M.E. or not M.E.? That is the question
The answer, often, is to look at your diet
Kathy came to us because she thought she had ME. Her chief symptoms were fatigue, breathlessness which sometimes lasted for three to four days, bloating, aching knees and toes, backache, headaches and occasional feelings of nausea.
Kathy was in her late 30s and had three children. Her husband, her GP and the specialist she had been referred to at one of the country's major teaching hospitals all thought she had ME.
I was sceptical. I didn't tell her because I know how important it can be to patients who have been searching for some years for an answer to their symptoms, at least, to be given a diagnosis.
But in truth, ME is sometimes no more than a label. As a clinical nutritionist, if you really want to help the patient, you have to look further in order to find out what is really going on.
I took a long medical history from Kathy. She had been in hospital no less than eight times in a two year period in the early 90s, mostly for tonsillitis, but also for suspected viral meningitis and severe urinary infections. As a result she'd regularly had masses of antibiotics.
Further prompting revealed there had been earlier signs that her health might not be very strong. As a child she had resisted being breast-fed.
Mother's milk contains many vitamins and minerals which are hard to provide in infant formulas. So the importance of being breast-fed for at least six months is hard to over-emphasise.
"I always had a bad chest and runny nose and I had my tonsils out at the age of three," she said. In addition her mother told her that, when she was a baby, she had thrush in her mouth. This is very significant because it suggests that her mother had candida when she was pregnant and passed it on to her child. This was obviously the cause of the cystitis that Kathy often had as a child and was still getting when she came to see me.
When I asked Kathy about her diet, she told me she had Fruit and Fibre cereal for breakfast, the occasional chocolate biscuit mid-morning, a sandwich and banana at lunchtime, shortcake topped with chocolate for tea and then chicken casserole or a stir-fry for dinner.
Many people would regard this as a fairly decent diet and, for many people, it is probably the norm. But for me - as someone who specialises in pinpointing people's food intolerances - it suggested an obvious sensitivity to wheat, given that she was so clearly harbouring a candida infection.
So I suggested to Kathy that she go on a two week elimination diet in which she would cut out all wheat, chocolate, and as she was eating them every day - often a sign of food sensitivity - bananas. In addition, I told Kathy to avoid all foods that encourage candida overgrowth i.e. anything containing added sugar, dried fruit as it is especially high in concentrated fruit sugar, and all foods containing yeast. It was significant that almost every food that candida feeds on was a food that Kathy liked. "I love mushrooms, wine and every kind of pickled food," she told me.
After she had been on the diet for a week I told Kathy that she should start taking certain naturally formulated products specially designed to combat candida and I warned her that for the first few days she might feel awful.
Abstaining from foods that you have been eating almost every day, and to which you have unknowingly become sensitive, often causes considerable withdrawal symptoms. General malaise, fatigue and headaches similar to those associated with giving up caffeine are common.
For the first week Kathy did indeed feel awful but, by the time she came back to see me two weeks later, she was amazed at the difference. Her husband had continually told her how much better a mood she was in and how she seemed - for the first time in years - like the person he had married. She'd lost 5 lb and had been reorganising the house. Kathy continued to make good progress. By the third appointment she had lost a stone and was back to the weight she had been five years ago.
The breathlessness had gone completely and she had totally lost her craving for sweets, chocolate, biscuits and cake. In addition, she had tremendous news about her son of eight who had bad eczema. Eliminating certain foods from his diet - in his case dairy products, oranges and tomatoes - had made the world of difference.
When I wrote my book about ME with medical journalist Jane Sullivan in 1989, I told readers that allergies and candida often played a considerable part in ME. I think that in those days only a small number of sufferers were quick to pick up on this and pursue this course of enquiry.
Nowadays the situation is different. Increasing attention paid to underlying food intolerances by national newspapers and magazines has made far more people aware of the part they play when a patient has many different symptoms. A multiplicity of symptoms often bewilders GPs. But when it comes to allergies, it is often a tell-tale sign.
Nutritionists and private doctors specialising in food intolerances and environmental medicine recognise this and know what to look for.
The author of a highly acclaimed book on ME, Michael Franklin specialises in helping people find precisely the right diet for them.
Victoria sees patients in London, Sussex, Oxford and Sussex and also offer a postal/telephone consultancy service.
The Allergy and Nutrition Centre
Harley Street London, Sussex and Oxford