Is this particular severe fatigue due to the pathogen or my immune system's response to it?

[Mary]

So I have been fighting an unknown bug off and on for a few months and it has returned again in full force. I describe it a little in this post - chief symptoms are mild congestion, no fever, but severe fatigue (feels like a crash but isn't) and sometimes night sweats.

I waited a little too long, again have been down for 2 days due to this, restarted everything yesterday (andrographis, astragalus and grapefruit seed extract - I don't think I need the colloidal silver), and finally this evening have a little bit of energy, which is what happened the last time I introduced astragalus into the stack I take when I get sick.

Since my other symptoms are so mild, I'm wondering if the severe fatigue is due to the pathogen, whatever it is, OR my immune system's response to it, in light of this post which talks about Interleukin 6, which is released by the brain in response to infection, causing mitochondrial dysfunction and weakness and fatigue.

This infection, whatever it is, is new for me. I'm used to getting mild sinus infections after I crash, but never with this degree of incapacitating fatigue. So I first wondered what pathogen this could be, but then wondered if it's the same old one I always get but that my immune response to it has been ramped up some how.

I'm guessing it would take some sophisticated immune testing to sort this out - anyways, any ideas anyone?

I'm mainly just curious and am extremely grateful that the astragalus apparently helps me so much.

 

[Violeta]

What causes the fatigue is the most difficult thing to pin down.
But glad you found something to help.

 

[Wayne]

I'm used to getting mild sinus infections after I crash,

Hi @Mary,

Have you considered whether your sinus infections ever completely go away? It seems curious that you would get so many different ones, and I can't help but wonder if it's possible you're dealing with a chronic low-grade one that flares up every now and then.

I used to experience a fair amount of sinus "stuffiness", which seems to have cleared up after doing some nebulizing of very dilute hydrogen peroxide as I recovered from COVID a couple years ago.

Also, I recently purchased some cod liver oil, and just tonight was perusing some of the 5,000+ ratings. I was struck by the following, and thought you might find it interesting. Below the long rating, is a much shorter one I also thought you might find interesting. -- Best!

Nordic Naturals Cod Liver Oil was recommended to me in 2005 by the owner of a health food store. Never in my wildest dreams did I think I'd go without a cold, the flu, nor any kind of virus for EIGHT years and counting. Yes, I try and take good care of myself in other ways, too (plenty of sleep most nights, daily vitamins and other supplement regimen for 25+ years, eat mostly organic foods and healthy diet in general, more frequent hand washing, etc.) But I've always attributed my being "sick-free" for almost eight years now, to my daily 1-teaspoon dose of Cod Liver Oil (lemon flavor is the best.)​

​

Prior to taking cod liver oil, I was good for at least one doozy of a cold each year, and generally the flu once a year as well (fairly typical of an average adult American, I think Plus I usually travel a couple times a year (domestic and/or international); so no small feat my immune system continues to stay off the charts, especially given an airplane's "dirty air and germs"​

....................................​

I feel like I have less arthritis pain and I’ve been sleeping like a baby every night since I began taking cod liver oil.​

​

The first rating actually reminded me of one of the guys that spent 33 years researching DMSO (in Portland, OR). He got into the habit of taking 1 tsp. of DMSO daily, and claimed he never got sick in all the years he took it.

 

[linusbert]

Nordic Naturals Cod Liver Oil was recommended to me in 2005

is this oil in a plastic bottle? i wouldnt use plastic bottles for oil. brown and dark glass ist best for oils.
fish oil can still be beneficial for you but maybe they offer also in glas?

 

[Wayne]

is this oil in a plastic bottle?

Hi @linusbert -- It's in a glass bottle. Unfortunately, it's not a good one in that the cap is flimsy, and oil runs down the side of the bottle whenever you pour some out. One guy's solution was to put it into a separate bottle with a pump, which is what I'm planning on doing. One reviewer said he put small amounts in the food for his pets, and their coat of fur significantly improved.

 

[lenora]

Hello Mary......Well, you sound a lot like me. Sinus is almost everywhere in TX, but it usually takes about 2 years for it to show up.

I agree with Wayne in that the sinus infection may not be fully gone. Mine isn't......and we're talking many years here. Some days it's better than others and my husband also suffers (but has multiple shots and they help him). Still, we have air purifiers everywhere, one is especially powerful, but it's quite large. Hidden under a table as it clears from the sides.

Nights are the worst and while Wayne sleeps (lucky man!), a lot of us aren't given that gift. I've had to go on meds for a few serious problems that nothing else has helped. I try to keep them to a minimum.

I think it's the immune system itself that poorly functions. Yes, a flare is caused by something....but it continues playing the same old tape long after it's necessary. Allergies are a major problem, I know that much, and really should add an allergist to my retinue of doctors. One more though? Really, it's a fulltime job.

