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The purpose of this web site is to provide research and educational material for those who believes they have Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia or a similar condition or who believe they have got sick due to environmental toxins and who wish to have a private consultation with Dr. David Bird or already have had one.
Dr. Bird consults at the NIIM Clinic in Hawthorn, Melbourne, Australia.
Dr. Bird consults at the NIIM Clinic in Hawthorn, Melbourne, Australia.
Disclaimer. This web site is for research and educational purposes only. The information given in this site is not intended to replace a therapeutic practitioner relationship.
Some Basic Ideas
In medicine we use labels. Often these labels don't give any clues regarding the cause of a problem.
For example, if you have been diagnosed with chronic fatigue syndrome (CFS) this means that you have long term (chronic) fatigue associated with other symptoms (a syndrome). It is a label given when no other recognised label or condition seems to fit.
If you have been diagnosed with fibromyalgia this means that you have abnormal pain (algia) of fibrous tissues (fibro) and muscles (myo). Again, it is a label given when no other recognised label or condition seems to fit.
Some people are told that they have both CFS and fibromyalgia. Symptoms do overlap. Most CFS sufferers have aching muscles and most fibromyalgia sufferers have chronic fatigue.
Let's talk about a couple of other labels. If you are told that you have motor neuron disease (MND) this means that you have a problem (disease) of the nerves (neurons) that power muscles (motor). But this label gives you no clue regarding the cause of the problem. If you have a diagnosis of multiple sclerosis (MS) this means that you have lots of (multiple) areas of scar tissue (sclerosis) in the tissue of the brain or spinal cord.
If you have a problem with your health, the most important thing to know is the cause or causes of this problem. The next most important thing to know is what you can do to alleviate or fix the cause(s).
What about the cause of CFS or FMS? I will reserve detailed comments for the individual web pages on these conditions. Here, I will state that that they are both conditions of exclusion. This means that other possible causes have been ruled out. One of the issues that I come across quite often is that some possible causes have not been considered because they are not that common or they have just not been checked out quite enough. These causes include:
Sick Buildings
Long term Infections
Poisoning
Epigenetics
Mental/social/spiritual stress
Nutritional and gut problems
Hormonal problems
Sleep disturbances
Another major cause in relation to fibromyalgia may be insulin resistance and this should probably be looked into before using the approach below for fibro sufferers. This is based on some recent (Published 6 May, 2019) research, as follows:
"Original Research: Open access
“Is insulin resistance the cause of fibromyalgia? A preliminary report”. Miguel A. Pappolla, Laxmaiah Manchikanti, Clark R. Andersen, Nigel H. Greig, Fawad Ahmed, Xiang Fang, Michael A. Seffinger, Andrea M. Trescot.
PLOS ONE doi:10.1371/journal.pone.0216079
Abstract
Is insulin resistance the cause of fibromyalgia? A preliminary report
Fibromyalgia (FM) is one of the most frequent generalized pain disorders with poorly understood neurobiological mechanisms. This condition accounts for an enormous proportion of healthcare costs. Despite extensive research, the etiology of FM is unknown and thus, there is no disease-modifying therapy available for this condition. We show that most (if not all) patients with FM belong to a distinct population that can be segregated from a control group by their glycated hemoglobin A1c (HbA1c) levels, a surrogate marker of insulin resistance (IR). This was demonstrated by analyzing the data after introducing an age stratification correction into a linear regression model. This strategy showed highly significant differences between FM patients and control subjects (p < 0.0001 and p = 0.0002, for two separate control populations, respectively). A subgroup of patients meeting criteria for pre-diabetes or diabetes (patients with HbA1c values of 5.7% or greater) who had undergone treatment with metformin showed dramatic improvements of their widespread myofascial pain, as shown by their scores using a pre and post-treatment numerical pain rating scale (NPRS) for evaluation. Although preliminary, these findings suggest a pathogenetic relationship between FM and IR, which may lead to a radical paradigm shift in the management of this disorder."
A Systematic Approach
Intro: To check out if the above list of possible causes may apply, I suggest this step by step approach. This approach can be used by people who have been diagnosed with CFS or FMS or who think they have some stealth bug like Lymes Disease. We are assuming that major lifestyle problems like smoking, junk food diets, drinking inadequate water or lack of exercise have already been addressed. Read through all steps before starting. These steps are not set in concrete. They are designed to be followed through with your practitioner who will consider your individual case carefully. Severe issues in any area will always need to be dealt with earlier in the treatment plan.
Step one: Assess whether or not you are living or working in a sick building. Sick buildings are usually a problem because of mould from water damage, unhealthy electromagnetic frequency levels, toxic pollutants, poor hygiene, inadequate ventilation or adverse lighting. In most cases the most practical and cost effective way to assess the situation is to have a holiday away for about two weeks where you live in a place where you are confident you are not in a sick building. Take the minimum of stuff with you (in case, for example, your things are contaminated with mould). For more information see our Sick Building page.
