Managing Brain and Nerve Health, Oxidative Stress, and Mitochondria in CFS, FM, and Lyme Disease

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Managing Brain and Nerve Health, Oxidative Stress, and Mitochondria in CFS, FM, and Lyme Disease
The month of May has many things that are recognized. Some of them are very familiar like Mother’s Day, graduations, last day of school, and other exciting things. It also brings other dates of recognition. One of them, May 12th is International ME/CFS, Lyme, and FM Awareness Day. (ME = Myalgic Encephalomyelitis, CFS = Chronic Fatigue Syndrome, FM = Fibromyalgia.) Those who suffer from these illnesses are often unable to participate in activities and “normal” life events due to fatigue, pain, and other debilitating symptoms. These disorders are often extremely complex, perplexing, and challenging for patient and practitioner alike. New research on the autonomic nervous system and mitochondria may help management of these complex disorders.

People with ME/CFS, Lyme, and FM disorders struggle with autonomic nervous system stress, such as pain, managing stimulation with noise, light, touch, blood pressure, temperature regulation, and more. Sleep difficulties, reversal of day-night body rhythms, digestive distress, leaky gut syndrome, and dysbiosis, poor tolerance to chemicals, methylation defects, brain fog, cognitive difficulties, unrelenting exhaustion and pain, headaches, central sensitization, food intolerances, and the list goes on.

[Jump to: Nutritional Options]

Brain Inflammation Induces Severe Fatigue


Two years ago, it was identified that brain inflammation is present in those with ME/CFS. Heightened and chronic activity of the brain’s microglial cells was detected leading to inflammation within the brain. The spinal cord also has microglial cells. Activation of microglial cells within the spinal cord lead to abnormally heightened sense of pain and central sensitization. The brain becomes wound-up and can’t stop the pain signals. It’s like a perpetual sunburn or a chronic migraine within the nerves of the spinal cord and brain.

Scientists have evidence that demonstrates inflammation, oxidative stress, and poor blood flow within the brain, immune system activation, and loss of gray matter (brain shrinkage) correlates with Chronic Fatigue Syndrome. This creates the severe fatigue and cognitive distress. The same constellation of features is also seen in multiple sclerosis, Parkinson’s disease, and lupus/SLE or other neuroinflammatory, neurodegenerative and autoimmune diseases that present with disabling fatigue.

The authors tested patients using FLAIR MRI technology and evaluated the presence of peripheral immune activation. The article concluded “peripheral inflammation and immune activation, together with subsequent activation of glial cells and mitochondrial damage, likely account for the severe levels of intractable fatigue and disability seen in many patients with neuroimmune and autoimmune diseases”.

Investigations have revealed the presence of several different germs that are capable of establishing lifelong infections with incredible immune evasive strategies. Infections may include Epstein-Barr virus, Borrelia burdorferi, HHV6, Parvoviruses, Cytomegalovirus, Mycoplasma, and even chronic mold toxicity. These chronic infections and toxins ramp up the microglial cells, immune cytokines, exhaust the mitochondria and damage tissues and often remain undetected by standard medical work-ups. The severe, intractable fatigue, physical and cognitive disability persists.

Research published last month shows the reality of these brain changes induced by the disease process. In a longitudinal study, scientists measured the progressive changes in patients with CFS by MRI. They measured different structures in the brain, i.e. gray matter, white matter, and signal intensities. They repeated the study again six years apart. They found that the white matter in the brain deteriorated or atrophied at an abnormal rate. The deterioration correlated with symptom severity.

Small Fiber Neuropathy and Pain in Fibromyalgia


Small fiber neuropathy has been a hot topic of research for fibromyalgia. Several studies have found and agree that small nerve fibers within the body are inflamed, causing neuropathy in fibromyalgia. Not only is the brain and spinal cord struggling with the microglial cells (the workhorses of the brain’s immune system) that are overworked and inflamed, the small nerve fibers are too. Small nerve fibers are throughout the body. They are involved with sensory functions like temperature and pain sensations. They are the small highway system of nerves that provide nerve signals to the autonomic and internal organ functions. It is also a mesh of nerves embedded within the lining of the digestive tract.

Symptoms of small fiber neuropathy are quite varied. It may feel like sharp shooting pains throughout the body. It may be that a bed sheet touching the skin is terribly painful. There may be symptoms of dry eyes, dry mouth, low blood pressure and light headedness upon standing, near-fainting or fainting, unusual sweating, erectile dysfunction, nausea, vomiting, diarrhea, constipation, early satiety/poor appetite, and difficulty with urinary frequency, night-time urination, and/or trouble with emptying the bladder. The skin may be shiny or dry and cracked. Note that these nerve symptoms may be found in other disorders that also have small fiber neuropathy, e.g. diabetes, hypothyroidism, and Sjogren’s disease.

Recent findings in FM patients showed an inter-relationship between mitochondria, inflammation, and small fiber neuropathy. Skin biopsies from fibromyalgia patients demonstrated significant mitochondrial dysfunction, with reduced activity and energy production, high levels of inflammation and oxidative stress, and small nerve fiber damage within the skin.

Lyme patients may struggle with the small fiber neuropathy as it was seen after Lyme disease vaccination injury. Chronic Fatigue Syndrome patients with POTS or POTS patients (postural orthostatic tachycardia syndrome) may also struggle with the small fiber neuropathy as it affects nerve input for the heart. Research on small fiber neuropathy with ME/CFS and Lyme has yet to fully develop. Neuropathic pain is present in the patients, but the research on small fiber neuropathy was not found. Theoretically and clinically, it would seem that it applies. Research in the next paragraph describes some of what is known with Lyme, microglial cell activation, and neuropathy.

