“Chronic Fatigue and Pain Syndromes Clinical Strategies and Treatment Applications”
Video: My new course – Chronic Fatigue and Pain Syndromes
Watch More Chronic Fatigue and Pain Videos Below
How to identify the mechanism underlying chronic pain syndromes
Chronic pain perception is a neurological phenomenon
Chronic pain syndromes are a neuroendocrine-immune vicious cycle
How do you evaluate fatigue
The overlap between chronic fatigue and pain syndromes
Why fatigue is a red flag for neurodegeneration
Many patients are stuck in a vicious cycle of chronic fatigue and pain
A key factor in this vicious cycle is inefficiency of the bioenergetic pathways
As a healthcare professional, you probably have noticed the two most common patient complaints are fatigue and pain. Many patients have been diagnosed with chronic fatigue syndrome or fibromyalgia and have gone from practitioner to practitioner.
Significant interrelationships exist between chronic fatigue and chronic pain syndromes, turning into vicious cycles involving the neurological, endocrine, and immune pathways.
These conditions can’t be treated by any single intervention. Instead, they require looking at the whole picture, understanding the interrelationships, and working your way through them with your patient.
Factors that can cause chronic fatigue and pain include:
To know what is causing your patient’s chronic fatigue and pain, it’s important to understand the interrelationships between neurology, endocrinology, immunology, and bioenergetic pathways.
You need to work step by step through the process of differentially diagnosing the underlying mechanisms of chronic fatigue and pain and then developing clinical strategies specific to those mechanisms.
Mechanisms you will learn to treat include:
Did you know chronic fatigue and pain can be red flags for the potential development of a neurodegenerative disorder?
When a patient has been suffering from chronic fatigue and pain issues for many years, the cellular mechanisms involved in the neurodegenerative process are all in place.
When you see patients who have these conditions you have to look for early signs of neurodegeneration.
If you catch it in time, you have an opportunity to make a big difference in their outcome as they start to age in the next 10 to 20 years.
These conditions can’t be treated by any single intervention.
They require looking at the whole picture of interrelated systems and working your way through them looking for areas of dysfunction.
In this course, we’re going to go through all the different mechanisms involved in chronic pain and fatigue syndromes that are so common in the healthcare system today.
I’m going to share with you all the major research of how these mechanisms work and the underlying pathophysiologies.
Then I’m going to teach you a step-by-step clinical approach:
Do you understand these mechanisms of ongoing fatigue and pain syndromes?
Multiple factors are involved in chronic fatigue and pain syndromes
The term bioenergetic refers to how we use the foods we eat to make energy in mitochondrial ATP production.
An inability to use these energy pathways efficiently can lead to significant imbalances.
This in turn leads to neurons that are close to threshold and increased depolarization of nociceptors.
As a result, they have greater pain perception. Their brains fatigue easily. Their muscle mitochondria becomes impaired.
They complain of significant muscle aches and they get worn out easily. They don’t want to do anything because it’s too tiring. And they usually have other conditions such as depression.
These patients don’t have a disease but they have multiple chronic health issues.
They have a hard time getting better.
Yet when they walk into a conventional model, they are prescribed one medication after the next, ending up in polypharmacy model—which confuses the picture with multiple side effects.
Yet the underlying mechanisms of neuroendocrine immune dysfunction and imbalances in their bioenergetic pathways are never addressed.
As a result, they go years, decades, or even a lifetime never breaking out of this vicious cycle.
Learn the roles of the brain, the immune system, and the endocrine system in chronic fatigue and pain issues
It is critical you have a step-by-step approach to developing treatment applications for patients with diverse fatigue and pain syndromes … which many people label as chronic fatigue or fibromyalgia.
You must master the underlying mechanisms of neuroendocrine immune dysfunction and imbalances that impact the bioenergetic pathways used to make ATP.
To best help your patients, you need to understand the underlying mechanisms, which areas of the brain are most affected, and how to treat the entire web.
Fatigue and pain are often associated with inefficiency in the body’s ability to produce ATP or energy.
When the body loses the ability to make ATP, this causes either brain-based fatigue, muscle fatigue, or both.
As a result, patients can’t think, focus, or concentrate for very long periods of time. They are easily exhausted if they push their brains too much.
Or they have achy muscles and any kind of movement or exercise exhausts and fatigues them. They don’t have the same level of endurance they once did.
Pain patterns usually accompany these patterns of fatigue—whether it’s sporadic general pain, unrelenting chronic pain, or an old injury they can never recover from.
When you see these patterns, the ultimate issue is the body may not have healthy mitochondrial function.
There is much more to mitochondrial function than taking things like CoQ10.
Instead, it’s a complex neuroendocrine immune phenomenon impacting multiple pathways that produce energy.
What is fatigue and how do you work it up?
One of the most common symptoms patients complain about is fatigue. When you look at fatigue, you have to ask, what is it and how do you work it up?
