Metabolic Features of Chronic Fatigue SyndromeOct 01, 2016
October 2016 Newsletter
In my last newsletter, I talked about a 2014 paper by Robert Naviaux’s discovery of something he has labelled the Cell Danger Response. I discussed how it could change how we think about many chronic conditions including ME/CFS, FM and ES and I bravely called it “The Theory of Everything”.
Naviaux Study on Metabolomics of ME/CFS.
Naviaux and his group at UCSD have teamed up with a group of experienced clinicians at Gordon Medical Associates in Northern California and have used the metabolomics methodology to study a group of individuals with “Chronic Fatigue Syndrome”. All individuals studied in the CFS group met the Canadian Consensus Criteria, the Fukuda Criteria AND The proposed SEID criteria.
ME/CFS Study Important Findings:
- Men and women with CFS differ from each other. This means that previous conclusions in which men and women were lumped together may not be accurate.
- Most of the cell chemicals (metabolites) that differed between the CFS and healthy groups were lower in the CFS group. This suggests a hypometabolic state – think hibernation in animals during which all of the cell processes slow down to conserve energy. The findings in CFS are most similar to a state called “dauer”, a state that allows animals to survive harsh environmental conditions. Being able to conserve energy in this way is highly adaptive when conditions are harsh but becomes counterproductive when we live in conditions of plenty (plenty of food, shelter etc.).
- The low level of many cell chemicals in CFS is opposite to that found in the Cell Danger Response and Metabolic Syndrome. Metabolic Syndrome is a condition consisting of high weight, high cholesterol, high blood sugar and insulin resistance.
- Although the abnormal metabolite levels found in this study accurately predicted who was ill and who was healthy and correlated with symptom ratings in the CFS group, this test is not ready for clinical use. The findings need to be confirmed in other samples. A further study with some of Paul Cheney’s patients is already underway. The analysis of each patient takes 8 hours of expert time – not a test easily reproduced in the average clinical laboratory.
- The metabolites which were present in lower/abnormal amounts in CFS include sphingolipids, phospholipids, purines, cholesterol, microbiome (made by bugs in the gut), pyrroline-5-carboxylate, Vit B2, branch chain amino acids, peroxisomal and mitochondrial function. Note that three of the deficiencies are in fats (lipids).
- Of these, the low amount of sphingolipids were the most abnormal compared to the healthy controls. Apparently, sphingolipids are tools used by cells to manage invaders. Shutting this down will prevent the invaders (viruses or bacteria) from usurping the use of the molecules for their own purposes so shutting down sphingolipids is protective in the short term.
- Naviaux has a hypothesis about what might be able to alter or even reverse this hypometabolic state. The purine molecule adenosine is needed to build APT (adenosine triphosphate) the body’s form of energy. However, adenosine itself is a powerful modulator of cell metabolism and animal behavior in its own right. For example, adenosine is the molecule responsible for sleep drive.
- The team feels that modulation of adenosine and guanosine (another purine molecule) may help flip the switch back to normal function. In a mouse autism model, they have shown that a single injection of Suramin (a 100-year-old anti-parasitic drug) acutely reverses these abnormalities, even in adults.
Author: Eleanor (Ellie) Stein MD FRCP(C)
I am a psychiatrist with a small private practice in Calgary and am an assistant clinical professor in the faculty of medicine at the University of Calgary. Since 2000, I have worked with over 1000 patients, all with ME/CFS, FM and ES. My passion for this field comes from my own struggle with these diseases, my desire to improve my health and then pass on what I learn. My goal is for every patient in Canada to have access to respectful, effective health care within the publicly funded system. If you are looking for help and resources to help combat ME/CFS, FM and ES, see my guides and webinars.