Post-viral fatigue - request for advice

I've been suffering with post-viral fatigue for several months now and despite my best efforts any improvement is very slow and fairly minimal, so I would like to ask the network for any advice or suggestions about resolving this condition.

A brief history: at the beginning of June this year I came down with a nasty viral infection. It was very much like glandular fever, but a blood test showed it was not. For a few days in the middle of the illness I had a temperature of 104. Just as I thought the illness was over, the very next day I was struck with the most debilitating fatigue I have ever experienced. This has been slowly improving since then, but in my current state of health and energy, I usually function for about 2 – 3 hours and then need a couple of hours rest in bed. I go to bed early, about 7 or 7.30 in the evening and get up about 9 or 9.30 the following morning. I'm not sleeping all the time I'm in bed, but I do need to rest.

There has been improvement since the middle of June, but it is very very slow. Last week I went out twice, for about an hour each time, once in the morning and once in the afternoon. The following day I was barely able to function at all and spent most of the day in bed. I sometimes am able to function for longer than 2 – 3 hours, other times less. I have learnt to manage my energy by taking plenty of rest in bed. It's only in the past few weeks that my mental energy has returned to pre-illness levels.

My diet is good. I have not eaten any gluten, dairy, sugar, soy, alcohol or other evils since March last year. I've got my carbs down to about 60g daily, and eat plenty of meat and fats. My only vice during the past few months has been to eat raisins, sometimes a cupful a day. However, after catching up with the 'Life without bread' thread here on the forum, I've substantially reduced my intake of raisins with a view to eliminating them completely.

My supplements are:

Vitamin C: 1 gram x 4 daily
Magnesium: 400 – 500 mg daily
Calcium citrate complex: 250mg x 2 daily
Potassium: 99mg x 1 daily
Vitamin D3: 2,400IU x 2 daily
Folic acid: 800mcg x 1 daily
Multi-vit & mineral (no iron): 1 daily
Alpha lipoic acid: 300mg x 2 daily
NAC: 600mg x 2 daily
Sea Kelp: 30mg x 2 daily
Co Q-10: 30mg x 1 daily
Olive leaf extract: 500mg x 4 daily
Milk thistle: 175mg x 2 daily
Digestive enzymes and probiotics

The calcium citrate complex, potassium and D3 were added earlier this year to combat cramps in my legs at night – successfully too! Some of the other supplements were added because I had read that they have been used successfully to treat post-viral fatigue, i.e. olive leaf extract; folic acid; Co Q-10. Sea kelp (for the iodine) was added in case the fatigue is caused by underactive thyroid. I've tried increasing my vit C intake, but I can only tolerate a few more grams before I reach bowel tolerance – in fact 6 hourly doses of 1 gram is my limit before the burbles and gurgles start.

So that's the current state of my health. If anyone here has any advice or suggestions on how to improve my condition I would be most grateful to hear it.

Thanks in advance!!

Endymion said:

My diet is good. I have not eaten any gluten, dairy, sugar, soy, alcohol or other evils since March last year. I've got my carbs down to about 60g daily, and eat plenty of meat and fats. My only vice during the past few months has been to eat raisins, sometimes a cupful a day. However, after catching up with the 'Life without bread' thread here on the forum, I've substantially reduced my intake of raisins with a view to eliminating them completely.

Click to expand...

So your source of carbs comes from raisins... I think it would be best to ditch the raisins completely, it's basically having a cup of sugar, and it's very bad for your system (you might want to read the articles on 'fructose' on this forum). Plus, as your immune system (and more) weakens by this consumption, it would become harder for you to get rid of this post-viral fatigue, no matter how many supplements you take. The diet has to be as perfect as it can be, it's all or nothing. I think it would be best to gradually switch to low-carb vegetables like green beans for your carb-source, and to increase your healthy fats intake.

There is no way your body can go into ketosis if you don't let it. And only in ketosis can we use fat for energy, which is something you seem to be lacking. I would think that your body might currently run on carbs and having not enough of it, it could be a reason for a lack of energy (or you might have been going in and out of ketosis). So if you want to get into ketosis optimally, best would be to gradually decrease carbs and obtain them from better sources (you would need to observe yourself to see what amount works best for you at the moment) and obviously to increase your fats intake. Fwiw.

Endymion said:

I've been suffering with post-viral fatigue for several months now and despite my best efforts any improvement is very slow and fairly minimal, so I would like to ask the network for any advice or suggestions about resolving this condition.

A brief history: at the beginning of June this year I came down with a nasty viral infection. It was very much like glandular fever, but a blood test showed it was not.

Click to expand...

