How To Be 7.5x More Likely To Develop Chronic Fatigue Syndrome
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First, what is it?
Many more people have chronic fatigue, which is the symptom of being exhausted all the time, than have chronic fatigue syndrome (CFS) which is the illness of myalgic encephalomyelitis (ME).
This is because fatigue can be a symptom of many, many other conditions, and can be heavily influenced by lifestyle factors too.
A lot of the advice for dealing with chronic fatigue is often the same in both cases, but some will be different, because for example:
- If your fatigue is from some other condition, that condition probably impacts what lifestyle factors you are (and are not) able to change, too
- If your fatigue is from lifestyle factors, that hopefully means you can change those and enjoy less fatigue…
- But if it’s not from lifestyle factors, as in ME/CFS, then advice to “exercise more” etc is not going to help so much.
There are ways to know the difference though:
Check out: Do You Have Chronic Fatigue Syndrome?
The chronic disease pipeline
While it had been strongly suspected that COVID infection could lead to CFS, with long COVID having chronic fatigue as one of its characteristic symptoms, a research team led by Dr. Suzanne Vernon has now established the nature of the relationship.
It was a large (n=13,224) longitudinal observational cohort study of people with no pre-existing ME/CFS, grouped according to their COVID infection status:
- acute infected, enrolled within 30 days of infection or enrolled as uninfected who became infected (n=4,515)
- post-acute infected, enrolled greater than 30 days after infection (n=7,270)
- uninfected (n=1,439).
(to be clear, that last means “never infected”, or else they would be in group 2)
Note: people who had COVID and were hospitalized for it were excluded from the study, so this risk is the risk represented by even just more “moderate” infections.
What they found:
❝The proportion of all RECOVER-Adult participants that met criteria for ME/CFS following SARS-CoV-2 infection was 4.5% (531 of 11,785) compared to 0.6% (9 of 1439) in uninfected participants.❞
There are then different numbers if we look per 100 person-years, as the study also did—in which case, we get a re-modelled increase in risk of 5x instead of 7.5x, but a) that’s still not good b) the “here-and-now” figures of 4.5% vs 0.6% are also relevant.
Read in full: Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study
The killer nobody wants to talk about anymore
Of course, as we all know the pandemic is over, because politicians declared it so, which is very reassuring.
Nevertheless, COVID is currently the still 4th leading cause of death in the US, placing it higher than stroke, Alzheimer’s, diabetes, and others.
See also: Emergency or Not, Covid Is Still Killing People. Here’s What Doctors Advise to Stay Safe
So, while it’s very good to take care of our hearts, brains, blood sugars, and so forth, let’s at the very least continue to keep on top of our vaccinations, avoid enclosed crowded spaces where possible, etc.
And for extra boosts to one’s chances: Why Some People Get Sick More (And How To Not Be One Of Them)
What if I do get (or already have) long COVID and/or ME/CFS?
Well, that is definitely going to suck, but there are still some things that can be done.
Here’s a big one: How To Eat To Beat Chronic Fatigue ← this will not, of course, cure you, but it’s a way of getting maximum nutrition for minimum effort, given that for someone with chronic fatigue, effort is a very finite resource that must be used sparingly
Finally, here are some further resources:
Support For Long COVID & Chronic Fatigue
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How To Leverage Attachment Theory In Your Relationship
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How To Leverage Attachment Theory In Your Relationship
Attachment theory has come to be seen in “kids nowadays”’ TikTok circles as almost a sort of astrology, but that’s not what it was intended for, and there’s really nothing esoteric about it.
What it can be, is a (fairly simple, but) powerful tool to understand about our relationships with each other.
To demystify it, let’s start with a little history…
Attachment theory was conceived by developmental psychologist Mary Ainsworth, and popularized as a theory bypsychiatrist John Bowlby. The two would later become research partners.
- Dr. Ainsworth’s initial work focused on children having different attachment styles when it came to their caregivers: secure, avoidant, or anxious.
