Dismissed for years as 'yuppie flu', malingering or a purely psychological condition, Chronic Fatigue Syndrome (CFS) is still very poorly understood in the wider health community. However, over many years
Dr Sarah Myhil, convinced that, far from being 'all in the mind' CFS was 'all in the body', has continued to seach for a physiological cause for the multiple and totally disabling symptoms of the condition. And she has found one: poorly functioning mitochondria.

Mitochondria are the tiny structures or 'engines'
which supply energy to every cell in every organ in
our body. If the mitochondria malfunction or operate under par, so do those organs. And, when an organ
runs short of fuel or energy it can have all kinds of
knock on effects elsewhere in the body. So low
cardiac output (a sluggish or 'underpowered' heart)
for example, will effect the efficient functioning of the skin, the liver and the gut, the muscles and the brain, to mention only the most obvious. Hardly surprising then that the symptoms of CFS include not only total exhaustion and lack of energy but muscle pain, brain fog, poor heat control and heart arrythmias among many, many other symptoms in apparently random parts of the body.

Together with Dr McLaren Howard of Acumen Laboratory and Dr Norman Booth of Mansfield, College Oxford, Dr Myhill has now shown that poorly functioning mitochondria provide the key to CFS - their research studies are to be found published in the peer reviewed International Journal of Clinical and Experimental Medicine:

Chronic fatigue syndrome and mitochondrial dysfunction - 2009
Mitochondrial dysfunction and the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) - 2012
Targeting mitochondrial dysfunction in the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – a clinical audit - 2013

During the course of her researches she has been logging her findings, and her treatment protocols based on those findings, on her website, DrMyhill.co.uk. Now those findings have been put down in print in her new book - and they are fascinating. Partly because her findings about CFS and the role of the mitochondria in it are so fascinating – but also because she writes so very readably. Only on page 3, for example, she says:

A useful analogy in understanding the mechanisms of this illness and recovery is to compare the human body to a car. If the body is a car then, to get it to go you need:

• Engine – Mitochondria
• Fuel – Diet and gut function
• Oxygen – Lungs
• Accelerator pedal – Thyroid
• Gearbox – Adrenals
• Service and repair – Sleep
• Cleaning oil – Antioxidants
• Cooling system – Detoxification
• Driver – The brain

So, immediately, the complexities of how mitochondria work and why their malfunction can have such wide ranging implications, becomes so much more understandable - and so much less intimidating.

Before going on to explain in great detail exactly how mitochondria work, how they should function and how it is that they often do not, she lists the six most usual causes of mitochondrial failure:

1. Genetics - often down the female line.
2. Direct damage by viral or toxic stress, in which she includes both recreational and prescription drugs such as 'the pill', HRT, statins and beta blockers
3. An inability to resist toxic stress because of poor nutritional status
4. Nutritional deficiencies
5. The natural ageing process
6. No time for healing/repair e.g. chronic sleep disturbance and insufficient sleep.

And good sleep, and plenty of it, is one of the most crucial elements in her protocol for treatment – which is what takes up most of the rest of the book.

Although every CFS sufferer is different, Dr Myhill has a basic protocol which she requires all her patients to follow before addressing their more individual problems – and it is focused on rebuilding the structures underlying the health of the mitochondria. To re-use the car analogy – it is no good just filling the tank with fuel – or unblocking the fuel pipe – or cleaning the spark plugs – or unblocking the air filter. If you want to the car to work you have to do all of these things.

In the same way, the CFS sufferer needs to pace themselves (so as not to exhaust their limited store of energy to the point that there is none left for recovery), rebuild their nutritional status, sleep (properly and for nine hours between 9.30pm and 6.30am) and eat a Stone Age, low GI diet which avoids all the major allergens and includes lots of probiotics.

Once these are in place the patient is ready to move forward.

I could continue to quote from the book - but I do not want to deny you the pleasure of reading it! And, if you are reading it because you need her help, not just because you are interested in her theories, then you will to need to read it all – and read it several times. You could, of course, just go to her website and read it all there but the advantage of the book is that it is – a book..... And useful though it is to be able to follow all of the links on the site, it is also nice to be able to read at your leisure and not in front of a screen.

So for anyone who suffers from, or knows someone who suffers from, or who works with, Chronic Fatigue Syndrome, I urge you to go and buy this book at once and read it from cover to cover.

You can buy it from her site (spool down the News column on the right and you will find instructions as to how to do so) for £13 inc P&P,
or
you can buy it in any good book shop (published by Hammersmith Health Books)
or
you can buy it here on Amazon.

June 2014

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