Summary of The Cheney Files

Dr Paul Cheney is a leading US expert on CFS/ME. He offers an explanation of ME/CFS which connects the post-exertional fatigue symptoms to the function of the heart (click here for the original "Cheney Files") . His theory is rather interesting and seems to make sense of some of the more baffling aspects of ME/CFS.

Dr Cheney sets out strong scientific evidence based on tests of a correlation between levels of fatigue in ME/CFS and blood output from the heart. My own view is that there could be a strong connection between an overactive (weak) immune system (inflammation or an imbalance in the ratio in the T-cells) and the symptoms of fatigue, which could mean that there is also a link in ME/CFS between the overactivated immune system and blood output from the heart. In my own experience, when my own T-cell ratio deregulated during my allergy/immune treatment in ME/CFS, I was unable to stand up and my brain "collapsed" into a vortex, until my next T-cell treatment. After treatment, although heart output is decreased by 30% when standing, I was still able to stand and my brain and emotional functions were also restored, just as rapidly. This could indicate that heart output can be increased by regulating T- cell ratios.

Summary of Dr Paul Cheney's main observations about ME/CFS
a) The one common denominator in all genuine ME/CFS cases (which is not found in Fibromyalgia) is post-exertional fatigue i.e. mental or physical effort makes the symptoms of ME/CFS worse and rest is required to recharge the body. Even after near total recovery from ME/CFS, relapse or even death can be caused by sudden exertion.
Alison's advice: avoid exertion which puts any strain on the heart (ME/CFS patients call this "pushing oneself") especially carrying weights, running, swimming and climbing mountains or even steep gradients, even when you feel nearly better.

b) Post-exertional fatigue in ME/CFS is best treated by patients lying flat. Climbing, walking or standing (even mental exertion) reverses the positive effects of lying flat. The positive effect of lying down is very marked in ME/CFS. Dr Cheney links this to heart output. Output of blood from the heart is decreased in everyone by 30%, when they stand. People with CFS/ME already have less output from the heart and the more severe their ME/CFS is, the lower their heart output measurement when standing.
Alison's advice: lie down flat frequently and whenever you need to recharge your brain and/or body. Use a sofa you can lie fully flat on to watch TV.

c) Medical tests have demonstrated a "Q" factor in ME/CFS patients. Healthy and near healthy ME/CFS patients have 7 litres of blood passing through the heart per minute when resting and 5 litres per minute when standing. This can reduce to as little as 3 litres in severe cases of ME/CFS when standing. "Q" measurement in ME/CFS is a measure of the standing and resting measurements of blood passing out of the heart in ME/CFS patients.
Alison's advice: assume that your heart output is lower in ME/CFS and adjust your mental and physical activities to take that into account.

061229_annisroticcio200px.jpg d) This "Q" factor indicates that the amount of blood passing through the heart in ME/CFS patients when standing is in direct proportion to the severity of their condition i.e. those with worse ME/CFS have considerably reduced blood output when they stand. When the most severe ME/CFS patients stand up, they are actually near to organ failure.
Alison's advice: in severe ME/CFS keep standing to a minimum. Use a stick, trolley, wheelchair or Nordic walking poles . In moderate ME/CFS, use Nordic walking poles which support the body when walking or climbing gentle slopes - see photo (right) of Nordic walking poles offering me good support on a flat mountain walk, accessed by car.

e) Dr Cheney believes that patients with ME/CFS have a condition of chronic heart failure which he calls "Compensated Idiopathic Cardiomyopathy" (structural or functional failure of the heart muscle) which could be linked to deregulation or imflammation of the immune T cells (Alison Bailey adds this latter observation). Patients with uncompensated idiopathic cardiomyopathy (which Dr Cheney himself has) require a heart transplant in 5 years. But people with ME/CFS do not require a heart transplant, Dr Cheney claims, because they are protected by ME/CFS. In fact, patients with ME/CFS do not suffer heart failure or require heart transplants at all. It is the alteration in body chemistry to combat heart stress that produces the ME/CFS that protects them against full blown heart failure. In other words CFS/ME successfully compensates for chronic heart failure. However, we have known cases of elderly patients who have ME and heart problems and some who appeared to have died in CFS/CFS of heart failure. Dr Cheney's work supports this observation too.
Alison's advice: try to view ME/CFS as a "protection" and a chance to build a healthier lifestyle

