Early History of CFS

Discussion in 'Fibromyalgia Main Forum' started by fibromaster, Sep 13, 2005.

  1. fibromaster

    fibromaster New Member

    Stress And You: Hypoadrenalism,
    Chronic Fatigue Syndrome,
    Environmental Disease
    When we first published It's Only Natural, more than twenty years ago, Chronic Fatigue Syndrome, Fibromyalgia, Candida infections, Epstein-Barr infections and the various Environmental Diseases were all unheard of. Patients with these conditions were considered to be malingerers or neurotics by the vast majority of physicians. We were considered a "quack" to even intimate that there might really be something wrong with these patients. All this has now changed. Not that we have been given any credit or respect for our pioneering work (that would be asking too much), but at least these patients are no longer considered to be neurotic hypochondriacs.

    In the original edition of this work I used the name functional hypoadrenia to describe these patients. Since there is no evidence that this is not the underlying cause of these various conditions I will retain this nomenclature in this chapter.

    To further the cause of individuals with these conditions I later wrote two separate books entirely devoted to this subject. They were Adrenal Syndrome and Chronic Fatigue Unmasked. The latter of these works is still available and is recommended for all those who see themselves or someone they love in the type of patient presented here.

    Many years ago, Dr. Hans Selye presented papers on the adverse effects of stress and what he called the general adaptation syndrome (GAS). This research showed that when the human body is placed in a situation that produces a degree of pressure greater than can be handled by its normal homeostatic organ functioning, a series of chemical and glandular changes are produced that he called the General Adaptation Syndrome.

    Click here to see an enlarged version of this Chart
    One of the most important factors in the GAS was found to be a previously often neglected gland, the adrenal. This small gland, which weighs about as much as a nickel and sits like a Bishop's cap on top of each kidney, is now recognized as one of our most important endocrine glands (glands that produce hormone-like substances discharged directly into the bloodstream).

    The adrenal glands are composed of two parts--the medulla (inner portion) and the cortex (outer surrounding portion). The adrenal glands produce many substances, the most noteworthy of which are epinephrine, (previously known as adrenalin), which is produced by the medulla; and the various sterols such as cortisone and aldosterone, produced by the cortex.

    Many observers believe that in hormonal responses to stress the adrenal medulla is the primary agent. According to this view, stress on the body stimulates (probably by way of the sympathetic nervous system) the adrenal medulla to increased epinephrine production. This hormone increases the secretion of adrenocorticotrophin (ACTH) by the pituitary, which in turn activates the adrenal cortex to a greater production of corticoids such as cortisone.

    Cortisone and its related sterols have been used for years in treating all forms of inflammatory reactions, from extremely severe diseases to mild skin conditions. Inflammatory conditions usually respond quite rapidly to cortisone therapy. Unfortunately, in chronic disorders cortisone usually doesn't bring about a cure but only temporary relief. The reason for this is simple. The production of cortisone and allied sterols represents only one step in the general adaptation syndrome (GAS). These sterols rid the condition of inflammation but they don't resolve other problematic aspects of the condition. This must be done by other agents of the GAS activity. If the endocrine gland system is weak and not able to carry on these activities, the condition will revert to its inflammatory stage as soon as cortisone is withdrawn. Because cortisone is notorious for its side effects when given for any length of time, every physician tries to withdraw it as soon as possible, if at all feasible. Although sterols are useful in serious cases and undoubtedly have relieved much suffering, they are definitely not the answer to a balanced glandular system. It is in the search for this balance that this chapter is devoted.

    So What Does This Mean to Me?

    About this time, you may be asking yourself, "Very interesting, but what does all this have to do with me?" It concerns you in this way. The General Adaptation Syndrome is reacting in your body every moment of the day. As long as it functions well, you should be healthy and contented. If it functions poorly, you undoubtedly will be vexed with problems that often tend to cause consternation among orthodox physicians. In fact, at the Beverly Hall Corporation Healing Research Center our experience shows that most of the misdiagnosed, neglected, and rejected patients who come to our doors are victims of a malfunctioning General Adaptation Syndrome. Most of these exhibit hypoadrenalism (also called hypoadrenia)--functional (non-disease-caused) adrenal insufficiency. The adrenal glands of these patients, through exhaustion, have ceased to function as well as they should, and they aren't capable of putting out the normal complement of the substances required for proper body function. Interesting in many of these patients they are overexcited when they should rest and sleep and tired and weak when they need to function. This seeming paradox is the "signature" of this condition.

