Chronic fatigue syndrome has been recognized as a diagnosis for many years now. Originally thought to be more of a psychiatric issue, traditional medicine now has an official diagnosis code for it and many papers have been written and published on the subject. These papers also cite various treatments for chronic fatigue ranging from sleep aids to antidepressants to anti-viral medications. In the integrative medicine arena, chronic fatigue has been attributed to such underlying causes as viral infections, allergies, imbalanced gut flora, and neurochemical imbalances. Various full-body treatments including diets, adrenal cocktails, nutritional supplements, and even medications have been offered. Any and all of these approaches do help some people some of the time. However, what both traditional and integrative doctors may be missing is the possibility of toxicity- or exposure-induced fatigue and how that very important factor can impact the system from the very basics of cell biology.
Fatigue Starts at the Cellular Level
First, I want to address the fact that digging into why a person is experiencing chronic fatigue is where taking a detailed patient history is so very important, as there may well be several issues compounding or playing off of each other to create the exhaustion. Of course, it is of particular interest, in this newsletter especially, to identify and address how mold and mycotoxins impact the body as a whole, and in the case of chronic fatigue, explaining this from the cellular level forward may provide additional enlightenment.
(Note: I realize that some readers may have extensive study in cell biology and others not at all, so I will try to find a middle ground for this topic to keep it interesting to all.)
Every organ and every system of the body is made up of trillions upon trillions of cells. These are the individual units that have multiple responsibilities, including metabolism and system maintenance, generation and response of the immune system, and producing energy to carry out these functions. Energy as we refer to it in cells is in the form of molecules called adenosyl tri-phosphate (ATP). Exactly how this energy is created happens in a series of biochemical reactions referred to as the Citric Acid cycle, or Krebs cycle, and then with the process of oxidative phosphorylation. These are reactions that are occurring every moment in every cell in your body. The molecules of ATP which are released by these cycles are then used in cells to drive or bring energy to all mechanisms and functions of the body. For example, just one heart contraction requires one billion ATP molecules! This fact helps you realize how any interference in ATP production in the cells can affect energy, and thus lead to fatigue–not to mention sluggish body systems.
The area of the cell in which these specific processes occur is called the mitochondria. Part of the process by which the mitochondria do their job to carry out the cycles for ATP energy is by shuttling electrons across the mitochondrial membrane using a small protein called cytochrome C. Cytochrome C can be released by the membrane under the influence of toxins, including mycotoxins, and thus can lead to cell death, also referred to as apoptosis. Enough premature cell death leads to a decrease in ATP production (which leads to fatigue) as well as to increased lactic acid which creates muscle pain and weakness. This has been well-documented in studies of how Ochratoxin A, a common mycotoxin of Aspergillus mold, affects the body.
Mycotoxins and Energy Production
With regards to the Citric Acid or Krebs cycle, there are multiple areas in which mycotoxins can interfere with the proper function of energy production. As mentioned, there are a series of ongoing biochemical reactions in each cycle, feeding into each other and releasing ATP as they go. The reactions are dependent on certain enzymes which may be blocked by these mycotoxins. This is the point at which we can gain a greater understanding of the use of certain supplements, as these enzymes are made up of or activated by elements you have heard of, such as riboflavin, Coenzyme Q10, magnesium, and B vitamins. If the body does not have these elements available or if they have become negatively affected by toxic exposures, depletion, and extreme fatigue can result.
Lack of Cellular Energy and the Trickle Down Effect
Not only does fatigue ensue when there is an improper function at the cellular level, but the immune system is negatively impacted as well. Receptor sites referred to as the Aryl Hydrocarbon Receptor (AhR) control multiple facets of immune system function and when these are impacted by toxicity, a lifetime of immune system dysfunction can occur, making one more susceptible to all infections, including viruses, and autoimmune conditions often implicated in the development or as the causes of chronic fatigue syndrome.
