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Nutritional deficiencies in ME/CFS
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ME/CFS is a [[neurological disorder|neurological disease]] that mostly common occurs immediately after a [[virus]], and is not caused by poor eating habits or malnutrition,<ref name="CDC-causes">{{Cite web |url=https://www.cdc.gov/me-cfs/about/possible-causes.html | title = Possible causes {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Jul 12, 2018 | website = [[Centers for Disease Control]]|language=en-us|access-date=2022-08-02}}</ref> and cannot be healed by dietary or nutritional interventions—there is no known cure.<ref name="CDC-treatment">{{Cite web |url=https://www.cdc.gov/me-cfs/treatment/index.html | date = Jan 28, 2021 | title = Treatment {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control]]|language=en-us|access-date=2022-08-02}}</ref><ref name="ICC2011primer"/> Patients with [[ME/CFS]] have been found to experience a number of nutritional deficiencies which cannot explained by patients' diet.<ref name="Joustra2017">{{Cite journal | title = Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis | date = 2017-04-28|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176631|journal=PLOS ONE|volume=12|issue=4| pages = e0176631 | last= Joustra | first = Monica L. | last2 = Minovic | first2 = Isidor | last3 = Janssens | first3 = Karin A.M. | last4 = Bakker | first4 = Stephan J.L. | last5 = Rosmalen | first5 = Judith G.M. | language=en|doi=10.1371/journal.pone.0176631|pmc=PMC5409455|pmid=28453534|issn=1932-6203}}</ref><ref name="Rayman2005"/> Nutritional [[:Category:Supplements|supplements]] have been recommended to reduce some [[ME/CFS]] symptoms,<ref name="altnutrition2000" /> but no particular [[:Category:Diets|dietary approach]] has found to be effective.<ref name="ICC2011primer"/><ref name="canadianconsensus-CCC"/> ==Deficiencies found == Nutritional deficiencies or reduced levels of certain nutrients that have in studies of ME/CFS patients include some [[B vitamin]]s, especially [[Thiamine|vitamin B1]], [[vitamin C]], [[magnesium]], [[sodium]], [[zinc]], [[L-tryptophan]], [[carnitine]], [[coenzyme Q10]], and [[essential fatty acid]]s.<ref name="altnutrition2000" /> ==Diet == Common nutritional deficiencies or lower levels of nutrients found in ME/CFS are not caused by diet.<ref name="CDC-causes"/> No particular diet has been shown to be effective in ME/CFS, the general recommendation is for a [[healthy, balanced diet]] although some dietary supplements may be helpful in addressing certain symptoms.<ref name="ICC2011primer"/><ref name="canadianconsensus-CCC"/> A number of clinicians that specialize in ME/CFS recommend certain diets based on personal experience, or certain dietary supplements. The [[Canadian Consensus Criteria]] states that the nutritional principles in Travell & Simons (1999) are helpful.<ref name=simons1999 /> ==Nutritional deficiencies as a differential diagnosis== Before a diagnosis of [[ME/CFS]] can be made a number of tests must be run including tests to detect common nutritional deficiencies known to cause of [[fatigue]] or [[pain]]. Standard tests for these can identify: *[[Anemia]] including iron deficiency anemia *[[Electrolyte]] imbalances (magnesium, potassium, and sodium) *[[Folic acid|folate]] deficiency *[[Iron]] overload *[[Vitamin B12 deficiency]]<ref name="ICC2011primer"/><ref name="canadianconsensus-CCC"/><ref name="CDC-differentialdiagnosis">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/other-conditions.html | title = Other Conditions for Evaluation {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Jul 12, 2018 | website = [[Centers for Disease Control]]|language=en-us|access-date=2022-03-28}}</ref><ref name="CDC-ruleoutests">{{Cite web |url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html | title = Evaluation {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = April 28, 2021 | website = [[Centers for Disease Control]]|language=en-us|access-date=2022-08-02}}</ref> Once after any nutritional deficiencies have been treated, and any other alternative [[differential diagnosis|possible causes]] for symptoms have been ruled out, a diagnosis of ME/CFS can be made in people meeting the diagnostic criteria.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref><ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 =Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols| journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02| url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf}}</ref> ==Notable studies == *2021, Life-Threatening Malnutrition in Very Severe ME/CFS<ref name="Baxter2021">{{Cite journal | last = Baxter | first = Helen | authorlink = | last2 = Speight | first2 = Nigel | authorlink2 = Nigel Speight | last3 = Weir | first3 = William | authorlink3 = William Weir | date = Apr 2021 | title = Life-Threatening Malnutrition in Very Severe ME/CFS|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070213|journal=Healthcare|language=en|volume=9|issue=4 | pages = 459|doi=10.3390/healthcare9040459|pmc=PMC8070213|pmid=33919671|access-date=|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070213 (Full text)] *2019, Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach<ref name="Bjorklund2019">{{Cite journal | title = Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach | date = 2019-01-01|url=https://www.sciencedirect.com/science/article/pii/S0753332218342987|journal=Biomedicine & Pharmacotherapy|volume=109|pages=1000–1007 | last = Bjørklund | first = Geir | last2 = Dadar | first2 = Maryam | last3 = Pen | first3 = Joeri J. | last4 = Chirumbolo | first4 = Salvatore | last5 = Aaseth | first5 = Jan|language=en|doi=10.1016/j.biopha.2018.10.076|issn=0753-3322}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0753332218342987 (Full text)] *2017, Role of dietary modification in alleviating chronic fatigue syndrome symptoms: A systematic review<ref name="Jones2017">{{Cite journal | title = Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review | date = 2017-06-14|url=https://doi.org/10.1111/1753-6405.12670|journal=Australian and New Zealand Journal of Public Health|volume=41|issue=4|pages=338–344 | last= Jones | first = Kathryn | last2 = Probst | first2 = Yasmine|doi=10.1111/1753-6405.12670|issn=1326-0200}}</ref> - [https://www.researchgate.net/publication/317623951_Role_of_dietary_modification_in_alleviating_chronic_fatigue_syndrome_symptoms_A_systematic_review/fulltext/595f87d10f7e9b8194e5bb13/Role-of-dietary-modification-in-alleviating-chronic-fatigue-syndrome-symptoms-A-systematic-review.pdf (Full text)] *2017, Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis<ref name="Joustra2017">{{Cite journal | title = Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis | date = 2017-04-28|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176631|journal=PLOS ONE|volume=12|issue=4| pages = e0176631 | last= Joustra | first = Monica L. | last2 = Minovic | first2 = Isidor | last3 = Janssens | first3 = Karin A.M. | last4 = Bakker | first4 = Stephan J.L. | last5 = Rosmalen | first5 = Judith G.M. | language=en|doi=10.1371/journal.pone.0176631|pmc=PMC5409455|pmid=28453534|issn=1932-6203}}</ref> - [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176631 (Full text)] * 2010, Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia<ref name=Porter2010>{{Cite journal | last = Porter | first = Nicole S. | authorlink = Nicole Porter | last2 = Jason | first2 = Leonard A. | authorlink2 = Leonard Jason | last3 = Boulton | first3 = Aaron | authorlink3 = | last4 = Bothne | first4 = Nancy | authorlink4 = | last5 = Coleman | first5 = Blair | author-link5 = | date = Mar 2010 | title = Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia|url=https://www.researchgate.net/profile/Leonard_Jason/publication/41655043_Alternative_Medical_Interventions_Used_in_the_Treatment_and_Management_of_Myalgic_EncephalomyelitisChronic_Fatigue_Syndrome_and_Fibromyalgia/links/5581c5b408ae6cf036c16e0b/Alternative-Medical-Interventions-Used-in-the-Treatment-and-Management-of-Myalgic-Encephalomyelitis-Chronic-Fatigue-Syndrome-and-Fibromyalgia.pdf|journal=Journal of Alternative and Complementary Medicine (New York, N.Y.)|volume=16|issue=3|pages=235–249|doi=10.1089/acm.2008.0376|issn=1557-7708|pmc=|pmid=20192908|access-date=|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Leonard_Jason/publication/41655043_Alternative_Medical_Interventions_Used_in_the_Treatment_and_Management_of_Myalgic_EncephalomyelitisChronic_Fatigue_Syndrome_and_Fibromyalgia/links/5581c5b408ae6cf036c16e0b/Alternative-Medical-Interventions-Used-in-the-Treatment-and-Management-of-Myalgic-Encephalomyelitis-Chronic-Fatigue-Syndrome-and-Fibromyalgia.pdf (Full text)] *2005, Nutrient intake is unrelated to nutrient status in patients with chronic fatigue syndrome<ref name="Rayman2005">{{Cite journal | title = Nutrient intake is unrelated to nutrient status in patients with chronic fatigue syndrome | date = 2005-01-01|url=https://doi.org/10.1080/13590840600681751|journal=Journal of Nutritional & Environmental Medicine|volume=15|issue=4|pages=177–189 | last= Jenkins | first = Michael | last2 = Rayman | first2 = Margaret|doi=10.1080/13590840600681751|issn=1359-0847}}</ref> - [https://www.tandfonline.com/doi/abs/10.1080/13590840600681751 (Full text)] * 2000, Nutritional Strategies for Treating Chronic Fatigue Syndrome<ref name="altnutrition2000">{{Cite journal | date = 2000|url=https://www.researchgate.net/profile/Mel-Werbach/publication/12548254_Nutritional_strategies_for_treating_chronic_fatigue_syndrome/links/59ea9d3eaca272cddddb8318/Nutritional-strategies-for-treating-chronic-fatigue-syndrome.pdf | title = Nutritional Strategies for Treating Chronic Fatigue Syndrome|journal=Alternative Medicine Review | first = Melvyn R. | last=Werbach|language=en|volume=5|issue=2 | pages = 93-108|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Mel-Werbach/publication/12548254_Nutritional_strategies_for_treating_chronic_fatigue_syndrome/links/59ea9d3eaca272cddddb8318/Nutritional-strategies-for-treating-chronic-fatigue-syndrome.pdf (Full text)] ==Books == *1999, [https://books.google.co.uk/books?id=sU0XupX7DGsC&lpg=PP1&pg=PA188#v=onepage&q=thiamine&f=true Travell & Simons' Myofascial Pain and Dysfunction: Upper half of body]<ref name=simons1999>{{Cite book | url =https://books.google.co.uk/books?id=sU0XupX7DGsC&lpg=PA188&pg=PA188#v=onepage&f=true | title = Travell & Simons' Myofascial Pain and Dysfunction: Upper half of body | last = Simons | first = David G. | last2 = Travell | first2 = Janet G. | last3 = Simons | first3 = Lois S. | date = 1999|publisher=Lippincott Williams & Wilkins|isbn=9780683083637|language=en}}</ref> ==Learn more == ==See also == *[[Healthy, balanced diet]] *[[Malnutrition]] *[[Dr Lapp's supplement recommendations]] *[[:Category:Supplements|Supplements]] (category) ==Related categories== *[[:Category:Potential treatments|Potential treatments]] *[[:Category:Diets|Diets]] *[[:Category:Amino acids|Amino acids]] *[[:Category:Herbs|Herbs]] *[[:Category:Supplements|Supplements]] ==References == {{Reflist}} [[Category:Potential comorbidities]] [[Category:Nutritional deficiencies]] [[Category:Supplements]] [[Category:Diets]]
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