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Why does pregnancy often banish CFS symptoms?

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by richvank, Feb 23, 2010.

  1. richvank

    richvank Senior Member

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    Hi, all.

    As I think you know, I believe that the core biochemical issue in CFS is a partial methylation cycle block, coupled with draining of the folate metabolites out of the cells by the "methyl trap" mechanism, and also coupled with depletion of glutathione. The glutathione depletion results in chronic oxidative stress. I believe that essentially all the symptoms of CFS can be related to this fundamental core issue, which is a vicious circle mechanism that keeps the person chronically ill.

    It has been known for several years now that a significant fraction of women who become pregnant while having CFS experience absence of their CFS symptoms while pregnant, only to have them return after the birth of their child. This is not true in all cases, but it is true in a lot of them. The study by Schacterle and Komaroff (PMID: 14980991) found it to be true in 30% of the cases they studied. Dr. Charles Lapp has reported a higher fraction in his practice, and Dr. Teitelbaum has also found it to be common. I have wondered for several years what the explanation of this intriguing phenomenon might be. I joined the CFIDSorFMSpregnant group nearly ten years ago because I wanted to track down these reports to see if they were true. I was, and still am, the only male member of the group! Among the women in the group, some did report that their symptoms were lessened during their pregnancies.

    Various hypotheses have been suggested to explain this, including increased blood volume during pregnancy, an effect on the immune system associated with the necessity for the mother's immune system not to reject the fetus, or an effect resulting from the hormonal changes during pregnancy.

    If the glutathione depletion--methylation cycle block hypothesis for CFS is valid, it must be able to explain this phenomenon, or at least to mesh with it. Somehow, the biochemical issues that result from this vicious circle mechanism must be either corrected or counteracted during the pregnancy for these women.

    The fact that the symptoms usually come back after the birth of the child suggests to me that this mechanism is not completely corrected during the pregnancy, but rather that the body compensatea for the effects of it during the pregnancy. So how would this compensation happen?

    There has been some additional research published in the past few years directed toward developing a better understanding of toxemia (pre-eclampsia), which a small percentage of otherwise healthy women have during pregnancy. This research indicates that oxidative stress is involved in toxemia, so that has received quite a lot of study. This research fortunately is useful in understanding what goes on in normal pregnancies as well, when the woman does not have toxemia.

    The research shows that during a normal pregnancy in a normal, healthy woman, there is increased production of reactive oxygen species, and these are dealt with both in the placenta and by the mother's red blood cells. There is a greater antioxidant capacity established during pregnancy to handle this oxidative stress. Also, it appears that the other aspects I mentioned, that is the problem with methylation and the problem with the folates, are also compensated during pregnancy.

    It appears that the oxidative stress is taken care of by higher activity of the enzyme catalase in the red blood cells and the placenta, which eliminates hydrogen peroxide, just as glutathione together with glutathione peroxidase does. So perhaps the additional catalase could compensate for the depletion of glutathione in a pregnant woman with CFS.

    In addition, there is evidence that more choline is made available during pregnancy to produce betaine, and that is used in the BHMT pathway in the liver and kidneys, which can compensate for the problem with methylation. Furthermore, the DMG that results from this reaction can support the folate metabolism. I don't know how the additional choline would be made available in women with CFS, since synthesizing it requires methylation, which is partially blocked according to the GD--MCB hypothesis. Perhaps it is taken from the woman's inventory of phosphatidylcholine. This is the biggest remaining question with this part of my hypothesis.

    But if this hypothesis is true, it looks as though there are mechanisms during pregnancy that can compensate for all three of the main biochemical aspects that are included in the vicious circle that exists in the body of a woman who has CFS.

    After the birth of the child, of course the placenta is expelled, and the new red blood cells that are made after the birth revert back to the way they were before the pregnancy (this can take at least several weeks, because the average life of a red blood cell is four months, and they are replaced on a continuous basis at about 1% per day). Also, the choline metabolism presumably reverts back also. Therefore, the original vicious circle mechanism remains, and is no longer compensated, so the symptoms return.

    That's what I suggest goes on. I don't doubt that the increase in blood volume during pregnancy also helps. And not having to break down and get rid of estrogen every month would also be a big help, because, as I suggested in a 2007 IACFS poster paper, I think this is what causes CFS to be more prevalent in women than in men. Those who inherit certain polymorphisms experience redox cycling when their bodies are disposing of estrogen, and this biases them toward oxidative stress and glutathione depletion, which I've suggested is what leads to the onset of CFS in people who are genetically predisposed.

