Objective: The purpose of this case report was to describe the examination and management of a patient with chronic fatigue. Clinical Features: A 34-year-old woman presented to a chiropractic clinic with complaints of fatigue and inability to lose weight for 2 years. When tested, she was found to have high serum thyroglobulin antibodies, low serum vitamin D 3 , low saliva dehydroepiandrosterone-sulfate, and low saliva total and diurnal cortisol. Intervention and Outcome: The patient was placed on an anti-inflammatory ancestral diet and given recommendations to decrease the aerobic intensity of her exercise routine. On the basis of the result of conventional and functional laboratory tests, she was prescribed a treatment plan of targeted supplementation. After 12 weeks of application of dietary, lifestyle, and supplementation recommendations, the patient reported experiencing increased energy and weight loss of 15 pounds. Her thyroglobulin antibodies returned within reference range, salivary cortisol increased and closely followed the proper circadian rhythm, and dehydroepiandrosterone-sulfate increased. Conclusions: This report describes improvement in a patient with chronic fatigue with the use of nonpharmaceutical polytherapy involving dietary changes, lifestyle modification, and supplementation. (J Chiropr Med 2016;15:314-320)
Chronic fatigue and depression are 2 symptoms that are increasing in frequency in the offices of physicians. Many of these individuals need obvious dietary and lifestyle changes as primary management. In contrast, this case report illustrates a 20-year-old male collegiate basketball player suffering from chronic fatigue, depression, and abnormal sleep patterns. This patient was being treated by a specialty physician group with the diagnoses of chronic fatigue syndrome and overtraining syndrome. The patient was under the care of the same physician group at the time of his initial visit to a chiropractic physician that specialized in functional medicine. Adrenal stress panel showed that the patient was in second-stage adrenal syndrome. Pathological gastrointestinal testing revealed Helicobacter pylori, Giardia, Entamoeba histolytica, and Cryptosporidium parvum infections. Heavy metal toxicity of lead and mercury also were present in this individual. Abnormal amino acid levels were seen when evaluating organic cation transporter (OCT2) status. In addition to changing to an ancestral diet and recommending a core multivitamin, antioxidant, and essential fatty acid supplementation, other personalized recommendations were given to the patient according to the results of the functional labs. The patient was given recommended specific dosages of DHEA, licorice root, pregnenlone to reduce adrenal syndrome; botanical antimicrobial and antiparasitic supplementation; additional nutrients and silymarin to reduce heavy metal toxicity; and a protocols of 5-HTP and tyrosine to restore proper OCT2 function to presynaptic nerves. After treatment, the patient experienced restoration of normal sleep patterns and elimination of his depression and chronic fatigue and was able to exercise and maintain a normal lifestyle. This case showed that uncommon patient populations can suffer from chronic fatigue secondary to subclinical infections regardless of apparent health status and also that functional analysis of the organ systems of adrenal, gastrointestinal, and detoxification can assist in complex cases.
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