Category: Ask The Doctor

Treatments for Insomnia

Posted on 11/29/14 by Charles W. Lapp, MD

Q:            Are there any reliable treatments for insomnia? A:            Most experts on ME/CFS agree that sleep disruption is the one symptoms that should be addressed first.  Sleep allows the tired achy muscles to recover; and lack of sleep increases pain and fatigue.   There are many ways to approach insomnia, starting with good sleep habits, especially […]

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Why Do I Wake Up Exhausted?

Posted on 11/29/14 by Charles W. Lapp, MD

Q:            I wake up each morning feeling tired, even though I have slept.  Would a sleep study be useful? A:            There are at least four core symptoms in ME/CFS:  pain, cognitive dysfunction, fatigue or post-exertional malaise, and non-restorative sleep.  Thus, awakening unrefreshed is one of the cardinal symptoms of ME/CFS, and one of the last […]

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Do I Have to Live Like This?!

Posted on 11/29/14 by Charles W. Lapp, MD

Q:            Do I have to live the rest of my life like this? A:            ME/CFS is considered a chronic illness, but longitudinal studies suggest that 17-64% of adult PWCs improve, less than 10% fully recover.  The improvement rate is even better for adolescents with ME/CFS.  The current standard of therapy is to treat sleep and […]

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Food Sensitivities

Posted on 11/29/14 by Charles W. Lapp, MD

Q:            Will it help me to eliminate gluten and milk? A:            Many PWCs report intolerance to both gluten (wheat products, barley, and rye) as well as dairy products.  These intolerances are rarely caused by true allergies to gluten (celiac disease or sprue) or dairy (milk protein allergy).  Researchers in Belgium have also suggested that many […]

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What is the MTHFR Mutation?

Posted on 11/29/14 by Charles W. Lapp, MD

Q:            What’s this gene defect in folic acid metabolism all about (the MTHFR gene mutation), and should I be tested?  Does insurance cover that test? A:            MTHFR (or methylenetetrahydofolate reductase) is an enzyme required to convert folate to methionine, which is then used in the production of necessary amino acids and other compounds. When MTHFR […]

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Is there one climate more conducive to good health?

Posted on 07/14/14 by Charles W. Lapp, MD

Q:            Maureen C wrote, “My husband and I are fortunate to be able to live wherever we would like.  Given my medical situation, where is the best location for me to live?” A:            There is not one best place to live in general, because everyone has different needs and desires. Some prefer cold climates and […]

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Why Do Antibiotics Make Me Feel Better?

Posted on 06/28/14 by Charles W. Lapp, MD

Many PWCs have experienced improvement of symptoms following antibiotic treatment for other conditions.  The natural questions then are why?  And should I continue to take antibiotics? The first answer is simple.  Antibiotics may “work” in more than one way.  Yes, they might be treating some hidden infection in the body.  But antibiotics have other ameliorating […]

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Do I Have Lyme, CFS/ME, or Both?

Posted on 06/28/14 by Charles W. Lapp, MD

On a regular basis PWCs return to me with a new diagnosis of Lyme Disease.  My main concern in such a situation is whether the diagnosis is accurate and treatment appropriate. Lyme Disease can be a trigger for CFS/ME just as can EBV, HHV6, and other infections [Steere AC, JAMA 1993].  That’s why we request […]

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Candida Infections and CFS/ME/FM

Posted on 01/26/14 by Charles W. Lapp, MD

Cally L. wrote me, “I’ve been reading about candida overgrowth. Is this something you think is valid? Something I should be tested for?” A:      Candida overgrowth is a common phenomenon in persons with CFS/ME/FM, probably because NK Cell Activity is low in most patients and it is the NK Cells that are thought to help […]

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Late Lyme versus ME/CFS

Posted on 12/07/13 by Charles W. Lapp, MD

Q: Nancy H asks, “Do you treat Lyme patients any differently than a patient with ME/CFS or FM?” A: While there is no known cause of ME/CFS or FM, it is well-acknowledged that infections trigger many cases. While EB Virus (mononucleosis) is probably the most common, I have also seen ME/CFS and FM apparently triggered […]

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