Originally published in
The Official Journal of
The American Naturopathic Medical Association &
The American Association of Nutritional Consultants and the
Townsend Letter for Doctors and Patients
Chronic Fatigue Assessment and Intervention: The Result of 101 CasesRobert J. Thiel, Ph.D., N.D. Director of Research, Center for Natural Health Research
Thiel, R.J. Chronic Fatigue Assessment and Intervention: The
Result of 101 Cases. ANMA & AANC Journal 1 (3): 17-19, 1996
Thiel, R.J. Chronic Fatigue Assessment and Intervention: The Result of 101 Cases. Towsend Letter 174: 70-71, 1998
Abstract: The purpose of this trial was to measure how often individualized nutrition-based interventions could benefit people with complaints of chronic fatigue within 60 days. Of the 101 participants, 88.12% of participants reported improvement within 30 days and 99.01% reported improvement within 60 days; P< 0.0001.
Most natural health professionals see people with chronic fatigue on a regular basis. Additionally, fatigue appears to be the number one complaint that even medical doctors hear . Chronic fatigue has been defined as persistant or relapsing debilitating fatigue for at
least 6 months with symptoms of abrupt onset, low grade fevers, arthralgias, myalgias, post-exertional fatigue, neurophyscological complaints, and sleep disturbances . Glandular malfunction, hypotension, infections, allergies, and various nutritional deficiencies have been speculated as potential causes of chronic fatigue [2-8]. Some researchers have speculated that chronic fatigue syndrome is not a discrete disease with a specific cause but is instead a clinical condition involving multiple factors [2,8].
This report includes the results of a clinical trial involving
101 people with long-term (chronic) fatigue. The intention of this trial was to
measure how often individualized recommendations could benefit people with
complaints of chronic fatigue within 60 days as well as to
measure some of the types of factors that were present in the chronically fatigued population.
Adults were eligible for inclusion in this trial if they resided in California, agreed to follow the recommended intervention, agreed to provide (and did provide) feedback, signed a consent agreement, and indicated they suffered from fatigue, CFS, fibromyalgia, tiredness, low energy, or similar problems for a period of at least 3 months. 108 people met these criteria, but seven later failed to provide the necessary feedback (nor did they participate for the length of the trial), thus this trial only includes the results of the 101 actual participants. Of the 101 participants, 90 of them had complaints of fatigue for 6 months or more. The ages of participants ranged from 18 to 82; the mean age of the participants was 47.8 years. 27 of the
participants were males and 74 of the participants were females.
After completing the selection documentation, all subjects were interviewed for approximately 45 minutes. All subjects were then assessed using Reflex Nutrition Assessment (RNA). RNA is a non-invasive technique used to assess nutrition status by observing the response of muscles under externally provided human-force (it is similar to other forms of muscle testing ). Performing RNA normally consists of performing two assessments. The first assessment
is to determine if a reflex indicates a nutritional need (by observing a reduction in muscular strength) and the second is to determine which nutritional intervention can help fit that need (by observing an increase in muscular strength). Many have reported success in using it and similar techniques [9-11].
The reflex points assessed for this trial included adrenal,
blood, heart, hemoglobin, hypoglycemia/other (checked at the pancreas or other
digestive reflexes), parasite, staph, strep, thyroid, viral, and yeast (checked
at the umbilicus) . It should be noted that having
a problem indicated by any of these reflexes does not necessarily mean that they would be confirmed by any type of allopathic diagnosis.