This is a very long time for you to still be suffering. Have you returned to your physician for additional testing of metabolic function, immune or rheumatic panels? Is the physician aware you are still having problems? Have you considered an elimination diet of the most problematic foods like peanuts, tree nuts, citrus, nightshades? We can develop an autoimmune disease in reaction to viral infections or immunizations, and that can be more permanent in nature than an infection usually is. There are a few supplements that help with cellular energy or antioxidants that you could try, such as ubiquinol, astxanthin, PQQ, vinpocetine, NAC, phosphatidyl serine and choline, DMAE, NADH. Mangosteen and Noni are natural anti-inflammatories that you could try, but one at a time lest you react to either. And there are sequestrants like zeolite and activated charcoal you could try, or the chelation recommended on the forum for heavy metals. Rebuilding or supporting gut flora is something that everyone should be doing. Some people respond well to anti-depressants for physical pain symptoms.
Early this year I had ALCAT testing done for dietary intolerances, because I had eliminated gluten and dairy but was still having lots of IBS symptoms. I have dozens of reactive foods (coffee, strawberry, mushrooms, oranges, etc) , and eliminating them from my diet was like night and day for the IBS; it also cleared a long-standing case of rosacea. It might be worth a shot. Hope you find something to work for you.

I second the suggestion to go get yourself checked out by a physician since the recovery process has been so slow. You could always get the tests done and then depending on the results decide what to do next.

If I remember correctly you had mentioned homeopathy in at least one of your posts on a different subject. Have you tried any for your current condition? Maybe a qualified homeopathic doctor can help?

monksgirl said:

This is a very long time for you to still be suffering. Have you returned to your physician for additional testing of metabolic function, immune or rheumatic panels? Is the physician aware you are still having problems?

Click to expand...

My GP is aware of the ongoing problems. I've been referred to a neurologist who is also a specialist in chronic fatigue syndrome. The referral was made over six weeks ago and I'm still waiting for the appointment. All these tests will be done at the neurologist's request, I hope. Some blood tests were done early on soon after the first attacks of fatigue, and all tests were normal, including C-reactive protein, a marker for inflammation.

monksgirl said:

Have you considered an elimination diet of the most problematic foods like peanuts, tree nuts, citrus, nightshades?

Click to expand...

I don't eat any of those food types and haven't done for a long time. The only problem food I was eating is raisins and those have now gone from my diet.

monksgirl said:

We can develop an autoimmune disease in reaction to viral infections or immunizations, and that can be more permanent in nature than an infection usually is.

Click to expand...

Actually this is why I started to take olive leaf extract. A theory I read suggests that a viral infection weakens the immune system to the point that the body cannot fight other virii that are latent in the body, such as human herpes virus. Therefore a logical treatment seemed to me to be an anti-viral. Hence the olive leaf extract.

monksgirl said:

There are a few supplements that help with cellular energy or antioxidants that you could try, such as ubiquinol, astxanthin, PQQ, vinpocetine, NAC, phosphatidyl serine and choline, DMAE, NADH. Mangosteen and Noni are natural anti-inflammatories that you could try, but one at a time lest you react to either. And there are sequestrants like zeolite and activated charcoal you could try, or the chelation recommended on the forum for heavy metals.

Click to expand...

Earlier this year after having my mercury fillings removed I did a three month protocol with liquid zeolite. Most recently I did one month which finished a few weeks ago. The most recent round of zeolite didn't make any appreciable difference. I will look into the anti-inflammatories you mention.

monksgirl said:

Rebuilding or supporting gut flora is something that everyone should be doing. Some people respond well to anti-depressants for physical pain symptoms.

Click to expand...

I take a good probiotic twice a day. I've been offered anti-depressants but I'm not going to take them under any circumstances.

monksgirl said:

Early this year I had ALCAT testing done for dietary intolerances,

Click to expand...

It seems that ALCAT testing is no longer available in the UK due to support issues with ALCAT USA.

Oxajil said:

So your source of carbs comes from raisins... I think it would be best to ditch the raisins completely,

Click to expand...

Actually, I wasn't completely clear in my post. I was also eating about a third cup of buckwheat in the mornings at breakfast, and onion in the evenings. I've now stopped eating raisins, and stopped eating buckwheat at breakfast, and reduced my carbs in the evening.

obyvayel said:

I second the suggestion to go get yourself checked out by a physician since the recovery process has been so slow. You could always get the tests done and then depending on the results decide what to do next.

If I remember correctly you had mentioned homeopathy in at least one of your posts on a different subject. Have you tried any for your current condition? Maybe a qualified homeopathic doctor can help?

Click to expand...

Although my recovery is very slow, this is fairly usual if as I suspect, post-viral fatigue has now become chronic fatigue syndrome/ME. These three names seem to be used interchangeably. Someone from the ME Association here in the UK told me that recovery can take a long time.

