Chronic Fatigue, Hypothyroid, Adrenal Fatigue, Folic Acid

Sunnyway, good to hear you are getting some benefit from the Nuvigil. I take a low dose Provigil myself. Some, even after getting proven therapeutic treatment (with data) and addressing other health issues have residual symptoms they need help with. Please do stay vigilant while on this med that it isn't helping you to overlook either a treatment or medical issue that needs attention. Just curious, how is your sleep now that you are 3 months in? Have you adjusted to that 18 pressure and are able to sleep all night with it on? At one time the doc was wondering if I have fibro, but after diagnosing and treating my Periodic Limb Movement Disorder it hasn't been mentioned. Hopefully continued time on cpap will bring you continued and sustained improvement.

I still think I sleep better without a CPAP than with, but I am committed to using it. Despite issues with leaking masks waking me up, I am working hard at compliance and am up to six hours a night, with a few of nights of eight hours. I've adjusted to the headgear and I don't mind the 18 pounds pressure. However, when a mask leaks, it wakes me up. If I don't sleep, I HURT the next day. I've learned to stop trying to adjust a leaking mask when the squealing and face farts wake me up. Now I reduce the awake time by ripping off the offending mask and plopping on a fresh one.

Thanks to the CPAP I don't have night time headaches any more and fewer during the day. I'm feeling a bit stronger, but flu-like fatigue is persistent. My sleep doc doesn't think the OSA is to blame for that--it's the fibromyagia and chronic fatigue syndrome.

Today I ran errands after work and even went to the mall to visit the Apple store and buy a new Mac. I didn't get home until 8:30 pm. I could not have possibly done that before the Nuvigil. I haven't been to a mall in years! Even with the CPAP, my life has consisted of waking, going to work, coming home and going back to bed. Today I got 2 1/2 extra hours of functionality after a full day at the office that did NOT exhaust me. Amazing. It's after 10 pm now and I'm still feeling fresh, but I'm going to bed now because I know I need to get the hours of sleep in.

Hi, Sunnyway, it sounds like you are dealing effectively with your high pressure. Have you discussed with your docs what any underlying causes might be for your sleep apnea? For me, my humongous tonsils and xl size tongue were to blame. I can't do much about the tongue, but the tonsils I had taken out. Though if you are in the middle of a cfs/fs flare, I would avoid any invasive procedures like the plague--they will only make it worse.

Interesting that you mention nuvigil and provigil. I was recently given a sample of nuvigil by my new sleep doc, however she has since advised to to hold off on trying it because I have some new issues that have cropped up that we should investigate first.

The very first thing my new sleep doc wanted to do was overnight oximetry to make sure I wasn't desatting. Turned out desats weren't much of a problem--I went from 97% saturation to 94% saturation a few times which she said isn't much of a concern, except it *might* interupt my sleep cycles and I should have another overnight sleep test to see about that. The bad result was that my heart rate frequently went down to 41 bpm. That I was NOT expecting! I had bradycardia listed on my initial sleep study 3 years ago, which I expected to resolve with bipap therapy. I had no way of knowing that I was bradycardic all this time, even through a pregnancy! Lets be honest here--I'm no athlete. This is not a good resting heart rate for me. She thinks I need a complet heart workup--holter monitor, EKG, stress test. But, THAT is all up to my internist. To start, he is ordering a holter monitor coming up this week, and says we will decide from there if I need a cardio doc. etc. etc. Ugh. Very distressing. I know I have a prolapsed mitral valve and I don't like to think about my heart being weak at age 37!

So, thinking I remembered reading about some kind of heart thing in my book by Dr. Teitelbaum (From Fatigued to Fantastic), I looked up the passage. The title of the chapter was mitochondrial dysfunction. Now I had some vague awareness that part of his theory about cfs/fs had something to do with mitochondria, which are the little energy factories we all have in every one of our cells, but aside from taking his recommended supplement for it (d-ribose), I hadn't given it much thought. Now, however my interest was piqued. I started doing tons of research into mitochondrial dysfunction, which, as it turns out, is now one of the leading theories about the underlying cause of cfs/fibro.

Now this brings back memories of my college days in my biochem class and cell biology etc learning the Krebs Citric Acid cycle so vital to life on Earth!