Sinus can cause problems for the eyes, nose, teeth, headaches and cheek aches. Infections can rapidly occur. Sometimes it's hard to know what's causing what if you have a symphony of pain going on. It's all close to the brain, so do be careful. Even antibiotics won't help a chronic sinus infection....or at least that's been my experience. (And yes, I know they can wipe out good things in our system). All things have to be carefully weighed.

Sometimes all we can do is to treat the symptoms, it's almost impossible to get to the cause. Cod liver oil may help.....again, I hate to add one more thing and don't think I'd take it each day b/c of things like liver damage. But certainly once/wk., can't hurt. Yes, dark glass bottles - as I'm sure you already know.

Sorry that this has also entered your life. To be an allergist in TX is like manna from heaven.....sorry!
Feel better, although better should be now while it's really hot and no humidity. Sorry. Yours, Penny

 

[Hip]

Sinus infections can cause a lot of fatigue, and in fact chronic sinusitis is sometimes mistaken for ME/CFS. It's the immune response to the pathogen which causes this fatigue (this is true in any infection).

Nasal irrigation with warm saline can help sinus infections. (I make physiological saline for this, which is 900 mg of salt per 100 ml of distilled or boiled water).

Incidentally, I devised a technique of nasal irrigation which is specifically designed to get warm saline into the sinuses.


Kidney infections are also known to cause a lot of fatigue. I have had a recurrent urinary tract infection (presumed to be in the kidneys) for decades. Every time it recurs, I get hit with a lot of extra fatigue.

 

[Mary]

I can't help but wonder if it's possible you're dealing with a chronic low-grade one that flares up every now and then.

I think this is quite likely. I know my immune system is subpar. I tested positive for EBV, coxsackie B, some echoviruses and maybe one or two others. The bug generally "flares up" right after I've been crashed.

I'm afraid I have doubts about the cod liver oil for me. I'm not like a normal healthy person who just needs some cod liver oil. I have ME/CFS with all that entails. And I often see people talk about EBV flaring up again, etc. I have no idea what this bug is that I have to keep fighting - it could be one of those viruses.

My question here though was whether it was a new bug, or if my body was reacting to it differently - because the new symptom with it is this severe fatigue. Before, it would make me tired but I could still function a bit, but with this new iteration I can barely move - it feels like a crash, only it's not. But the astragalus really seems to be helping with that severe fatigue which may be related to its action in downregulating IL-6.

I experiment a lot but the cod liver oil is a bit pricey for an experiment for me right now - $46 . . . thanks Wayne!

 

[Mary]

I think it's the immune system itself that poorly functions. Yes, a flare is caused by something....but it continues playing the same old tape long after it's necessary. Allergies are a major problem, I know that much, and really should add an allergist to my retinue of doctors. One more though? Really, it's a fulltime job.

@lenora , I totally agree about the immune system poorly functioning. It's been demonstrated we have low NK cell functioning, my white cells are always in the low range and the doctors just shrug, we have abnormal CD4-CD8 ratios (something like that) etc. I don't think I'm suffering from allergies though. This has been happening for years, it hits generally right after I crash. But the new aspect is the severe fatigue which leaves me bedridden. I don't think allergies do that. Plus, my congestion is so mild - barely enough to blow my nose once or twice a day - allergies aren't like that.

It's a puzzlement! I think we would need near constant sophisticated lab testing to keep on top of everything that goes wrong with us, which of course is impossible and even if possible would be a full-time job, as you noted!

I do believe the astragalus is making a big difference for me, so I'm leaning towards the idea that the severe fatigue is caused by IL-6 and that the astragalus is downregulating IL-6.

Anyways, thanks @lenora -

 

[Mary]

Sinus infections can cause a lot of fatigue, and in fact chronic sinusitis is sometimes mistaken for ME/CFS. It's the immune response to the pathogen which causes this fatigue (this is true in any infection).

Hi @Hip - I still don't know if this is the same bug I've been getting for years , which never caused this severe fatigue before, or if it's a new bug. If it's the same bug then my immune system is mounting a different response and I want to know why. We would all like to know a lot of things!

fwiw, there is no doubt I have ME/CFS despite repeated sinus infections. I have a set energy envelope - about 4 hours of light activity a day - which if I exceed lands me in bed the next day. And the activity includes socializing, phone calls, intense cognitive exertion as well as physical activities. The sinus infection is just the icing on the cake! which hits after I recover from the crash.

I used to get a lot of UTIs, haven't had one for a few years.

Lots of things can cause fatigue. I'm well aware of that. And as we all know, just being tired is not ME/CFS nor PEM. I was more tired all the time before I started taking folate and potassium and B1. Vitamin deficiencies are not ME/CFS either.

