ME/CFS and Long-COVID: confusingly similar

ME/CFS, i.e. myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS), is a complex multisystem disease that affects about 300,000 people in Germany. The disease is usually accompanied by reciprocal dysfunctions of the body’s regulatory systems, such as the autonomic nervous system. The severity of the disease varies greatly, but in many cases it can lead to occupational disability or the need for nursing care.

Since the COVID pandemic and the appearance of the Long Covid Syndrome, the topic of ME/CFS has also received much more attention – after all, the symptoms of these clinical pictures are very similar. In particular, it is often a diffuse pattern of symptoms with the main theme of “exhaustion” or “stress intolerance”. And whatever name the child bears, in the end it remains mostly difficult to treat and affected patients start odysseys of visits to doctors and therapists to find someone who can help. Unfortunately, many do not get this help and so they spin day after day, week after week in the disease vortex of various symptoms and helplessness.

Many ME/CFS patients suffer from pain symptoms, infection associated symptoms and allergies, neurocognitive and vegetative symptoms. Many sufferers also report marked hypersensitivity to environmental stimuli such as light or sound. But what is the way out?

What causes ME/CFS and what does it have to do with COVID?

In most cases, ME/CFS develops as a result of an acute infection. Examples of such an infection and its pathogens are the Ebstein-Barr virus (EBV), Borrelia or herpes viruses. Various bacteria or fungi can also be triggers. If these pathogens really throw the immune system out of kilter, this can subsequently lead not only to pathogen persistence in the body, but also to permanent immune dysregulation. This means that the immune system is weakened and/or overreactive. And this is then reflected not only in symptoms such as susceptibility to infections, allergies, irritable bowel syndrome or autoimmune diseases, but also in the blood count: immune cells are altered in their number and function (e.g. reduced activity of NK cells), certain cytokines are increased (e.g. TGF-ß or TNF-alpha). And, of course, this is not without consequences: The nervous system, cell regulation and hormonal system are closely linked to the immune system. In sum, all this leads to a downward spiral with continuous weakening of the system.

Fig.: Microbes such as Epstein-Barr virus (EBV), herpes viruses, influenza, Borrelia, chlamydia, and many others are suspected as triggers of ME/CFS. However, autoimmune diseases, mitochondriopathies or hormonal disorders can also trigger the syndrome.

Similar to how EBV infection can lead to ME/CFS described above, coronavirus can cause a very similar issue: Long or post-COVID syndrome. Thus, not only the symptoms of these two syndromes are similar, but also the mechanism of development is the same.

Further pathophysiological correlations and explanatory models

At the causal or triggering level of this complex multisystem disease, other possible triggers are described in addition to the explanatory model of a pathogenic infection. Ultimately, these are always events or stressors that cause significant damage to the body. These can be primarily severe traumas – physiological in the area of the cervical spine or psychological-emotional traumas. Furthermore, severe damage to mitochondria and cellular regulation, for example, by highly toxic substances/ various environmental toxins can cause ME/CFS.

But what happens subsequently in the body when affected individuals spiral downward and stress intolerance becomes such a major and ever-increasing limitation of quality of life?

One mechanism described is the so-called reaction rigidity of the cell.

If the organism is stressed for a very long time, tissue overacidification occurs regularly, which consequently favors and promotes disease and disease processes. One speaks of extracellular hyperacidity when the body deposits the excess acids in the intercellular spaces. If this condition persists continuously without countermeasures, then sooner or later the acid-base balance inside the cell will also be disturbed (intracellular acidosis). The acid from inside the cell can no longer be “disposed of” and so acid builds up until the cell finally “freezes”. As a result of this “overacidified cell”, nutrients can no longer adequately reach the interior of the cell and the normal regulatory and metabolic processes are significantly disturbed.

Other explanatory models include stress-induced chronic hyperventilation, adrenal insufficiency with cortisol deficiency, or mitochondrial dysfunction.

How is ME/CFS diagnosed?

A questionnaire according to the Canadian Consensus Criteria is usually used to diagnose ME/CFS, because there is no definitive laboratory parameter or other investigative technique to detect ME/CFS.

Canadian consensus criteria

Therapy options/help and treatment options

Due to the interdisciplinary, holistic and integrative treatment approach in the THERA Practice Clinic, a wide variety of treatment options are available to our patients. Especially with such a complex clinical picture as ME/CFS, it is invaluable if different therapies can interlock and support takes place at all levels.

In particular, we would like to mention our oxygen and detoxification therapies. These therapies have proven to be a great support in the recovery process, especially with the recent increase in long covid and post-vac syndrome.

If you are interested in further information, you can find detailed information about the individual forms of therapy on the website:

• Ozontherapie
• IHHT
• Blutwäsche
• Schwermetallausleitung

REFERENCES:

https://cfc.charite.de/fuer_aerzte/

Charité: DMW_PCS.pdf

https://www.mecfs.de/was-ist-me-cfs/

Charité: CME_CFS.pdf

Charité: CFS eine unterschätzte Erkrankung.pdf