    There has been much research, particularly by Dr. John W. Tintera, relating this condition to another common metabolic defect--hyperinsulinism (low blood sugar). A great deal has been written in recent years about this connection. The nutritionalist authors--Carlton Fredericks, E. M. Abrahamson, and Allan Nittler--have all presented in great detail the symptoms, the methodology, and the basic nutritional and supplemental care for these patients. Although I agree with Tintera and others that many cases of hypoglycemia are caused by malfunctioning adrenal glands, it's been my experience that patients can have functional hypoadrenalism and all its symptoms without necessarily having the hyperinsulinism of the low blood sugar syndrome. And hypoglycemic patients do not always have lowered adrenal functioning, but many do.

    Many patients come to our Center with typical symptoms of low blood sugar who have had one, two, or even more normal glucose tolerance tests. Often, as an empirical treatment, these patients had been placed on the low-blood-sugar diet by their previous physician, but to little avail. Upon examination, we usually find these patients suffering from adrenal exhaustion, which has not yet manifested as hypoglycemia. Under treatment, these patients usually respond well; almost without exception, they have been able to return to a normal, productive life.

    Functional adrenal exhaustion is poorly understood by most physicians, and very little has been written for the general public on this condition. Surprisingly, the earlier investigators in hormones and hormone therapy knew it well. The reason it has been so ignored is difficult to explain. I personally think this apathy has been produced by the general vagueness of its character, the seeming neurotic symptoms of its victims, and the slowness of its correction, even with the most advanced therapy. In our Center, I always meet the newly diagnosed hypoadrenal patient with mixed feelings. I am, on the one hand, very pleased to know that we have a patient who will once again become useful and productive instead of being only half-functioning. On the other hand, I always groan a little bit inside when I think of all the care, time, and constant loving support necessary to carry this patient through the seemingly nonproductive early stages of treatment. With perseverance, however, they all respond. In the end, they prove to be among our most appreciative patients, which gives the physician a great sense of accomplishment. (While this paragraph was written over twenty years ago it is still as true today as it was then.)

    I mentioned earlier that the hypoadrenal syndrome has been known for some time. To verify this statement I want to quote from one of the great early investigators in glandular therapy, Dr. Henry R. Harrower, M.D., F.R.S.M. (London). In his book Practical Organic Therapy, the Internal Secretions in General Practice, Harrower had this to say:

    "Since the adrenals are so extremely susceptible to so many outside influences, it is likely that they would be easily worn out, and as a matter of fact, functional hypoadrenia is as common a condition as any endocrine manifestation. From a practical standpoint, this is an extremely important symptom complex." Remember this was written just a short time after World War I. Harrower goes on: "It is quite some years since Sajous began to emphasize the importance of this condition, and while his opinions were scouted, and some of his ideas declared visionary, it must be admitted that our present knowledge of this subject is very much in harmony with the following quotation from Sajous' monumental work: 'Functional hypoadrenia is the symptom complex of deficient activity of the adrenals due to inadequate development, exhaustion by fatigue, senile degeneration, or any other factor which without provoking of organic lesions in the organs of their nerve paths, is capable of reducing their secretory activity. Asthenia, sensitiveness to cold and cold extremities, hypotension, weak cardiac action and pulse and anorexia, anemia, slow metabolism, constipation, psychoasthenia are the main symptoms of this condition.' "

    Therefore we see that this condition was not only known in the early 1920s, when Harrower wrote, but Harrower himself quotes Dr. Charles Sajous an even more famous endocrinologist, who discussed it at a still earlier time.

    Harrower goes on to say that "Hypoadrenia is a complication of all the serious acute infectious fevers, since the adrenals are so intimately connected with the driving of the body and are so susceptible to toxemia, that the ultimate reduction of the accustomed adrenal stimuli is responsible for a slowing down of many of the sympathetic controlled functions of the organism. Too often this sympathetic asthenia is the actual cause of death from disease of this character.

    In such cases Harrower stated that, "Asthenia is the rule and muscular tone (both striped and unstriped muscle) is poor. Exertion is difficult, if not impossible, and the fatigue syndrome is prominent. The intestinal musculature is inactive. Stasis, a common cause of hypoadrenalism, is also a usual result of it. Mental exertion, even the simplest exertion, often causes so much weariness and exhaustion as to be prohibitive. Mental elasticity is lost, and there is both mental and physical depression with the fear that the individual now can not accomplish his accustomed good mental work; and the story that he 'has lost his nerve.' With this, one frequently notes a fearfulness of making wrong decisions and vacillating and indecisive frame of mind. This is the most usual form of adrenal insufficiency. It is chronic both in origin and in its course."

    Another section in Harrower's book is entitled "Neurasthenia as an adrenal syndrome." The word neurasthenia isn't used as much as it once was, nor is it well-understood by the general public as it was at one time. Neurasthenia means weak nerves. Although they may not have heard of neurasthenia, we frequently hear people speak of their weak or sensitive nerves and upset nervous system. I personally still find neurasthenia an acceptable term and an exact description of many patients we see daily.