But I don't think there is any question the astragalus is helping a lot with the severe fatigue. So I think my theory that it's downregulating IL-6, or that too much IL-6 is causing the severe fatigue, is on the right track.

I did try nasal irrigation before - it was sort of unpleasant and I didn't stick with it, though I know I should give it a go, so thanks for the info.

However, there is one other thing which might be easier for me to do and is certainly worth a try - humming - https://www.sciencedirect.com/science/article/abs/pii/S0306987705006328

 

[Violeta]

Hi @Hip - I still don't know if this is the same bug I've been getting for years , which never caused this severe fatigue before, or if it's a new bug. If it's the same bug then my immune system is mounting a different response and I want to know why. We would all like to know a lot of things!

fwiw, there is no doubt I have ME/CFS despite repeated sinus infections. I have a set energy envelope - about 4 hours of light activity a day - which if I exceed lands me in bed the next day. And the activity includes socializing, phone calls, intense cognitive exertion as well as physical activities. The sinus infection is just the icing on the cake! which hits after I recover from the crash.

I used to get a lot of UTIs, haven't had one for a few years.

Lots of things can cause fatigue. I'm well aware of that. And as we all know, just being tired is not ME/CFS nor PEM. I was more tired all the time before I started taking folate and potassium and B1. Vitamin deficiencies are not ME/CFS either.

But I don't think there is any question the astragalus is helping a lot with the severe fatigue. So I think my theory that it's downregulating IL-6, or that too much IL-6 is causing the severe fatigue, is on the right track.

I did try nasal irrigation before - it was sort of unpleasant and I didn't stick with it, though I know I should give it a go, so thanks for the info.

However, there is one other thing which might be easier for me to do and is certainly worth a try - humming - https://www.sciencedirect.com/science/article/abs/pii/S0306987705006328

I find this very interesting, Mary, and it's making me look more closely at astragalus with respect to IL-6.

I'd never have thought LPS would be involved in sinus issues, but I found this. This is not related to astragalus, but is related to the LPS inducing IL-6.

Increased lipopolysaccharide content is positively correlated with glucocorticoid receptor-beta expression in chronic rhinosinusitis with nasal polyps​

https://onlinelibrary.wiley.com/doi/full/10.1002/iid3.346

I am not saying this is what is causing your problems, I am just brainstorming because I think it's interesting.

 

[Violeta]

Fatigue and interleukin-6 – a multi-faceted relationship​

https://www.ncbi.nlm.nih.gov/pmc/ar...-6 (IL,autoimmune and non-autoimmune diseases.

The cytokine interleukin-6 (IL-6) is involved in the development of fatigue in both autoimmune and non-autoimmune diseases. It is secreted during acute and chronic inflammatory responses by many cell types, including immune, endothelial, and muscle cells. Elevated levels of IL-6 are observed in connective tissue diseases such as rheumatoid or psoriatic arthritis, Sjögren syndrome and many others [4–6].

 

[Dysfunkion]

That is similar to what flared with me after some kind of infection got out of control unexpectedly when I was trying out glucosamine. It's very responsive to herbals whatever it is like in your case there. I can't sweat very well though so I almost never get night sweats, there was one period recently I was able to get sweating almost completely back online but then it went back down again. I recently tried astralagus and it was a very mixed experience, I got a little physical fatigue reduction but mentally it only increased but I also got a reduction in the feverish flares and my skin sensitivity felt normal all over for once. I didn't take anymore because I was scared of what would happen if the other side effects got worse. Then I tried cryptolepis and got crushed by the smallest doses of it so I'm sure it's something in the lyme and friends bubble. I'm not sure if I should try the astralagus again but at a sprinkle of a dose and slowly work my way up, not sure specifically what it fights against infection wise the most.

I tried hesperidin today and it rescued me though with the intense malaise and fatigue. Still have a little inflamed feeling in my head and nasty nasal stuff but it's not horrible right now. It did make me a bit too calm for my liking during the day but at least it got rid of the torturous, inflamed anhedonic haze the last thing put me in and now I'm in a decent mood. Gonna keep this on hand now cause it appears to be good at pulling me out of things like whatever just happened that was similar to what you had flare.

 

[Violeta]

Holy cow, IL-6 in relation to postherpetic neuralgia from shingles!

 

[Violeta]

This is interesting.

"In another study, patients hospitalized for moderate bacterial and viral infectious diseases were checked for their cytokines. IL-6 was associated with a bacterial rather than a viral infection [213]. This is useful information when trying to figure out if someone’s problems are more likely viral or bacterial. In the study, people who took antibiotics had their IL-6 normalize after only 3 days (from 39 to 2) [213, 214]. The average IL-6 level for people with bacterial infections was 237 pg/ml. It was undetectable for viral infections [215]"

 

[Mary]

@Violeta - your above posts are all so interesting! Actually you're the reason I'm taking the helpful astragalus because of this post in another thread. I was crashed yesterday and still recovering a bit but will look at your posts in more depth when I get a bit more energy - thank you for all this information!