Immune and Microglial Cell Activity Gone Awry in Lyme


Animal studies show that Lyme disease or Lyme neuroborreliosis causes microglial cells activation and high levels of immune activity. Immune compounds like cytokines and chemokines coordinate the immune repair response in the body. This is a fine balance. There needs to be enough activity to clear the pathological trigger, but too much activity overloads the microglial cells and immune compounds that clean up the brain. This dysregulation is a central component of nervous system inflammation, degeneration and nerve cell death, and loss of myelin with the brain and peripheral nervous systems. This process is known to occur in Lyme disease and neuropathy pain disorders.

Quenching the Damage


For those who look normal on the outside, but are suffering with any of these disorders, the fatigue, pain, and disability are real. Research confirms the serious dysfunction that patients experience. It also provides a direction on how to nutritionally support and optimize the body as much as one can. The focus is to help dampen microglial cell over-activation, neurological inflammation, and support healthy mitochondria function.

Research published last month offers hope for improving autonomic nervous system function and cognitive difficulties with the use of coenzyme Q10 ubiquinol. In this randomized, double-blinded, placebo-controlled study, patients with Chronic Fatigue Syndrome were divided into two groups. One group received 150 mg of coenzyme Q10 ubiquinol per day for 12 weeks. The other group received a placebo. The patients who received the coenzyme Q10 ubiquinol experienced improved autonomic nervous system function and cognitive function. Autonomic function relates to blood pressure, temperature regulation, pain management, digestion, heart rate, and more. Cognitive function improved thus there was less brain fatigue, brain fog, and better information processing.

The lack of energy, mental or physical fatigue or exhaustion, poor endurance, and prolonged recovery after physical activity are hallmark symptoms of CFS, FM, and Lyme. A review article published in 2014 identified six major areas of disruption within mitochondria activity that cause fatigue. Dysfunction occurred in the mitochondrial structure, function (enzymes and oxidative stress), immune and post-viral infection, protein transport, energy production, and central nervous system brain dysfunction. After reviewing numerous articles, the authors found two nutrients, carnitine and coenzyme Q10 deficits, were involved with this broken chain in energy production. Low levels of these nutrients were persistently involved with poor energy production within one or more of the areas of dysfunction.

The focus on mitochondria, nerve support (brain, microglial cell inflammation, small fiber neuropathy), and cooling off oxidative stress are necessary principles to focus on for regaining healthy and vitality. Last week’s article focused on peripheral neuropathy support primarily for diabetes and chemotherapy induced nerve injury. These same nutrients can be used protecting and supporting small fiber neuropathy found in FM, etc. The most critical nutrients for this are acetyl-l-carnitine, r-alpha lipoic acid, coenzyme B vitamins, curcumin, and calcium AEP.

Nerve tissue also requires adequate choline, vitamin D and fish oil to help protect the myelin sheath. The CFS study mentioned earlier that showed loss of white matter in the brain reflects loss of myelin. It is imperative to make sure choline stores are supported. Individuals with methylation defects may possibly be more at risk because of how healthy methylation is required for healthy myelin and nerve tissues. It has been found that some patients with CFS have autoimmune inflammation attacking choline receptor sites in the brain.

It is essential though to combine nutritional support to reduce central sensitization and mitochondrial injury. Several nutrients help naturally reduce inflammation and over-sensitization within the microglial cells. Several of these same compounds also provide powerful anti-inflammatory protection to the mitochondria and provide germ killing support without toxic side effects. Some of the most noted nutrients include boswellia, curcumin, grape seed extract, resveratrol, and ginger. As noted above, coenzyme Q10 and carnitine are integral to managing the fatigue.

There are other processes that have not been discussed with support for ME/CFS, FM, and Lyme. Sleep, gastrointestinal health, liver and detoxification, lymph stagnation, immune system, adrenals, thyroid and hormonal balance are often universally involved with these chronic illnesses. Focus on sleep, digestive health, and germ overgrowth problems first, if you have to prioritize.

Ask anyone who has Chronic Fatigue Syndrome, fibromyalgia, or Lyme and you will find these disorders are extraordinary challenges. Individuals with these invisible illnesses struggle with finding appropriate health care, support, and solutions. They are often dismissed as hypochondriacs, attention seeking, or lazy. This information can help change the awareness and understanding of the disorders. It can also help change the supportive care needed to take the journey of a thousand steps to healing.

Nutritional Options


Coenzyme Q10 Ubiquinol – Q10 is at the backbone of energy production for mitochondria. Numerous studies over the decades demonstrate the effectiveness of Q10 for energy production, brain and heart health, mitochondria, and fatigue disorders. 200-300 mg of Q10 ubiquinol per day is a must.

Acetyl-L-Carnitine – When it comes to brain and mitochondria support, acetyl-l-carnitine is essential. ALC helps the mitochondria burn fat for fuel and making energy production.

Grape Seed Extract – Grape seed extract is a versatile nutrient. Not only does it provide connective tissue support for aches and pains, but it is a powerful antioxidant for the nervous system. It has been shown to help protect microglial cells in the brain.

Boswellia – Also known as frankincense, boswellia offers help for more than just helping with pain. Research shows that it can block infectious germ gangs and rejuvenate your brain. It has demonstrated ability to disrupt biofilms from troubling and hidden staph and Candida albicans overgrowth.

Ginger – This sweet and spicy herb not only helps with digestion and pain, it helps the brain too. Research demonstrates that ginger helps defend against insults and inflammation to the brain by quenching dangerous free radicals.

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