Chronic Fatigue
Illnesses
Prof. Garth L. Nicolson
Chronic Fatigue Syndrome, Fibromyalgia Syndrome and Other Fatigue
Conditions
Chronic
fatigue is reported by 20% of all patients seeking medical care and is
considered as a nonspecific sign that is associated with many well known
medical conditions. Chronic Fatigue Syndrome (CFS), Myalgic
Encephalomyelitis (ME), and Fibromyalgia Syndrome (FMS) patients suffer
from complex overlapping signs and symptoms. (see 'Signs/Symptoms'
Questions, above) CFS is primarily characterized by persisting or
relapsing fatigue without previous history of comparable symptoms that
does not resolve with rest. In these patients other clinical conditions
are absent that can explain the signs and symptoms such as malignancies
or autoimmune diseases. In contrast, FMS patients have overall muscle
pain, tenderness, and weakness as primary complaints, but they have most
if not all of the commonly found signs and symptoms for CFS. We
previously proposed that CFS/ME patients might be suffering from chronic
infections that can cause, in part, their complex signs and symptoms.
For example, systemic mycoplasmal infections can cause chronic fatigue,
muscle pain and a variety of additional signs and symptoms, some of
which are related to dysfunctional immune responses and in extreme cases
autoimmune-like disorders. Some mycoplasmas can invade virtually every
human tissue and can compromise the immune system, permitting
opportunistic infections by other bacteria, viruses, fungi and yeast.
When mycoplasmas exit certain cells, such as synovial cells, nerve
cells, among others that can be infected, they can stimulate autoimmune
response. Our recently published studies demonstrated a possible link
between mycoplasmal infections and CFS and FMS, since we found high
frequencies of mycoplasmal infections in these patients. Previously we
examined patients with chronic illnesses for the presence of mycoplasmal
infections. We found that about one half of patients with Gulf War
Illness and two third of patients with CFS/ME and FMS were positive for
mycoplasmal infections in their blood. The Gulf War Veterans suffer from
signs and symptoms similar to patients diagnosed with CFS and FMS. They
can be treated using antibiotics effective against mycoplasmal
infections, and once they recover, their blood is no longer positive for
the presence of mycoplasmal infections. Our recent results indicate that
Rheumatoid Arthritis is also associated with mycoplasmal infections.
(see 'Autoimmune Diseases')
Recent
reports and publications indicate that in addition to mycoplasmal
infections, CFS/ME and FMS patients have other chronic infections caused
by other intracellular bacteria and viruses. For example, patients with
Lyme Disease, caused by intracellular Borrelia infections, have
been diagnosed with CFS/ME. Also, CFS/ME and FMS patients can have
intracellular Chlamydia
species infections. These patients can also have infections by other
bacteria that enter their bodies through 'leaky gut' problems.
Chronically ill patients often have inflammatory bowel syndrome and
other gut problems, and this can allow pathogenic bacteria to enter
their systems.
Patients
with CFS/ME and FMS can also have viral infections that complicate their
conditions and cause morbidity. Such infections can occur with or
without the bacterial infections described above. Viruses that have been
associated with CFS/ME and FMS are Human Herpes Virus-6 (HHV-6) and
Cytomeglovirus (CMV). These viruses have been found at high incidence in
chronically ill patients, and especially those with CFS/ME. Patients
with CFS/ME or FMS can have predominantly intracellular bacterial
infections, predominantly viral infections, or a combination of
intracellular bacterial and viral infections. This may be one reason why
the underlying causes of these chronic illnesses are so difficult to
determine and effectively treat. The other reason could be the
persistent nature of the infections and their ability to hide inside
cells where they are essentially refractory to immune system responses,
their slow growing natures and their relative insensitivity to
therapeutic drugs (see references below).
A new direction at the Institute is
studying the role of decreased cellular energy in causing fatigue.
Cellular energy is mainly produced by the mitochondria, subcellular
organelles that contain the machinery that converts fats and sugars to
energy in the form of the high-energy molecules, such as ATP.
Mitochondrial function requires an intact inner membrane where the
electron transport chain or energy machinery is located. When the
inner mitochondrial membrane is damaged, the efficiency of the electron
transport chain is reduced along with the ability of cells to produce
the energy that they need for vital functions—thus fatigue becomes a
problem. Various environmental insults and even aging
produce excess oxidation molecules that can damage the mitochondrial
membrane, including chronic infections of the type mentioned above.