e) Some organs in the body are more heavily defended against loss of circulation than others. When heart output dramatically drops, the last organs to fail are the lungs and the kidneys, at the expense even of the brain and the heart. The first organ to be deprived of blood, during shortage is the skin (causing pallor). Then the digestive system and brain are deprived and then the heart and liver function (causing toxicity in the body and brain). Finally, if heart output continues to fail, the lungs and the kidneys are affected, causing death.
Alison's advice: follow the dietary advice on this site to combat toxicity in the gut caused by deregulated immunity and poor diet e.g. take garlic and enrich the quality of your blood and general vitality with a high raw diet. Drink plenty of filtered water

f) If your immune system is over-activated (weakened) through having T cells deregulated by a chronic virus, a toxic digestive system (candida infection in the gut caused by too much sugar consumption), by exposure to food chemicals or additives, exposure to moulds, eating too much of one food e.g wheat, impoverished diet or other physical stresses, including chronic life stresses (Alison Bailey adds "relationship breakdown or problems, grieving, bullying, moral dilemmas, assaults, shocks, operations") your body produces too much nitric oxide which combined with other components produces a lethal chemical, peroxynitrite, which left unchecked, will cause death. It is well known that negative life experiences suppress the immune system.
Alison's advice: avoid exposure to infections, toxins, moulds, bullying and abuse, aggression, processed foods, get your allergens treated, avoid sugar, build up your immunity through advice on this site, avoid stress - discipline yourself into forgetting, mentally blocking or just to cease thinking about anything that upsets you: concentrate on positive thoughts or click here for our "fun, delight and laughter" page.

g) the major scavenger of lethal peroxynitrite is carbon dioxide. Many patients with CFS/ME are not getting enough carbon dioxide in their bloodstream because they are hyperventilating (overbreathing). So they need to rebreathe their own exhaled carbon dioxide. Dr Cheney advises ME/CFS patients to do an exercise to retrain their breathing twice a day: cup your hands over your mouth and rebreathe your own exhaled carbon dioxide, every 4-5 minutes for one minute at a time, during a 30 minute period. This will raise your levels of carbon dioxide and eventually correct your overbreathing habit. (Alison Bailey adds that another way excellent way of correcting overbreathing is music therapy - see the exercises on the "Music "page on this site. The best method is to combine music therapy with the rebreathing exercise explained above). Dr Cheney thinks that the ME brain is in a mild seizure (rather than tending towards coma) and that anything to balance this effect is beneficial (which includes music).
Alison's advice: follow Dr Cheney's breathing exercise lying down for 30 minutes, while listening to Mozart or other classical music on earphones, in a dark room, twice a day - see my page on "Music".

h) Dr Cheney sets out other ways of scavenging lethal peroxynitrite. These include avoiding too much hyperventilation at altitude, consciously slowing your beathing, avoiding coffee altogether and tea after 6pm, eating meat and raw vegetables (see this site for raw salad recipes), seeds and nuts e.g. organic brazil nuts, vitamin B12 injections, zinc and selenium, organic grapeskins (see his site)
Alison's advice: consciously slow your breathing, eat red meat and raw vegetables, take a multivitamin every day, eat organic brazil nuts for selenium and other nuts and seeds, eat organic grapeskins.

i) The body produces over-activation or deregulation of the immune system when it produces energy. Dr Cheney says that to protect itself against "a death spiral" related to this over-activation (inflammation) of the immune system and its possible effects on the heart, the body drastically restricts its production of energy. When the immune system is normalised and rebalanced again (see treatment on this site), the body starts to produce more energy.
Alison's advice : view your ME/CFS as a protection against other fatal diseases and a chance to restore well-being, treat immune dysfunction, counter environmental stress, without developing heart failure. Aim to control the inflammation of the immune system (e.g. control your ingested toxins) and systematically tackle over breathing, causing lack of carbon dioxide.

j) Improve your heart's output during the day by increasing your water intake (but read the restrictions on the Cheney site). Lie down to increase your heart output, by up to 2 litres per minute, as often as possible. Relax.
Alison's advice: lie down once a day at least, even when you recover (a "siesta" is a good idea). Drink at least litre of purified water a day (preferably in the morning).