    Of course, many women with CFS do not experience improvement of their symptoms during pregnancy, and in those cases my guess is that these compensating mechanisms are not as effective, perhaps because of genetic differences or nutritional factors that limit them in some women, just as some women develop toxemia or gestational diabetes, while most do not.

    Anyway, it's something to think about. It's pretty amazing how a woman's body can "rise to the occasion" and overcome even something as debilitating as CFS during pregnancy.

    Best regards,

    Rich
    Anteah likes this.
  2. laura

    laura Senior Member

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    your post gives me hope

    Thanks, Rich, for your post.

    I don't have children yet and have been very worried about the effect of the CFS on my health both during pregnancy and after. I didn't know some women experience better health during pregnancy. Gives me hope that I can do it! And it's an interesting avenue to explore CFS causes...

    Laura
  3. brenda

    brenda Senior Member

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    This is interesting rich. I have had 4 pregnancies during the time I have been ill - though nowhere as ill since contracting lyme. The first few months were not so good, and the last pregnancy was terrible with severe nausea and insomnia but later I would feel better than usual. One theory I have heard is that once the unborn child starts producing it's own cortisol, the mother feels better if her endocrine system is depleted which mine was from early childhood mercury poisoning. The children were all born more stressed than other children I feel. The did not sleep as well as others, and I knew this as I had been a nursery nurse.
  4. Carrigon

    Carrigon Senior Member

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    Around 2001, I went on Ortho Tri Cyclen birthcontrol pills. After one month on them, I had no Fibro pain at all! It was the most amazing thing ever. I kept telling the pharmacist that it was helping my Fibro. I was literally Fibro pain free, my back and shoulders didn't hurt me for the first time in a million years. I also experienced a day where for a short period of time, the brain fog lifted, the fatigue lifted and I was in a grocery store when it happened. And all I can remember is looking at all the people around me and......hating them all because they take that life energy for granted. That energy that is stolen from us and that brain clarity. They all take it for granted. Rational or irrational, I just plain hated them for it. Shortly thereafter, I was in a car accident, some idiot rearended my mother's car and I got all the symptoms back. So we will never know if I would have had a form of recovery or not from the birth control pills. I wasn't able to stay on them for more than a year and a half. My blood pressure skyrocketed and I was close to having a stroke from them. I haven't been able to take them since. But the point is, there's something going on with the hormones and this disease. Birth control pills simulate pregnancy. So it basically got rid of the Fibro pain and symptoms temporarily. I really think more study needs to go into this whole area.
  5. Jenny

    Jenny Senior Member

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    Thanks for this Rich - I remain very moved by your seemingly never-ending search for explanations of what we're all experiencing.

    I have to say though that my ME actually started when I was 3 months pregnant. I was in bed for 3 months then seemed to recover for the last 3. I was OK after my daughter was born but then got worse when she was about one year old, and was then bedridden for most of the next 4 years.

    Many years later, I started to get much worse again when on a type of HRT that contained quite a lot of progesterone. (But that may have been coincidence as some of my symptoms were triggered by a ski-ing accident.)

    I think there are others on this board who got worse during pregnancy and given that progesterone may be one of the hormones that turns on XMRV, we've wondered whether progesterone has been the trigger for us.

    I'm one of the people who haven't yet improved on your Simplified protocol after being on it for nearly 2 years- this may be relevant.

    Jenny
  6. fds66

    fds66 Senior Member

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    I improved while I was pregnant after the first few monthes. It is the one and only time my symptoms have lifted in the 18 years I've had ME. I didn't relapse straight away either but did later on but I had severe post natal depression when I stopped breast feeding at nine months so that complicated things - my ME certainly returned but I couldn't tell you exactly when. 12 years later I have still not experienced another relief from the ME symptoms and I think I've probably gradually worsened over time. I am finding a progestogen only birth control pill has evened everything out well. I had to move to that sort of pill because I am now too old to take the other sort but I think it suits me.
  7. muffin

