium-term response that kicks in after 6-8 hours.

Here is how this works… Say a person is in stress, the nervous system is in sympathetic dominance and metabolism (including breathing) work extra hard. As a result, pH increases – a state of respiratory alkalosis. Within minutes the breathing reflex in the brain sends a signal to lower breathing volume to adjust pH. However, the person already has an overbreathing habit and continues overbreathing. Coffee and stimulating substances keep metabolism and energy levels high by pumping adrenaline. After a few hours of increased pH, the kidneys go into action and release electrolytes. Magnesium, bicarbonate and phosphorus literally go down the drain.

A resilient body can take this even fairly regularly without any larger issues. We have all heard of the workaholics who not only get by without much sleep but are seemingly thriving on high workloads with much success. But anyone in a persistent state of respiratory alkalosis and hence lower electrolyte balance will find it more and more difficult to maintain high energy despite strain and stress. Electrolytes are necessary to transport energy molecules inside and between cells. If they are lacking the whole cellular energy production process is affected. It may take one stronger event like a virus or traumatic event that can cause a tipping point to be reached when the body decides to reduce energy output because there simply is no other way.

How can good breathing help the CFS sufferer?

Restoring healthy breathing habits will ensure CO2/O2 balance and pH balance with less or no electrolytes lost allowing the body to restore mineral levels in time. This is key for getting out of the low energy production cycle that hallmarks CFS. With improved CO2/O2 balance, more oxgen is available to cells which will reduce any lactic acid build-up and allow for improved cellular energy production. These changes will be slow but steady and eventually a new steady state with restored electrolyte levels and increased energy creation is maintained.

How can I support the process?

  1. Avoid overstimulation of the sympathetic nervous system that drive high breathing volumes. This includes avoiding stimulating substances and other external stressors.
  2. Be aware that the main stressors for most people are internal, i.e. tension from negative self-talk and emotional distress due to interpersonal conflicts. These cost huge amounts of energy and cause overbreathing yet are commonly ignored.
  3. Spend a good time every day in a deeply relaxed state. Deeply relaxed means not watching TV or reading a book. Think meditation, a deep relaxation practice like yoga nidra, relaxation massage or other relaxing bodywork. Activating the parasympathetic part of your nervous system naturally reduces breathing volumes, releases feel good hormones and allows restoring what needs restoring… energy levels, cell repair, etc.
  4. Supplementing with minerals/electrolytes is a good idea but only if you ensure they are not simply excreted these by your kidneys straight away because you are overbreathing. Good breathing comes first, supplementing second.

References and Recommended Reading

Myhill S (2014) Diagnosis and Treatment of Chronic Fatigue Syndrome, 2nd Ed., Hammersmith Books, London, UK.