Dr John Chia has noted that corticosteroids when given during an acute viral infection seems to be a "recipe" that can often precipitate ME/CFS. That is to say, quite often: acute infection + corticosteroids = ME/CFS
I think the cause is below. ongoing stress = ME/CFS which can lead to all the symptoms, including viral reactivation from supression of TH1 immune system by the stress.
Cortisol from ongoing stress depletes the Magnesium and Dhea, B Vitamins, Zinc etc. Cortisol prevents cells from losing sodium and accelerates the rate of potassium excretion as well. And stressors are not just the mental/emotional life stress. Mercury from seafood and dental amalgams (and wifi/radiofrequencies from cell phones double the mercury release of amalgam mercury and also deplete mag as well even without amalgams), copper in excess (coppertoxic.com), alcohol, caffeine, blood sugar issues, body tissue inflammation and more are all treated like you were being chased by a tiger, activating the body's same fight or flight response with release of cortisol and adrenaline same as any stressor. The normal reaction of the body to stress is to produce greater quantities of both cortisol and DHEA. When the stress is gone, the body reduces its output of cortisol and DHEA to resting levels and everything is fine. This is what happens with short episodes of stress which is how our bodies work best. However, when the stress is prolonged which as you can see is quite common, the body prefers to make increasingly greater amounts of cortisol and less DHEA in order to be already ready to handle the expected stress, bypassing things like pregnenolone to make more of the downstream things - cortisol.
One study showed that after just 28 days of ongoing stress, cortisol levels had climbed to 240 percent of starting values and DHEA had dropped to 15 percent of initial levels! What's even worse is that even after the stress is removed, the body sometimes does not recover and bring these hormones back to normal levels, but instead, remains in the stress response mode with high cortisol and low DHEA output. No matter which of these types of stress are present, the body's response is always the same: initially both cortisol and DHEA increase, and with prolonged stress, the DHEA drops heavily. Zinc loss from stress causes copper to accumulate faster putting more stress on them. Eventually however the body runs out of these resources it uses to deal with the ongoing stress, the adrenal glands become exhausted, and you will see a reduction of cortisol below normal levels when not using stimulants/cortisol, with DHEA coming back up to normal range.
The consequences of elevated cortisol and reduced DHEA levels are devastating: The immune system is compromised with increased risk to infections, certain cancers, allergies and autoimmune diseases. Glucose utilization and insulin function are altered with resultant higher blood sugar levels. Salt and water are retained and higher potassium excreted, producing tendency toward high blood pressure (low in later exhaustion). Blood cholesterol and triglycerides increase and predispose to heart disease. Thyroid function becomes impaired due to lower potassium and higher calcium, resulting in decreased metabolism, lowered body temperature, and reduced vitality. The body stores fat, especially around the midsection. Depression/Anxiety from loss of minerals as well as insomnia, hunger, and PMS result. Reproductive function falters with resultant infertility and cessation of the menstrual cycle. The body becomes more susceptible to the accumulation of toxins and heavy metals such as mercury and copper. Stomach ulcers form. Memory and learning become impaired. Brain Fog. The combination of reduced R.E.M. (rapid eye movement) sleep depletes melatonin and lowered growth hormone release at night diminish mental and physical regeneration, which results in acceleration of the aging process. Protein synthesis is reduced and protein breakdown is increased, leading to bone loss, skin wrinkles, arthritis, muscle loss and weakness, and all the protein supplements in the world won't make a difference.
The Th1 immune system is supressed by chronic stress as well. Th1 of the immune system protects us from viral reactivation. When TH1 is supressed, viral infections can then reactivate, including Epstein Barr Virus, Herpes, and a host of other viruses. When a viral infection becomes active it “hijacks” what’s known as the “mevalonate pathway.” Viruses use this pathway to make their protective outer coats. In response, your body makes interferon, which suppresses the mevalonate pathway, which in turn suppresses the virus. However, inhibiting this pathway leads to a reduction in synthesis of pregnenolone and CoQ10. Acute infections respond well to this, as the interferon production is helpful in the short term. But in the long term, this can lead to starving your body of CoQ10 and key hormones. This appears to be part of what happens in CFS.
Magnesium which is depleted by the stress is essential to create 'energy' in the body by facilitating the production of ATP (adenosine triphosphate) in the mitochondria (the power stations) of the cell. ATP is the main source of energy in cells, and must be bound to a magnesium ion in order to be biologically active. What is called ATP is often actually Mg-ATP. The process of moving sodium and potassium ions across the cell membrane is mostly an active transport process involving the hydrolysis of ATP (ATP + Water) to provide the necessary energy. This energy is used to drive the sodium/potasssium pumps that sit inside the cell membrane pumping two potassium ions into the cell and three sodium ions out of the cell. Magnesium is needed in the serotonin/melatonin pathway as well. Potassium as part of this process has a RDA of 4,700 mg a day, and cortisol depletes it while retaining sodium. The lack of Mag/Potassium/B6 are big factors in energy. Boron 3-6mg/day seems to be required for proper absorption of magnesium and calcium.
http://www.mgwater.com/dur09.shtml (chloride is involved, as is some calcium)
The Na-K-Cl cotransport system moves sodium, potassium and chloride ions across the cell membrane. Movement is electroneutral: the number of chloride ions moved equals the sum of the number of sodium and potassium ions. In most cells, the ratio of ions moved is 1Na:1K:2Cl. This system is activated by cell shrinkage and is important in regulating cell volume and potassium content. K-Cl cotransport is the electroneutral movement of one K+ ion with one Cl- ion across the cell membrane K-Cl cotransport is usually measured as the flux of K+ which depends on the presence of Cl-
Mercury blocks Na-K-ATP, it competes with Magnesium. The mercury antidote 2,3-dimercapto-1-propanesulfonic acid (DMPS) was able to reactivate approximately 70% of the blocked enzyme. I used pectaclear which is pectasol c and sodium algimate to detox mercury without chelating essential minerals as can methods like cutler and why they need breaks.