“Ce n’est pas pas le germ; c’est le terrain”

Several patients, hoping to have found the magic bullet that will cure their chronic fatigue, have brought to my office an article they feel shows that a retrovirus causes fatigue.[1] First of all, the article merely “links” the virus to fatigue; it does not prove a cause and effect relationship, which is what the authors recommend to do.

Are micro organisms to blame for all diseases? I don’t believe so. Attempts to do so are commonplace, given our present infectious paradigm in medicine. This is unfortunate and reminiscent of our general attitude to blame outside factors for our problems, including character and relationship problems. This is why I tend to side with Pasteur; after a brilliant career that included the creation of vaccines in the West, he ended up stating that “the germ is nothing; the terrain (or our immune system) is everything”.

The retrovirus is yet another clue that our immune system is not adequately protecting those who are affected by fatigue. If the virus was the main cause for fatigue we would all be tired, since that family of viruses is found in practically all people. When we consider that most of our immune system is in the intestines, we can see that any compromise of intestinal function will lead to poor absorption of the energy we consume in food; hence, fatigue. In other words, most immune system defects point to the gut.

Also, the immune system consumes significant amounts of energy. Food intake is the main factor in how our metabolism works, or how we use the energy of food at the cellular level. It is our metabolism that determines how strong our defenses may be against micro organisms. The worse our diet, the weaker our immune system is.[2] The other critical factor for both our metabolism and our immune system in the intestines is the friendly organisms that live therein. Pardon me for highlighting this concept so often, but the medical literature is abuzz with research into these wonderful organisms. The point here is that probiotics strengthen our immune system much better than all the garbage people take over the counter for their colds. A study showed that supplementing probiotics reduced rates of fever by 73%, cough by 62%, and a runny nose by 58% compared to placebo.[3]

[1] J. Science 2009;326:585

[2] “The Intricate Interface Between the Immune System and Metabolism”, J. Trends in Immunology 2004;25:193

[3] J. Pediatrics 2009;124:e172