Role of overstress in CFS

[Mary]

In medical terms is physical stress on the body considered to be a stress the same as a stress on the brain. Ie would someone who exercises to a high level be considered stressed the same as someone under a lot of pressure from work or money or relationships etc.?

I saw a cardiologist during the week for my POTS and she mentioned in passing that
she had seen many marathon runners with same.
She couldn't back it up with anything when I probed and she did say it could be that she just happened to get refferred more marathon running patients but I did find it odd that she said it, given my personal association of onset with exercise.

Excessive high level exercise can lead to chronically elevated cortisol levels and other damage to the body:
http://chriskresser.com/why-you-may-need-to-exercise-less/
http://running.competitor.com/2014/...isol-and-should-you-be-worried-about-it_39176

There's lots of info about the potentially harmful effects of endurance training and heart damage in marathon runners.

 

[Mary]

I agree, but even if we are wrong we can't blame ourselves for continuing on with our lives while sick. Most people barely take time off or if they do they get back to work fairly quickly and nearly all of these cases don't result in me/cfs. I do wonder if I had rested more during the acute infection if I would have me/cfs today but like I said there must be plenty of people out there feeling sick and not taking adequate rest. It might be a factor but there must be more to it.

I totally agree. I know people who endured severe stress for many years or got sick and ate crap and did not take care of their health and did not develop CFS/ME. I wonder too what that "factor" is which allows some to sail through and others capsize (for a rather clunky metaphor! ) under the same or similar circumstances.

 

[Hip]

That looks a pretty hopeless study to me. Reporting of negative and positive events is almost bound to be influenced by how well the patient is. If they have had more attacks they are pretty sure to report more negatives and less likely to get to weddings!

That is a good point.

Though it looks like there were two separate MS studies involved: one study which tried to correlate positive and negative life events to the appearance of new MS brain lesions, and a second study which tried to gauge the effect of stress management therapy on the appearance of new MS brain lesions.

In this second study, for around half a year, MS patients received stress management therapy, and the number of new lesions was reduced; once the stress management was discontinued, the number of new lesions went back up to normal levels (ie, matched the controls).

I am pretty brain dead at the moment, so can't really think this through, in order to detect possible shortcomings to the second study. But the second study looks reasonable to me.

 

[BurnA]

Excessive high level exercise can lead to chronically elevated cortisol levels and other damage to the body:
http://chriskresser.com/why-you-may-need-to-exercise-less/
http://running.competitor.com/2014/...isol-and-should-you-be-worried-about-it_39176

There's lots of info about the potentially harmful effects of endurance training and heart damage in marathon runners.

Thanks Mary. Yes I have read these but they seem fairly inconclusive and vague. A lot of speculation into how cortisol levels from training may impact your health but I haven't seen any definitive evidence that it does.

 

[Mij]

I agree, but even if we are wrong we can't blame ourselves for continuing on with our lives while sick. Most people barely take time off or if they do they get back to work fairly quickly and nearly all of these cases don't result in me/cfs. I do wonder if I had rested more during the acute infection if I would have me/cfs today but like I said there must be plenty of people out there feeling sick and not taking adequate rest. It might be a factor but there must be more to it.

I can tell you that I rested very well for at least 5.5 years and return to feeling almost 100%(for at least 3 months), then I returned to work and it only took 3 weeks to become completely disabled (worse than before).

So resting and pacing helps but it's not going to change the underlying pathology.

 

[alex3619]

My recall is that cortisol therapy was standard in CFS, and it worked. My aunt was on it in the 70s for post viral fatigue, which admittedly might not be the same, though this was Ross River virus. However this was immunosuppressive dosing, and had to be continued for long time periods, hence leading to all the bad things we hear about cortisol. The dosage was too high for too long.

Also recall that the biochemistry of CFS can induce issues with regulation of eicosanoids, which are also regulated by cortisol. These are hormones that regulate every cell in the body, and we keep discovering more. This angle has inadequately been explored.

Stress is a complicated topic, and overlaps with other biochemistry. I doubt anyone understands the complex interplay.

 

[Mary]

Thanks Mary. Yes I have read these but they seem fairly inconclusive and vague. A lot of speculation into how cortisol levels from training may impact your health but I haven't seen any definitive evidence that it does.