- Later, she would add a fourth attachment style: disorganized, and then subdivisions, such as anxious-avoidant and dismissive-avoidant.
- Much later, the theory would be extended to attachments in (and between) adults.
What does it all mean?
To understand this, we must first talk about “The Strange Situation”.
“The Strange Situation” was an experiment conducted by Dr. Ainsworth, in which a child would be observed playing, while caregivers and strangers would periodically arrive and leave, recreating a natural environment of most children’s lives. Each child’s different reactions were recorded, especially noting:
- The child’s reaction (if any) to their caregiver’s departure
- The child’s reaction (if any) to the stranger’s presence
- The child’s reaction (if any) to their caregiver’s return
- The child’s behavior on play, specifically, how much or little the child explored and played with new toys
She observed different attachment styles, including:
- Secure: a securely attached child would play freely, using the caregiver as a secure base from which to explore. Will engage with the stranger when the caregiver is also present. May become upset when the caregiver leaves, and happy when they return.
- Avoidant: an avoidantly attached child will not explore much regardless of who is there; will not care much when the caregiver departs or returns.
- Anxious: an anxiously attached child may be clingy before separation, helplessly passive when the caregiver is absent, and difficult to comfort upon the caregiver’s return.
- Disorganized: a disorganizedly attached child may flit between the above types
These attachment styles were generally reflective of the parenting styles of the respective caregivers:
- If a caregiver was reliably present (physically and emotionally), the child would learn to expect that and feel secure about it.
- If a caregiver was absent a lot (physically and/or emotionally), the child would learn to give up on expecting a caregiver to give care.
- If a caregiver was unpredictable a lot in presence (physical and/or emotional), the child would become anxious and/or confused about whether the caregiver would give care.
What does this mean for us as adults?
As we learn when we are children, tends to go for us in life. We can change, but we usually don’t. And while we (usually) no longer rely on caregivers per se as adults, we do rely (or not!) on our partners, friends, and so forth. Let’s look at it in terms of partners:
- A securely attached adult will trust that their partner loves them and will be there for them if necessary. They may miss their partner when absent, but won’t be anxious about it and will look forward to their return.
- An avoidantly attached adult will not assume their partner’s love, and will feel their partner might let them down at any time. To protect themself, they may try to manage their own expectations, and strive always to keep their independence, to make sure that if the worst happens, they’ll still be ok by themself.
- An anxiously attached adult will tend towards clinginess, and try to keep their partner’s attention and commitment by any means necessary.
Which means…
- When both partners have secure attachment styles, most things go swimmingly, and indeed, securely attached partners most often end up with each other.
- A very common pairing, however, is one anxious partner dating one avoidant partner. This happens because the avoidant partner looks like a tower of strength, which the anxious partner needs. The anxious partner’s clinginess can also help the avoidant partner feel better about themself (bearing in mind, the avoidant partner almost certainly grew up feeling deeply unwanted).
- Anxious-anxious pairings happen less because anxiously attached people don’t tend to be attracted to people who are in the same boat.
- Avoidant-avoidant pairings happen least of all, because avoidantly attached people having nothing to bind them together. Iff they even get together in the first place, then later when trouble hits, one will propose breaking up, and the other will say “ok, bye”.
This is fascinating, but is there a practical use for this knowledge?
Yes! Understanding our own attachment styles, and those around us, helps us understand why we/they act a certain way, and realize what relational need is or isn’t being met, and react accordingly.
That sometimes, an anxiously attached person just needs some reassurance:
- “I love you”
- “I miss you”
- “I look forward to seeing you later”
That sometimes, an avoidantly attached person needs exactly the right amount of space:
- Give them too little space, and they will feel their independence slipping, and yearn to break free
- Give them too much space, and oops, they’re gone now
Maybe you’re reading that and thinking “won’t that make their anxious partner anxious?” and yes, yes it will. That’s why the avoidant partner needs to skip back up and remember to do the reassurance.