Mitochondria are one of the more fascinating aspects of our physiology. They have their own DNA and they are passed down from mother to child--none is donated by the sperm during fertilization. So, the few mitos that you start with as a tiny egg, multiply with each cell division and populate your whole body. If you start out with dud mitos, it seems you might be stuck with them, unless you can manage to get them working better. One researcher noted that she often sees mothers and their children coming in together, rarely a father and child, which makes sense. Having had energy problems my whole life, I can see some of those same issues reflected already in my oldest child, but not really at all so far in my youngest, thank God--he must have gotten some of my better mitos!

There are some theories about how to get those mitochondria to either multiply or work better. When they aren't working well, you feel like crap--your brain, your heart and your muscles are the biggest users of energy in the body--so you get brain fog, fatigue and muscle pain when they aren't working well, or you don't have enough in each cell.

I for one know that the slightest amount of energy expenditure gives me the "lactic acid burn." For most people this occurs after exercising for some time, you burn off all your stored ATP (the energy currency in the cell) and your body is trying to make more as fast as it can, but it cannot do it efficiently anymore. So instead of turning each molecule of glucose into pyruvate and going through the Krebs Citric Acid Cycle, which is 100% efficient, it turns the glucose into lactic acid to make ATP which is only about 5% efficient and you get lactic acid buildup in the cells, causing the "burn" associated with extended exercise.

For me, I get the burn just grasping a wooden spoon to break up a pound of hamburger meat when cooking. That is NOT normal. My hand cramps up, too. And of course, that is just the tip of the iceburg!

Clearly, I'm convinced this is the underlying cause of my problem now. I have been searching for this for 6 months. Had I not had all those college cources in chem and bio, i'm not sure I would have recognized this when I saw it. The solution is to take supplements that give the body all the raw materials it needs to make ATP. These include d-ribose, niacinamide, NaDH, Acetyl L Carnitine, creatine, ubiquinol, magnesium and a few others. I already take most of them, so only needed to add the creatine, and NADH and increase my dose of niacinamide. Today was my first day with the new supplements. I'm hopeful this will help my heart and everything else! Many of these supplements are recommended for people who have congestive heart failure, because science is aware, for that condition, how critical maximizing energy to the heart can be. I'm very hopeful. I can't say I really feel much difference yet, though optimistically, I will say I had a very good day energy-wise today.

Researchers in this field believe this mitochondrial problem leads to the sequelae of symptoms associated with fibro/chronic fatigue--including things like hypothalamus/pituitary/adrenal axis and thyroid issues, blood issues, poor immunity, even hypochlorhydria leading to poor digestion--which probably perpetuates the problem.

If you would like to read up on this for yourself here are a few places I researched:

http://chronicfatigue.about.com/b/2009/ ... nction.htmThis is the About.com page about this topic in the fibro/cfs category.

http://www.ijcem.com/files/IJCEM812001.pdf This is a scientific paper out of England by a Dr. Myhill talking about this hypothesis. Myhill also has a webpage.

http://www.endfatigue.com/book_notes/Ff ... ter_2.html Dr. Teitelbaum's book notes on this topic on his website.

Hope this might help anyone out there searching just like me!

Thanks for the links Jen. I was just getting interested in mito cells with my own research.

DreamStalker wrote:Thanks for the links Jen. I was just getting interested in mito cells with my own research.

DreamStalker,

Curious! What got you interested in mitochondria? If you have any questions about the science, let me know and if I DO know the answer I will try to explain it in layman's terms. I hope my description of what mitos do was understandable above! Also, you might read the Wiki about mitochondria. It is probably a good backbone with lots of good diagrams. Myhill's website has an e-book you can download that has lots of diagrams and info for free about mitochondrial dysfunction and her recommended tests and treatments. I don't think any of us are going to go to the UK to have testing done, but the information is helpful. I haven't read the whole thing, yet. It is quite long.

jen

socknitster wrote:

DreamStalker wrote:Thanks for the links Jen. I was just getting interested in mito cells with my own research.

DreamStalker,

Curious! What got you interested in mitochondria? If you have any questions about the science, let me know and if I DO know the answer I will try to explain it in layman's terms. I hope my description of what mitos do was understandable above! Also, you might read the Wiki about mitochondria. It is probably a good backbone with lots of good diagrams. Myhill's website has an e-book you can download that has lots of diagrams and info for free about mitochondrial dysfunction and her recommended tests and treatments. I don't think any of us are going to go to the UK to have testing done, but the information is helpful. I haven't read the whole thing, yet. It is quite long.

jen

I seem to have exceptionally high insulin resistance. Despite going very low carb for some time now, my insulin levels are still high.

