A Treatment for Chronic Fatigue Syndrome

A Treatment for Chronic Fatigue Syndrome
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An industry-funded, randomized, double blind, placebo-controlled crossover trial study suggests chocolate may improve symptoms for those suffering from chronic fatigue syndrome—a debilitating condition currently affecting as many as seven million Americans. But how do you get the cacao phytonutrients without the saturated fat and added sugar?

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Chronic fatigue syndrome is a debilitating condition characterized by a minimum of six months of crushing mental and physical exhaustion, and we have no idea what causes it. We don’t even have a good idea of how many people even have it. The Centers for Disease Control estimates that as many as seven and a half million Americans currently suffer from it. And we as physicians have very little to offer patients in terms of relieving those symptoms. So, this is one of the conditions that I’m always keeping an eye out for in terms of new treatments.

And one of the latest they just discovered? Chocolate.

Evidently, Montezuma the Second, who reigned the Aztec empire 500 years ago, noted: “This divine drink, which builds up resistance, and fights fatigue. A cup of [cocoa] permits people to walk for a whole day without food.’’ Not willing to take the emperor’s word for it, it was put to the test.

I’m always skeptical of industry-supported research, but it was actually a pretty good study. At first glance, it looked like they were basically saying eat three chocolate bars a day for eight weeks, and call me in the morning. But it was actually a randomized, double-blind, placebo-controlled crossover trial, which is about as good as you can get.

The mad scientists over at Nestle took white chocolate, dyed it brown, and then added some sort of fake chocolate flavor, such that people couldn’t tell if they were eating the real chocolate or the fake. Comparable amounts of sugar and fat, but one had cocoa solids—phytonutrients—and the other basically didn’t.

So, they were able to put people on one, and then switch them over, without anyone knowing, to see if their chronic fatigue symptoms got better or worse. And there was a significant improvement in the real chocolate group, meaning it apparently wasn’t just the yummy taste of chocolate, but the action of the cacao phytonutrients.

Of course, no one should be eating three chocolate bars a day, but you can get the equivalent dose of cocoa solids, the equivalent dose of those wonderful cocoa phytonutrients, by consuming two and a half tablespoons of cocoa powder a day. You can put it in coffee, you can make a chocolaty smoothie, or, my personal favorite, you can blend it in a high-speed blender with frozen cherries or strawberries, a touch of nondairy milk, vanilla extract, and some erythritol or some dates, and you have instant, decadent chocolate ice cream; low-fat, low-calorie, no cholesterol, no added sugar chocolate ice cream. The more you eat, the healthier you are—whether or not you’re suffering from chronic fatigue.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

Please consider volunteering to help out on the site.

Images thanks to John Loo and FrankBonilla.tv via Flickr, Mariluna and Evan-Amos via Wikimedia Commons, , and ChocolateCover.

Chronic fatigue syndrome is a debilitating condition characterized by a minimum of six months of crushing mental and physical exhaustion, and we have no idea what causes it. We don’t even have a good idea of how many people even have it. The Centers for Disease Control estimates that as many as seven and a half million Americans currently suffer from it. And we as physicians have very little to offer patients in terms of relieving those symptoms. So, this is one of the conditions that I’m always keeping an eye out for in terms of new treatments.

And one of the latest they just discovered? Chocolate.

Evidently, Montezuma the Second, who reigned the Aztec empire 500 years ago, noted: “This divine drink, which builds up resistance, and fights fatigue. A cup of [cocoa] permits people to walk for a whole day without food.’’ Not willing to take the emperor’s word for it, it was put to the test.

I’m always skeptical of industry-supported research, but it was actually a pretty good study. At first glance, it looked like they were basically saying eat three chocolate bars a day for eight weeks, and call me in the morning. But it was actually a randomized, double-blind, placebo-controlled crossover trial, which is about as good as you can get.