I have used pendulum dowsing with success for my health for many years, but strangely in this instance dowsing has suggested that I do not use any treatments such as homeopathy, traditional Chinese medicine, and so on. I find this rather unusual, but I have checked and re-checked my dowsing and always get the same answer, so there may be other factors at play that I am not aware of.

A cup of raisins is about 130 carbs which makes a lie of your statement "I've got my carbs down to about 60g daily". You are actually eating about 200 grams of carbs per day, as mentioned, a cup of sugar. This is preventing your recovery by keeping the insulin pumping like crazy.

If it were me, I would just titrate Vitamin C for awhile to bowel tolerance, see what that does. I would take plenty of fish oils, and really load up on meat and fats which assist with detox. Also, NAC two or three times a day. That's it.

Thanks for the advice, Laura! I've got my carbs down to about one and a half tablespoons of buckwheat flour per day. If I feel a little 'suspect' I take a bit more carbs in the form of green beans or sweet potato. And I've implemented your other recommendations too. Thank you.

Endymion said:

Thanks for the advice, Laura! I've got my carbs down to about one and a half tablespoons of buckwheat flour per day. If I feel a little 'suspect' I take a bit more carbs in the form of green beans or sweet potato. And I've implemented your other recommendations too. Thank you.

Click to expand...

Ummm... what part of "simple carbs" and "no grains" that we have discussed extensively in "Life Without Bread" do you NOT understand?

If you need carbs, eat the green beans, eat a bit of sweet potato, but NO SIMPLE CARBS. They stimulate insulin sharply which you do NOT want. Especially if you are recovering and having fatigue problems.

Laura said:

Endymion said:

Thanks for the advice, Laura! I've got my carbs down to about one and a half tablespoons of buckwheat flour per day. If I feel a little 'suspect' I take a bit more carbs in the form of green beans or sweet potato. And I've implemented your other recommendations too. Thank you.

Click to expand...

Ummm... what part of "simple carbs" and "no grains" that we have discussed extensively in "Life Without Bread" do you NOT understand?

If you need carbs, eat the green beans, eat a bit of sweet potato, but NO SIMPLE CARBS. They stimulate insulin sharply which you do NOT want. Especially if you are recovering and having fatigue problems.

Click to expand...

Cauliflower, broccoli, and kale are also good if you want or need a 'carb'. For a time, even avoid using xylitol....I've had trouble with fatigue and asthma symptoms after eating anything with xylitol in it, in addition to stomach/bowel problems. (Please bear in mind, we're all individual. My system has been screwed up for a very long time.)

Very gentle exercise, and I mean just stretching or walking, will also help with fatigue. I know that sounds like it wouldn't work, but it can't hurt to try.

I've been dealing with severe adrenal fatigue for months now, treating it with supplements, gentle exercise, strict low/no carb diet, EE, and sleep. What I've discovered is that anything at all with sugar in it, and I mean anything, knocks me flat on my back for two days, inflames joints, causes rashes from dry skin, and turns my temper into a hair trigger Grumpasaurus. ;D

The diet may sound strict, but I can't argue with the results: decent sleep (waking refreshed instead of wondering if I can stand without falling down), significant reduction of pain ( down from a constant 5 on a 10 scale to a 2), and above all: a better attitude.

Just my two cents.

Gimpy said:

The diet may sound strict, but I can't argue with the results: decent sleep (waking refreshed instead of wondering if I can stand without falling down), significant reduction of pain ( down from a constant 5 on a 10 scale to a 2), and above all: a better attitude.

Click to expand...

Yup. That's the bottom line, isn't it? I'm experiencing more better days now than before and it does seem that the healing proceeds, but it takes time. We didn't get in the shape we were in overnight, and we can't get out of it overnight either.

Laura said:

Endymion said:

Thanks for the advice, Laura! I've got my carbs down to about one and a half tablespoons of buckwheat flour per day. If I feel a little 'suspect' I take a bit more carbs in the form of green beans or sweet potato. And I've implemented your other recommendations too. Thank you.

Click to expand...

Ummm... what part of "simple carbs" and "no grains" that we have discussed extensively in "Life Without Bread" do you NOT understand?

If you need carbs, eat the green beans, eat a bit of sweet potato, but NO SIMPLE CARBS. They stimulate insulin sharply which you do NOT want. Especially if you are recovering and having fatigue problems.

Click to expand...

Ah. Thanks again. I'm still catching up with the 'Life without bread' thread and I haven't got to the discussion of simple carbs yet.

Endymion said:

Ah. Thanks again. I'm still catching up with the 'Life without bread' thread and I haven't got to the discussion of simple carbs yet.

Click to expand...

Okay, I'll say it again: if anybody is going to be experimenting with changing their diet, they really need to stay up with the ongoing discussion on this topic where everyone is sharing their findings and experiences and all kinds of problems are being studied and solved. It is crucial to be on top of this! You can generally tell what topics are "busy" by clicking "show most recent posts" at the top of the entry page every day.