Step two: Assess your stress. Is there anything that you can do to reduce stress in your life? One way to reduce stress is to re-frame our beliefs about traumatic events in our lives. It is not traumatic events themselves that cause stress disorders but our beliefs about those events. Can you re-frame the way that you look at the traumatic events in your life in order to reduce their negative impact or even change them to a positive influence? For more on the role of stress please see the page on Stress If you would like to listen to a half hour MP3 talk on burnout and managing energy, click here.
Step three: Check out some epigenetic stuff. The most useful testing I have come across is the MTHFR genes C677T and A1298T. My experience is that if you have mutations in these genes, particularly C677T then you may not be activating vitamin B12, folic acid and possibly other vitamin B's at the optimum speed, resulting in lowered energy. For more information, please see Epigenetics.
Step four: Assess your sinuses and whether or not you have what I refer to as Staph Toxin Illness. I believe this area involves the most common missed causes of "CFS" or "Fibromyalgia". There are three issues that I am aware of: (1) Mould or yeast colonisation (uncommon) (2) MARCoNS associated with Chronic Inflammatory Response Syndrome (3) Staphylococci associated with Staph Toxin Illness. In Australia you can test for Staph and maybe yeast colonisation by calling a lab called Nutripath and getting a kit sent out - Nutripath send the test to a US company called MicrobiologyDx. You can also get a practitioner to request a kit direct from MicrobiologyDx and then send your specimen straight to this lab. For more information please refer to our Sinus page. As I understand it, the normal Medicare nose swabs are only cultured for about 3 days and don't readily pick up some of the slow-growing Staphylococci which are an issue for the above problems. MicrobiologyDx does a 14 day culture for Staph and 28 day culture for mould/yeast.
Step five: Do you have a "messed up" gut? If so, make sure you have had a decent - I mean really good - stool analysis for parasites and pathogenic bacteria. This should include PCR analysis. When you have the all-clear on this, get a Faecal Microbial Analysis done by Bioscreen in Melbourne. If this is really mucked up, you may need to see an integrative gastroenterologist for consideration of a faecal microbial transplant. Moderate problems need intensive probiotic therapy with top quality (expensive) probiotics that really work. But, if your digestive supplements don't provide relief, stop taking them! I see many patients who are on way too many pills and potions that just don't do anything helpful. Please also see our Gut page.
Step six: Stealth bugs. I think that these bugs are like seeds. They are what we call in medicine, "opportunistic infections". That means they only grown and multiply and cause trouble when your system is compromised in some way - thus providing these bugs with 'good soil conditions'. In dealing with the first five steps on this page you will have got rid of or reduced many things that might compromise your system. So you may already have fixed the stealth bugs. I generally recommend dealing with known bugs in order of size, big to little. Larger parasites, including worms, are surprisingly common and can be challenging to test for. In patients that I have dealt with it appears that if you eat poorly cooked meats or traveled to places where hygiene is compromised then you are at increased risk. Due to space constraints, I refer you to our Bugs page for more information.
Step seven: Get checked out for metal toxicity and maybe other pollutants as well. This can be tricky. Blood testing is only usually applicable in cases of large acute exposure. It is not often helpful in cases of gradual low grade, long term exposure. Hair testing needs an experienced person to interpret it and is still somewhat controversial. An alternative is a Comprehensive Urinary Elements Profile (CUEP). Check with a functional pathology service to see if you can get a CUEP kit posted out. You may need a practitioner referral. To get more sensitive results you can modify the test by taking some chelating agents before you pass your urine sample. This should be done under medical supervision. For the testing of other environmental toxins there is a test called GPL-Tox from the Great Plains Laboratory in the USA. A company in Australia called Research Nutrition processes requests for this test. You need a practitioner involved. For more information on the matter toxins, see our Toxins page.
Step eight: Address hormonal imbalances. Of course, severe hormonal problems like very low or high thyroid or Addisons will have had to be dealt with already, often in conjunction with a hormone specialist (endocrinologist). I am referring in this step to the subtler imbalances associated with fatigue syndromes and muscle pain. Previous steps will have assisted already. For details, see the Hormones page.
Step nine: Sleep. Again, severe troubles will have needed emergency help earlier. If not dealt with earlier, now is the time to seek to optimise your sleep experience. See our Sleep page.
Step ten: Dental. Often expensive. Sometimes really needed. For details, please see the Dental page.