When we look at the physiological mechanisms of ATP production, it starts with what happens when we eat food, whether it’s protein, fats, or carbohydrates, and all the steps that lead to mitochondrial oxidative phosphorylation.
Respiratory issues, anemias, thyroid dysfunction, blood sugar stability, dysautonomia, neuroinflammation or degeneration, oxidative stress, and other factors impact mitochondrial biogenesis.
Many practitioners have a hard time helping their patients with fatigue because they don’t understand the big multi-variable picture.
They’re missing steps in their workup that prevent them from figuring out what’s really going on.
In the Kharrazian Institute Chronic Fatigue and Pain Syndrome’s Clinical Strategy and Treatment Applications, I’m going to teach you all the steps involved in evaluation chronic pain and fatigue.
You will learn how to not overlook any of the steps involved in working up a chronic fatigue and pain patient.
You will know exactly what to do and how to develop a protocol customized for each patient.
Neuroplasticity: A frequently overlooked factor in chronic pain
Did you know that chronic pain syndrome may be due to a neurological phenomenon called negative plasticity? Plasticity refers to neurons connecting together.
You can have positive plasticity or negative plasticity.
When you activate neurological pathways over and over again to learn a favorable new task that’s positive plasticity.
But if you develop pathways that are not healthy, that’s negative plasticity.
An example of negative plasticity is PTSD. A stressful event activates the brain centers for a stress response, causing anxiety, nervousness, and heart palpitations.
Over time, that system becomes so efficient that a very trivial stimuli triggers the stress response, causing chronic anxiety after a traumatic event.
Another example of negative plasticity is when people feel pain or burning in amputated limbs. Pathways in the brain that perceive pain in those regions of the body are still active despite the missing limb.
This also applies to chronic pain — negative plasticity in the brain perpetuates pain from an injury even though the injury isn’t happening at the pain fibers.
Learn to identify the source of chronic fatigue and pain – it is different for each patient
Maybe your patient has had an injury in the past that’s never really healed—such as a herniated disc or a torn rotator cuff, and they’ve never been the same since. They now have a debilitating pattern of pain impacting their quality of life.
Or they have just a general pain syndrome affecting their entire body. Their whole body aches for no apparent reason.
There is usually more than one variable involved in chronic pain and fatigue syndromes
Patients with complex pain and fatigue syndromes usually have more than one variable involved. Theirs is a multi-variate model, which explains why no one seems to be able to help them.
Variables include underlying autoimmunity, leaky gut, endotoxemia, neuroinflammation, neurons close to threshold, systemic inflammation, dysautonomia, blood sugar and metabolic imbalances, poor antioxidant status, limbic overactivation, negative plasticity, and so on.
How do you know which ones apply to your patient?
By knowing how all of these mechanisms work, you can develop clinical strategies and treatments to personalize a plan for each patient to unwind the vicious cycles of chronic pain and fatigue.
Dr. Kharrazian is a leading expert in diagnosing and treating chronic fatigue and pain
Datis Kharrazian, PhD, DHSc, DC, MS, MMSc, FACN, is a Harvard Medical School trained researcher, clinical research scientist, academic professor, and a functional medicine health care provider. Dr. Kharrazian earned a Master of Medical Science degree (MMSc) in Clinical Investigation from Harvard Medical School, and is a member of the Harvard Medical Alumni Association and the American Association of Immunologists.
Today, Dr. Kharrazian’s clinical models of functional medicine are used by several academic institutions, and thousands of health care clinics and practices providers throughout the world.
He maintains a private practice near San Diego, California, and consults with patients from all over the world who are seeking non-pharmaceutical alternatives. His practice is focused on developing a personalized medical approach using diet, nutrition, and lifestyle approaches.
After decades of analyzing thousands of studies and working with patients in the United States and Europe, Dr. Kharrazian developed never-taught-before clinical strategies to successfully manage chronic fatigue and pain.
Is the Kharrazian Institute Chronic Fatigue and Pain Syndromes course right for you?
The Kharrazian Institute cognitive decline and dementia course is not for everyone. See if the course features below are right for you:
Frequently Asked Questions
Do any materials come with this course?
You receive access to all the recorded live videos, presentation slides, published papers, Q&A’s, assessment forms, supplement information, protocols, and all other supporting material for one year after the livestream. This means you can rewatch the recorded lectures as many times as you’d like during this period.
Do I receive continuing education credits for this class?
12 hours of CEs are available for licensed health care practitioners. Please see the bottom of this page for more particulars.
What if I can’t digest all the information at once?
First, you are given pre-class reading material to begin familiarizing yourself with the material. Then, you have access to the recorded lectures and supporting materials for up to three years (depending on when you purchase). This means you can rewatch lectures as many times as you need.
What if I have questions after the class?
When you register you are invited to join a Members Only Kharrazian Institute Facebook group where you can ask questions and discuss cases with other practitioners.
How can patients in my area learn about me and the fact that I have taken this class?
