Home > Essential Oils, Heart Disease, POTS > Chronic Fatigue as a Response to Organ Failure

Chronic Fatigue as a Response to Organ Failure

 In 2004 a patient of Dr. Cheney, Carol Silverling wrote down her interpretations of the cardiac dynamics of CFS.  Her article was based on interviews with Dr. Cheney and her own knowledge.CS

The premise is that because of mercury poisoning or viruses we are creating too much peroxynitrite which causes oxidation and aging Reduced microcirculation as a result of the mercury  begins to cause organ failure.  In “normal” people this may result in a fast path to organ transplant (or death), but for others (those who have CFS)  it results in organ failure in a progressive slower fashion.  This means you have time to address the problems! 

Heart Failure

Dr. Cheney’s premise is that every CFS individual is in the process of heart failure, this is termed Idiopathic Cardiomyopathy (ICM). The difference between CFS and heart failure is that the body is trying to compensate for the lack of microcirculation  by symptoms found in CFS. 

 Dr. Natelson applied for an NIH grant to find physiological parameters that may independently be a measure for the degree of disability. The purpose of this was to find a quantifiable way to designate those that are disabled from those that are not.  But also a measure of the degree of disability…how disabled are you? This could be significant in a “two-sides-of-the-same-coin” kind of way.  With an objective marker you could not fool anyone into providing disability services that were not needed.

And on the other side, you could get disability services even though you “don’t look sick”. The measure they looked at was “Q”, which stand for cardiac output in liters per minute.  CFS individuals have the largest variation of Q when they stand up.  This lowered Q could result in organ failure due to low cardiac output.  In this measure the higher the score the greater the disability.  Using an FDA approved algorithm to measure impedance of blood,  they determined this Q measure.  The idea was that the Q value would be adjusted for size of the individuals so that the it was a true measure of disability across the population and body types.

There is a another statistic that correlates with Q, and that is post extertional fatigue (PEF).  This is not the “no pain, no gain” kind of pain you want while building muscle. This is a breakdown and can’t repair kind of muscle ache.  As it turns out all disabled CFS patients have PEF. 

At the same time you may be aware of POTS (Postural Orthostatic Tachycardia Syndrome). There are several kinds of POTS, but one is when one stands up and  the drop in blood pressure is large enough that the heart must compensate by beating faster.  The reason for the drop is that the end arteriole or resistance vessel was not doing its job of moving  blood up against gravity from your feet.  When this is not working your body also tries to compensate by increasing the pressure to get it moving.  When this occurs the main line (to the heart)  improves but peripheral blood is not moving optimally and microcirculation is decreased.    These compensations by the heart are just that — compensations.

Organ Failure Progession

Peripheral organs fail first without enough Q, but they are sacrified in priority.  Here is that priority in normal circumstances. See if this lines up with the progession of illnesses in yourself or family/friend:

  • Skin and hypothyroidism. The skin and nails are at the extreme “end” of your body and therefore will suffer the most from loss of microcirculation. Now you can’t regulate your temperature from your skin so your body turns down your thyroid ON PURPOSE.  Your skin which is one way to detox is now unable to do this and so detox through sauna is often recommended.
  • Muscles.  Not only do you get pain when you exercise, you get NO GAIN.  The more capillaries (like male athletes have) the less likely this is going to happen, and if you are a sedentary female…well you can guess. This is because women have fewer capillaries then men on average and based on the  lack of activity do not grow (or maintain the ones you have).  This could explain how with intense exercise you are still unable to gain muscle.
  • Gut.  Since your gut needs microcirculation to function, you won’t be able to digest, and will develop food allergies, and be unable to detoxify.  You could get flatulence, constipation and all sorts of overgrowths.  Less digestion also means less absorption. 
  • Brain.  As the master controller of your bodily functions if this doesn’t work, neither does anything else really.  You could get autonomic problems to hypothalamus regulation of hormones, decreased processing speed, memory and cognition.  The combination of thinking and being sedentary (office work anyone?) is the worst possible combination.  Meditation might help those who are sedentary, but even slow deliberate exercise would be good.  In the worst cased you could get a rebounder, a small trampline and just bounce on it.
  • Heart.  Now your heart struggles with even the smallest amount of exertion, if the microcirculation problems get worse your hearty heart cells begin to die.  If  this in turn causes more microcirulation problems you have begun a feedback loop of cardiac failure. 
  • Kidneys and Lungs are the last to go and are considered the cause of death.  The only thing that can save you is a transplant.  In CFS though it’s different. You may have most of the early steps, but you don’t end up with extreme pulmonary edema and renal failure.


