In Burnout syndrome, the immunological theory (the theory of humoral blockade by antibodies in type V hypersensitivity, similar to myasthenia gravis) could lead to the use of plasmapheresis, in decompensated cases, and immunomodulation tests, in chronic cases.
Burnout syndrome could have an immune mechanism in the central nervous system (reticular system), through the intervention of the immune system at this level (antibodies formed by cross-reactivity with certain antigens – possibly chemical?).
Cortisone treatment at high doses of immunosuppressants is not effective in myasthenia gravis, sometimes in myasthenic attacks. Myasthenia responds to the classic Prednisone regimens, in doses of anti-inflammatory (15 mg / day – 3 times the basal secretion of the adrenal gland), associated with Myostin.
At these doses alone, Prednisone may displace acetylcholine antireceptor antibodies, release receptors, and allow myostin to bind because there is no local inflammation to justify the anti-inflammatory effect.
In Burnout syndrome, antibodies can occur in the most commonly used chemical in work environments: disinfectant detergent solutions or products resulting from their action on floors. The high frequency in the medical field, the persistence of symptoms when removed from the immunological memory, the low frequency in surgeons and nurses (who probably have resistance through prolonged manual use), all these are in support of the immunological theory. The low frequency in the Asian and African breeds denotes the involvement of the genetic factor.
Some attempts at magnesium treatments have also been described, in the idea that it acts on most enzymes involved in muscle contraction. Asthenia does not appear to be myasthenic or myastheniform, but magnesium must be adapted to an appropriate concentration to act intracellularly, probably other than that used in spasmophilia or stress. Lately, the efficacy in asthenia of magnesium preparations has decreased and increased in combating stress (in combination with vitamin B6); the use of magnesium in food diets seems more effective.
In some physical efforts good results were found through the combination: bread with grapes or bread with tomato / cucumber. It would seem that this combination increases the efficiency of magnesium (increased intestinal absorption is possible) because magnesium is difficult to absorb and absorption is low by foods rich in phosphates, lipids, proteins, alkalizers.
In cardiology, chocolate has been tried as a source of magnesium, but it seems that the combination with milk decreases its efficiency. The only formula without milk is bitter chocolate which has proven to have a superior effect. It seems that, in addition to the high concentration of magnesium (cocoa), its bioavailability is also important.
Vegetarian diets greatly increase the bioavailability of all combinations and in Burnout syndrome it is important that vegetables and fruits do not contain preservatives and growing solutions. If they cannot be consumed in their natural state, it would probably be useful to consume them in irradiated form. In this form, they do not show immunogenicity. The vegetarian diet is more invigorating if sugar and sweet (fruit) glucose are removed.
In Romania, a case of severe burnout syndrome with lethargy was remitted by using total chemical eviction: lying in bed, without walking, diet with white bread and water in a person with rice intolerance. The diet required a period of 3 months, when it was possible to gradually reintroduce food, because the immune response extended to food chemicals that previously had tolerance.
This regimen is also used by some postoperative abdominal surgery departments, in cases that have difficulty refueling. It is indicated biscuits with tea, as a unique food for a few days, until the resumption of digestive tolerance. The old regime with strained vegetable soups can no longer be used, probably also because of its chemical load. Patients should be without celiac disease (with gliadin-negative antibodies).
In terms of physical activity, light exercise improves the symptoms, while lying in bed for an extended period seems to accentuate it, as well as hypoxia. Among the physical activities, the most important seems to be walking outdoors (probably increases the purification of the immunogen absorbed through the sole of the shoe, in people with enzyme defects).
The first cases with chronic fatigue syndrome in Lake Tahoe were 6 professors from the local University, the condition having a good prognosis.
In recent years, patients who have died from Burnout syndrome have probably had several factors combined (the infectious agent entangled with a possible chemical agent), as well as other factors that have elicited a particularly severe response from the immune system to the CNS. culminating in a lethargic encephalopathy.
Probably, in milder cases, there is only one etiological agent. The case that survived in Romania seems to have had a double etiology: infectious and chemical. It is possible that the infectious agent and the chemical agent have antigenic determinants with similarities to certain S.N.C. structures, which leads to cross-reactivity.
If future studies confirm the etiology of Burnout syndrome, it is necessary to strictly follow the manufacturer’s instructions regarding the time of washing and rubbing on the floors, the maximum number of washes allowed per 24 hours, the drying time.
The alcohol base seems to provide good stability; some window washing solutions are based on alcohol so it resists well to the action of U.V. and temperature.
In medicine, the most commonly used skin antiseptic is medicinal alcohol (some alcoholic solutions have a revulsive effect in local frictions – the solution of 53.605%); a local analgesic effect is also observed. Some Romanian immunologists consider that 70% ethyl alcohol is the most reliable in disinfecting laboratory work surfaces.
In chronic hepatitis, some phytotherapists indicate hydro-alcoholic extract of silymarin, although shovel medicine strictly forbids this. It may induce an immunomodulatory effect at the concentration indicated in phytotherapy.
Some antiseptics may be limited depending on the concentration (Iodaformium with a maximum dose of 0.2g at a time; for 24h – 0.6g). The chemical agent can also become immunogenic by conjugating it with certain products in the body, a situation encountered in some drugs in the category of hapten. A good therapeutic effect could have nootropics such as Meclofenoxate, Meclosulfanate, which are metabolic regulators of the nerve cell and which facilitate the penetration of glucose into the neuron that uses, as a single energy source, glucose. The preparation meclosulfonatum hydrochlorhidrium also described antidepressant, psycho-energizing effects, increasing the capacity for intellectual work.
Some authors have found changes in serotonin in the pathogenesis of asthenia. Asthenia is often associated with depression and Alzheimer’s disease, so serotonin may be low in response to antidepressants that increase serotonin.
Some psychiatrists consider sleep to be the best way to restore a nerve cell.
Mihaela Ghimpu
Clinical immunology specialist
and allergology