The mad scientists over at Nestle took white chocolate, dyed it brown, and then added some sort of fake chocolate flavor, such that people couldn’t tell if they were eating the real chocolate or the fake. Comparable amounts of sugar and fat, but one had cocoa solids—phytonutrients—and the other basically didn’t.

So, they were able to put people on one, and then switch them over, without anyone knowing, to see if their chronic fatigue symptoms got better or worse. And there was a significant improvement in the real chocolate group, meaning it apparently wasn’t just the yummy taste of chocolate, but the action of the cacao phytonutrients.

Of course, no one should be eating three chocolate bars a day, but you can get the equivalent dose of cocoa solids, the equivalent dose of those wonderful cocoa phytonutrients, by consuming two and a half tablespoons of cocoa powder a day. You can put it in coffee, you can make a chocolaty smoothie, or, my personal favorite, you can blend it in a high-speed blender with frozen cherries or strawberries, a touch of nondairy milk, vanilla extract, and some erythritol or some dates, and you have instant, decadent chocolate ice cream; low-fat, low-calorie, no cholesterol, no added sugar chocolate ice cream. The more you eat, the healthier you are—whether or not you’re suffering from chronic fatigue.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

Please consider volunteering to help out on the site.

Images thanks to John Loo and FrankBonilla.tv via Flickr, Mariluna and Evan-Amos via Wikimedia Commons, , and ChocolateCover.

Doctor's Note

For some of my previous videos on chocolate, see: Healthiest Chocolate FixUpdate On Chocolate; and my last recipe video on this topic, Healthy Chocolate Milkshakes. For why I’m so skeptical of industry-sponsored studies, see Food Industry “Funding Effect”, and my other videos on industry influence

For more context, check out my associated blog posts:  Strawberries Can Reverse Precancerous Progression, and How Probiotics Affect Mental Health.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

94 responses to “A Treatment for Chronic Fatigue Syndrome

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    1. This I think has been well established that epicatechins (flavanoids from cocao) produce mild analgesia. I remember Neal Barnard presenting a study that showed they could stop people craving for chocolate (and cheese) if they used Naltrexone for blocking the opiod receptors. Here is a link for a study showing activation of the delta opiod receptor from epicatechins in chocolate: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993198/?tool=pubmed
      My question is in these people with Fibromyalgia if you keep feeding them chocolate does an adaptation mechanism take place and the patients have to keep increasing their cocao intake to provide the same pain relieving effect? Nestle would sure like that!

    2. I am wondering though if any of the beneficial effects of the high real cocoa powder group was because their product was free of the milk which was around 30 % of the fake chocolate. They didn’t control both types of chocolate for milk ingestion and the rich dark chocolate was dairy free. In some other studies I read about coffee, studies found that adding milk caused a further increase in blood sugars for longer than dairy-free caffeine free beverages. I wonder if somehow the dairy in the nonchocolate sample caused a negative effect on blood sugars which then translated in to more symptoms symptoms or if the improvement in the chocolate group was somehow related to the caffeine content of their chocolate. More questions than answers here!

      1. fantastic point Angie!
        I wonder about something else (as a CFS patient who sees one specialist recommending dark chocolate consumption till 2pm) – vasoconstriction from the caffeine and maybe some of the other stimulants in that bundle of cocoa chemicals as well. CFS sufferers commonly have either general orthostatic intolerance (problems getting blood to extremities including brain) or the more specific POTS- postural orthostatic tachycardia . we get worn out quickly because on standing up we suddenly get less blood to muscles and brain, body responds with adrenaline, heart rate goes up, blood gets where it needs to eventually but we are anxious and worn out.

        enough coffee,tea or cocoa will keep the blood vessels squeezed tighter, wonder if nestle is pushing any liquorice products because that can raise the blood pressure another way if indeed this is a part of the benefit for some CFS people.