ICM can often caused by infectious diseases; Dr. Cheney thinks there might be a link to some viruses.  The other contributing factor could be heavy metal poisoning.  An Italian study found that ICM hearts had 23K times more mercury than control and 18K more mercury than other types of heart disease.


Dr. Pall has another angle on CFS and that is Peroxinitrite.

NO + Super Oxide = Peroxinitrite

Peroxynitrite is deadly and this is the celluar cause of “old age” and death.  However it is made from two compounds that are essential for life, Nitrous Oxide (NO) and Superoxide (SO). Peroxynitrite participates in oxidation with free radical formation. Dr. Pall studied these dynamics in CFS which can be explained as follows:

Nitrous Oxide  (NO)

 There are three kinds of Nitrous Oxide, iNOS, eNOS and nNOS. iNOS is created to fend off bugs and allergies.  eNOS is for microcirculation, and nNOS is for memory and learning, but also makes you sensitive to (Electro Magnetic Radiation) EMR and noise. The NMDA receptor makes NO when activated; some practitioners use GABA to downregulate NMDA.

Superoxide (SO)

is made while manufacturing energy, in the mitichondria. NO is found outside the mitochondria, thus NO and SO have no way of interacting with each other to create peroxynitrite. Until SO starts to leak out.  Within the mitochondria, SO should be broken down by SOD before leaking out, but this assumes that glutathione is present.  If you have the CBS mutation you may not be making enough glutathione.  If you are very toxic, the glutathione you make might be attending to other problems and not be around to help.

Mercury can block the binding site of selenium on a cell and therefore not allow the SO to be broken down, now it begins to leak out of the cell. The more energy you generate the more SO begins to leak in the presence of mercury. Eventually having not enough glutathione will result in injury to the mitochondria membrane.

CoQ10 in the mitochondria and ALA in the cytoplasma bind to SO to prevent leaking out and unable to form peroxinitrite in the when it does.  CoQ10 is tricky in that there is an optimum amount and taking more than that you may generate more SO than you wanted. (It appears that Idebenone may be better than CoQ10 in that case) 

Without CoQ10 and ALA to help, your body stops making energy in order to reduce the creation of peroxynitrite.  Provigil is often used to create energy by activating the NMDA receptor, but this is creating more NO, which can contribute  to peroxynitrite in the presence of SO. 

So what gets rid of peroxynitrite once it is created?  CO2.  CO2 is a peroxynitrite scavenger and is created when ATP is made. Normally this would work great, but as ATP is reduced (because peroxinytrite is not being scavenged) so is CO2 and thus the scavenging of Peroxynitrite gets reduced further.

You can increase CO2 by rebreathing your own breath. This will also improve microcirculation.  Have you notice you or family member sleeping comfortably entirely under the covers?  Could this be the mechanism going on?

How do you reduce NO and SO?

    1. Klonopin gets rid of the enzyme that creates NO.
    2. You could live at or below sea level to increase CO2. POTSIES often feel better at these elevations.
    3. Uric acid is a scavenger of peroxynitrite and is found to be low in CFS.  It is made from RNA and DNA metabolism, and fasting!  So those religious folks had it right. 
    4. Sushi is very high in digestible RNA and DNA. Microwaving kills RNA and DNA efficiently.   You can also eat “young food” such as eggs and raw milk. If you can’t get raw milk consider raw milk cheeses.  Nuts and seeds and baby lettuces and spinach as well.
    5. B12 injections (if you have the MTHFR mutation this means Methyl B12 injections)
    6. Magnesium Sulfate blocks NO production. Finally you can take Zinc and Selenium to block and/or chelate mercury.  

