Realising Counselling And Exercise Is Not Helping CFS

[Herbie]

Giving people counselling and excise for chronic fatigue... fortunately Dr Heidi Nicholl is heading in the better direction.

'Potentially harmful and old-fashioned' chronic fatigue treatments under review

Treatment recommended to Chronic Fatigue Syndrome (CFS) patients can be potentially harmful and is old-fashioned, according to a patient group who are asking a new government advisory committee to research potential cures, not counselling or exercise relief.

The predominant treatment for many of Australia's 200,000 sufferers of CFS — now called ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) — has been a combination of graded exercise therapy (GET) and psychotherapy (CBT).

Dr Andrew Lloyd from UNSW's Fatigue Clinic is a physician who recommends this treatment and he maintains it is "somewhat helpful" but concedes the treatment "doesn't help everybody". -

"In general it helps most. In my experience it's very rarely harmful, if it's sensibly applied," Dr Lloyd told 7.30.

But medical ethicist Dr Heidi Nicholl, CEO of the Emerge ME/CFS patient group, said the treatment was "potentially harmful and old-fashioned".

She said a risk of harm arises when exertion is recommended to people who have "problems with energy production".

"Once you start looking at ME/CFS as a patho-physiological illness, then things like graded exercise therapy seem like old-fashioned approaches to the condition," Dr Nicholl said.

"We found that 89 per cent of patients felt worse after doing physical activity, so if you feel worse after graded exercise therapy, it's not going to be something that you want to do," she said.

The Government's National Health and Medical Research Council (NHMRC) is currently investigating treatment and research for ME/CFS. It is expected to meet in August and hand down its findings before the end of the year.

Relax, take it easy, sleep in, do nothing, enjoy.

 

[haidut]

Giving people counselling and excise for chronic fatigue... fortunately Dr Heidi Nicholl is heading in the better direction.

'Potentially harmful and old-fashioned' chronic fatigue treatments under review

Treatment recommended to Chronic Fatigue Syndrome (CFS) patients can be potentially harmful and is old-fashioned, according to a patient group who are asking a new government advisory committee to research potential cures, not counselling or exercise relief.

The predominant treatment for many of Australia's 200,000 sufferers of CFS — now called ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) — has been a combination of graded exercise therapy (GET) and psychotherapy (CBT).

Dr Andrew Lloyd from UNSW's Fatigue Clinic is a physician who recommends this treatment and he maintains it is "somewhat helpful" but concedes the treatment "doesn't help everybody". -

"In general it helps most. In my experience it's very rarely harmful, if it's sensibly applied," Dr Lloyd told 7.30.

But medical ethicist Dr Heidi Nicholl, CEO of the Emerge ME/CFS patient group, said the treatment was "potentially harmful and old-fashioned".

She said a risk of harm arises when exertion is recommended to people who have "problems with energy production".

"Once you start looking at ME/CFS as a patho-physiological illness, then things like graded exercise therapy seem like old-fashioned approaches to the condition," Dr Nicholl said.

"We found that 89 per cent of patients felt worse after doing physical activity, so if you feel worse after graded exercise therapy, it's not going to be something that you want to do," she said.

The Government's National Health and Medical Research Council (NHMRC) is currently investigating treatment and research for ME/CFS. It is expected to meet in August and hand down its findings before the end of the year.

Relax, take it easy, sleep in, do nothing, enjoy.

I think there is a quote from Broda Barnes somewhere on the forum saying something along the lines of "Tuberculosis used to be treated by bed rest, sedatives, and strong nutrition. Definitely not by exhaustive exercise and fasting. Why would it be any different for any of the other debilitating diseases?"

To which, I suppose, Hemingway would have answered with "Common sense is not very common".

 

[zewe]

I recently read this and it was a long time coming. I went through this type of treatment being pushed on me. Being the anti-authoritarian that I am,
I pushed back!

 

[sunraiser]

Relax, take it easy, sleep in, do nothing, enjoy.

Chronic fatigue can come from so many different causes but I'd say eventually exercise is going to be needed by everyone to regain full health. There are times to lay off but there's also a point of diminishing returns for rest. If you feel remotely like exercising, even just walking, you should absolutely do it.

It might sound like stating the obvious but it can be easy to become scared of exercise with such a mindset.

 

[haidut]

Chronic fatigue can come from so many different causes but I'd say eventually exercise is going to be needed by everyone to regain full health. There are times to lay off but there's also a point of diminishing returns for rest. If you feel remotely like exercising, even just walking, you should absolutely do it.