We have created an online practitioner referral page. Licensed practitioners who have completed all of the Kharrazian Institute courses will be added to the list. Patients can search the list to look for practitioners in their area.
What if parts of the class are unfamiliar to me?
All of the Kharrazian Institute classes are designed to complement one another. As you take all the courses over time you will receive an extraordinarily comprehensive functional medicine education. Different pieces of human physiology, neurology, immunology, and endocrinology all fit together like pieces of a puzzle for one comprehensive understanding of patient evaluation and care.
MARK HYMAN, MD
Dr. Kharrazian has been a prominent educator and highly-respected clinician in the functional medicine community since the inception of functional medicine. He is an expert clinician and an innovator in this field.
CLEVELAND CLINIC, DIRECTOR OF CENTER FOR FUNCTIONAL MEDICINE
CHAIRMAN, INSTITUTE FOR FUNCTIONAL MEDICINE
TEN-TIME NEW YORK TIMES BEST SELLING AUTHOR
JEFFREY BLAND, PHD, FACN, FACB
I have had the pleasure of knowing Dr. Kharrazian for more than a decade and observing his professional growth and impact as a key opinion leader in the field of Functional Neurology. He is voracious in his pursuit of learning and skill development. His pursuit of post-graduate studies at Harvard in research methods has embellished his already significant expertise in systems medicine and its application to Functional Medicine. He has a unique skill in making complex information accessible to his students and patients alike, which is a measure of an individual who is a master of his field. Dr. Kharrazian is a humble, quietly competent leader who leads by example and his presence. The Functional Medicine field is rapidly evolving, and it is through the work and leadership of a select group of professionals, of which Dr. Kharrazian is a recognized leader, that it is growing in both its adoption and successful application to the treatment of complex chronic diseases. It is truly a pleasure to call Dr. Kharrazian both a colleague and friend in our mutual advocacy in the development and application of Functional Medicine.
CO-FOUNDER, INSTITUTE OF FUNCTIONAL MEDICINE
PRESIDENT, PERSONALIZED LIFESTYLE MEDICINE INSTITUTE
Why is Dr. Kharrazian’s chronic fatigue and pain syndromes course different?
Dr. Kharrazian is an actual clinician who has been successfully treating chronic fatigue and pain syndromes in the United States and Europe for more than 20 years.
Dr. Kharrazian has witnessed countless real-life patient scenarios and developed proven strategies to address commonly overlooked issues.
Dr. Kharrazian is both a scientist and an educator.
Dr. Kharrazian has been an innovator in the field of functional medicine since its inception.
Dr. Kharrazian stays continually up-to-date with the latest scientific and medical research.
Dr. Kharrazian was trained as a clinical investigator (Master of Medical Science in Clinical Investigation) at Harvard Medical School and can effectively share with you the most relevant research.
Dr. Kharrazian has published a number of immunology studies in the most respected medical journals in the world.
DAVE PERLMUTTER, MD, FACN, ABIHM
Dr. Kharrazian’s work represents the vanguard in our understanding of the role of lifestyle choices in charting the brain’s destiny. His highly effective educational outreach has opened the door for countless healthcare providers, allowing them to dramatically increase their effectiveness in treating and indeed preventing so many of the pernicious conditions that plague our modern society.
AUTHOR, #1 NEW YORK TIMES BESTSELLING BOOK,
GRAIN BRAIN AND BRAIN MAKER
KELLY BROGAN, MD, ABIHM
Dr. Datis Kharrazian is one of the most powerful clinicians of our time. From the lab to the clinic, he has studied, vetted, and applied his cutting-edge science to heal patients all over the world. I consider him to be a foremost authority in a systems approach to recovery and wellness.
AUTHOR, NEW YORK TIMES BESTSELLING BOOK, A MIND OF YOUR OWN
TERRY WAHLS, MD, IFMCP
Dr. Kharrazian is a brilliant clinician educator who has inspired many, myself included. He is superb at teaching clinicians the power of using functional medicine-oriented history and physical examination to understand and address the root causes of disease and health. Integrating the latest research and years of clinical experience, Dr. Kharrazian, is an international leader in Functional Medicine.
NEW YORK TIMES BEST SELLING AUTHOR OF THE WAHLS PROTOCOL – HOW I BEAT
PROGRESSIVE MS USING PALEO PRINCIPLES AND FUNCTIONAL MEDICINE
CLINICAL PROFESSOR OF MEDICINE, UNIVERSITY OF IOWA, CARVER COLLEGE OF MEDICINE
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Chronic Fatigue and Pain Syndromes Clinical Strategies and Treatment Applications
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Chronic Fatigue and Pain Syndromes Course
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IMPORTANT NOTE: After registration, you will receive an email titled Important Login Info: Kharrazian Institute… which contains your login credentials for immediate access to all course materials and videos. After watching all videos and successfully completing the online examinations for each course, you will receive a “KI Certificate of Completion”. Otherwise, you are incomplete for the course.
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