    Again, Harrower's report is so lucid that I am presenting the entire section on neurasthenia:

    Neurasthenia as an Adrenal Syndrome

    "The minor form of functional hypoadrenia is more common than some have appreciated, and the fact that there is a psychic origin as well as the other physiologic causes already considered, allies it to the fashionable neurasthenia of today. In fact, some have stated that what is improperly called 'neurasthenia' is not a disease per se, but really a symptom complex of ductless glandular origin and that the adrenals are probably the most important factors in its causation. Campbell Smith, Osborne, Williams and others, including the writer, have directed attention to the importance of the adrenal origin of neurasthenia (though a pluralglandular dyscrasia is practically always discoverable), but so far this is not understood as well as its frequency and importance warrant.

    "A few quotations from the literature will firmly establish the importance of this angle from which to study this common and annoying symptom complex. Quoting from the Journal A.M.A. (Dec. 18, 1915): 'The typical neurotic generally has, if not always, disturbance of the thyroid gland. The typical neurasthenic probably generally has disturbance of the suprarenal glands on the side of insufficiency. The blood pressure in these neurasthenic patients is almost always low for the individuals and their circulation is poor. A vasomotor paralysis, often present, allows chilling, flushing, cold or burning hands and feet, drowsiness when the patient is up, wakefulness on lying down and hence insomnia. There may be more or less tingling or numbness of the extremities.'

    "Again, Kinnier Wilson in his monographs on The Central Importance of the Sympathetic Nervous System, makes the following pertinent remarks: 'Many of the common symptoms of neurasthenia and hysteria are patently of sympathetic origin. Who of us has not seen the typical irregular blotches appear on the skin of the neck and face as the neurasthenic patient 'works himself up into a state'? The clammy hand, flushed or pallid features, dilated pupils, the innumerable paresthesias (tinglings), the unwanted sensations in head or body, are surely of sympathetic parentage. In not a few cases of neurasthenia, symptoms of this class are the chief or only manifestations of the disease. Here then, is a condition of defective sympatheticotonus; may it not have been caused by impairment of function of the chromophil system? [Adrenal System] .... There does not appear to me any tenable distinction between the asthenia of Addison's Disease and the asthenia of neurasthenia. Cases of the former are not infrequently diagnosed as ordinary neurasthenia at first. It is difficult to avoid the conclusion that defect of glandular function is responsible for much of the Central picture of neurasthenia.'

    "Later this same author makes the following apothegm: 'Sympathetic tone is dependent on adrenal support, and until the glandular equilibrium is once more attained, sympathetic symptoms are likely to occur.' "

    Interestingly, this quotation from the Journal of the American Medical Association of 1915 postulates a relationship between neurasthenia and low adrenal function. Yet to this day, such a relationship is rarely considered in medical treatment. At the Beverly Hall Corporation Healing Research Center, we consider such a cause and effect very common, and we treat accordingly. We have become internationally known for our treatment of the weakened nervous system.

    Our treatment methods aren't so original or revolutionary; it's just that we are willing to get down to causes and accept as facts the postulates of Harrower, Sajous, and the many other brilliant investigators of those earlier days. Their work showed that many emotional states have glandular causes. We believe our duty as physicians is to find these causes and correct them whenever possible. The path to follow has been shown. Harrower established the basic treatment more than fifty years ago; yet today, not one physician in a thousand is familiar with this malady even though his office may be jammed with patients suffering from it. (This was true twenty years ago but not now. These patients are now beginning to be recognized. The only problem is that most physicians still have no idea of how to treat them or of the underlying glandular weaknesses. Maybe in another twenty years?)

    How Can One Tell if He Has Adrenal Insufficiency (Hypoadrenalism--Chronic Fatigue Syndrome-Environmental Disease)?

    Usually the first and most obvious symptom is tiredness, apparent laziness, or lack of ambition. A young person often feels as if he has some serious wasting disease. The young hypoadrenal patient usually is by nature a go-getter, smart in school, and extremely conscientious. With hypoadrenalism, he finds it more and more difficult to concentrate. The harder he tries to work, the more tired he becomes. Parents and friends become alarmed, and the patient is usually taken to a variety of physicians to correct the enigmatic condition.

    In middle age, the hypoadrenal person usually feels he is just slowing down, or that he is beginning to grow old prematurely. Again, he tends to push himself to added effort. Sometimes he takes special exercises or courses to stimulate mental activity. As in the younger person, the harder he tries, the less he is able to accomplish. The situation can become so bad that the hypoadrenal person may even become dizzy or have fainting spells, which usually brings him to a physician.

    In the elderly, this condition is blamed on old age. It is believed that Mom or Dad is finally wearing out. But the symptoms of senility and of hypoadrenalism are not the same; usually the difference can be discovered by a physician reasonably versed in the latter disorder.

