The 3 Levels of Chronic Fatigue (ME:CFS:LC) Treatment with Evan H. Hirsch, MD

The 3 Levels of Chronic Fatigue (ME:CFS:LC) Treatment with Evan H. Hirsch, MD

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So does your fatigue, your chronic fatigue and other related symptoms require a level one, level two or level three treatment? That's what we're be talking about today on the Energy MD podcast. So welcome back, good to see you all. Welcome to the next episode of the Energy MD podcast where we help you resolve your long COVID and chronic fatigue syndrome naturally so that you can get back to living your best life. So I'm Evan Hersh, the Energy MD. I came up with this concept.

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after seeing people get better from different levels of treatment. So let me talk a little bit about what this looks like. So a level one treatment that works for resolving your symptoms is when you adjust your lifestyle habits. So this is drinking enough water, getting enough movement or getting your Goldilocks dose of movement, which we'll talk about more in a second. uh Eating the right foods, avoiding the foods that are potentially toxic or harmful to you, and then getting enough sleep.

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Okay, so that's the four lifestyle habits. Level two treatment is when you're replacing deficiencies. And then a level three treatment is when you have to move into removing what I call the toxic five, a combination of heavy metals, chemicals, molds, infections, and nervous system dysfunction. So this really is a consequence of severity. So there are some people who are tired all the time. They're surviving on caffeine, energy drinks.

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needing to nap throughout the day and they can resolve their symptoms by fixing their lifestyle habits. And so what does this look like? If you're looking at sleep, we're talking about sleeping seven to nine hours a night, going to sleep closer to 10 o'clock or even nine o'clock, then midnight, having a nice dark room, making sure, you know, maybe there's a sound machine or some white noise, making sure that you're, that it's cold, the environment is cool and dark.

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So you're creating an environment for sleep. Okay. So you're optimizing sleep. You're just getting better sleep. So if you're staying up to midnight, 1 a.m., you're trying to get work done or whatever it is, and you have chronic fatigue, maybe you just need to optimize your sleep. And maybe you need your Goldilocks dose of movement. So this is the ideal dose of movement that doesn't make you feel worse. So for a lot of people with chronic fatigue syndrome and long COVID, this means that, you know, they have post-exertional malaise.

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which means that if you exert yourself and you feel worse, you don't want that. That's too stressful on the body. You want to exert yourself to the point that you don't feel worse, but you want to move as much as you can in order to get the natural benefits of movement. And this may be walking around the house. This may be walking around the block. This may be being able to do five, 10, 15, 30 minutes of exercise per day, right? So it's figuring out what your Goldilocks dose of movement is. So that's sleep. That's movement in terms of your food.

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Maybe you go gluten-free, dairy-free, sugar-free, is generally what I recommend for folks also avoiding uh alcohol and processed foods. But oftentimes you do that and that can really help resolve your symptoms. um And then last, we've talked about sleep. We've talked about movement. We've talked about food and water consumption. So maybe if you increase your water consumption,

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over time up to two or three liters a day and you put some sea salt into that in order to support your adrenals. Maybe that helps to resolve your chronic fatigue syndrome or long COVID or chronic fatigue related symptoms. those are all, you, if you optimize your lifestyle habits and that fixes your, your symptoms, then that's considered a level one problem or level one treatment.

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So if you've done all that and you still have your symptoms, then it's time to move on to level two. And so this would be replacing the deficiencies. Deficiencies in hormones like adrenals, thyroid, sex hormones, mitochondria, which produces 70 to 90 % of our energy found in every cell in the body except for red blood cells gets damaged through the process. And if you've got chronic fatigue, then uh nine, 10 times out of 10, you're going to have a mitochondrial issue.

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Maybe vitamin and replacing vitamin and mineral deficiencies. That's generally it. And replacing maybe some amino acids. So that if your symptoms get better after you do that, that means that you had a level two um issue, level two problem that was then resolved. And then if you've done level one and you've done level two and your symptoms still haven't resolved, that means that you have the toxic five that need to be addressed. And this is a level three problem. And this is when people come to see us.

