Possible role of pseudo-allergic reactions and intolerances in chronic fatigue syndrome (CFS/ME) and fibromyalgia.

Since 2005 Christine has been cooperating with Prof. K. De Meirleir to improve the fatigue and the symptoms associated with the chronic fatigue syndrome (CFS/ME).
cvsIt is striking that the symptoms of most CFS/ME patients ease just by applying an adapted dietary scheme. Most of the time the food anamnesis will point at an intolerance to milk or dairy products, certain cereals and/or fruits dating back to infancy. An aversion to certain food can indicate an intolerance to certain food products. This may be a sensitivity to lactose and/or casein, fructose and/or citric acid. Coffee and certain fats are often badly tolerated, which may be indicative for an impaired liver function. What is more, most ME patients are also hypersensitive to biogenic amines (histamine and tyramine) and alcohol.

How come these patients quickly experience a change for the better once they have adapted their dietary scheme?

A significant number of CFS/ME patients suffers from shortness of breath or asthma. This can be induced by allergic (IgE and IgG mediated) and pseudo-allergic triggers such as tyramine and histamine. Tyramine and histamine are biogenic amines that can induce muscle contractions in the gastrointestinal tract, as well as in the lungs. In the bronchial muscles this may lead to shortness of breath or asthma. This strongly reduces the amount of oxygen intake. Besides, histamine and tyramine may also affect the flexibility (dilatation and contraction) of the blood vessels and, hence, the blood circulation. If the blood circulation is reduced, less oxygen and nutrients necessary for a maximum energy production and a quicker recovery are supplied.

Oxygen uptake through our lungs is necessary for energy production (aerobic oxidation) and enables us to do physical work. In case of a lack of oxygen, the body will switch to other mechanisms to produce energy, but this process is far less efficient (supplies us with less energy). This process is called the anaerobic metabolism (without intervention of oxygen). The drawback of this energy supply is that an end product, namely lactic acid, is produced which can provoke fatigue, muscular pain and muscle spasms. The fuel we use for both processes are carbohydrates (glucose).

Intake of the right type of carbohydrates, taking into account a possible intolerance to lactose and/or fructose and certain cereals, is therefore very important for these patients as a supplement to their glycogen reserves (carbohydrates). Fat combustion on the other hand is less of an issue with people suffering from CFS/ME, because this process needs oxygen.
Furthermore, it is of utmost importance to look for triggers that induce shortness of breath or asthma, so that more oxygen can be taken up through the lungs. This way the patient can switch to an aerobic oxidation.
Pseudo-allergies can lead to inflammations in the connective tissue, which forms the structure of muscles and tendons. If the inflammation becomes chronic, bone development and calcium absorption problems will occur. A lack of calcium reduces the bone density and muscle contraction required to do physical activity or exertion.

Another special feature of people with CFS/ME is gastrointestinal problems: gastric acid, intestinal spasms, constipation, diarrhoea and bloated feeling. This can also be triggered by biogenic amines. This can lead to dysbiosis (imbalanced intestinal flora), which will increase the level of histamine, tyramine and other toxic by-products in the body even more. That way you end up in a vicious circle. In order to break it, it is necessary to find out as quickly as possible which food triggers induce the gastrointestinal symptoms. Also the so-called "leaky-gut" (increased intestinal permeability), of which many CFS/ME patients suffer and which could be the consequence of dysbiosis, allergic reactions or infections, has to be dealt with. After all, this can lead to food deficiencies because less nutrients, vitamins and minerals are absorbed .And these are exactly what we need to produce energy (see aerobic combustion) and to repair our muscles. If not you might have to deal with underweight (because of inadequate intake of fuel, muscle proteins will be used as fuel suppliers).

An infection can lead to more intolerances because of the increased intestinal permeability, but on the other hand the development of allergies and intolerances may also increase the uncontrolled fungus growth in the body, which in turn can lead to more allergies. As it happens, intolerances can cause an imbalance between health and immunity, which allows several hosts (e.g. candida) in the intestine to grow. In this case it may also be useful to discover intolerances and allergies.

Sleep disorders are also a common symptom of CFS/ME. It can be a problem of falling asleep, a light sleep or sleeping long hours yet still feel tired when getting up. Also night sweats, restless legs and dreams are typical problems.
These sleep disorders are significantly reduced in a large number of people when the adapted dietary scheme is applied. Growth hormone deficiency can be found in CFS/ME patients, which complicates muscle recovery. So, sleeping better implies a higher production of growth hormone, which can contribute to a better muscle recovery.

Also stress, hormonal fluctuations or a seasonal allergy (pollen, yeasts ...) can dramatically increase the level of histamine in the body which causes the symptoms to increase. So it is very important to adapt the diet during this period.

To improve the fatigue and the associated symptoms, all possible food factors have to be dealt with together.

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