It might sound like stating the obvious but it can be easy to become scared of exercise with such a mindset.

Maybe, but I don't think it is a given that exercise would help. Related to what @Benyamin Bulluc posted above.
Receptor protein in the brain controls the body's fat 'rheostat'
“When we eat less and exercise more to lose weight, our bodies sense when the energy balance has tipped below the established lower boundary and try to adjust by using less energy and increasing appetite, to return to homeostasis. This lower boundary is what makes it difficult to keep weight off,” said lead study author Masoud Ghamari-Langroudi of the Vanderbilt University School of Medicine.

Lowering RMR, which is what happens with chronic exercise (as per the link above) can hardly be seen as good for CFS patients whose metabolism is already quite low.

 

[Herbie]

Chronic fatigue can come from so many different causes but I'd say eventually exercise is going to be needed by everyone to regain full health. There are times to lay off but there's also a point of diminishing returns for rest. If you feel remotely like exercising, even just walking, you should absolutely do it.

It might sound like stating the obvious but it can be easy to become scared of exercise with such a mindset.

Yeah in the context of not feeling like exercising because of chronic fatigue and needing rest but doing it because an authority told the person to. This is a cultural problem where people are told they will get more energy from exerciseing which it’s just stress hormones.

 

[sunraiser]

Yeah in the context of not feeling like exercising because of chronic fatigue and needing rest but doing it because an authority told the person to. This is a cultural problem where people are told they will get more energy from exerciseing which it’s just stress hormones.

It's a human problem.

Those of immense privelage and ease need the impetus to push and work hard and they often tend to have the largest sphere of influence due to life opportunity. They can't fathom the notion that many are working hard just to exist because they haven't lived it and therefore the Conservative assumption of struggling people being lazy has a wide influence.

@haidut I believe exercise is the only thing that actually robustly solves liver problems long term. I'm not saying it should be forced when too tired, though.

 

[Herbie]

It's a human problem.

Those of immense privelage and ease need the impetus to push and work hard and they often tend to have the largest sphere of influence due to life opportunity. They can't fathom the notion that many are working hard just to exist because they haven't lived it and therefore the Conservative assumption of struggling people being lazy has a wide influence.

@haidut I believe exercise is the only thing that actually robustly solves liver problems long term. I'm not saying it should be forced when too tired, though.

You have taken this way out of context.

 

[Tarmander]

Chronic lactic acidosis is probably an aspect of CFS...creating more lactic acid is like adding fuel to the fire.

 

[energyandstruct]

Chronic fatigue can come from so many different causes but I'd say eventually exercise is going to be needed by everyone to regain full health. There are times to lay off but there's also a point of diminishing returns for rest. If you feel remotely like exercising, even just walking, you should absolutely do it.

It might sound like stating the obvious but it can be easy to become scared of exercise with such a mindset.

Chronic Fatigue Syndrome is different than just normal fatigue, exercise can't help with this condition. Or it can't be forced. I imagine peat would say that if you increase the thyroid function you can increase exercise "naturally". But even tiny amounts of exercise can make people crash worse... there's been lots of evidence against GET and CBT, like the debunking of the PACE trial.

Common sense doesn't always apply in physiology... also the idea that exercise cures everything isn't really common sense, people used to prescribe bed rest and sedatives for serious illnesses. it's more likely a Protestant meme

 

[energyandstruct]

It's a human problem.

Those of immense privelage and ease need the impetus to push and work hard and they often tend to have the largest sphere of influence due to life opportunity. They can't fathom the notion that many are working hard just to exist because they haven't lived it and therefore the Conservative assumption of struggling people being lazy has a wide influence.

@haidut I believe exercise is the only thing that actually robustly solves liver problems long term. I'm not saying it should be forced when too tired, though.

with CFS it's a metabolic problem and people have a lower threshold for going into glycolysis (peat's version of 'glycolysis') and producing lactic acid instead of pyruvate... this has to be fixed before doing activity. most doctors recommend doing less activity than you're able to (pacing)

 

[Collden]

Chronic lactic acidosis is probably an aspect of CFS...creating more lactic acid is like adding fuel to the fire.

But done right an exercise program can enhance lactic acid clearance, and improve aerobic capacity, both issues in CSF.

 

[SB4]

But done right an exercise program can enhance lactic acid clearance, and improve aerobic capacity, both issues in CSF.

In some patients maybe but there has been a study done showing that CFS patients exercise thresholds are very low. So like a brisk walk for a normal persons metabolism would be laying down still for a CFS person. So if they increase there activity even a bit, it pushes them into the danger zone of very high lactic acid build up and very high heart rate etc.