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because you can get support with level one and level two at your local naturopath, functional medicine doctor, integrative doc, but it's really these other ones that they're just not specialized in that the people that we see who've got chronic fatigue, chronic fatigue syndrome, and long COVID that they really need to address in order to be able to get better. So this is like I mentioned previously, heavy metals, chemicals, molds, infections, and nervous system dysfunction. And that's a level three problem.

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And it really requires addressing all of those in order to get better. And so we P we take people through a four step process in which we are addressing all of your causes in step one and matching them up with treatments that really work in step two, we're replacing the deficiencies, making sure that that's done appropriately. Step three, we're opening up the drainage pathways, the detox pathways, the exit pathways.

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So that when you go into step four and you start removing the toxic five that you have, that you have success. And this is really where most practitioners are, what most practitioners and what you're missing in terms of your treatment protocol, it's that you're not addressing all of the toxic five and or addressing them correctly. Cause it's really, you know, getting better is really a combination of making sure that you're addressing all the causes that you have using a treatment that actually works.

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and then having really great support along the way to navigate any bumps. Cause there's always going to be bumps. There's, you know, this process really is three steps forward, one step back or one step back and three steps forward. And I tell people that over the course of 12 months, you're going to be pivoting somewhere between 20 and 50 times. So when we know your causes and we're addressing them, addressing all of the toxic five, not just the causes that you find on a laboratory test,

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but all of the toxic five so that you leave no stone unturned and you make sure that you're addressing everything so that at the end of your time with us, that you have addressed all of your potential causes. That's really the fastest way to have success is not to just address the causes that you find on laboratory tests, but all the causes that have been associated with long COVID and chronic fatigue syndrome, because unfortunately the problems are way too complex and the testing is highly imperfect.

07:07

You want to make sure that you're addressing all of those. So once you've done that and you've addressed all those causes, you're just going to be that much more successful. So that's the process that we take people through. Those are the levels. Level one. Once again, if you address all of your lifestyle habits and you get better, wonderful, great. That is a level one problem. If you need to also address all the deficiencies, that's a level two problem. um

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If you have to address the toxic five that's a level three problem and unfortunately the toxic five does take at least 12 months in order to be able to get better so You just have to have that expectation in order to make sure that you're addressing everything and make sure that when you're done with this process You'll have the knowledge but without having to have these significant ups and downs that you have When you have the toxic five where you're just not sure when you can schedule a date

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or an appointment with a friend or travel because you don't know if you're gonna feel badly. You don't know if you're gonna have flu-like symptoms. You don't know if you're gonna be in a crash, which is really so challenging and makes it so hard for maintaining relationships with the people you love and you care about because it's so hard to keep canceling on them. Friends have a threshold where eventually they'll be like, I can't really count on this person because I don't know if they're going to be able to be there for...

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You know, they're going to cancel again and people just don't have they can have as much compassion, but they don't know what it's like unless they've had it. You know, I know when I had my chronic fatigue syndrome for five years that it just about destroyed my life, destroyed my relationships. And I have a lot of compassion for anybody who needs to cancel on me or people who can't show up or whatever. Like that's that's part of unfortunately this condition. And you have to really be vulnerable and share with people that, hey, this is not

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This is not a personality disorder. This is not me not behaving badly. This is just the nature of my condition. And so you want to be really transparent and tell people, I feel like crap today and I just can't meet you and I'm really sorry so that they can have that understanding and potentially that they can have that compassion for you. So I hope this was helpful for you today.

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um If you are interested, I just came up with a new fatigue score or fatigue assessment to see if your fatigue is fixable. You can go ahead and click on that link below or go to myfatigescore.com in order to be able to take the assessment. After you take that, you'll get a percentage of how fixable your fatigue is. And then there'll be some other information to provide some education around what you can do next in order to be able to support you on your journey.

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So if you learned something in this episode, please give it a thumbs up, subscribe to the channel, like and share, and I'll see you in the next episode. Have an amazing day.