    If hypoadrenalism is not diagnosed and treated in the early stages, the patient will start to manifest symptoms that he takes as signs of mental deterioration. He becomes more and more forgetful; he begins to have small blacking-out incidents, and dizziness is particularly prevalent, especially that which occurs on arising from a seated or reclining position. He begins to fear that he has a brain tumor or perhaps cancer of some vital organ. The most common fear however is fear of a mental disorder. This is the point at which he is driven to seek medical attention.

    Let's take a look at this picture. We have a person who is tired, much more than he should be, has occasional dizzy spells, and has disturbing mental aberrations--all contrary to his usual physical and emotional status. This person had always been bright, overconscientious, a perfectionist by nature, had an overabundance of energy, and had been able to drive himself constantly to accomplish what he would with his life. Now this whole pattern is reversed--not that his desires are gone, but the physical and mental entities are no longer able to carry out the dictates of his will. This is most frightening to any intelligent person, and is the sad story he pours out to his physician.

    Now let's put ourselves in the position of his physician and listen to his story. You find before you a patient who is obviously intelligent, able to present his symptoms with great lucidity, and yet whose symptoms don't seem to fit any disease that you're familiar with. You find the patient excitable, agitated, and apparently overly concerned. Although you aren't one to pass snap judgments, your first thought is that he is becoming neurotic because of the pressures in his life. You are, however, very thorough so you give him a complete physical examination, a reasonably complete blood chemistry examination, a urinalysis, and all the other things any physician should do to discover a known pathologic condition that may cause such symptoms.

    The tests all are within the normal range. The physical examination is unremarkable. The patient's blood pressure might be slightly lower than normal, but not seriously so, and of course it's only high blood pressure to be worried about anyway. Slightly lower pressure just means that the man will live longer.

    Your examination confirms that you have before you a strong, healthy person with symptoms that obviously are of a neurotic nature. He is probably just overworked. So you talk to him. You recommend that he slow down, that he find himself a hobby, or that he take a vacation.

    You give him a mild tranquilizer, and if he feels depressed, you give him a gentle antidepressant (Today Prozac is the fashion). Because he doesn't sleep too well at night (insomnia being one of the symptoms of the second stage of hypoadrenalism), you give him a mild sedative. You send him home with a comforting pat on the back, reassuring him that there's nothing really wrong with him, he's just been working too hard, and he's to settle down a bit, keep on his medication, and try to get some enjoyment out of life.

    This, in a nutshell, is the therapy most patients with hypoadrenalism received twenty years ago. It was very professional and was usually given with the best of intentions. Unfortunately, not only was it insufficient, but it also was usually detrimental, because the various drugs put a greater strain on an already overloaded glandular system. And so more problems are heaped on those that already exist.

    Today a few knowledgeable physicians will prescribe a more rational treatment program, but even today, if our patients are any indication, the majority of physicians are still treating this condition as they did in 1975.

    Many patients, not realizing they have organic problems, continue with this archaic treatment. Unless certain changes occur in their life that remove much of the stress originally causing the condition, they will continue to go downhill as they become more and more dependent on their drug therapy. The drugs don't help the basic condition at all; the imbalances are all still there. The drugs simply mask the patient's ability to be affected by the symptoms.

    If this condition goes unabated in some persons, it can in time lead to mental institutionalization. Knowledgeable investigators frequently have found both hypoadrenal patients and hypoglycemic patients in mental institutions. Many of these patients are willing to admit themselves to mental institutions because they have been told very clearly that they have no physical condition that could cause their symptoms; yet these symptoms are so severe the patient no longer feels capable of coping with society. This is a sad commentary on a condition whose cause and treatment have been known for more than seventy-five years.

    When we first wrote about these patients we were seeing most of them in the early stages of this condition. That is not true today. The majority of our new adrenal patients today are in the second or third stage of the GAS as outlined in the diagram of Dr. Selye. Rather than exhaustion being their major complaint, nervousness, panic attacks and insomnia take first place with fatigue being there but it is these other symptoms that bother them the most. What is happening is, as outlined in Dr. Selye's chart, that their body is overstressing the gland and nervous system to keep them going despite the serious glandular weakness. They are running on vital reserve energy and when this runs out total collapse may well ensue (Again see Dr. Selye's chart).

    We now run a test called the Adrenal Stress Index (ASI) test on all suspected adrenal patients. This test can pinpoint exactly where the individual patient is in the Selye sequence. Once this is known, then the correct treatment plan can be implemented. Without this knowledge it is entirely possible to worsen the condition if the first stage treatment is given to a second stage patient and vice versa.

    http://www.chronicfatigue.org/History.html
  2. Empower

    Empower New Member

    Interesting

    I am 95% sure that my CFS is a result of severe, extended stress