Step one: Assess whether or not you are living or working in a sick building. Sick buildings are usually a problem because of mould from water damage, unhealthy electromagnetic frequency levels, toxic pollutants, poor hygiene, inadequate ventilation or adverse lighting. In most cases the most practical and cost effective way to assess the situation is to have a holiday away for about two weeks where you live in a place where you are confident you are not in a sick building. Take the minimum of stuff with you (in case, for example, your things are contaminated with mould). For more information see our Sick Building page.
Step two: Assess your stress. Is there anything that you can do to reduce stress in your life? One way to reduce stress is to re-frame our beliefs about traumatic events in our lives. It is not traumatic events themselves that cause stress disorders but our beliefs about those events. Can you re-frame the way that you look at the traumatic events in your life in order to reduce their negative impact or even change them to a positive influence? For more on the role of stress please see the page on Stress If you would like to listen to a half hour MP3 talk on burnout and managing energy, click here.
Step three: Check out some epigenetic stuff. The most useful testing I have come across is the MTHFR genes C677T and A1298T. My experience is that if you have mutations in these genes, particularly C677T then you may not be activating vitamin B12, folic acid and possibly other vitamin B's at the optimum speed, resulting in lowered energy. For more information, please see Epigenetics.
Step four: Assess your sinuses and whether or not you have what I refer to as Staph Toxin Illness. I believe this area involves the most common missed causes of "CFS" or "Fibromyalgia". There are three issues that I am aware of: (1) Mould or yeast colonisation (uncommon) (2) MARCoNS associated with Chronic Inflammatory Response Syndrome (3) Staphylococci associated with Staph Toxin Illness. In Australia you can test for Staph and maybe yeast colonisation by calling a lab called Nutripath and getting a kit sent out - Nutripath send the test to a US company called MicrobiologyDx. You can also get a practitioner to request a kit direct from MicrobiologyDx and then send your specimen straight to this lab. For more information please refer to our Sinus page. As I understand it, the normal Medicare nose swabs are only cultured for about 3 days and don't readily pick up some of the slow-growing Staphylococci which are an issue for the above problems. MicrobiologyDx does a 14 day culture for Staph and 28 day culture for mould/yeast.
Step five: Do you have a "messed up" gut? If so, make sure you have had a decent - I mean really good - stool analysis for parasites and pathogenic bacteria. This should include PCR analysis. When you have the all-clear on this, get a Faecal Microbial Analysis done by Bioscreen in Melbourne. If this is really mucked up, you may need to see an integrative gastroenterologist for consideration of a faecal microbial transplant. Moderate problems need intensive probiotic therapy with top quality (expensive) probiotics that really work. But, if your digestive supplements don't provide relief, stop taking them! I see many patients who are on way too many pills and potions that just don't do anything helpful. Please also see our Gut page.
Step six: Stealth bugs. I think that these bugs are like seeds. They are what we call in medicine, "opportunistic infections". That means they only grown and multiply and cause trouble when your system is compromised in some way - thus providing these bugs with 'good soil conditions'. In dealing with the first five steps on this page you will have got rid of or reduced many things that might compromise your system. So you may already have fixed the stealth bugs. I generally recommend dealing with known bugs in order of size, big to little. Larger parasites, including worms, are surprisingly common and can be challenging to test for. In patients that I have dealt with it appears that if you eat poorly cooked meats or traveled to places where hygiene is compromised then you are at increased risk. Due to space constraints, I refer you to our Bugs page for more information.
Step seven: Get checked out for metal toxicity and maybe other pollutants as well. This can be tricky. Blood testing is only usually applicable in cases of large acute exposure. It is not often helpful in cases of gradual low grade, long term exposure. Hair testing needs an experienced person to interpret it and is still somewhat controversial. An alternative is a Comprehensive Urinary Elements Profile (CUEP). Check with a functional pathology service to see if you can get a CUEP kit posted out. You may need a practitioner referral. To get more sensitive results you can modify the test by taking some chelating agents before you pass your urine sample. This should be done under medical supervision. For the testing of other environmental toxins there is a test called GPL-Tox from the Great Plains Laboratory in the USA. A company in Australia called Research Nutrition processes requests for this test. You need a practitioner involved. For more information on the matter toxins, see our Toxins page.
Step eight: Address hormonal imbalances. Of course, severe hormonal problems like very low or high thyroid or Addisons will have had to be dealt with already, often in conjunction with a hormone specialist (endocrinologist). I am referring in this step to the subtler imbalances associated with fatigue syndromes and muscle pain. Previous steps will have assisted already. For details, see the Hormones page.
Step nine: Sleep. Again, severe troubles will have needed emergency help earlier. If not dealt with earlier, now is the time to seek to optimise your sleep experience. See our Sleep page.
Step ten: Dental. Often expensive. Sometimes really needed. For details, please see the Dental page.
Images and content © D. Bird 2019