I don't think all the studies are inconclusive and vague:

http://health.clevelandclinic.org/2014/09/can-too-much-extreme-exercise-damage-your-heart/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538475/
http://www.ncbi.nlm.nih.gov/pubmed/22160404

But I don't want to get into a debate, it sounds like you've studied this more than me.

 

[Hip]

There is certainly not much in the literature about it. ( nothing apart from a few cases of athletes getting chronic fatigue ) However, I did start a thread on this topic a while ago - read it here.

For me the most intriguing data about the role of exercise comes from Dr Chia's interferon treatments of ME/CFS patients. These interferon treatments put quite a few patients into full remission, to the point that they were able to enjoy a full life again. After interferon treatment, some patients stayed in full remission for up to 14 months.

However, Chia noted that the factor which frequently caused these patients to crash right back into ME/CFS again was a period of excessive exercise. In the case of Chia's son Andrew, it was a hiking vacation in Hawaii that triggered his crash back into ME/CFS — with the day-after-day strenuous hiking, the virus and ME/CFS came right back.

 

[BurnA]

I don't think all the studies are inconclusive and vague:

http://health.clevelandclinic.org/2014/09/can-too-much-extreme-exercise-damage-your-heart/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538475/
http://www.ncbi.nlm.nih.gov/pubmed/22160404

But I don't want to get into a debate, it sounds like you've studied this more than me.

Thanks Mary. No I haven't studied it that much but these papers are a good example of exactly what I am talking about.
If you read them...
" potential adverse cardiovascular effects..."
" ...may induce adverse cv remodelling "
"..May lead to patchy myocardial fibrosis "
" the long term clinical significance of which warrants further study "

It seems to me they are speculating a lot and even when they find something measurably different in some endurance athletes they are unaware of the significance of such a finding.

 

[mermaid]

When I looked at my own experience of ME, I could see the factor of psychological stress as perhaps being a prime driver, though I couldn't begin to describe the biological process going on. My own guess is that some of us are set up more than others genetically if a set of circumstances brings it into being. Maybe those circumstances can happen over a very long time as seemed the case for me before it reached tipping point - I can almost track it happening, but wonder if I could have stopped it.

Firstly an autoimmune condition started some 20 years ago - but what triggered it? I WAS going through severe stress - in a new job, husband was suicidal and it happened the following year. Could I have prevented it? It was underactive thyroid so I was encouraged to think I could pop in some Thyroxine and all would be well then.

Then some more years down the line, my menopause seemed to trigger it a bit more - constant feeling of sore throats and viruses going on which never really let up. I had ongoing stress in my marriage and an adult son who was heading into a black hole. Still, that is all part of life isn't it? We don't all get ME/CFS from it.

Then followed a change in life which was supposed to bring relief, but instead brought even more psychological stress that I could not control - on and on, with trauma following trauma over several years. I got another autoimmune condition and began to wonder if I had mild ME at around that time.

Even worse psychological stress was around the corner, but my ME was still mild, and I could walk pretty well and work part time....until I caught whooping cough, and that gave me a relapse that I have never really recovered fully from. So that was biological stress that sent me there, not psychological stress. If the brain gets changed neurologically by a big impact then maybe that is hard to recover from.

I have had cortisol saliva tests done in recent years (over the past 4) and my levels have tended to be on the low side, but it's possible that they were high before I became dysfunctional and became conscious of loss of stamina. I took a small amount of Pregnenolone over about 6 months, and it definitely seemed to help, though I am having a break from it at the moment.

 

[alex3619]

However, Chia noted that the factor which frequently caused these patients to crash right back into ME/CFS again was a period of excessive exercise. In the case of Chia's son Andrew, it was a hiking vacation in Hawaii that triggered his crash back into ME/CFS — with the day-after-day strenuous hiking, the virus and ME/CFS came right back.

Exercise might indeed be a trigger, though I would go with excessive activity rather than just exercise. However this can induce many changes. We are simply guessing as to which changes are the critical ones.

 

[barbc56]

There were some retrospective studies, about a decade ago, I think with cancer, where it was speculated that you might feel stressed or experience depression when you first get cancer but before actually becoming symptomatic.

I can't find this study nor do I remember if the study design was very robust. I can see where there might be all sorts of potential problems interpreting data like this.

I'm not sure if this would apply to me/cfs patients who come down with somthing like a viral illness but don't get better.

Nevertheless, it's an intriguing theory.

Barb

 

[sorin]

There were some retrospective studies, about a decade ago, I think with cancer, where it was speculated that you might feel stressed or experience depression when you first get cancer but before actually becoming symptomatic.

