How CFS and Fibromyalgia Stress Can Make You Gain Weight
In addition to the myriad of problems that plague fibromyalgia and CFS patients, our recent study found that these individuals have an average weight gain of 32 pounds. The metabolic problems that occur in these syndromes make it almost impossible to lose and keep the weight off until proper treatment is received. Losing and keeping the weight off is easier when one understands the many things that contribute to this problem. For people with CFS/FM, simply altering your diet is not enough to lose weight. A large percentage find it is impossible to lose weight and keep it off no matter what you do. If this is the case, this article will be helpful to you.
So why is it impossible to lose weight and keep it off?
There are a number of ways that CFS/FM contributes to the inability to lose weight. Both physical stresses (e.g. infections, nutritional deficiencies) and emotional/situational stresses can create a metabolic chain reaction which results in weight gain in CFS/FM sufferers. With effective treatment of FM that includes complimentary medical approaches most people find that their weight gain stops and typical weight loss measures will finally work.
So what is going on in CFS/FM?
CFS/FM should not be viewed as the enemy but rather as the body’s attempt to protect itself from further harm and damage in the face of any of a number of toxic situations. A simple way to look at fibromyalgia and CFS is to view them as circuit breakers in a house. When certain systems are severely over-stressed, some of the circuit breakers will go off to prevent damaging the home’s wiring. In milder cases, the body’s circuit breakers can come back on and systems can return to healthy function by simply supplying the body with rest and proper nutrition. In CFS/FM it is as if the main circuit breaker or this case, the hypothalamus, a master gland in the brain, has shut down. When this occurs, rest is no longer enough to restore proper function.
Despite the many diverse stresses that can cause these syndromes, most patients’ symptoms seem to come from a common endpoint--dysfunction or suppression of the hypothalamic "circuit breaker". This gland controls sleep and its malfunction is the reason you can’t sleep. The hypothalamus impacts hormonal function, temperature regulation and the autonomic nervous system (e.g. blood pressure). The hypothalamic dysfunction by itself therefore can be the cause of most symptoms.
So how does this lead to the weight gain?
Let’s begin with poor sleep. 100 years ago, the average American got nine hours of sleep a night. The expression "getting your beauty sleep" actually has a basis in fact. Deep sleep is a major trigger for growth hormone production that stimulates production of muscle, burns fat and improves insulin sensitivity thus decreasing the tendency to make fat. Systematically symptoms associated with fibromylagia are reduced. Therefore getting the required eight to nine hours of sleep each night can powerfully contribute to staying young and trim.
How else does CFS/FM stress contribute to weight gain?
As we noted above, the hypothalamic "circuit breaker" that gets suppressed with stress also controls our hormone system. This results in inadequate levels of thyroid hormone (which acts as our body’s gas pedal) and adrenal hormone. The blood tests currently used are notoriously unreliable in picking up thyroid and adrenal deficiencies. In addition, the usual approach to treating hypothyroidism is ineffective in most patients. For example, the most common medication used to treat hypothyroidism, Synthroid may not work in a large percent of patients, as multiple studies suggest that the T4 hormone may not be converted to the active T3 hormone properly.
In addition, many patients do not get the proper amount of thyroid. It is not enough to merely treat someone by getting their blood tests to the normal range. Being in this range simply means that you are no longer in the lowest 3% of the population. In addition, the TSH test is not reliable for monitoring therapy because of the hypothalamic suppression. Only the free T4 blood test should be used to monitor therapy. The thyroid dose should be adjusted to the level that feels the best to the patient and the free T4 should be checked on that dose to determine if it is within the normal range. As long as your thyroid function is inadequate it is nearly impossible to avoid weight gain.
So how can I tell if I need thyroid hormone?
The symptoms of hypothyroidism are fatigue, weight gain, cold intolerance with low body temperature (under 98.6 degrees Fahrenheit), and achiness and poor mental function. Having even a few of these symptoms is enough to justify a therapeutic trial of thyroid hormone. Highly recommended is Armour thyroid and as noted above, it should be adjusted to the dose that feels best while keeping the Free T4 blood test in the normal range.
What other hormone problems contribute to weight gain?