        Dr Greger, I am so pleased with the respect with which you addressed the condition that is so commonly trivialised. very refreshing, please keep my set in mind again if you see any studies with plants that may beneficially augment our lives

  1. Great, when you say no added sugar, are dates high in Fructose? Is this why they don’t affect blood sugar levels? I know the Erythritol has no issue but I personally don’t like man made sugars due to the feeling that they may fool my body initially but later I tend to crave the real stuff. Nutritionist Jeff Novick points out that if you look at the ingredients of Date powder, they seemingly don’t give you much nutrition as opposed to when you look at Unsulphered molasses label. I know you cite a study that a group of individuals had little effect on their blood sugar levels but was it because Dates are higher in Fructose?
    Here’s my humble recipe for a cocoa desert.
    2 Tbl’s of Hershey’s dark cocoa baking powder
    3/4 cup of frozen cranberries
    1 whole Indian Gooseberry fruit
    1 cup of soft Sprouted Tofu
    1 teaspoon of a pre-mixed cloves, cinnamon and Acerola powder
    3/4 cup of pre-soaked and dehydrated Pecans and 1/2 cup of raw Cashews for creaminess.
    1 cooked medium size purple sweet potato (Asian Market)
    1 teaspoon of Stevia Leaf
    I find that Stevia leaf has no Licorice aftertaste if you mix it with something that does have glucose like the Purple sweet potato….
    Makes about 4 servings

    1. To answer your question, dates have more sugar than jelly beans, but a lot of fiber that keeps it from hitting your bloodstream so fast. Your recipe looks very good, kind of like a lot of mine. I have a question about the tofu in yours, however, since Toxins pointed out elsewhere that soy milk may block absorption of the phytonutrients.

  2. I tried your “recipe” this morning. Except for the cocoa, I didn’t know how much of the other ingredients to use, so I had to guess. It came out tasting very bitter and was watery. I must have guessed wrong! How much of the other ingredients do you use? Thanks.

    1. Mine turned out amazing, try this.
      5 dates
      3 tbsp. Cacao powder
      ¾ cup mix frozen berries.
      ½ tsp. vanilla extract
      2 tbsp. Unsweetened Almond Milk

      Mix all in blender and put in freezer. Wait an hour or until consistency of ice cream.

  3. I just made the ice cream! Oh my god. I cannot believe how Tasty it is!!! I guesstimated too, used 2 big handfuls of frozen mixed berries, about 80 mls of coconut milk (from a carton, not the tinned kind), 1 tbsp cocoa, cap of vanilla essence and a decent sprinkle of stevia. Yeah i know. Theres no erythritol in Ireland. Anyway the ice cream was such a treat! And….. Super healthy????

    Ben and jerry, it’s over between us. It’s THIS kind if thing that will help me help others too! Keep em coming!

    I have a question. Any idea how much is too much cocoa? In my porridge (with cinnamon), shakes, protein pancakes… Fake Ice cream??? Too much?

  4. I use frozen bananas as the stock for my ice cream. I add cherries, strawberries, bananas, cocoa powder, vanilla extract, or whatever else I desire. When I was little I said that I was going to eat ice cream everyday. Of course I was obese as an adult and I didn’t eat ice cream everyday, but now on a plant-based diet I do and I am healthier for it!

  5. I love this ice cream as well.  However, I have a question.  If this is made with soy milk, will it block the antioxidants from the cherries and cocoa?  In one of the videos, soy milk blocked antioxidants from tea.

    1. Based on the study, one can safely assume that soy will indeed block the phytonutrients from the cacao and berries. I would suggest using almond milk.

      1. Hi Toxins, would a silken tofu have the same effect? Lots of chocolate dessert recipes are based on this. Is there an applicable stoichiometry, couldn’t I just use more cacao powder?

        1. I wish I had the answer to this question, but I do not. The only study presented was in vitro and I have no way of getting the full access to the article.