Stress is often considered as an important factor in triggering cancer. I was just asking myself some time ago if CFS itself could be a form of long-time evolving cancer? After all, viral infections, cancer, leukemia seems to be linked between them.

 

[Valentijn]

Stress is often considered as an important factor in triggering cancer.

By whom? Sounds like a pretty absurd theory.

 

[Skippa]

By whom? Sounds like a pretty absurd theory.

Stress leads to an abundance of free radicals as waste products of all the processes it involves, free radicals harm mitochondria, and damaged mitochondria in turn lead to more errors in cell division, inhibition of apoptosis etc, so I think there is some truth to that theory. Although how much it has a baring, science is only just discovering.

 

[sorin]

By whom? Sounds like a pretty absurd theory.

By health experts. It is not absurd at all.
http://www.mdanderson.org/patient-a...-and-screening/health/stress-cancer-risk.html

 

[barbc56]

Stress, if it does have anything to do with cancer, is probably miniscule, if even that.

My point is not that stress causes cancer but the other way around. Perhaps sometimes the cancer starts which may make us more susceptible to stress, yet we are still not overtly aware of any symptoms

This is just a theory but probably just as plausible as stress causing cancer.

Barb

ETA I think it's too simplistic that stress causes cancer. It blames the patient and gives the impression that if we had just learned how to handle stress, you wouldn't have cancer.

 

[sorin]

Stress leads to an abundance of free radicals as waste products of all the processes it involves, free radicals harm mitochondria, and damaged mitochondria in turn lead to more errors in cell division, inhibition of apoptosis etc, so I think there is some truth to that theory. Although how much it has a baring, science is only just discovering.

Your point is very interesting and if I am not wrong mitochondria damage exists also in CFS (explaining energy loss). In cancer, cell division is corrupted, as you mentioned earlier due to damaged mitochondria! So we have damaged mitochondria which in one case leads to cancer and in another case leads to CFS. It would be very interesting to know under which circumstances happens the first case and under what circumstances happens the second.

 

[Hip]

There is also the connection between psychological stress and Herpesviridae reactivation:

The EBV Stress Connection

Stress has long been known to increase the risk of herpesvirus (EBV, HHV-6, CMV, etc.) reactivation in humans. About ten studies have indicated that psychological stressors can reactivate EBV. Poor academic performance in combination with high internal demands of perfection was associated with an increased tendency of ‘seroconversion’ to EBV in West Point cadets. Stressors have also been shown to induce the production of the early EBV proteins (enzymes) Dr. Glaser believes is present in chronic fatigue syndrome (ME/CFS).

Epstein Barr Virus in chronic fatigue syndromeSeroconversion occurs when antibodies to a virus can be detected in the blood stream. This means the virus is active. After replicating inside cells the virion moves into the blood stream to find new cells to infect.

Several studies have indicated chronic fatigue syndrome (ME/CFS) patients have a higher than normal incidence of stressful events in the months preceding their illness (White et. al. 2001). One study found that being female, having family support (?) and having more stressful life events prior to having CFS was associated with poor recovery from infectious mononucleosis (Buchwald et. al. 2000).

A recent study which suggested chronic fatigue syndrome (ME/CFS) patients were more physically active than normal prior to their illness implicated physical stress as a possible contributing factor.

This suggests that chronic stress may increase the risk for herpesvirus reactivation and/or chronic fatigue syndrome (ME/CFS) by impacting immune functioning. But how? The two stress response systems, the autonomic nervous system and HPA axis, also regulate immune function.

When these systems are chronically activated they appear to thrust the immune system into an a state of Th2 cytokine dominance; a situation we have seen EBV appears to be particularly well adapted to and which some studies suggest is present in chronic fatigue syndrome (ME/CFS). Thus chronic stress may be able to produce an immune state which allows some viruses to proliferate.

Source: EBV II: A Chronic Infection?

 

[mermaid]

http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-controversies/stress
Does stress affect cancer risk?
Stressful events can alter the levels of hormones in the body and affect the immune system. But there is no evidence that these changes could lead to cancer.

Most scientific studies have found that stress does not increase the risk of cancer. Research that combines the results from many different studies, called meta-analyses, can often provide the most reliable indication of cancer risk. A recent meta-analysis, including over 100,000 people, found no link between stress and bowel, lung, breast or prostate cancers.