# Food Intolerance In Chronic Fatigue Syndrome



## Mike NoLomotil (Jun 6, 2000)

CHRONIC FATIGUE SYNDROME AND FOOD INTOLERANCEResearchers at the School of Biological and Chemical Sciences, University of Newcastle, Australia, assessed the clinical value of diagnosing and managing food chemical intolerances in 76 CFS patients with gastrointestinal symptoms.Symptom severity was evaluated before and after patients participated in an elimination diet. Multiple symptom improvement was reported by 89.5% of the patients when particular food chemicals and proteins were excluded from their diets, including milk, wheat, commercially prepared bread, natural food chemicals such as salicylates and glutamates, brewerï¿½s yeast, and additives such as nitrites and nitrates, sulphur preservatives, colorings, and antioxidants.Symptom improvement included reduced fatigue, fevers, sore throats, muscle pain, headaches, painful joints, difficulty concentrating, and unrefreshed or prolonged sleep. The study suggests that food intolerances may be a co-morbid condition in a subgroup of CFS patients.Emms TM et al. Food intolerance in chronic fatigue syndrome. Abstract number 15. WWW.CFIDS.ORG ______________MNL_______________ www.leapallergy.com


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## weener (Aug 15, 2000)

Hi Mike:I hope this isn't a silly question, but would this apply to FM too. I tried the Candida diet earlier this year. It was very restrictive in the types of foods that I could eat, but I must admit I did feel much better.


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## Mike NoLomotil (Jun 6, 2000)

OSCAR MEYER:Sorry I missed yer question. Not been back for awhile. In simple terms yes and no. Huh? He queried?FM is an intersting symptom set with clinical findings that, from an immunologic response to foods and additives perspective, is much more equivocal than some of the other symptom sets.Almost all FM patients I have seen in the last several years whose tests have come through our lab do test positive for one or more cellular intolerances. However the clinical response is much more variable than IBS, migraine, and fatigue-related complaints.Some FM patients, usually those with clearly comorbid d-type or cyclic IBS, have the same dramatic reduction in symptoms when thier reactive foods and additives are removed as the d-ers do.However, those patients without clear clinical presentation of the 'IBS" symptom set comorbid with their physician-assign diagnosis of FM are less responsive.I think this may be a case of patient selection, as we do not get the patient we get the specimen and the basic history and we follow up when we can on a doctors patients (they are all independent so the onlt ones we see start to finish are the HomeCare patients and those are almost always IBS or migraine...some eating disorders and morbid obesity).So I sometimes wonder how the DX was made....This is the Abstract of a study examining immunologic rsponse markers (specific interleukins) when care was taken in the diagnosis, and in assesseing the presence of comorbid depression in the FM patients examined. It is instructive:-------------------------------------Psychoneuroendocrinology 1999 May;24(4):371-83The immune-inflammatory pathophysiology of fibromyalgia: increased serum soluble gp130, the common signal transducer protein of various neurotrophic cytokines.Maes M, Libbrecht I, Van Hunsel F, Lin AH, De Clerck L, Stevens W, Kenis G, de Jongh R, Bosmans E, Neels H.University Department of Psychiatry, Clinical Research Center for Mental Health (CRC-MH), Antwerp, Belgium. m.maes###unicall.beFibromyalgia is a chronic, painful musculoskeletal disorder characterized by widespread pain, pressure hyperalgesia, morning stiffness and by an increased incidence of depressive symptoms. The etiology, however, has remained elusive. The aim of the present study was to examine the inflammatory response system (IRS) in fibromyalgia. Serum interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), sgp130, sIL-1R antagonist (IL-1RA) and sCD8 were determined in 33 healthy volunteers and in 21 fibromyalgia patients, classified according to the American College of Rheumatology criteria. Severity of illness was measured with several pain scales, dolorimetry and the Hamilton Depression Rating Scale (HDRS).Serum sgp130 was significantly higher and serum sCD8 significantly lower in fibromyalgia patients than in healthy volunteers. Serum sIL-6R and sIL-1RA were significantly higher in fibromyalgia patients with an increased HDRS score (> or = 16) than in normal volunteers and fibromyalgia patients with a HDRS score < 16. In fibromyalgia patients, an important part of the variance in sCD8 (50.3%) and IL-1RA (19.3%) could be explained by the HDRS score; 74.3% of the variance in sIL-6R was explained by the combined effects of pain symptoms and the HDRS score; and 25.9% of the variance in serum sgp130 was explained by stiffness. The results support the contention that pain and stiffness in fibromyalgia may be accompanied by a suppression of some aspects of the IRS and that the presence of clinically significant depressive symptoms in fibromyalgia is associated with some signs of IRS activation.----------------------------------------The summary expresses a possible explanation for some of the cinical observations, since from where I sit outside the lab and just peeking at results and histories we do not ofetn see the distinction being drawn between these two patient subsets...simply those with significant depression and those without significant depression. The study "suggests" that the response of the immune system as assessed by the chemokines measured (IL-6, IL-1 classes)may in one population be accentuated and ina nother attenuated. These interlekins are produced by macrophages, the immune systems cleanup cells which are activated in acute inflammatory processes and in innate immune responses. They are usually accompanied by another powerful mediator called Tumor Necrosis Factor-alpha (TNF). Each exterts specific known effects on the brain, liver, bone marrow, muscle, fat tissue and the activation of dendritic cells.They consume entire chapters in immunology books to understand their function. Gets way past me I'll tell ya.The mediators released which cana ccount for some of the symptoms associated with comorbid CFS seem a bit easier to fathom as far as what we see in cvellular reactions to foods and additives. So while many FM patients do respond in like fashion there are those who do not in spite of the fact they are test positive. Why those do not respond as well may be beter undertood if someone applied the patient selection method used in this study to a stady of the response of these (2) seeming FM subpopulations. I suspect that a specific serum mediator analysis combined witht he end-point assay might give some insight into this seeming paradox.This is why my answer is ambivalent....this condition is even farher from being fully elucidated as far as etiology than is the IBS set of subpopulations and CFS.Youir response to the candida diet is tempting to explain in the context of this study, as IF you were suffering froma candida overgrowth we have seen that the patients immun system starts reacting to candida as if it were a pathogen. it should not, as it is normal flora, but in cases of overgrowth it appears to be detectible by activation of a cellular response in vitro to candida (probably secondary to a humoral response in the gut mucosa). Anyway, this would prodcue the effects described of releasing proinflammatory mediators and if there is a macrophage response this can elicit pyrogenic effects (chilliness, feel "fevery", muscle pains, etc). So IF then an effective means of eliminating the overgrowth is affected it woukld be logical for the symptoms to subside. But since this has not been studied directly I can only speculate. Makes nice wine-and-cheese talk though. If you can tolerate wine and cheese that is.If I do see anything new along the way I will post it since I know you are here and interested.MNL_____________ www.leapallergy.com


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## Guest (Aug 12, 2001)

Good article, Mike I am lucky because the only food problem I have is with sugar. If I eat too much, I get pretty nauseous and just all around don't feel as good. I have found flax seed oil in the gelcaps (I couldn't get the oil close to my lips without gagging







) helps with digestion, alleviates the constipation that I have trouble with. I no longer have "abdominal labor" as I call it. Thanks DD [This message has been edited by DD (edited 08-12-2001).]


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