It helps also when either partner is going to be away (physically or emotionally! This counts the same for if a partner will just be preoccupied for a while), that they parameter that, for example:
- Not: “Don’t worry, I just need some space for now, that’s all” (à la “I am just going outside and may be some time“)
- But: “I need to be undisturbed for a bit, but let’s schedule some me-and-you-time for [specific scheduled time]”.
Want to learn more about addressing attachment issues?
Psychology Today: Ten Ways to Heal Your Attachment Issues
You also might enjoy such articles such as:
- Nurturing secure attachment: building healthy relationships
- Why anxious and avoidant often attracted each other
- How to help an insecurely attached partner feel loved
- How to cope with a dismissive-avoidant partner
Lastly, to end on a light note…
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I want to eat healthily. So why do I crave sugar, salt and carbs?
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We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods.
So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it?
There are many reasons for craving specific foods, but let’s focus on four common ones:
1. Blood sugar crashes
Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone.
Neurons responding to sugar are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar.
In the long term, research suggests a high-sugar diet can affect mood, digestion and inflammation in the gut.
While there’s a lot of variation between individuals, regularly eating sugary and high-carb foods can lead to rapid spikes and crashes in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy.
2. Drops in dopamine and serotonin
Certain neurotransmitters, such as dopamine, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving.
Serotonin, the feel-good hormone, suppresses appetite. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more carb-rich snacks in the afternoon.
Low carb diets may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for anxiety and depression.
Compared to men, women tend to crave more carb rich foods. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual symptoms and could be linked to reduced serotonin levels.
3. Loss of fluids and drops in blood sugar and salt
Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, depletes insulin levels, decreasing sodium and water retention.
Very low-carb diets, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates.
Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings.
4. High levels of stress or emotional turmoil
Stress, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences.
The stress hormone cortisol, in particular, can drive cravings for sweet comfort foods.
A 2001 study of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption.
A more recent study found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain.
What can you do about cravings?
Here are four tips to curb cravings:
1) don’t cut out whole food groups. Aim for a well-balanced diet and make sure you include:
- sufficient protein in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on breakfast and lunch and an overall daily protein intake of at least 0.8g per kg of body weight for muscle health
- fibre-rich foods, such as vegetables and whole grains. These make you feel full and stabilise your blood sugar levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats
2) manage your stress levels. Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising mindful eating, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating
3) get enough sleep. Aim for seven to eight hours of quality sleep per night, with a minimum of seven hours. Lack of sleep can disrupt hormones that regulate hunger and cravings
4) control your portions. If you decide to indulge in a treat, control your portion size to avoid overindulging.
Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.
Hayley O’Neill, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Avoid Knee Surgery With This Proven Strategy (Over-50s Specialist Physio)
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A diagnosis of knee arthritis can be very worrying, but it doesn’t necessarily mean a knee replacement surgery is inevitable. Here’s how to keep your knee better, for longer (and potentially, for life):
Flexing your good health
You know we wouldn’t let that “proven” go by unchallenged if it weren’t, so what’s the evidence for it? Research (papers linked in the video description) showed 70% of patients (so, not 100%, but 70% is good odds and a lot better than the alternative) with mild to moderate knee arthritis avoided surgery after following a specific protocol—the one we’re about to describe.
The key strategy is to focus on strengthening the quadriceps muscles for joint protection, as strong quads correlate with reduced pain. However, a full range of motion in the knee is essential for optimal quad function, so that needs attention too, and in fact is foundational (can’t strengthen a quadriceps that doesn’t have a range of motion available to it):
Steps to follow:
- Improve knee extension:
- Passive knee extension exercise: gently press your knee down while lying flat, to increase straightening.
- Weighted heel props: use light weights to encourage gradual knee straightening.
- Enhance knee flexion:
- Use a towel to gently pull the knee towards the body to improve bending range.
