Chronic Fatigue Syndrome (Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS)) affects .4-1% of the Australian population, up to 250,000 people and there are over 9000 studies published about it.  

While chronic fatigue can be a symptom of many conditions, the defining symptom for ME/CFS sufferers is post-exertional malaise (PEM). In other words, when they exert themselves, they have a relapse. If they try to build exercise tolerance, they get worse, not better. If they do too much one day (eg a trip to the supermarket), they may be able to do far less the next. Some of these people can barely get out of bed for years, and others are debilitated to varying degrees, often invisible to others.

This condition affects women more than men (80%) and while it is commonly triggered by a viral illness, it can also be triggered by genetics, stress, trauma and toxins.

Other symptoms of CE/MFS include: 

• flu-like symptoms

• muscle and joint pain

• unrefreshing sleep

• sensitivities to food/medications/chemicals

• digestive issues

• tachycardia (fast heart rate)

• cognitive difficulties including dementia

• sensitivity to light and sound 

• and difficulty being upright/standing. 

Unfortunately despite being well studied, most GPs do not understand this condition well and it is commonly treated as a psychological condition. There are very few effective treatments for it. (The most important one is Pacing.) Studies show many people do not improve over several years. Others do improve. Unfortunately, many people end up with depression due to the loss of their previous abilities and lifestyle.

ME/CFS has similarities with Long Covid

The SARS CoV-2 virus causes long Covid and refers to the lingering of symptoms from weeks to months to years after the initial acute infection. The malaise that can linger is very like ME/CFS. 

We don’t yet know what percentage of people who catch covid get Long Covid but conservatively, some doctors are suggesting 10-30%.

Symptoms of post covid and long covid can include: 

• Shortness of breath, difficulty breathing

• Post Exertional Malaise (PEM)

• Chronic cough

• Joint pain

• Chest pain

• Loss of taste or smell

• Cognitive difficulties including dementia

• Brain shrinkage

• Heart disease, strokes, pulmonary embolism, heart attack

• Depression or anxiety

• Dizziness when you stand

• Tachycardia

• POTS - Postural orthostatic tachycardia syndrome

• Covid is also now being realised to affect fertility. 

• People who have had severe Covid can also have Post Traumatic Stress Disorder, and depression and anxiety related to their experience, especially if they were hospitalised.

We also know that women age 40-60, have the highest rates of long covid, however it occurs at any age, including in children. Women also have the highest rates of other conditions like fibromyalgia,  rheumatoid arthritis and ME/CFS, so this fits that same pattern. 

Australian Scientists at the Kirby Institute (UNSW) and St Vincent’s Hospital in Sydney have been exploring the characteristics of Long Covid. They have been studying the blood of unvaccinated people from the first waves of Covid and found that 30% of them have sustained inflammatory markers 8+ months after the initial infection, even if the initial infection was mild.

“...what we’re seeing with long COVID is that even when the virus has completely left the body, the immune system remains switched on. If you measure the same thing after a standard cough or cold, which we did in this study through one of our control groups, this signal is not there. It’s unique to sufferers of long COVID.”

While Covid-19 primarily affects the lungs, it can also damage the heart, kidneys and brain and can also cause a multi-systemic inflammatory syndrome in both adults and children. In fact, neuroinflammation, the inflammation of nerves in the brain and body, is a relatively well known and common symptom of long covid. Some people say it feels like you have drunk many cups of coffee, all the time.

““One of the most surprising aspects of our analysis is that people don’t need to have had severe COVID to experience these ongoing immunological changes,” says Dr Phetsouphanh. “This suggests that the pathophysiology – that is the disordered physical processes associated with long COVID – apply regardless of disease severity.””

The virus that causes covid, SARS-CoV-2, has been found in the testes, ovaries, brain, kidneys and other organs, sometimes months after the person was initially infected. Some people test positive for months, others do not but it has still been found in their body. 
Of course, there is still much we don’t know about Long Covid, but hopefully the intense research being directed toward it will also help the long term ME/CFS sufferers. 

Naturopathic Approach- Wholistic Approach

From a Naturopathic perspective, here are a few simple ideas I want to express in this article. 

I encourage everyone to build their immunity and vitality, to help protect against the more severe aspects of Covid. Give your body its best chance of getting through it well. There are many ways to do this and I will address these in other articles. 

Do not take Covid lightly and wish to hurry to catch it to get it over with. This is reckless for three reasons. 

1. Catching Covid does not mean you cannot get it again. In fact, Omicron reinfections are becoming even more common than with previous strains, and there are cases of reinfection within 1 month. Getting Covid does not provide long term immunity (whether or not you are vaccinated!).

2. Scientists do not think that catching Covid multiple times is likely to have a good outcome for many people. Especially children with long lives ahead of them. Cumulative multi-organ damage and long covid fatigue and other debilitating symptoms are showing up at all ages.

3. Fit and healthy people are not exempt from getting severe illness or long covid. In fact many with long covid were previously fit and active community members.

I strongly recommend avoiding getting Covid if possible. And not being overly casual about getting it just because initial symptoms may be mild for many. And if you get it, do not presume you can’t get it again, or that it’s ok to keep getting it every few months or year. The damage is cumulative. It’s not a cold or flu.

If you get Covid, I recommend taking 3 full weeks to recover, even if you feel better after 1 week or a few days. Do not rush back to your normal busy routine so quickly. Many with long covid, who often had initially mild symptoms, wish they had taken more time to recover.

Prevention is a Foundational Naturopathic Philosophy.

That is the main message I, a Naturopath in the middle of a pandemic, wanted to convey in this article. One of the foundations of Naturopathic Philosophy is Prevention. We are likely heading for a huge wave of chronic illness triggered by mass covid infections.  It is already a documented reality for millions of people. This can occur in the young and the old, the healthy and those with underlying conditions. It happens most in women. 

In my own community I am seeing people wanting to get Covid over and done with, in order to get some immunity. I understand that sentiment but I believe it is misguided. Sure it will build immunity to at least the current strain for a few weeks to a few months, but the risk of long covid is considerable, and the damage is cumulative.  And that includes in children. 

I will talk more about how to work with long covid in future articles.  I believe this will be a very significant health issue for many thousands of Australians in the future. It already is in the U.S and the U.K and Europe and likely right across the world.

Prevention, if at all possible, is definitely the best medicine.