Case From the Center:Chronic Fatigue and Depression

The patient is a 55 year old female, married with three adult children and is employed as an elementary school
teacher. She had been seen previously by numerous physicians for treatment of long standing “depression”.
Just prior to her first visit to The Center she was under the care of a psychologist and a psychiatrist.
On her first visit she listed the following complaints: “depression, shakiness, sleeplessness, head and body
aches, dry mouth, indigestion, stomach cramps and gas, anxious, fatigue, job stress, dizziness, fluid retention,
swollen eyes, popping ears, chills, night sweats, cold hands and feet, dry coarse skin, hair loss and no energy.”
When asked to list her most dominant feelings two weeks prior to her visit she list “helpless/hopeless, panic,
anger, anxious and frustrated”. Two years ago her problems became so severe she had to take three months
sick leave from her teaching position. Just prior to her visit, a psychologist advised her to quit her teaching
position to avoid stress.


On her first visit to The Center, a complete physical examination, nutritional profile, psychological and mental
evaluation and laboratory tests were performed. In reviewing her past records, no evaluation of the patient’s
nutritional status was found. Only the basic laboratory procedures, CBC and urinalysis were performed on the
patient. In addition to the history given above, she had the usual childhood diseases and a tonsillectomy at four
years of age. Her spouse, children, siblings and parents were still living. She denied any history of smoking or
alcohol use. She stated an allergy to sulfa drugs.


A list of medications she was presently taking included: “Estertest, Bumex, Advil, Atarax Syrup, Pepsid,
Haldol, Prozac, Librium, B12 and Armour Thyroid”. She stated she had been taking thyroid for two years, “not
because it was low, but because it might help!”


The psychological evaluation revealed the patient had signs of severe, agitated depression with a high level of
fear and panic. Laboratory test results showed the CBC, urinalysis, candida IgG antibody titer, vitamin B1, A,
C, E, folate, B12 and buffy coat vitamin C in the accepted reference range. A cholecystography examination
revealed a normal gall bladder. A glucose tolerance test was borderline for hyhpoglycemia, however, the
fructosamine, glucose and A.M. cortisol levels were all within the reference ranges. Thyroid functiont ests were
also normal. The urine vitamin C screen was “0” mg/dL. During her Center visits, three different hair analyses
were done for trace and toxic minerals. The first hair analysis showed elevated levels of sulfur and magnesium
and low levels of phosphorus, copper and zinc. Based on the physical, history and preliminary laboratory
results, a diagnosis of fibromyositis, depression and zinc deficiency was made. She was initially treated with
buffered vitamin C, 1000 mg two times a day, zinc, 0.6 mL in juice or water once a day, niacinamide 500 mg
once a day and intravenous calcium.


A second hair analysis a month after her first examination showed elevated magnesium, barium and strontium
and decreased levels of copper, zinc and phosphorus. The same treatment was contined except her zinc intake
was increased. Her depression, shakiness, sleepiness, body aches and stomach cramps gradually decreased. A
third hair analysis again showed a decreased zinc and elevated magnesium levels. Her zinc intake was
substantially increased.


On her next visit (about six months after the first visit) the patient stated that her physical and mental
conditions were much improved. Physical and psychological evaluations showed an increased energy level,
much less pain and a positive mental outlook. She was continued on zinc sufficient to correct her deficiency,
together with other nutrients as described above. She has slowly been “weaned” from her long list of previous
medications.


The patient continues in her job and to improve with less pain, stress, anxiety and greatly improved mental
outlook. This case illustrates the importance of the multifactorial approach to disease and the need for
monitoring nutrient levels to insure adequate tissue uptake of what has been prescribed.

1. The Center for the Improvement of Human Functioning International, Inc., 3100 Hillside, Wichita, Kansas 67219.

2. Professor and Chair, Clinical Sciences Department, The Wichita State University, Wichita, Kansas 67208.

Avatar Written by Hugh D Riordan MD

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