    muffin Senior Member

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    I have heard several women say that their CFIDS/ME symptoms got much better when they were pregnant. All the female hormones go up, but doesn't Progesterone (or is it Progesterine ?) rise really high? Does the Progesterone hit super high levels at the end of the pregnancy and then do a pretty sudden drop after birth? Again, what role does Progesterone play in all of this? I know that Prog. cream helps my neck pain at night but it also causes me other female issues that need to be avoided at this point. It also caused me to become very sleepy minutes after rubbing it into the neck/skull area.
  8. leaves

    leaves Senior Member

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    I saw dr Klimas on wed and she mentioned that it could be because pregnant women make more blood volume, and pwc have too low blood volume.This effects remains for a while after giving birth, and then goes away.
    BTW at high altitudes people make more blood too; therefore some pwc feelbetter after going to a holiday in the mountains.
  9. xchocoholic

    xchocoholic Senior Member

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    Hi Rich,

    Can you tell me what this quote means in layman's terms ? Do you know what we can do if our bodies are having trouble breaking down estrogen ? Or how we can be tested for this ? I'll have to google "redox cycling" ...

    I'm not sure if this will help you or not but I'm experiencing a return of some of my "CFS" symptoms due to ovulation this month. Most women experience an increase in allergies, abdominal symptoms, etc when menstruating but I'm not sure if it's all related to ovulation or what part of the cycle or which hormones. Do you know ?

    It's probably been 6 months since I ovulated and over a year since I've had a period. I wasn't sure what this was the last time I did this but now I know for sure. All the signs are there ... lol ...

    I'm post menopausal so this is something I can look at without being confused by the normal stress, loss of blood, etc. that having regular menses cause. And since I have my candida, vulvodynia, UTIs, allergies, sleep disturbances and food intolerances under control most of the time I can tell what's up now.

    By a return of my "CFS" symptoms, I mean that my allergies, esp my chemical sensitivities are back. I'm super sensitive to laundry soaps, newspaper, etc. My nose is running quite a bit and I'm sneezing about 20 times a day.

    If I still had an obvious candida problem and vulvodynia I can assure you that these would be worse now too. TMI ...

    My digestion has slowed and I have to be careful what I eat right now.

    I had one day of cloudy urine and took AZO just to be sure I wasn't getting a UTI. I figured out awhile back that I was getting UTIs regularly and taking AZO and staying on a low oxalate diet is keeping that under control. This could've just been something I ate too and unrelated to ovulation. I haven't had any other UTI symptoms with this just some pain in the lower region around my bladder and uterus.

    My sleep is being interrupted by this too. I was wide awake for 5 hours in the middle of the night and had to increase my 5HTP to 200 mg in order to sleep. And I need 100 mg of theanine for my myoclonus now too. At least this is working though ...

    And I'm more tired / weak than I was despite keeping the same regime.

    I'm not sure where my glutathione levels are now but when they were tested in 2008, they were good and my diet is still healthy. I did however show a decrease in the ability to detox via Spectracell testing. Vitamin E was the only recomendation ... FWIW. I'm craving raw aspargus which has glutathione ... lol ... oh and my chocolate cravings were horrible last week and totally gone now. At $4 a bar, I'm glad that's over ... ; )

    I was going to wait until I understood all this better before posting this here but realistically, it would take me too long to learn all of this ... HTH ... Marcia

    PS. I experienced massive blood loss when peri menopausal and can tell you that the feeling of weakness I got from that had nothing to do with the symptoms I get from gluten or other food intolerances, or constant UTIs, or vulvodynia or candida, etc etc ... Those were seperate conditions ... So, IMHO, low blood volume has little to do with my CFS. I tested positive for iron anemia, used a cast iron pan for several months and then retested fine ...

    BTW, I can't remember the name of the test they ran at the ER that showed that my blood volume had dropped significantly in a couple of days but wouldn't that work for us too ...
  10. redo

    redo Senior Member

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    Hi xchocoholic,
    Thanks for sharing your experiences. I am thinking it might be related to this: www.ncbi.nlm.nih.gov/pubmed/15870720/
    As you can see, cytokines, and especially IL1 gets higher during ovulation. It might be that when an increase in IL1 comes, the symptoms gets exaggerated because the IL1 is already high. I have terrible insomnia, newfound MCS like symptoms and I'll try to dampen the IL1 response. It's done with often good results in RA...
  11. Nielk