Oxidative stress, which I equate to rusting, also happens at this cellular level. Increased levels of oxidative stress are associated with all degenerative diseases, from heart disease to Parkinson’s disease to cancer. Thus, when cells are not producing energy, the whole body suffers and eventually succumbs to illness and disease.
Fatigue and Mold Illness
While fatigue is certainly one of the most prevalent symptoms among the patients that I see with mold-related illness, other things I must keep in mind when mitochondria are not functioning properly include recurrent infections (particularly viral), persistent immune system activation (allergy and autoimmunity), altered cell death leading to degenerative conditions, delayed healing due to decrease in stem cells, altered metabolic energy leading to obesity, and cancer.
Looking at Organic Acid testing of the urine is, to me, one of the best ways of assessing mitochondrial function and raising the level of suspicion of toxicity from mycotoxins or chemicals. There are particular patterns identified consistent with these exposures and identification of what specific nutrients may be helpful in restoring cell function. That said, these interventions may not be discernibly helpful if there is ongoing exposure. Exposure, as much as possible, must be stopped, as you cannot repair damage if the poison is still coming in.
Speaking of exposures, other toxins must be considered as well. While mycotoxins may be the main culprit, the total body load must be reduced by avoiding exposures to chemicals such as solvents, pesticides, phthalates, and glyphosate as these toxins all disrupt mitochondrial function. The combination of multiple ongoing exposures increases exponentially the negative effects on a person’s body.
What to Do?
Start with the big 3: clean air, clean water, and clean food. I don’t think this can be repeated enough or given too much emphasis. When air, food, and water are clean, ALL additional interventions can and do work better. Fatigue can be helped and improved, immune systems can be balanced, and the ravages of chronic disease can be quelled if these steps are taken. Obviously, the greatest success is in addressing these 3 main components sooner than later, but all quality of life can be improved to some extent by taking any steps to improve them.
Rules for Mitochondrial Health
To summarize, I believe that this very basic list of “rules” will help you feel better, live longer, and experience greater health and vitality:
1. Keep your air clean, and free of mold, mycotoxins, and chemicals.
2. Eat simple, clean, and organic foods, not those with added chemicals, coloring agents, pesticides, hormones, or antibiotics.
3. Drink purified or spring water, but not out of plastic bottles!
4. Spend time outdoors and consciously move your body each day to oxygenate tissues and to move lymph.
5. Work with a qualified practitioner to ensure you are supplying your body with the additional nutrients and minerals required for your cells to produce and utilize energy properly. Your health practitioner can also help determine if you already have accelerated cell “rusting” or deficient cell processing.
Questions and comments may be written below or feel free to email us at newsletter@sinusitiswellness.com. We love hearing from you!
Susan Tanner has practiced medicine for over 33 years, concentrating primarily on chronic illness and the impacts on the individual, the family and the community. Her driving curiosity into why people are made ill caused her to pursue education in Environmental Medicine, completing coursework, exams, and necessary practice years to earn board certification in this area in 2009. Her own struggles with mold-related illness drove her desire to teach those similarly affected. While in clinical practice, Dr. Tanner wrote and contributed to a number of publications on environmental health, prepared narratives for understanding in legal matters, and researched new techniques for modulating the body’s ability to clear toxins and infections. She now has a fitness and health website www.thebodynexus.com, where she writes articles and shares education on utilizing the various body systems into improve overall health.
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My wife is a loyal follower of Susan Tanner and has a history of mold issues. THANK YOU!!!!!!
I do enjoy reading your articles. I dream of having good energy and have for years…
Can you follow up with an article about some ways to boost mitochondrial health and ATP production?
We will definitely address this topic in a future article.
One of the Best articles I have read thus far on Chronic Fatique Syndrome!
Thank you!
This is so interesting to me. How would I find help
In my area. 38117
My recommendation is to use the American Academy of Environmental Medicine website http://www.aaemonline.org to find a doctor in your area.