I really found this topic very interesting.  It explains a progression of symptoms that are familiar and for me points back to mercury being the culprit.  Luckily we have ways to remove the mercury even if is a complex process.  Other ways to help with microcirculation in the meantime are L-Arginine and Black Pepper Essential Oils.  

In summary, instead of running headlong into heart failure, PWCFS are going through the same progression just much slower…giving us time to maybe address the problem.

  1. jada sarfate
    February 2, 2013 at 4:16 pm

    Great read! I ws dignosed with pots in Deccember ws feeling better for a bit but now relasped and I’m bed ridden for 5 days now. Where can we find a doc well versed in all of this?

    • February 2, 2013 at 5:18 pm

      Jada, there are several doctors that look at POTS, unfortunately most of them have a waiting list up to a year long. Which area are you in?

      • Jada
        February 2, 2013 at 5:32 pm

        I’m in Arizona. That’s discouraging… A year is way to long to wait with my scary symptoms! Do you know of someone?


      • February 2, 2013 at 6:24 pm

        I will email one to you.

  2. jada sarfate
    February 2, 2013 at 6:29 pm

    Thank you! I also have cbs and mthfr mutation. My pots came on suddenly in june after a sressful event.

    • February 2, 2013 at 6:30 pm

      OMG, definitely see the doctor I sent you, she specializes in MTHFR

  3. Carolyn
    March 6, 2013 at 10:44 pm

    I am very familiar with Cheney’s research but you seemed to take some of his research to a different or more comprehensive level. When you say, “Uric acid is a scavenger of peroxynitrite and is found to be low in CFS. It is made from RNA and DNA metabolism, and fasting! So those religious folks had it right,” what do you mean? Are you suggesting RNA & DNA supplements? Are you suggesting some kind of a fast? And if so, what kind? Also, can say more about the inability to gain muscle with CFS. You are the first person I have seen say this and this was one of the first signs I was sick. I was working out very intensely and unlike the rest of my life, I couldn’t build muscle and get stronger. I believe this is one of the reasons I have gained so much weight since getting CFS. Not only is it harder to work out, but I don’t gain muscle and therefore don’t burn calories very efficently.

  4. March 7, 2013 at 8:51 am


    When it comes to fasting, I would recommend something that is not too dramatic. One term is called “intermittent fasting”. Generally you fast for about 13-16 hours and this gives the body a break from food and allows several metabolic markers to reset. It’s not too crazy because you can leverage your sleeping time for these. A google search will provide more information.

    In terms of RNA, I would go with “young food”. For instance I get pastured eggs instead of storebought. I’ve noticed that when I moved up from 1-2 a morning there were subtle changes to my energy/strength. Of course that’s not the only thing I was doing.

    “Cysteine is a precursor to glutathione. It has been hypothesized that glutathione and cysteine metabolism may play a role in skeletal muscle wasting and muscle fatigue. The combination of abnormally low plasma cysteine and glutathione levels, low natural killer (NK) cell activity (with a resulting susceptibility to viral infection), skeletal muscle wasting or muscle fatigue, and increased rates of urea production define a complex of abnormalities that is tentatively called “low CG syndrome.” These symptoms are found in patients with HIV infection, cancer, major injuries, sepsis, Crohn’s disease, ulcerative colitis, Chronic Fatigue Syndrome, and to some extent in overtrained athletes (Droge et al. 1997).”

    “Glutathione is needed for both the immune system and for aerobic muscular contraction. The authors proposed that glutathione depletion by an activated immune system also causes the muscular fatigue and myalgia associated with Chronic Fatigue Syndrome (Bounous et al. 1999).”

    The above two quotes are from “http://www.immunesupport.com/chronic-fatigue-syndrome-causes.htm”. If you have the CBS mutation you will have difficulty creating the glutathione. I’m trying to keep an eye on that aspect.

