a combination of immunization side effects, the toxic atmospheric pollution, poor hygiene, various toxic sprays, and stress. Although these victims of the war are relatively few (30,000 plus), what happened in the Gulf may encourage a greater willingness by the medical establishments to consider environmental and chemical factors when diagnosing chronic fatigue.
The Problems of Diagnosis
Many people suffering from chronic fatigue do not fit into a neat medical pigeon hole. This situation has unfortunately lead some medical doctors to define chronic fatigue as psychosomatic (mind-body). This diagnosis is often followed with a prescription for drugs to treat anxiety and/or depression.
There may be no evidence of disease or damage with fatigue, but there is often evidence of malfunction. Functional medicine recognizes that the simple under-efficiency of a gland, organ or system, can give rise to symptoms. Nowhere is this more clearly shown than in mild or low grade hypothyroidism. This concept of imbalance or mild hypofunction rarely applies to a single function. The domino effect often applies to ill health.
The concept of several poorly functioning but non-diseased glands has been termed multiple enzyme deficiency syndrome (MED), polyendocrine syndrome (PS) or polyendocrinopathy.
An underactive thyroid can lead to adrenal exhaustion, muscle pain, fatigue, obesity, depression and a host of other symptoms. With many health problems there exist recognizable degrees of severity. This can be seen very clearly in diabetic patients. The diagnosis of diabetes can range from a mild glucose intolerance in old age needing care with carbohydrate foods, to a severe diabetic requiring three or four insulin injections daily to stay alive. This concept of ‘shades of grey’ can be applied to almost any illness. Unfortunately a certain standardization of definitions is required in order to determine drug dosages and treatment protocol, so many conditions are diagnosed in terms of ‘black or white’. Hypothyroidism is seen as either severe enough to warrant a lifelong prescription for thyroxine or normal and no treatment is offered.
Functional assessment requires a more sensitive awareness of test results based on a full knowledge of the patients symptoms. Unfortunately many British GPs are simply given a patient’s test results, stating ‘normal’. Yet it is the GP who is in contact with the patient, not the laboratory staff. The diagnosis of mild or early-stage imbalances can easily be missed with this method. The need for more sensitive tests to assess disorders of function, and mild deficiencies or excesses, has lead in the last 10 years to the development of a range of specific laboratory tests. These have included tests to measure or identify leaky gut, malabsorption, candidiasis, gut transit speed, stomach emptying speed, pancreatic enzyme status, 24-hour adrenal function tests and many more.
Therefore the key to understanding the reasons for your fatigue consists of careful test selection and subsequent test interpretation. When this is carried out efficiently and assessed alongside the symptoms you may feel, some understanding of your problem can be achieved and an accurate diagnosis arrived at. Although changes to diet and supplement use are usually harmless, the good response to any treatment depends on specificity (see page 148). The correct supplements and dosages and the appropriate food and drink are always preferable to guesswork. Once you have drawn together a symptom picture as shown in Part Two, and armed with the results of your practitioner’s tests, you can begin to recover from your tiredness and enjoy renewed vitality and well-being.
CHAPTER THREE ‘Why Can’t I Lose Weight?’
The Thyroid Gland and Your Weight
JANE’S STORY
Jane had battled with her weight since her early teens, when she consulted me she had peaked at 174lb. With her height at 5ft her ideal weight was 120-130lb.
THE CONSULTATION
At her initial consultation Jane was aged 27 years, and in spite of a careful diet she had increased her weight by 5-6lb a month over the previous six months. Prior to this Jane had always been a lively, happy young woman with a settled job in the family business and a caring fiance. She was concerned that the recent weight increase was making her ill, for she now suffered from fatigue, depression and low backache. Her doctor and her family were convinced that her increasing weight (now 50lb over her optimum weight) was causing the backache and fatigue, and these symptoms were making her depressed.
I know from my many years in practice that being overweight does not inevitably cause fatigue and depression, having encountered many underweight exhausted patients, and many overweight patients who were happy and full of energy.
Jane had also linked the fatigue to her weight, because the fatigue and depression had developed when her weight suddenly increased eight months previously, and her doctor’s comments had endorsed her suspicions.
Everyone including Jane believed that all her symptoms would improve if she could only lose 50lb of her surplus weight.
Unfortunately, the low fat diet that she usually followed to control her weight did not seem to work any more. This failure further added to her depression, and she became obsessed with the idea that she had let her fiance down by looking and behaving quite unlike her old self.
THE SYMPTOMS
Upon questioning Jane, other symptoms emerged. In spite of her extra ‘padding’ she could not seem to get warm. She found it difficult to get up in the morning, when she felt particularly tired and depressed with frequent headaches. Her friends and family had remarked how impatient and irritable she had become, and her memory and concentration were noticeably worsening. All these symptoms were new to Jane, having developed with the weight increase over the previous six to eight months.
THE TESTS
I requested a morning temperature check and a thyroid profile blood test. Jane’s temperatures showed an average of 97.2°F (36.2°C) and her thyroid hormones were in the lower end of the normal range. Jane showed all the signs and symptoms of mild hypothyroidism.
THE TREATMENT
A nutritional programme was prescribed which included thyroid glandular supplements, and advice on regular exercise.
Within three months she was feeling more vital and less depressed. She had managed to lose 12lb on her usual diet.
By six months her blood thyroxine had improved by 25 per cent and her weight was down to 1501b. Jane was particularly encouraged that the diet was now working and she was hoping to regain a satisfactory weight before her wedding. Her mental lethargy and depression had slipped away and she was able to face the world upon waking with her old energy and enthusiasm.
Why are People Overweight?