Regular practice (multiple times daily) leads to improved knee function and pain relief. Exercises should be performed gently and without pain, aiming for consistent, gradual progress.And of course, if you do experience pain, it is recommend to consult with a local physiotherapist for more personalized guidance.
For more on all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Treat Your Own Knee – by Robin McKenzie
Take care!
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- Improve knee extension:
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The Best Mobility Exercises For Each Joint
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Stiff joints and tight muscles limit movement, performance, and daily activities. They also increase the risk of injury, and increase recovery time if the injury happens. So, it’s pretty important to take care of that!
Here’s how
Key to joint health involves understanding mobility, flexibility, and stability:
- Mobility: active joint movement through a range of motion.
- Flexibility: muscle lengthening passively through a range of motion.
- Stability: body’s ability to return to position after disturbance.
Different body parts have different needs when it comes to prioritizing mobility, flexibility, and stability exercises. So, with that in mind, here’s what to do for your…
- Wrists: flexibility and stability (e.g., wrist circles, loaded flexions/extensions).
- Elbows: Stability is key; exercises like wrist and shoulder movements benefit elbows indirectly.
- Shoulders: mobility and stability; exercises include prone arm circles, passive hangs, active prone raises, easy bridges, and stick-supported movements.
- Spine: mobility and stability; recommended exercises include cat-cow and quadruped reach.
- Hips: mobility and flexibility through deep squat hip rotations; beginners can use hands for support.
- Knees: stability; exercises include elevated pistols, Bulgarian split squats, lunges, and single-leg balancing.
- Ankles: flexibility and stability; exercises include lunges, prying goblet squats, and deep squats with support if necessary.
For more on all of these, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Building & Maintaining Mobility
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The Stress-Proof Brain – by Dr. Melanie Greenberg
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The premise of the book is as stated in the subtitle: using mindfulness and neuroplasticity to manage our stress response.
As such, it’s divided into three parts:
- Understanding your stress (and different types of stressors)
- Calming your amygdalae (thus, dealing with your stress response while the stressor is stressing you)
- Moving forward with your prefrontal cortex (and thus, gradually improving automatic stress responses over time, as we learn new, better responses to do automatically)
The content ranges from the neurophysiological to “therapist’s couch” stuff; Dr. Greenberg having her PhD in psychology has prepared her to write both of those different-but-touching fields with equal competence. In-line citations are given throughout, for those who want to look up studies.
The style is direct and informative, with little to no attention given to making it an entertaining read. As a result, it’s information dense (which is good), and/but not necessarily a “couldn’t put it down” page-turner.
Bottom line: if you’d like to improve your ability to deal with stress, this book is as good as any.
Click here to check out The Stress-Proof Brain, and stress-proof yours!
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What immunocompromised people want you to know
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While many people in the U.S. have abandoned COVID-19 mitigations like vaccines and masking, the virus remains dangerous for everyone, and some groups face higher risks than others. Immunocompromised people—whose immune systems don’t work as well as they should due to health conditions or medications—are more vulnerable to infection and severe symptoms from the virus.
Public Good News spoke with three immunocompromised people about the steps they take to protect themselves and what they want others to know about caring for each other.
[Editor’s note: The contents of these interviews have been condensed for length.]
PGN: What measures have you been taking to protect yourself since the COVID-19 pandemic began?
Tatum Spears, Virginia
From less than a year old, I had serious, chronic infections and have missed huge chunks of my life. In 2020, I quit my public job, and I have not worked publicly since.
I have a degree in vocal performance and have been singing my whole life, but I haven’t performed publicly since 2019. I feel like a bird without wings. I had to stop traveling. Since no one wears a mask anymore, I can’t go to the movies or social outings or any party.
All my friends live in my phone now. It’s a community of people—a lot of them are immunocompromised or disabled in some way.
There are a good portion of them who just take COVID-19 seriously and want to protect their health, who feel the existential abandonment and the burden of all of this. It’s really isolating having to step back from any sort of social life. I have to assess my risk every single time I leave the house.