    Nielk

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    Hi Rich,

    Thanks for your post.
    I just wanted to add that when I had my pregnancies, I was suffering from Crohn's which I think is considered an autoimmune disease. I was very ill when not pregnant and with each pregnancies (5) I was in a complete remission from Crohn's which reappeared after I gave birth. I wonder if there is a correlation being that it is an autoimmune disease?
  12. snowathlete

    snowathlete

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    Thats really interesting! My wife had her first baby this year, so well done on doing that five times!
    I have always wondered about the pregnancy/remission thing too. My mum had chrohns when she was young, but got healed before any of us were born. My mum has always wondered if there is some link (suceptibility or whatever) genetically between the two illnesses.
  13. dmbaken

    dmbaken

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    Hi,

    It was the opposite of this for my wife. She became unwell with ME (we did not know it then but she fits the Canadian Criteria) with our third and it went away after. Then she became unwell again with our fourth and has not gone away since (about 14 years).

    Don
  14. kaffiend

    kaffiend Senior Member

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    One theory about reductions in auto-immunity during pregnancy has to do with placental corticotropin releasing hormone (CRH). Cells releasing CRH signal the release of cortisol (immune suppression) to prevent the immune system from treating the fetus as non-self.
  15. allyann

    allyann Senior Member

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    For those who are interested in changes in symptoms during pregnancy, I have been keeping a blog. I am now 36 and a half weeks. Each blog entry covers the week before.

    http://forums.phoenixrising.me/blog.php?6307-allyann

    So far overall, ME/CFS systems are less and FM symptoms are worse. This tends to indicate to me that there is a wider gap between FM and ME/CFS than most researchers think. On the sleep side, my sleep seems to be deeper, even though I cannot achieve continous sleep for more than a couple of hours due to pain from my hips, fibroid and FM.

    My thoughts for possible reasons for improvement, especially in cognitive functions, seem to be increased blood flow volume, hormone changes and change in sleep patterns.

    Allie
  16. Andrew

    Andrew Senior Member

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    I saw a documentary series called Mystery Diagnosis where a woman had CFS symptoms except when pregnant. An Endocrinologist realized took note of one hormone dropping way down after pregnancy. Even though it was not below normal, she treated the woman with the hormone, and her CFS symptoms went away.
  17. u&iraok

    u&iraok Senior Member

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    Anyone know, what part progesterone might play since it's higher during pregnancy?
  18. aprilk1869

    aprilk1869 Senior Member

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    All I know is that it can block NMDA receptors and therefore reduce excitotoxicity. Studies are being done on progesterone in relation to brain injuries including strokes. It's currently being used in Afghanistan and Iraq on troops who've suffered traumatic brain injury.

    Progesterone for acute traumatic brain injury.
    www.ncbi.nlm.nih.gov/pubmed/21249708
  19. ukxmrv

    ukxmrv Senior Member

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    I wonder if it could be Estriol?

    Here is a webpage that talks about this as a possible tx for ME

    ()

    "We've already done a pilot study with estriol," Voskuhl commented. Estriol, a naturally occurring estrogen produced during pregnancy, doesn't have the side effects associated with estrogens traditionally used for hormone therapy. Similar to the testosterone study in men, the pilot trial using estriol in women showed decreases in MS severity. In fact, "the lesions in the brain were reduced by 80 percent," Voskuhl reported.

    A larger trial using estriol to treat women with MS is under way. Given as a pill, estriol will provide patients with hormone levels equivalent to six months of pregnancy, since the last trimester of pregnancy is often a time at which MS symptoms improve and relapse rates decrease. The study, currently recruiting participants, will be a two-year placebo-controlled study and will treat patients concurrently with a standard treatment.

    ()

    http://www.msrc.co.uk/index.cfm/fuseaction/show/pageid/708
  20. filfla4

    filfla4 Senior Member

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    I have to agree with what's been said. I got pregnant about 3.5yrs after first getting ME. During my pregnancy my symptoms all disappeared, I was FULL of energy and I actually lost all the weight I had accumulated during my illness. I weighed less at 9 months pregnant than I had before and I gave birth to a healthy 3.7kg baby. However the joy ride disappeared within just hours of giving birth. I picked up a hospital bug (pseudomonas infection) with spiking fevers, developed a massive haematoma where I had been given a pethadine shot, and dislocated my pelvis in the delivery. I was terribly ill for several months after the birth and all my ME symptoms reappeared.

    That's a long time ago now and over the years I've experienced good times and bad with my symptoms. However about 5yrs ago I became prematurely peri-menopausal and within a few months my health deteriorated considerably....I'm still struggling.

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