 

[lenora]

Feel better, Mary. I'm glad that something seems to be helping you.

I didn't realize that this happened to you each year, but this year was especially bad. I know you live alone and that's tough when you have to prepare your own meals, etc.

I expect that you're spending a lot of time in bed and that's exactly where you should be until you improve.
Can you have meals delivered to your door? That would help immensely. I know plenty of people who do that on a regular basis. After all, everyone gets ill and I hope it's respected b/c it's a fact of life. I also hope the days don't seem too long. Are you sleeping (you may have said above). It will help if you can....but then you know that.

I do hope you'll feel better soon and yes, @Violeta has some very good input. Thanks. Yours, Lenora

 

[Mary]

@Violeta - I'm coming back to IL-6 again - I'm still dealing with the bug (I think it's the same one I've had on and off all summer) but my fatigue is about half of what it was, which is nice. I'm guessing the astragalus is still helping. I've also been taking 1 teaspoon of baking soda each morning - supposed to help calm down autoimmunity, which I know is a different subject, but I recently came across a study indicating that there is an autoimmune component to Long Covid, and so I'm guessing presumably to ME/CFS as well.

And this study describes how baking soda can help tamp down the immune response in autoimmunity.

So it might be a combination of the astragalus and the baking soda which is lessening that severe fatigue.

In any event, in looking at your posts above again, one of them states:

IL-6 was associated with a bacterial rather than a viral infection [213].

However, another post says that elevated IL-6 is found in shingles, which, as we all know, is one of the ubiquitous herpes viruses. . .

So elevated IL-6 might not be such a definitive marker for a bacterial vs. viral infection - but I'm still very glad for all your posts, as they seem to be helping me a little in trying to navigate this labyrinth!!

 

[Violeta]

@Mary, I actually was very tired I guess it was 2 weeks ago now when we had been talking, and then I came down with a stomach flu! When I get sick it really knocks me back from not only researching, but also from taking stuff that I had found helpful.

Anyway, I guess I have something always going on on the back burner, too.

I have a hard time making myself drink plain baking soda in water, but I do like it with lemon juice. I wonder if you get the same effect. I frequently take alka seltzer, too, and it's always helpful for what feels like digestive upsets. It helps me sleep, sometimes, too.

I am trying to be consistent with taking grapefruit seed extract.

Since the stomach flu, I have cut out all starches, but also I cut out the homemade keifer I had been drinking. This is just a tangent, but back to the IL-6. The herb that seems to help me the most is ginseng, and I see that it does help with inhibition of IL-6 production.



Panax ginseng
https://pubmed.ncbi.nlm.nih.gov/17436372/

Red Korean ginseng
https://www.sciencedirect.com/science/article/pii/S1226845321000427

I still haven't read the study about IL-6 being involved in fatigue. Too tired

 

[Mary]

Hi @Violeta - So sorry to hear you got the stomach flu - that's just miserable! How are you doing now? I almost never get stomach problems, "just" sinus and upper respiratory bugs.

About the baking soda - now I'm having second thoughts. I've been having a very hard time getting my energy back, after first it seemed to be returning. I've been taking the baking soda for about 2 weeks I think and now am wondering if it's playing a role here in dampening my energy, in one of 2 ways that I can think of: (1) I just may be having a paradoxical reaction to baking soda - it's used by athletes to improve energy and stamina so that seemed to be a further reason for taking it. But sometimes I react the opposite of what should happen . . . or,

(2) baking soda does neutralize stomach acid. I was taking it on its own, and then 35 - 40 minutes later would take my first dose of BCAAs, which are crucial for me to shorten the duration of PEM and also help with energy, but now am wondering if the baking soda was interfering with my absorption of the BCAAs.

In any event, I'm stopping the baking soda for now, and if I improve, then sometime later when I feel well enough I'll try taking the baking soda at a different time of day so that it couldn't interfere with the BCAAs and see what happens. It's always something!

Thanks for the links about ginseng. I'm really glad to hear that it's so helpful with inhibiting IL-6 production. Is there a particular brand or product that you use? I've tried ginseng in the past with no apparent results, but I'm guessing I just wasn't taking a good product.

I've found eleuthero root (often called Siberian ginseng) to be helpful with energy - I'm taking this product. The recommended dose is 3 to 4 tablets twice a day, or 6 to 8 a day total, and I've been taking 2 total for quite awhile but am cautiously increasing it to 3 and may go up to 4. Anything that helps me with energy almost inevitably ends up causing insomnia so have to be very careful with it!

I hope you're feeling better by now