  6. Could it be that the caffene assisted the energy levels on the short term. Caffene and theobromines in chocolate are know to be very harmfull in the long term. I tsp of  cocoa powder contains 8 mg of caffeine and 106mg of theobromine.  http://www.hersheys.com/nutrition-professionals/chocolate/composition/caffeine-theobromine.aspx

    Theobromine and caffeine both are known to have problems, even suspected to cause birth defects http://www.ncbi.nlm.nih.gov/pubmed/9629863

    I think the vested interest is showing in the  study. You can still use double blind cross over to show beneficial components and leave out the bad effects.

  7. Brilliant! So, 2.5tbsp a day of cocoa powder = how much in other forms? Cacao nibs? Kinds of chocolate bar? I will not rush out and start eating any old chocolate treat – I need to find ways of working out proper portions of the actually healthy stuff, rather than making my poor ME/CFS system crash with fat and sugar. Where can I find out how to convert between forms of chocolate?

    1.  Typically, the dark chocolate bars you find at stores have most of the phytonutrients processed out. It would be best to consume non dutch processed cacao. Cacao nibs would work out just fine as this is a concentrated source of cacao powder. 2.5 tablespoons of cacao powder = approximately 1/3 of an ounce of cacao nibs.

      1. Thanks for pointing out this important aspect. Do you know if there is any way to tell if it is (non) Dutch cacao by taste or anything like that (even home made chemical reaction) – there are no labels which is which in the place I live. (Cacao powder I buy now is pretty bitter, if that helps. I will try to search, yet still not sure it will be easy). Thanks anyway.

      2. Re: finding no dutched cocoa, after I tried several such (pricey) products on Amazon and trying them (they were a light brown – not very chocolately for my taste), I decided to call Hershery’s to ask if their “Hershey’s 100% Natural Unsweetened” was dutched and they assured my that is in NOT dutched. It is very dark & chocolately, and available at Sam’s Club & Kroger at a reasonable price. It is true that NOT dutched cocoa has much more of the phytonurtients.

  8. Thank you so much to share this wonderful video with us, but i wish to know more about fatigue and its good and effective treatments. Please share more information with us.

    ———————————————————————
    Fatigue Treatment 

  9. I have Chronic Fatigue Syndrome.  Was diagnosed many years ago after having several major health problems at one time.  However, a year ago I embarked on my journey to be vegan and since then I have had very little issue with it.  I will admit I probably still eat more processed foods than I should and then maybe I would have no CFS at all.  We will definitely try this ice cream though.  Thanks Dr Greger for always posting fun and insightful information.

    1. I know this is an older posting, but I just found it. I wanted to comment that since going WFPB, pretty “religiously”, because I was trying to get rid of diabetes, miraculously, the chronic fatigue, fibromyalgia, IBS and a slew of other long standing issues disappeared too, including half my body weight! Yeah, I’m a fan!

  10. This is good! I was surprised because I’ve tried using raw cacoa powder and stevia for brownies before and they were nasty. I think it’s the strawberries that make the difference. I couldn’t imagine eating that much every day though.

  11. The control in this study had significant amounts of milk/whey, whereas the experimental did not. A confounding variable? Animal protein, immune trigger….

  12. I actually discovered this on my own. Have had CFS for 13 years now and I found out that when I ate some chocolate, I had a much better day than if I didn’t. I’ve never been into fruit with chocolate, but I do like the powder in some sweetened almond milk. It’s especially good at hot chocolate in the winter, or with chia seeds for a nice pudding type dessert.

    1. Fat-free is skim milk, and it has has been discussed on this site as being the form of milk with the highest hormones except for butter milk among skim 2% or full fat milk. This promotes cancer. Every nut, seed, and grain when blended with water will produce a plant based milk. Have you tried some of these? It is much better to avoid ingesting anything that isn’t plant based.

    2. It would work… but the milk isn’t very good for you.

      Try almond milk. It’s about the same price of milk, but much, much safer.