At the Institute for Molecular Medicine clinical studies have shown the
benefits of dietary membrane lipids (Lipid Replacement Therapy) in
replacing damaged mitochondrial membrane lipids, increasing the
efficiency of the electron transport chain, increasing energy and
reducing fatigue. A number of non-pharmaceutical approaches to
decreasing fatigue are being investigated at the Institute.
Publications
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Metabolic Syndrome and Mitochondrial Function: Molecular
Replacement and Antioxidant Supplements to Prevent Membrane
Peroxidation and Restore Mitochondrial Function, Garth L.
Nicolson, Journal of Cellular Biochemistry 2007; 100:in press.
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Considerations when Undergoing Treatment
for Chronic Illnesses and Autoimmune Diseases,
by Prof. Garth L. Nicolson, Reprint - Intern.
J. Medicine 1998; 1:123-128. Plus Supplemental Suggestions: Prof.
Nicolson June 15, 2006.
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Lipid replacement and antioxidant nutritional
therapy for restoring mitochondrial function and reducing fatigue in
chronic fatigue syndrome and other fatiguing illnesses,
by Nicolson and Ellithorpe, Journal of Chronic Fatigue Syndrome
2006; 13(1): 57-68.
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Lipid replacement/antioxidant therapy as an adjunct supplement to
reduce the adverse effects of cancer therapy and restore
mitochondrial function, by Prof. Nicolson, Pathology &
Oncology Research 2005; 11(3): 139-144.
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Evidence for
Brucella spp. And Mycoplasma ssp. Co-Infections in
Blood of Fatigue Syndrome Patients, by Nicolson et al.,
Journal of Chronic Fatigue Syndrome 2005; 12(2): 5-17.
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Deregulation of the 2.5A synthetase RNase L antiviral pathway by
Mycoplasma spp. in subsets of Chronic Fatigue Syndrome By J.
Nijs et al., J. Chronic Fatigue Syndr. 2003; 11(2):37-50.
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Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6)
in blood of chronic fatigue syndrome patients: association with
signs and symptoms. By G. L. Nicolson et al., Acta Pathol.
Microbiol. Immunol. Scand.(APMIS) 2003; 111: 557-566.
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Immunophenotyping predictive of mycoplasma infection in patients
with chronic fatigue Syndrome. By J. Nijs et al., J. Chronic
Fatigue Syndr. 2003; 11(2): 51-70.
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Evidence for Bacterial (Mycoplasma,
Chlamydia) and Viral (HHV-6) Co-Infections in Chronic Fatigue
Syndrome Patients by G.L. Nicolson et al., Journal of
Chronic Fatigue Syndrome 2003; 11(2):7-20.
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High
Prevalence of Mycoplasma infections among European Chronic
Fatigue Syndrome patients. By J. Nijs et al., FEMS Immunol.
Med. Microbiol. 2002; 34:209-214.
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Bacterial and Viral Co-Infections in
Chronic Fatigue Syndrome (CFS/ME) Patients, by Nicolson et
al., Proc. Clinical & Scientific Conference on Myalgic
Encephalopathy/Chronic Fatigue Syndrome, the Practitioners
Challenge, Alison Hunter Foundation, Sydney, Australia 2002.
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Review: Immunology of Chronic Fatigue
Syndrome by R. Patarca et al. J. Chronic Fatigue Syndr. 2000;
6(3/4): 69-107.
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Examination of mycoplasmas in blood of
565 Chronic Illness patients by polymerase chain reaction. by
M. Nasralla, J. Haier, N. Nicolson and G.L. Nicolson, Intern. J.
Med. Biol. Environ. 2000; 28(1): 15-23.
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Diagnosis and integrative treatment of
intracellular bacterial infections in Chronic Fatigue and
Fibromyalgia Syndromes, Gulf War Illness, Rheumatoid Arthritis and
other chronic illnesses. by G.L. Nicolson et al., Clin.