Gwendolyn Alyse Bishop, Washington
I was hit by a car when I was very young. I woke up from surgery, and doctors told me I had lost almost all of my spleen. So, I was always the sickest kid in my school.
When COVID-19 hit, I started working from home. At first, I wore cloth masks. I didn’t really learn about KN95 masks until right around the time that COVID-19 disabled me. [Editor’s note: N95 and KN95 masks have been shown to be significantly more effective at preventing the transmission of viral particles than cloth masks.]
I actually don’t get out much anymore because I am disabled by long COVID now, but when I do leave, I wear a respirator in all shared air spaces. My roommate and I have HEPA filters going in every room.And then we test. I have a Pluslife testing dock, and so we keep a weekly testing schedule with that and then test if there are any symptoms. I got reinfected [with COVID-19] last winter, and a Pluslife test helped me catch it early and get Paxlovid. [Editor’s note: Pluslife is a brand of an at-home COVID-19 nucleic acid amplification test, which has been shown to be significantly more effective at detecting COVID-19 than at-home antigen rapid tests.]
Abby Mahler, California
I have lupus, and in 2016, I started taking the drug hydroxychloroquine, which is an immunomodulator. I’m not as immunocompromised as some people, but I certainly don’t have a normal immune system, which has resulted in long-term infections like C. diff.I started masking early. My roommates and I prioritize going outside. We don’t remove our masks inside in public places.
We are in a pod with one other household, and the pod has agreements on the way that we interact with public space. So, we will only unmask with people who have tested ahead of time. We use Metrix, an at-home nucleic acid amplification test.
While it’s not easy and it’s not the life that we had prior to COVID-19’s existence, it is a life that has provided us quite a lot of freedom, in the sense that we are not sick all the time. We are conscientiously making decisions that allow us to have a nice time without a monkey on our backs, which is freeing.
PGN: What do you want people who are not immunocompromised to know?
T.S.: Don’t be afraid to be the only person in a room wearing a mask. Your own health is worth it. And you have to realize how callous [people who don’t wear a mask are] by existing in spaces and breathing [their] air [on immunocompromised people].
People think that vaccines are magic, but vaccines alone are not enough. I would encourage people to look at the Swiss cheese model of risk assessment.
Each slice of Swiss cheese has holes in it in different places, and each layer represents a layer of virus mitigation. One layer is vaccines. Another layer is masks. Then there’s staying home when you’re sick and testing.
G.A.B.: I wish people were masking. I wish people understood how likely it is that they are also now immunocompromised and vulnerable because of the widespread immune dysregulation that COVID-19 is causing. [Editor’s note: Research shows that COVID-19 infections may cause long-term harm to the immune system in some people.]
I want people to be invested in being good community members, and part of that is understanding that COVID-19 hits the poorest the hardest—gig workers, underpaid employees, frontline service workers, people who were already disabled or immunocompromised.
If people want to be good community members, they not only need to protect immunocompromised and disabled people by wearing a mask when they leave their homes, but they also need to actually start taking care of their community members and participating in mutual aid. [Editor’s note: Mutual aid is the exchange of resources and services within a community, such as people sharing extra N95 masks.]
I spend pretty much all of my time working on LongCOVIDAidBot, which promotes mutual aid for people who have been harmed by COVID-19.
A.M.: An important thing to think about when you’re not disabled is that it becomes a state of being for all people, if they’re lucky. You will become disabled, or you will die.
It is a privilege, in my opinion, to become disabled because I can learn different ways of living my life. And being able to see yourself as a body that changes over time, I hope, opens up a way of looking at your body as the porous reality that it is.
Some people think of themselves as being willing to make concessions or change their behavior when immunocompromised people are around, but you don’t always know when someone is immunocompromised.
So, if you’re not willing to change the way that you think about yourself as a person who is susceptible [to illness], then you should change the way that you consider other people around you. Wearing a mask—at the very least in public indoor spaces—means considering the unknown realities of all the people who are interacting with that space.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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