  13. Aloha Dr. Greger,

    We have been enjoying your recipe for “chronic fatigue syndrom” i.e. blueberries, bananas, and organic raw cacao nibs. We were wondering if the cacao powder would be better than the nibs (lower fat) and that got us to researching cacao with Dr. McDougall’s site and Jeff Novick. Anyway, below is what Jeff Novick had to say about Cacao and we were wondering if you could respond. The link Jeff Novick gives in his response takes you to a longer response he gave about chocolate.

    I found this product at my local health food store. The title on the package is in the subject line of this post. The ingredients on the package says, organic raw cacao beans (nibs).

    A 1 ounce serving contains 13 grams of total fat, 8 grams saturated fat. The 1 ounce serving provides a daily requirement of 314% iron, 21% vitamin C and 24% magnesium. It also contains 20 times more antioxidants than red wine and 30 times more than green tea.

    I’ve also read studies that say chocolate has been shown to significantly reduce blood pressure.

    Does the high fat and saturated fat content negate any of the potential nutritious benefits of this food?

    Yes.

    There is little if any benefit to either of these substance, neither of which I would call a “food” for humans.

    You can read some thorough discussions on chocolate and blood pressure here.

    http://www.drmcdougall.com/forums/viewtopic.php?t=6010

    In Health
    Jeff

    1. Jeff’s article talked mostly about chocolate not cocoa powder in the healthy way it is presented here. Even with the powder he looks at the fat content. 50% of 10 or 20 calories doesn’t amount to a hill of anything in my estimation. At the end he does present this….

      I once tried an experiment with some clients as they wanted to include some cocoa but did not want to use any sweeteners, natural or artificial. So, I mashed up a large banana (or 2), added in a TB (or 2) of pure cocoa powder, and mixed them together. Then I added in some fresh blueberries, and it was fairly good. Then, the next day, we did the same thing but this time topped it with some toasted oats (regular rolled oats we toasted) and then some cinnamon. This was also fairly good.

      Mary McDougall does have recipes using cocoa powder but she uses a non-fat cocoa powder. John isn’t against any sugar at all.

  14. Dear Dr Greger,

    Just Regarding CFS/ME. I have seen the videos on this website but I unfortunately am not getting results despite a raw vegan diet . I was mainly having thoughts on how diets would help the gut dysbiosis, channelopathy, orthostatic intolerance , oxidative stress, immune dysregulation and other neuroendocrionological symptoms of this syndrome.
    This being such a complex subject, most molecular details are unanswered but I’d appreciate whatever information you can provide with a big big bow down Thank you.
    Btw, the kale seeds you sent have come out so very well. Thank you for those.

    Kind regards,

    Rashmi Cabena

    >

    1. Hey Rashmi,

      I have been dealing with CFS for 22 years now. I have found the most benefit from both a vegan diet and doing a periodic anti candida diet. This involves using no sugars, yeast, mold/fungus, or anything else fermented. There are many online resources about it and books (look for The Yeast Connection). I find if I do that for 3 weeks once or twice a year I feel much better.

      Best of luck,

      Holly

  15. I can’t consume any caffeine due to having pvcs. So no caffeine , chocolate or alcohol for me. Stops pvcs almost completely. How can I consume chocolate? I have cfs and can’t seem to get better no matter how clean my diet is.

  16. cocoa powder and frozen bananas in blender also results in similar chocolate ice cream…though the berries would be healthier..

    also..2.5
    tbsp of cocoa powder a day is quite a lot! gonna try it for a few days
    and see if it helps chase these winter blues away!

    Thanks Dr. Gregor – love the videos!

  17. Does this apply to ADRENAL fatigue? I’ve been reading that stimulants (coffee, coke, all caffeine actually) exhaust the adrenals and make you even more tired). Although cocoa doesn’t have THAT much caffeine, it is still a stimulant. Can someone please answer this? Thanks so much!

  18. Hey Dr. Greger, could you post more on the subject of chronic fatigue syndrome? I’ve been suffering from it for over 5 years and I would be really grateful for anything I could learn about how to help myself get better. There’s so little in the way of reliable information out there about this crippling illness.