Participants who appeared to have (through the interview process
combined with reflex assessment) hypoglycemia were given a dietary plan to
follow which essentially recommended increasing consumption of lower glycemic
food while decreasing consumption of high glycemic
foods: high glycemic foods include sucrose, alchohol, and other refined carbohydrates; lower glycemic foods include fruits, whole grains, nuts, animal products, and vegetables . Participants who had reflex problems were advised to consume an average of three
tablets (per day) of one nutritional supplement for each fatigue-related reflex concern. Although the actual supplements varied, most used were from Nutri-West such as Adrenal-Lyph (bovine glandular) for adrenal reflex, Ferrous-Fumuro Chelate for blood (iron with synergists), Myo-Cardio-Lyph (fortified glandular with l-carnitine) for heart, Tillandsia B-12 (herbs and b vitamins) for hemoglobin, Glyco-Lyph (chromium GTF with synergists) for
hypoglycemia, Parazym-A (fortified herbs) for parasite, Thymo-Lyph (bovine glandular) for staph, Con-Lyph (fortified herbal-glandular) for strep, T-Lyph (bovine glandular) for thyroid, ACP/M for viral (fortified herbs), and Exspore (fortified herbs) for yeast (other products were used instead if they reflex checked as better).
Subjects were interviewed at approximately 30 day intervals to determine any change in energy level or fatigue.
The interview process suggested that nearly all participants could remember some stress, trauma, illness, or event (or combination of factors) that proceeded their bout with fatigue. Reflex assessment revealed that some participants had problems with as many as five
fatigue-related reflexes. This trial found that the average participant had problems with 2.0 fatigue-related reflexes. The following table demonstrates the frequnecy:
Table 1. Frequency by Reflex
88.12% of participants reported improvement within 30 days. 99.01% reported improvement within 60 days; the P value of this result was less than .0001. This trial did not attempt to quantify the degree of improvement.
Every participant who reported having fibromylagia (all of whom were female) had problems with adrenal and heart reflexes; some had other reflex concerns as well.
In this trial, gender did not appear to play any significant role in determining improvement.
This trial confirms that a variety of factors can contribute to fatigue. Low thyroid function , nutritionally related heart concerns , adrenal issues , parasites , infections , diet
[6,13], and nutrient deficiencies [6,8] have all been shown to play some role in chronic fatigue.
The high incidence of thyroid reflex involvement (57.4%) may be consistant with a medical study which found that 61% of people with chronic fatigue syndrome ate little, if any, salt or highly salted foods . Consumption of iodized salt is the main way that most Americans receive iodine  (the other way is eat foods which naturally contain organic iodine such as sea vegetables ). The only known need for iodine in the human body is to support the thyroid gland for the production of its hormones .
The relatively low incidence of viral reflex involvement is not surprising. It is consistant with the findings of other researchers who have found that viruses appear to be present in only a very small percentage of people who are chronically fatigued [8,16].
Dr. Demitrack (M.D.) has hypothesized that acute infection, stress, physchiatric illness, and other factors which existed before chronic fatigue is manifested, appear to ultimately converge into a final common biological pathway that is then known as chronic fatigue . This hypothesis is consistant with the findings of this report. It is believed that it is the combination of seemingly unrelated factors which has frustrated many people with energy complaints.
Although this trial was restricted to California residents, it is believed that similar results could be obtained by properly trained researchers in other areas.
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 Defreitas, E. et al. Evidence of retrovirus in patients with chronic fatigue immunity deficiency sydrome. CFIDS Chronicle: 1, Sep 1990
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 Thiel, Robert J. Serious Nutrition for Health Care Professionals. Arroyo Grande (CA): California Health Group, 1995
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 Rosen, Marc S. and Williams, Louisa. The research status of applied kinesiology, part II: An annotated bibliography of applied kinesiological research. In: A.K. Review, Vol. 1, No. 2: 34-47, 1991
 Jenkins, D.J. et al. Glycemic index of foods: A physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 34: 362-366, 1981
 Bondy P. and Felig P. Disorders of Carbohydrate Metabolism: 221-340. In: Duncan's Diseases of Metabolism. Phil.: W.B. Saunders, 1974
 Clugston, Graeme A. and Hetzel, Basil S. Iodine: 252-263. In: Modern Nutrition in Health and Disease, 8th ed. Phil.: Lea & Flebinger, 1993
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 Buchwald, Dedra. Chronic fatigue and the chronic fatigue syndrome: Prevalance in the Pacific Northwest health care system. Annals of Internal Medicine 123 (2): 81-88, July 15, 1995
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