ME (myalgic encephalomyelitis), also known as chronic fatigue syndrome (CFS), is more a 'body state' than a disease. Sometimes it seems as if there are many different triggers. Alternatively, the one trigger might be toxic overload, and the trigger people with ME CFS remember is simply the latest toxin or stress to which they were exposed, the 'one that broke the camel's back'.

Various pieces of research have shown beyond doubt that, whatever is going on in the ME CFS body state, it has physical repercussions (e.g. reduced blood flow in parts of the brain, changes in brain chemistry, muscle weakness) which can, in turn, have their own psychological repercussions. But what is going on? And can anything be done to correct it? A strong possibility is 'mitochondrial dysfunction'.

John Maclaren Howard
Ever since he discovered that the muscles of people with ME CFS take longer to recover after exercise than those of healthy people, Biolab’s John Maclaren Howard has believed that some failure of the mitochondria must be central to ME. Over those years, John has developed ways of testing each stage of ADP production. The three principal stages are:

• Producing ATP. A normal healthy cell refreshes its store of ATP around every ten seconds. Slower refreshment, as often found in people with M.E., can result in inadequate supplies of ADP leading to low cell energy
• Converting ATP into ADP. Poor function in a process known as the ‘Krebs Cycle’ can result, again, in inadequate supplies of ADP
• Passing from the mitochondria to the rest of the cell. If the ADP has difficulty crossing the mitochondria’s membrane, the cell may be starved of the fuel it needs to function

John recommends supplementation with any or all of the four substances key to the above process (oxygen, co-enzyme Q10, L-carnitine and magnesium (Ed.- which Dr Sarah Myhill (see below) calls ‘The Awesome Foursome’) may bring dramatic improvement. If it does not, it suggests that the underlying cause(s) are too strong, and that these must be addressed first. And, of course, any improvement may be temporary unless underlying causes are addressed. Environmental toxins in the body - heavy metals, pesticides, air pollution, etc. - are the obvious place to start. John has developed a wide range of tests for these possibilities.

If John is right (that a major cause of ME CFS is mytochondrial dysfunction), taking Stephen Sinatra’s findings into account (see below), one of the officially agreed diagnostic criteria of ME CFS should be heart failure caused by poor muscle function (cardiomyopathy), but currently it is not. Could such a fundamental symptom have escaped the attention of so many researchers into the causes of ME CFS for so long?

Dr Arnold Peckerman
The answer is Yes, because none of the conventional tests of heart health - ECG, ECHO, angiograms, etc. - test for this particular abnormality, which would manifest as low blood pressure, low blood volume and perfusion defects (areas of reduced bloodflow around the body). A new test to measure how many litres of blood a heart pumps out in a minute, developed by US Dr Arnold Peckerman specifically in response to the need to diagnose M.E. more precisely, will change all that.

Arnold’s ‘Q test’ takes two measurements: one when the patient is standing, one when the patient is lying down. In a healthy person, typical pumping volumes are five litres (standing) and seven litres (lying down). Five litres a minute is sufficient to provide every organ with all the blood they need. In someone with ME CFS typical pumping volumes are three and a half litres (standing) and five litres (lying down). Three and a half litres a minute is barely enough for proper body function (borderline organ failure), which would explain why people with ME CFS often feel better lying down. Furthermore, Arnold showed that the people with the most severe ME CFS had the lowest blood pumping volumes.

Stephen T. Sinatra
US cardiologist Stephen T. Sinatra has demonstrated that at least half of all cardiac problems are due to poor mitochondrial function rather than because of an inadequate supply of blood to the heart due to clogged arteries. The mitochondria are the little ‘batteries’ in every cell in the body which produce a substance called adenosine triphosphate (ATP), then convert it into adenosine diphosphate (ADP) that the fuel cells need to function. Without adequate ADP, muscle cells, for instance, take longer to recover after exertion (the heart is a muscle). In extreme cases cells may not function at all.

Stephen’s therapeutic package, which combines the cell sugar D-ribose (the raw material from which ATP is made), co-enzyme Q10, L-carnitine and magnesium, is explained in his book, The Sinatra Solution - Metabolic Cardiology.

Ed.- In CFS is Heart Failure Secondary to Mitochondrial Malfunction, Dr Sarah Myhill explains Arnold’s ‘Q test” in more detail, as well as how low blood pumping volume would cause most of the symptoms experienced by people with ME CFS She also suggests adding vitamin B3 to John’s “Awesome Foursome” when considering the therapeutic approach.

Her article may be downloaded from website www.drmyhill.co.uk/article.cfm?id=373 or obtained from the Green Health Watch Office (please send A4 addressed envelope enclosing a £1stamp).