  19. Just EAT IT! Yes love the frozen choco-smoothies. Methinks I’ll make one NOW!

    Such fun eating “decadent and delicious” with ZERO/NONE/NADDA guilt or reservations or limitations.

    I don’t know why “they” think it is so impossible.

  20. I’m interested in solutions for CFS with chronic headaches. We’re trying the chocolate in smoothies from today. I’m talking about daily headaches, worse in the mornings.

  21. Hi Michael,

    I’ve been a vegan for one year now and everything has been going well expect for the fact that I’m always tired.

    I have had this symptom prior to going vegan but I feel I notice it more now that I am vegan. I occasionally take B12 and not too long ago got a B12 injection but is there anything else that you would recommend in improving prolonged fatigue?

    Thanks for this website,

    Nathanoj

    1. Nathanoj: I forwarded your post to our medical moderators in the hopes that someone will have some ideas for you. In the meantime, I thought I would suggest something to look into even though I’m not an expert. I think paying attention to the B12 was a good first call. After that, you might want to make absolutely sure you are getting enough calories. I’ve met several people who were able to cure this problem by eating more calorie dense (but still healthy!) food. (Let me know if you need examples.) You wouldn’t want to over eat. So, the only reason to do this would be if you might not be getting enough calories. Maybe it is something you could try for just a couple of weeks to see if it works? I don’t know if it is a good idea, but maybe???

    2. Nathanoj: I am Christine, a NF volunteer moderator. I have a Master’s degree in nutrition, but without knowing more about your diet and lifestyle, it is difficult to answer your question. Vegan can mean many things, and there is a lot of junk food available that is vegan. Sleep habits and exercise could also be factors, as could minerals such as iodine and iron, but taking supplements you don’t need can be harmful, so please do not go out and buy supplements just to see if they help. It would probably be a good idea to see your doctor to rule out any medical conditions that could be causing your fatigue. You might also want to find a nutritionist or dietitian who is knowledgeable and supportive of vegan diets to evaluate your intake for potential deficiencies and help to address any that may exist. I hope that helps!

      1. Christine,
        I’ve been trying to find a nutritionist to discuss my diet. I’ve been on WFPB for 6 years and have had wonderful results. I had a stint placed in a single artery that was 80% blocked 7 years ago and was on the regular pack of drugs (statins etc). Was actually told to stop taking them by my doc after my blood d test showed my LDL reached a level of 35. He now praises what I’ve done with diet and exercise. I want to take this to the next level by validating my diet but don’t know where to go for help. Any suggestions? I live in the Cincinnati area.

        Thank you

  22. How concerned do you think we should be about mycotoxins in raw cacao? We really don’t know the practices of those who harvest the pods.

  23. Please someone put it to the test.

    I want to know if you 4 real can walk a whole day without food on coca.

    It sounds better than coffeine.

  24. Can someone recommend a cacao powder with low heavy metal contamination? I am finding cacao really does provide more energy and would like to consume it daily but don’t want to cause harm through possible cadmium and lead contamination. I am using about 4 large tablespoons a day of Navitas raw cocoa powder.

  25. There are other differences than you mentioned in the video. Compared to real chocolate, the simulated “chocolate” contains 2 times the sugar, 27% vs. 0% milk powder, and 4.95 vs. zero whey powder. Maybe the subjects just reacted poorly to all the sugar and milk.

  26. I’m doing some research on here to help my fatigue relapse. I was curious…Is cacao powder okay? I thought I heard “cocoa” in the video above. I prefer cacao myself.

  27. I have suffered from M.E./CFS for 25 years and think this study is probably a load of rubbish although if we could see the exact criteria for those participating in the study it may be helpful.