My glucose levels are good, my D levels are good, my endo ran a bunch of tests and the only thing that came out high was fibrinogen and insulin.

Anyway, I have read the insulin resistance may be caused by mitochondial disfunction and so now I'm trying to learn more about my mitochondria. One quote I came across somewhere was that "you are only as good as your weakest mitochondria".

All of my life I seem to have had pretty good fast-twitch muscle fibers (quick reflexes and powerful energy bursts) but always lacked a bit in slow-twitch fibers (the ones used for long duration aerobics ... slow twitch-fibers have the most mitochondria). There is a natural loss of muscle mass and atrophy as we age and perhaps that may be part of my insulin resistance problem.

Again thanks ... will check out Myhill's site and get the e-book.

Very solid thought process, DS. You may be on the right track. I assume you are taking chromium, magnesium, cinnamon and other vitamins/minerals and supplements that help with sugar metabolism? I'll keep a notepad nearby to jot some down as I come across them for you. I read at least a couple of hours on health a day and often come across things related to this and I try to mentally take note since diabetes runs in my family. My recent A1C was 5.2, which I'm told is "good" but I would like to to be not soooooo near the 5.9 cutoff for insulin resistance, ya know?

Anyway, I've been reading a book called "Solve it With Supplements" coauthored by Carolyn Dean, the author of "the Magnesium Miracle" which I thought was a very, very good book. This supplement book is a very solid book that often references the German monographs which I believe to be the gold standard in supplement therapy.

I'll keep my eye out for the good ones for you,
Jen

Appears 3 of us are turning to our mitochondria as the next variable to address Thanx for the links...will read when I get some time to read, waaay too busy at the moment...

Also, DS,

Just occurred to me that I read somewhere that nattokinase is often given to reduce levels of fibrinogen. Might be worth researching as high fibrinogen isn't good for the heart.

Muse, ever thought you'd be looking at ways to improve your health at a sub-cellular level?!?! Huh? Not me. Can't believe all those college courses that I thought I would never use again are actually coming in handy for my own health.

I'm 4 days in to taking creatine (still in the "loading" phase) and NADH. I think I might have a bit more stamina. It isn't a sudden huge change so far. Maybe it works slowly. No idea. I've read rave anecdotes about it online. Time will tell. NADH is very expensive. If you decide to spring for it, make sure its manufactured by ENANDA. I bought mine from Source Naturals. ENANDA will have sold its raw material to several brand manufactureres. This is along the same line of only using Suntheanine type of L-theanine. These are the proven products that have science behind them.

Jen

socknitster wrote:Also, DS,

Just occurred to me that I read somewhere that nattokinase is often given to reduce levels of fibrinogen. Might be worth researching as high fibrinogen isn't good for the heart.

Muse, ever thought you'd be looking at ways to improve your health at a sub-cellular level?!?! Huh? Not me. Can't believe all those college courses that I thought I would never use again are actually coming in handy for my own health.

I'm 4 days in to taking creatine (still in the "loading" phase) and NADH. I think I might have a bit more stamina. It isn't a sudden huge change so far. Maybe it works slowly. No idea. I've read rave anecdotes about it online. Time will tell. NADH is very expensive. If you decide to spring for it, make sure its manufactured by ENANDA. I bought mine from Source Naturals. ENANDA will have sold its raw material to several brand manufactureres. This is along the same line of only using Suntheanine type of L-theanine. These are the proven products that have science behind them.

Jen

Thanks Jen. Yes I think those fermented beans also have some the good K2 along with the nattokinase enzyme. I just got myself a book on enzymes and trying to learn about that too.

The human body sure is a complex system to understand.

I'm officially being monitored by the Holter, right now. Keeping my fingers crossed that all is well. Heart trouble is the last thing I need!