Edymion, this is serious. PLEASE read that thread, and don't make assumptions. You are kind of wasting your time by making all those changes, when they are not the right ones. It is irresponsible to take our health in our hands half-way. When or if you can't really take the time to do your homework, better get on with the "official" way. But, if you can take the time, I'm sure you'll see the results.

I recently had a virus too, and following the recommendations here, and breaking a fast the "paleo way", I am getting better and better every day. Some of us had a nasty virus last year too, and it took a few months to be totally in good shape again, but it was only really 2 or 3 months. No surprise it's taking you so long when you are eating quite a lot of carbs and lectins every day. But you can get there (after you've read the entire thread!). The point is, study the subject before, and be patient, because it takes time!

Wishing you a speedy recovery.

Over the past couple of days I've spent several hours reading the thread: 'Life without bread'. There I've found answers to many of my questions. In fact, as it turns out, I didn't really need to start this thread at all, or so I think. I apologise for posting something that amounted to not much more than noise.

Oxajil said:

There is no way your body can go into ketosis if you don't let it. And only in ketosis can we use fat for energy, which is something you seem to be lacking. I would think that your body might currently run on carbs and having not enough of it, it could be a reason for a lack of energy (or you might have been going in and out of ketosis). So if you want to get into ketosis optimally, best would be to gradually decrease carbs and obtain them from better sources (you would need to observe yourself to see what amount works best for you at the moment) and obviously to increase your fats intake. Fwiw.

Click to expand...

Hi Oxajil,
"bolding" and "underlining" in Your text is mine.

It looks like that not only in ketosis our bodies use fat to be precise. Fatty acids are preferable fuel for heart metabolism with little use in normal conditions of glucose.

Metabolic and genetic regulation of cardiac energy substrate preference
Izaäk Frederik Kodde, Johan van der Stok, Ryszard T. Smolenski, Jan Willem de Jong,
Comparative Biochemistry and Physiology, Part A 146 (2007) 26–39

[taken from abstract of the paper]
Healthy myocardium uses mainly fatty acids as its major energy source, with little contribution of
glucose. However, lactate, ketone bodies, amino acids or even acetate can be oxidized under certain circumstances. A complex interplay exists
between various substrates responding to energy needs and substrate availability.

Click to expand...

Biochemistry. 5th edition.
Berg JM, Tymoczko JL, Stryer L.
New York: W H Freeman; 2002.

Section 30.2Each Organ Has a Unique Metabolic Profile
link: http://www.ncbi.nlm.nih.gov/books/NBK22436/

Click to expand...

I am giving this for example that metabolism is a bit more complicated.

Other thing is that going into ketosis can be stopped by too high amount of carbs and / or too high amount of proteins. Excess proteins are transferred into different metabolites and one of them may be glucose.
See for example here:
http://www.ncbi.nlm.nih.gov/books/NBK21182/ - nice book :)

Biochemistry. 5th edition.
Berg JM, Tymoczko JL, Stryer L.
New York: W H Freeman; 2002.

Chapter 23Protein Turnover and Amino Acid Catabolism
[...]
Rather, surplus amino acids are used as metabolic fuel. The α-amino group is removed, and the resulting carbon skeleton is converted into a major metabolic intermediate. Most of the amino groups of surplus amino acids are converted into urea through the urea cycle, whereas their carbon skeletons are transformed into acetyl CoA, acetoacetyl CoA, pyruvate, or one of the intermediates of the citric acid cycle. Hence, fatty acids, ketone bodies, and glucose can be formed from amino acids.

Click to expand...

Too high carbs and too high proteins means that our blood glucose is rather higher than lower and that takes insulin into action which one in turn is blocking use or release of "fat" in general (this subject may be found also in biochemistry book). I have started to study those aspects of biochemistry for myself and if You wish, can also check that.

In dietary protocols (ketogenic diet) for treating children with epilepsia for example John Hopkins Hospital (JHH) have established ratios of fat to protein to carbs daily intake which is 3:1 or 4:1. You may find it also described in linked paper below. Below I have linked one article which for me is giving nice overview of ketogenic diet aspects:

Adam L. Hartman and Eileen P. G. Vining; Clinical Aspects of the Ketogenic Diet Epilepsia, 48(1):31–42, 2007
link (paper free of charge): http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2007.00914.x/abstract;jsessionid=E3BB1DBEEA0C2916DD20CA201E3CDB77.d03t04

Click to expand...

And for all interested in studying ketogenic diet subject, that below is really good link to different aspects of ketogenic diet gathered in one place - Site is called Methews Friends. That site is dealing mainly with epilepsia problem however ketogenic diet here may be understood and used practically in all kinds of uses in my opinion.
http://site.matthewsfriends.org/index.php?page=medical-papers