Pract. Alt. Medicine 2000; 1(2): 92-102
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Role of Mycoplasmal Infections in
Fatigue Illnesses: Chronic Fatigue and Fibromyalgia Syndromes, Gulf
War Illness and Rheumatoid Arthritis, by G.L. Nicolson et
al., J. Chronic Fatigue Syndr. 2000; 6(3/4):23-39
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Identification And Treatment Of Chronic
Infections In CFIDS, Fibromyalgia Syndrome And Rheumatoid Arthritis,
by G.L. Nicolson, CFIDS Chronicle 1999; 12(3): 19-21
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Multiple Mycoplasmal Infections
Detected in Blood of Chronic Fatigue Syndrome and Fibromyalgia
Syndrome Patients, Eur. J. Clin. Microbiol. Infect. Dis. 1999
; 18 : 859-865
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Mycoplasmal Infections in Chronic
Illnesses: Fibromyalgia and Chronic Fatigue Syndromes, Gulf War
Illness, HIV-AIDS and Rheumatoid Arthritis, by G.L. Nicolson
et al., Med. Sentinel 1999; 4: 172-176
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The Pathogenesis and Treatment of
Mycoplasmal Infections, by G.L. Nicolson et al., Antimicrob.
Infect. Dis. Newsl. 1999; 17(11) : 81-88
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Diagnosis and Treatment of Chronic
Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue
Syndromes: Relationship to Gulf War Illness, by G.L. Nicolson
et al., Biomed. Therapy 1998; 16: 266-271
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Diagnosis and Treatment of Chronic
Infections in Chronic Fatigue Syndrome, Fibromyalgia Syndrome and
Gulf War Illness, by G.L. Nicolson and N.L. Nicolson,
International Journal of Occupational Medicine, Immunology
and Toxicology 1996 ; 5 : 69-78
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*PDF files can be opened by
obtaining a free copy of Adobe Acrobat from:
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Reports
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Chronic Fatigue Syndrome Patients Subsequently
Diagnosed with Lyme Disease Borrelia burgdorferi: Evidence for
Mycoplasma species Co-Infections -
by Garth L. Nicolson, PhD, Nancy L. Nicolson, PhD and
Joerg Haier, MD, PD, Journal of Chronic Fatigue Syndrome 2007. -
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Recommendations for Diagnostic Testing,
by Prof. Garth Nicolson, updates - 2007
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Co-Infections in Fibromyalgia Syndrome, Chronic Fatigue Syndrome and
Other Chronic Illnesses by Prof. Garth Nicolson,
Fibromyalgia Frontiers 2002; 10(3):5-9, 27-28.
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Update on Gulf War Illnesses:
Relationship to Fibromyalgia Syndrome, Chronic Fatigue Syndrome/M.E.
and the Possible Role of Vaccines By Prof. Garth Nicolson,
The Fibromyalgia Survivor, 2001
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Mycoplasmas: the Missing Link in
Fatiguing Illnesses by Michael Guthrie Alternative Medicine;
2001; Sept: 60-70.
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Research Overview: Professor Garth
Nicolson's Studies and Treatments Explained By Deborah
Cooper, ImmuneSupport.com Treatment & Research Library
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CFS National Radio Program 11/21/00
with Dr. Roger G. Mazlen interviewing Prof. Garth Nicolson
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Chronic Infections in Fibromyalgia
Syndrome: Sources of Morbidity and Illness Progression. by
Prof. Garth Nicolson, Fibromyalgia Survivor 2000
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New Treatments for Chronic Infections
Found in Fibromyalgia Syndrome, Chronic Fatigue Syndrome, Rheumatoid
Arthritis and Gulf War Illnesses, by Prof. Garth Nicolson,
Kuwait University Faculty of Science and Medicine Newsletter,
1999
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The Role of Chronic Infections in the
Maintenance and Progression of Chronic Fatigue Syndrome,
Fibromyalgia Syndrome, Rheumatoid Arthritis, Immune Deficiency
Syndromes and Gulf War Illness, by G.L. Nicolson et al.,
ME/CFS Congress, Sydney, Australia, 1999
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Identification and Treatment of Chronic
Infections in CFIDS, Fibromyalgia Sydrome and Rheumatoid Arthritis
Patients that Cause Morbidity and Illness Progression, by
Prof. Garth Nicolson, Doctor's Educational Booklet, CFIDS Assoc. of
America, 1998
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Mycoplasmal Infections in Blood from
Patients with Chronic Fatigue Syndrome, Fibromyalgia Syndrome or
Gulf War Illness, by G.L. Nicolson et al., International CFS
Congress, Sydney, Australia, 1998
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New Treatments for Chronic Infections
Found in CFS, Fibromyalgia Syndrome and Gulf War Illnesses, by Prof. Garth Nicolson, American Academy of Environmental Medicine
Newsletter (Winter 1997)
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*PDF files can be opened by
obtaining a free copy of Adobe Acrobat from:
http://www.adobe.com/products/acrobat/readstep2.html
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