    If as some say it can take up to 3 days to recover from exercise, one can imagine that you may not have the capacity to build muscle if it takes so long just to get back to your baseline.

    “Impaired oxygen delivery to muscle in chronic fatigue syndrome. (Abstract) McCully KK, Natelson BH. Department of Medicine, Medical College of Pennsylvania and Hahnemann University, Philadelphia, PA 19129 “In conclusion, oxygen delivery was reduced in CFS patients compared with that in sedentary controls. This result is consistent with previous studies showing abnormal autonomic control of blood flow.” ”

    “Exercise capacity and immune function in male and female patients with chronic fatigue syndrome (CFS). (Abstract) Snell CR, Vanness JM, Strayer DR, Stevens SR. University of the Pacific, Department of Sport Sciences, Stockton, CA 95211-0197, USA. “These results implicate abnormal immune activity in the pathology of exercise intolerance in CFS and are consistent with a channelopathy involving oxidative stress and nitric oxide-related toxicity.””

    Also uric acid is created by purine metabolism which is helped by molybenum.

    You could try the “Pall Protocol” outlined at

    If you do, let us know how it went!?

  5. Carolyn
    March 7, 2013 at 11:19 am

    I’ll have to think about this more and do some research. I’ve been on the Cheney’s Protocol for 2 years and am doing really well except for the weight gain. Health wise it concerns me and carrying around 50 extra pounds is exhausting. I can work out for up to 2 hours every other day. The workouts help in some ways like stretching from yoga, but aerobics and weights don’t seem to be bad for me, but I don’t see any benefits either. They don’t make me lose weight or make me have more stamina or help in any way at all.

    I’ve seen some things on the internet about the benefits of fasting and I had come to the same conclusion, that it needed to be for short periods of time.

    What do you think about a high protein diet? Based on a lot of things I’ve read about how your body functions when you have CFS, high protein seems like a possible way of losing weight. My husband who understands chemistry better than me says a high protein diet would probably keep me from gaining more weight but “would it force your body to use it’s stored fat for energy?”

    Your thoughts?

    • March 7, 2013 at 11:32 am


      I think high protein diets may work if you are not middle aged, because then your hormones are working against you as it were. I suspect your goal is to lower your glycemic load, and fats and protein can help with that. I would look into serotonin in the gut. People have been known to lose hunger, lose weight, but not otherwise have a nutrition deficiency when serotonin was adjusted. If you have the CBS mutation however you will not want to try to eat more protein, as it can contribute to a push of cysteine towards taurine instead of glutathione…which is what we desperately need.

      I assume you have checked out your thyroid?

  6. Carolyn
    April 13, 2013 at 4:30 pm

    I just wanted to let you know that I’ve been on a very high protein diet since our exchange in March. I want to thank you for your help. I’ve lost 10 lbs since we last talked. I’ve been losing at least a pound a week. I just can’t believe it. Your article made me rethink everything and I just am amazed that this is working. I’m not fasting. I tried it a few days, but it didn’t seem to be of much help. I’m exercing every day at a lower level for longer. I haven’t paid too much attention to calories until this last week and I lost 2 pounds when I tried lowering my calorie intake this week. Here’s the other article that was so helpful to me on this issue http://forums.phoenixrising.me/index.php?threads/dealing-with-weight-gain.1364/ Go to Rick’s post that starts with ‘Hi, all.” Thanks again.

    • April 13, 2013 at 5:05 pm

      Carolyn so sweet of you to post your progress, I’m glad it is working for you. Richvank is famous in the methylation world. In that area there are often considered about 5 cycles including Krebs. The others are folate, methionine, transulfuration, and urea. Increasing the folate cycles feeds into the methionine cycle which feeds into the transulfuration cycle which creates glutathione. Mutations in the genes that create enzymes along these cycles makes these steps not so straightforward.

      Lots of complexity in these, but I’m glad you have something that is helping for now, congratulations!!!

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