I had an interesting experience with niacin yesterday. It is recommended as a building block of ATP in the references I gave a few days ago. When I filled up my pillboxes monday morning I had not yet received the 500 mg niacinamide I had ordered, so I decided to use the regular niacin I had on hand which was in 100 mg capsules. Took 2, 2 times monday. Noticed nothing unusual. Yesterday, about a half hour after taking my lunchtime pills, I suddenly got very itchy and noticed my skin was hot and red. I thought it was odd since it had been 24 hours since being in the sun, but dutifully got up and dug out the aloe vera juice. Then I started realizing it was happening in non-sun exposure places and I started to think I was having an allergic reaction and had a momentary panic because I was home alone with the kids and my husband was on his way home from an out-of-state trip. It seemed like whatever it was was happening very fast! Then I started combing my brain about what I could have ingested or put on my skin that could have caused an allergic reaction like this and suddenly the words, "niacin flush" popped into my head. Whew! I ran to the computer and looked it up and sure enough that is what it was. Very strange and interesting vitamin, this niacin! If you are a supplement geek like me, look it up on wiki. Apparantly it dialates the blood vessels and capillaries. The reason I didn't have a reaction the first day is because I was as yet not saturated with niacin. Once you reach saturation, then you start flushing. It typically lasts 15 to 30 mins, but it sure seemed like a lot longer at the time. Niacinamide came yesterday and I went through the whole week of pillboxes, taking out the niacin and replacing it with niacinamide! No flushing for me!

The therapeutic thing about niacin, if you start slower and work your way up to higher doses (and don't mind the flushing) is that it can lower cholesterol and help with circulation. Two things I could actually use, but for the moment, I'll hold off. The alternate forms of niacin do not provide these effects because it is the CONVERSION of niacine to niacinamide that causes these therapeutic effects to occur. For my purposes, for now anyway, I just want to built more ATP. I may revisit niacin again in the future.

Just for the curious. Like me.

Yes, DS, the human body is absolutely fascinating. I'd be interested in this stuff even if I wasn't sick. Guess I'm just a geek, but I have always been a perpetual student. I have studied so many interesting things over the years after my formal education was done. My knitting friends love to come to me for help! I adore reading about the middle ages, particularly the era of Richard Lionheart and the Plantagenets. I love gardening books, books about pets, aquaria, cooking and nutrition! My friends and family love to make fun of me. I'm like the guy on Cheers. You know, the one they always wish would shut up with the obscure facts. The chronic fatigue has made it harder for me now to recall a lot of the information I used to know--seems like a lot of stuff is just on the tip of my brain. Frustrating sometimes. Especially since I practically had photographic memory as a child. That has ebbed away with time, sadly. But I still have a great memory and still enjoy learning new stuff and always will. Its just me.

Jen

Jen, hate to break it to ya, but I think you might want the flush-causing form of niacin. Each form has different effects so you'll have to check whether it matters for what you're taking it for. Interesting quote:

DIETARY SATURATED FATTY ACIDS ACT LIKE NIACIN

Fatty acids including saturated fatty acids also bind PUMA-G and HM74 receptors. This is the receptor family that Niacin binds to and exerts its potent abilities to regress plaque (raise HDL2b 200-300%, lower TGs 40-60%) and evoke its anti-inflammatory effects. See Table 1 full list of the range of ketone body and the saturated fatty acids and their relative receptor affinities.

Taggart A, Waters MG et al. (D)-beta-Hydroxybutyrate inhibits adipocyte lipolysis via the nicotinic acid receptor PUMA-G. J Biol Chem. 2005 Jul 22;280(29):26649-52. Full 'accelerated publication' PDF here.

Other fatty acids which bind this astounding receptor PUMA-G are in listing of decreasing potency:
--Hydroxy-butyrate (ketone bodies associated with exercise training and intermittent fasting)
--Lactate (by-product of anaerobic exercise, strength training, intense exercise like CALIfornication)
--Acetate (C2), Proprionate (C3)
--Decanoate (C10) = caprylic acid, a medium chain saturated fatty acid (MC SFA)
--Heptanoic acid (C7)
-- Butyrate (C4) = short chain saturated fatty acid from butter oil and produced by gut flora from ingested fiber like oat bran, pectin, etc
--Octanoate (C8) = capric acid, MC SFA
--Pentanoic acid (C5)
--Hexanoate (C6) = caproic acid, MC SFA
--Nicotinic acid (niacin, SLO-NIACIN, NIASPAN) -- binds with high affinity to HM74 receptors

extracted from http://drbganimalpharm.blogspot.com/search/label/Niacin bottom of the page

Muse-Inc wrote:Jen, hate to break it to ya, but I think you might want the flush-causing form of niacin. Each form has different effects so you'll have to check whether it matters for what you're taking it for. Interesting quote:

DIETARY SATURATED FATTY ACIDS ACT LIKE NIACIN

Fatty acids including saturated fatty acids also bind PUMA-G and HM74 receptors. This is the receptor family that Niacin binds to and exerts its potent abilities to regress plaque (raise HDL2b 200-300%, lower TGs 40-60%) and evoke its anti-inflammatory effects. See Table 1 full list of the range of ketone body and the saturated fatty acids and their relative receptor affinities.