 

[Constatine]

Chronic lactic acidosis is probably an aspect of CFS...creating more lactic acid is like adding fuel to the fire.

Definitely, though light movement is important in reducing lactic acid as well. So just going on walks or lightly swimming can probably help. But if its so bad that people can't do these things then getting a massage is the next best thing as it enhances lactic acid clearance: Effect of manual lymph drainage on removal of blood lactate after submaximal exercise.

Its worth noting that chronic lactic acidosis is often caused by an overabundance of lactic acid producing bacteria in the digestive system. A lot of people have found relief with reducing EMF exposure and grounding the bed as well.

 

[sunraiser]

Chronic Fatigue Syndrome is different than just normal fatigue, exercise can't help with this condition. Or it can't be forced. I imagine peat would say that if you increase the thyroid function you can increase exercise "naturally". But even tiny amounts of exercise can make people crash worse... there's been lots of evidence against GET and CBT, like the debunking of the PACE trial.

Common sense doesn't always apply in physiology... also the idea that exercise cures everything isn't really common sense, people used to prescribe bed rest and sedatives for serious illnesses. it's more likely a Protestant meme

I respect what you're saying but I didn't say at any point that forcing exercise is the cure for chronic fatigue.

I see lots of people that fear exercise, but at SOME point in your chronic fatigue recovery your body is going to tell you to move.

If you're too headfucked by exercise fear at that point then you may not be able to progress towards complete health.

 

[Amazoniac]

Newsletter On Hormesis November 2017
And the person with chronic fatigue is already in such state without exertion, so bicarbonate of soda should be particularly helpful before physical activity.

 

[thomas00]

Dr Andrew Lloyd from UNSW's Fatigue Clinic is a physician who recommends this treatment and he maintains it is "somewhat helpful" but concedes the treatment "doesn't help everybody". -

Always comforting to hear a doctor speak in total vagaries.

I've wasted so much time and effort with pretentious individuals like this for my CFS. They are the sort who will be the last to admit what they are doing is totally useless. I hate CBT with a passion. The only thing the massive subsidies for this nonsense has achieved is keeping a bunch of useless quacks in the job. It isn't effective for any of the things it's prescribed for.

But ‘extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Mr James.

'CBT is a scam and a waste of money', says leading psychologist | Daily Mail Online

A second high-profile clinical psychologist has delivered a hard-hitting criticism of cognitive-behavioural therapy (CBT) claiming it is simplistic and “does not work”

Dr Oliver James accused government ministers of being "downright dishonest” when they claimed that new NHS CBT-trained therapists will cure half of 900,00 people of their depression and anxiety.

"“There is not a single scientific study which supports that claim,” says Dr James.

"Being cheap, quick and simplistic, CBT naturally appeals to the government. Yet the fact is, it doesn’t work,” added Dr James.

http://www.psychminded.co.uk/news/news2009/march09/oliver-james-cbt003.htm

it was unsettling to learn, from a paper in the journal Psychological Bulletin, that it seems to be getting less effective over time. After analysing 70 studies conducted between 1977 and 2014, researchers Tom Johnsen and Oddgeir Friborg concluded that CBT is roughly half as effective in treating depression as it used to be.

Why CBT is falling out of favour

 

[Tarmander]

Definitely, though light movement is important in reducing lactic acid as well. So just going on walks or lightly swimming can probably help. But if its so bad that people can't do these things then getting a massage is the next best thing as it enhances lactic acid clearance: Effect of manual lymph drainage on removal of blood lactate after submaximal exercise.

Its worth noting that chronic lactic acidosis is often caused by an overabundance of lactic acid producing bacteria in the digestive system. A lot of people have found relief with reducing EMF exposure and grounding the bed as well.

But done right an exercise program can enhance lactic acid clearance, and improve aerobic capacity, both issues in CSF.

These will both help. When I was unable to exercise, light walks were helpful as well as getting rid of EMF, spending time in nature, and a host of other things. However it still does not address the root issue of why your body cannot clear the lactic acid. High amounts of Potassium Chloride and other Chlorides is what finally made exercise start to be fruitful for me.

 

[allblues]

@Tarmander Interested in your comments about potassium chloride helping - mind sharing doses you've used, and maybe a little on the rationale?

 

[lampofred]

So sounds like CFS is basically a pre-cancerous state? Large amounts of lactic acid production even in the presence of oxygen. So maybe high-dose aspirin could help?