Q:I have a patient with Chronic Fatigue Syndrome (ME). I have cleared the Candida, pinpointed her allergic reactions (both food and environmental) filled her with minerals, vitamins and amino acids, and she still feels lousy. Before I try the parasite route, what is the known incidence of giardiasis in the UK? Also, if this should fail, what should I try next? M.C., Barnet, Herts.
A:We consulted with Martin Lev, the director of ME Action and a former sufferer. His organization keeps well abreast of any new treatments of ME, and what appears to be working safely. His response:"No one knows the incidence of giardiasis among ME sufferers in the UK, and following that route may lead you down a blind alley. It is true that one study discovered giardiasis in more than one quarter of American ME cases (see WDDTY, Vol. l, No. 6), and that treatment with a Chinese herb (Artemisia annua) appeared effective. The problem is, we don't know the precise effect the herb had in the bowel. Was it antifungal (which would have cleared an overgrowth of Candida albicans, a common problem in ME sufferers), antibacterial or antiviral? In other words, giardiasis may be a component of ME; what we don't know is how large a component.
"The point is, as we're discovering, ME appears to be a cocktail of different problems, so that it is very unlikely that you can cure it by attacking one or even two of them. Many times an ME patient will be treated for candida and have symptomatic relief, but if his bowel contains a mix of bacteria, viruses, fungal infections and parasites, curing the candida won't sort out the entire problem.
"In our experience, one of the keys to overcoming ME is establishing a healthy bowel. Repeated courses of antibiotics often seem to disrupt the long term balance of bugs in the bowel, causing candida overgrowth and a host of other problems.
"A method that has helped many of our members is to use a powerful probiotic, such as BioAcidophilus, by BioCare, which contains lactobacilli, the good bacteria which keep the bad ones in check.
"Another, highly controversial possibility is colonic irrigation, which supposedly cleanses the bowel of matter which is impeding digestion.
"We have found that it is a bad idea to fill people with vitamin and mineral supplements indiscriminately because in many cases if they don't need them it simply imposes an additional toxic load and is an unnecessary expense. In fact, we feel that it is irresponsible to sell vitamins and minerals without knowing if the patients need them.
"We suggest that you look very closely at your patient's magnesium levels. As you undoubtedly know, magnesium is a vitally important mineral involved in hundreds of enzyme reactions, including energy production in muscles. A deficiency causes muscle aches, cramps, and depression. Recently we finished a study which has been submitted for publication in the medical press suggesting that many ME sufferers are deficient in magnesium and appear to benefit from supplementation.
"However, this doesn't mean that they will respond to ordinary supplements. Usually inorganic, magnesium in supplement form is not easily absorbable. Many magnesium supplements are possibly ineffective because the enzymes used for absorbing magnesium may be depleted in the ME patient but at the same time be dependent on normal magnesium levels to work. In other words, the patient has got into the vicious cycle of needing the magnesium to make the enzymes work properly and the enzymes to make the magnesium work.
"ME patients have got around that problem by having it injected intramuscularly. This is not the entire cause of the problem, but it certainly appears to be a component."