I wrote an article last week basically stating that Chronic Fatigue Syndrome is not a legitimate diagnosis and that if you have been diagnosed with CFS, then you need to find someone that can help you look deeper into your condition.
In that article, I also said that I would be exploring the possible mechanisms that could be driving your fatigue, poor exercise tolerance, brain fog, etc.
This is the first mechanism that I’m going to talk about: Your tissue and particularly, your brain, is not getting enough oxygen and this is causing you to feel fatigued and struggle with brain fog.
Oxygen Needs of Your Body
Capillaries are the smallest blood vessels in your body, but these tiny blood vessels are what provide all of your tissues with blood and oxygen. Most research has focused primarily on the large blood vessels of the body, but this might be an oversight.
If the capillaries are not delivering oxygen into the tissues, then it doesn’t really matter how well your large blood vessels are working. You’re up a certain creek without a paddle.
To put it simply, every inch of your body needs oxygen.
Oxygen is used in chemical reactions in every tissue in the body to produce energy and carry out the functions of that particular tissue.
If you have any doubt about the oxygen needs of your body, try holding your breath for several minutes. You’ll get dizzy and light headed pretty quickly. This is due to a lack of oxygen to your brain.
If you’ve ever been hiking in the Rockies or at very high altitudes, you’ve probably found that you have to stop and rest more frequently. This is because there is a lower concentration of oxygen at higher elevations and less oxygen is getting to your tissues.
See how this works?
Now, if you’re suffering from chronic inflammation, your body is likely not receiving the oxygen that it needs.
Instead of a voluntary breath holding exercise or a decreased oxygen concentration, this is happening because the ability of your capillaries to deliver oxygen to the tissues has been compromised.
This is a very complex process and I’m not going to bore you with the details of it, but essentially, chemicals in your body known as inflammatory cytokines are decreasing the ability for your capillaries to receive and deliver oxygen to the tissues, particularly the brain.
This leads to fatigue, brain fog, exercise intolerance… are these starting to sound familiar?
Good. Now keep reading…
How to Test Oxygenation
We have several different methods of determining if your body is delivering oxygen appropriately to the tissues. Some of these are more practical than others.
VO2 Max. This is a test that is generally used to determine the cardiac reserve of heart patients, but fortunately, we can use it for our purposes as well. You are put on a stationary bicycle in a lab and they measure the air your breath out during exercise. When you can no longer deliver enough oxygen to the tissues, this is known as the VO2 Max. If you have an issue with capillary hypoperfusion, your VO2 Max will be extremely low.
VEGF. VEGF or Vascular endothelial growth factor is a growth factor that can be measured in the blood. It causes the growth of blood vessels to supply tissues with blood and oxygen. Often, if someone is struggling to provide oxygen to the tissues, as in the case of chronic inflammation, then VEGF will be low on a blood test.
VIP. Vasoactive Intestinal Peptide (VIP) helps to regulate blood flow to a certain extent via effects on the pressure in the pulmonary artery. It can be measured via a blood test. You’ll usually find that VIP is low if you’re struggling with oxygenation.
Stress Echocardiography. This test goes hand-in-hand with VIP levels. In normal physiology, the pressure in the pulmonary artery would decrease during exercise, but in the case of chronic inflammation, this is not the case. So, with this test we’ll look at how the pressure in the pulmonary artery changes during exercise. If you are in an inflamed state and are not delivering oxygen appropriately, your pulmonary artery pressure will not decrease in response to exercise.
Obviously, after laying out all the options for testing, the blood tests of VEGF and VIP are the most practical, while the stress echocardiography and VO2 max are more difficult and more expensive.
Your doctor or functional medicine practitioner should be able to order VEGF and VIP through a lab such as Quest or LabCorp. (I personally prefer Quest for these tests.)
Correcting Oxygen Delivery
In formulating a treatment plan, we want to first establish, what is causing the chronic inflammation?
This could be from an infection, toxic exposure, hormone imbalances, gut abnormalities, food intolerances, etc.
Often, there will be more than one pathology driving the inflammation. So, after we establish the underlying cause or causes, then we want to start addressing those.
While waiting on further test results or while determining that underlying cause, there are a few things that you can put into action immediately to help decrease the inflammation.
These are things that I talk about a lot, including:
- Stress management
- Getting appropriate amounts of exercise
- Insuring that you’re getting enough sleep
- Eating a nutrient-dense diet that omits foods that commonly increase inflammation (gluten, dairy, soy, etc)
Also, to help oxygenation levels in the short term, you could talk with your doctor about using low-dose erythropoietin.
Erythropoietin has been shown to open capillary beds in the brain, lower C4a and fix refractory cognitive symptoms in those with chronic inflammation.
A word of caution, if you have late-stage kidney failure or have a history of head and neck cancer, then erythropoietin is not appropriate for you to use.
Although erythropoietin is not appropriate for everyone, those that are able to take it, show great benefits from its use, so it is worth having a conversation with your doctor.
Looking for Help?
If you or someone you know is suffering from chronic fatigue, please call me at (940) 241 – 7158 to find out you can conquer chronic fatigue and get back to the life you want to live. There is no one-size-fits-all approach, and each person’s case must be evaluated to determine the appropriate course of action. If you’re ready to take action, you can schedule your initial consultation by clicking here.