Taggart A, Waters MG et al. (D)-beta-Hydroxybutyrate inhibits adipocyte lipolysis via the nicotinic acid receptor PUMA-G. J Biol Chem. 2005 Jul 22;280(29):26649-52. Full 'accelerated publication' PDF here.

Other fatty acids which bind this astounding receptor PUMA-G are in listing of decreasing potency:
--Hydroxy-butyrate (ketone bodies associated with exercise training and intermittent fasting)
--Lactate (by-product of anaerobic exercise, strength training, intense exercise like CALIfornication)
--Acetate (C2), Proprionate (C3)
--Decanoate (C10) = caprylic acid, a medium chain saturated fatty acid (MC SFA)
--Heptanoic acid (C7)
-- Butyrate (C4) = short chain saturated fatty acid from butter oil and produced by gut flora from ingested fiber like oat bran, pectin, etc
--Octanoate (C8) = capric acid, MC SFA
--Pentanoic acid (C5)
--Hexanoate (C6) = caproic acid, MC SFA
--Nicotinic acid (niacin, SLO-NIACIN, NIASPAN) -- binds with high affinity to HM74 receptors

extracted from http://drbganimalpharm.blogspot.com/search/label/Niacin bottom of the page

I agree with Muse that the flushing is actually the beneficial part of taking niacin with regards to anit-inflammatory and HDL-raising effects.

I had never heard of niacin being used to increase ATP production so I'm not sure if the flushing is required for effective use of niacin as an ATP building block.

No, the flushing niacin is not necessary to help form ATP. If you read the Dr. Myhill info, she specifically recommends niacinamide. I could USE the effects of the flushing niacin, but right now that is not what I'm after. If you will pardon the pun, I'm going to wait until I'm "flush" with the niacinamide before I stop it and go back to the flushing form of niacin.

The flushing form of niacin, also known as nicotinic acid (NIcotinic ACid VItimin=NIACIN--they named it as such because they didn't want people to think nicotinic acid meant that cigarettes had vitamins in them!) is converted by the body to niacinamide. It is this conversion that causes the flushing, from what I've read. Here is a quote from Myhill's online "book" about how niacinamide affects ATP:

Part B - Oxidative phosphorylation – the recycling of ATP
from ADP
This part of the test looks at the rate at which ADP is converted back to ATP. The whole process is
done by Krebs citric acid cycle (KCA) (dig out those old “O level” biochemistry books at once!)
followed by oxidative phosphorylation. There is lots of potential for things to go wrong here! The
bits we know about (and there will be others!) which may make oxidative phosphorylation go slow
include:
Vitamin B3 is vital as the raw material to make NAD – most people replete levels on 500mgs of
niacinamide, but some people seem to need 3,000mgs daily to get a result. At levels above 500mgs,
liver function tests need checking every month for three months, then every 6 months. Low B3 may
also be a symptom of poor function of Kreb‟s citric acid cycle. This is because NAD is a functional
test and it does not just reflects B3 status. The job of KCA is to take energy from acetyl groups and
convert it into NADH, which is then of course converted to NAD in the process of driving oxidative
phosphorylation. Therefore, to see normal levels of NAD needs not only an adequate supply of B3,
but also a functioning Kreb‟s citric acid cycle

So, the niacinamide helps recycling of ATP by making more NADH and making the Krebs citric acid cycle more efficient. So, it doesn't directly make ATP, but it does help recycle it more efficiently, which is critical for energy production. Look back several posts and you will find a link to the Myhill information and you can read the whole paper yourself, if you choose. But I warn you, it can be hard to understand in places, even if you have a degree in biology. And believe me, my biology is rusty!

So, yes niacin is a good thing for a lot of people and I certainly intend to return to it, but for now, my goal is to maximize energy potential.

jen

By the way, when you see NAD, NADH and NAD+, I believe these are all the same "things" just oxidized and reduced forms of the same molecule and different nomenclature. NADH is a supplement I just started taking and the niacinamide helps you to make more of your own NADH (far, far cheaper!).

Jen