The adrenal gland is the body’s stress handler and triggers what is known as the body’s "fight or flight" reaction. In times of stress, the adrenal gland releases cortisol and adrenaline. This might occur every few weeks when we saw a saber tooth tiger or an enemy. It would then have plenty of time to recover. Nowadays, however, we set off the fight or flight reaction dozens if not hundreds of times a day. In the beginning, chronic stress (and depression) results in elevated cortisol levels, which can directly cause weight gain. Continuing excessive stress may result in exhaustion of the adrenal gland over time. As it is the job of the adrenal gland to maintain blood sugar levels in the time of stress, adrenal exhaustion can result in episodes of hypoglycemia (low blood sugar). If you get periods where you feel like somebody better feed you NOW or you’re going to kill them, you are likely hypoglycemic and would benefit from adrenal support. Other symptoms of inadequate adrenal function include emotionally and physically crashing during stress, low blood pressure and dizziness when first standing. Unfortunately many people crave sugar and eat more than normal when they get hypoglycemic and can lead to further weight gain.
What else is contributing to the weight gain?
Clinical experience has shown that fungal (also known as Candida or yeast) overgrowth contributes powerfully to both sugar cravings and weight gain. Although we do not know the mechanism for this, we have repeatedly seen excess weight drop fairly easily once this overgrowth is treated and eliminated. The main causes of fungal overgrowth are excess sugar intake and antibiotic use.
The main symptoms of yeast overgrowth are chronic sinusitis and spastic colon (gas, bloating, diarrhea and/or constipation). If you have these, you probably have fungal overgrowth. The good news is that treating this will not just help you to lose weight and decrease your fibromyalgia, but can also eliminate your spastic colon and sinusitis.
Another major problem is carnitine deficiency, which is present in most CFS/FM patients. Unfortunately, this deficiency forces your body to turn calories into fat and makes it almost impossible to lose fat. Simply taking carnitine does not help adequately however, as it does not get into cells optimally. I recommend that people take Acetyl - L-Carnitine 1000 mg daily (which does get into the cells more effectively) for four months, as this can help both energy and weight loss.
To treat these problems, lose weight and ultimately get well, there are a few simple lifestyle changes to be considered.
Reduce the sugar and simple carbohydrates in your diet and increase water intake. If your mouth is dry you are thirsty and need to drink more water even though you already drink like a fish, unless you are on medications that cause the dry mouth. Sometimes thirst is confused with hunger and causes over eating.
Get optimum nutritional support. When you are deficient in vitamins or minerals your body will crave more food than you need and your metabolism will be sluggish. Powders and a variety of supplements are available making it easy to get adequate nutritional support. In addition take 500 to 1000 milligrams of acetyl l-carnitine daily.
Get proper sleep. Eight to nine hours of solid sleep per night is recommended. If you cannot sleep or have insomnia a combination of herbals such as Wild Lettuce, Jamaican Dogwood, Hops, Theanine, Valerian and Passionflower is very helpful. In addition, taking ? to one milligram of melatonin and calcium with magnesium at bedtime can aid in restful sleep.
Thyroid Regulation. If you are also tired and have cold intolerance or achiness, ask your holistic doctor for a prescription of Armour Thyroid. Adjust to the dose that feels best while keeping the Free T4 blood test in the normal range.
Yeast treatments. If you have chronic sinusitis or spastic colon, there is a good chance you have fungal/yeast overgrowth in your bowels. Avoid sugar and try stevia, which is a great sugar substitute.
Adrenal stress support starts by making an attitude change. Whenever you notice that you’re getting anxious or worried ask yourself the simple question "Am I in imminent danger?" The answer is almost always no and you’ll find that your adrenal glands relax as you realize this. If you are experiencing hypoglycemic episodes, consider taking an adrenal glandular that includes licorice.
It is no longer necessary to be on extreme, unsustainable or unhealthy diets to lose weight and keep it off. The recommendations above will not just help you stay trim, but they can leave you healthy and full of vitality as well.
Jacob Teitelbaum M.D. is a board-certified internist and director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies. Having suffered with and overcome these illnesses in 1975, he spent the next 28 years creating, researching, and teaching about effective therapies. He sees CFS/fibromyalgia/chronic pain patients from all over the world in his clinic in Annapolis, Maryland (410-266-6958). He lectures internationally. He is also the author of the best-selling book From Fatigued to Fantastic! and the just released Three Steps to Happiness! Healing through Joy. His web site can be found at: www.vitality101.com.