  28. Hi,

    I was wondering if you could help please. I have friend that I talk a lot about diets with. I became vegan a couple of years after a blood test and an elimination diet. So I was convinced. But my friend has CFS and is very adamant that his diet needs meat. His points of research are Wahls Protocol and similar resources.
    What advice can I give him which refutes that Protocol for example.

    Thanks

    1. Hi Chris,

      I am not qualified to advise on nutrition but as you are on this site you can point to the huge quantity of science behind Doctor Gregor’s book. I have only just read it but I found it very convincing and have substantially altered my diet accordingly.

      I am unfamiliar the Wahls protocol but just looking at her web site I see she has written books like the Dream Dictionary which makes me wonder about her.

    2. From an objective point of view, just explain to your friend that nothing should be believed without peer-reviewed clinical evidence. Someone writing a book and saying “oh all my patients get better taking supplement zzyzx” is NOT evidence. Painstaking experimental design, rounding up hundreds of patients, following them carefully in a “double blind” manner over time, performing statistical analysis, and then having other medical authorities review the work to verify that it’s unbiased….THIS is evidence (as long as its not funded by a special interest group). Explain to your friend that ALL unbiased evidence like this supports the notion that animal products are hazardous to health, while NONE of the unbiased research suggests that animal products improve CFS. Challenge your friend to come up with one peer-reviewed clinical study, published at PUBMED, in support of his/her claim.

      Dr. Ben

  29. Thanks Simon and Ben,

    I really appreciate your help and will pass on the message. It’s amazing how stubborn people are about food. I will keep plugging away this site and to buy the books. Looking forward to the Cook Book!

    Kind reagards

    Chris

  30. I have been reading about a relatively new syndrome called MCAS/MCAD (Mast Cell Activation Syndrome/Disorder – Book “Never Bet Against Occam – MCAD and the Modern Epidemics of Chronic Illnesses and Medical Complexity – Dr. Lawrence Afrin, 2016) – it seems it may account for many / most of CFS symptoms. It would be great if Dr. Greger could do a video / video series on this disorder. If anyone knows how to get this sent to Dr. Greger directly, it would be helpful!

    1. Hi Donna, MCAS appears to be an interesting condition with multiple symptoms and its treatment could help a subset of people who think that they may have ME/CFS. However my understanding is that they are separate diseases that can coexist.

      1. Interesting. Can you tell me what you have read to come to that conclusion?
        Afrin’s book doesn’t really deal with the questions directly; merely commenting that he believes it is likely that many CFS sufferers have MCAS (he never says all) – and we know that CFS is not a homogenous group by any means. Have you read Afrin’s book on MCAD?

        1. I quote from the mastcelldisease.com web site:

          Chronic fatigue syndrome is not just a symptom of mast cell dysfunction. It is its own disorder and afflicts millions worldwide.According to the experts http://www.umm.edu/health/medical/reports/articles/chronic-fatigue-syndrome , it has had several names and in recent times it has been recommended that the current name be changed fromchronic fatigue syndrometomyalgic encephalomyelitis or myalgic encephalopathy chronic fatigue syndrome (ME-CFS)to better characterize the condition:

    2. Hi Donna- I’m Dr Anderson, a volunteer with Dr Greger. I will pass on your request! Also, I’ll include here the most thorough and recent summary of what we know and don’t know about diagnosing, treating, and findings causes for the now-named Myalgic Encephalopathy/Chronic Fatigue Syndrome. Here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474682/ The full text of the article is available and very useful.

      Mast cells release many inflammatory compounds that are found to be elevated in ME/CFS patients. This may be just one of many mediators of this complex and disabling condition. Also, there are many potential causes of abnormal mast cell release, as you’ve likely read. What is clear is that the pathophysiology (disease process) is complex and not yet fully understood. There is a lot of research into this disease, so hopefully that will yield much more information with time.

      Best to you!

  31. looking for information on evans syndrome…didnt come up on a search, any info? Sorry to post this question here, but it is what was suggested in the help center (to post under a video)

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