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Severe Fatigue and Muscle Weakness Case Wrap

When I started working with this client the first thing she told me was she "wanted to feel normal again" and that she was "willing to do whatever it takes". The client reported being generally healthy but had episodic severe fatigue with muscle weakness. She suspected that her symptoms were associated with a condition such as lupus. She indicated she managed the symptoms with Tylenol and alkaline water. Her primary care physician referred her to a rheumatologist and no abnormalities were ever detected in her labs. At this time, she was prescribed hydrochloroquinone which did not relieve the symptoms.

After an adverse reaction to one course of prednisone and 20 years of pain management she elected to pursue an herbal and nutritional route.

In cases like this it is important to create a regime that will manage symptoms over the long term that will help prevent any exacerbations of the condition. I also feel that because of the chronic nature of the condition and the complexity associated with "conditions of exclusion" where it is difficult to get a correct diagnosis of a problem, the client should seek additional medical consultation that aligns with an integrated medicine approach that considers dietary, lifestyle, herbal and traditional medical system support. The short term goals the client decided to work on after the initial consultation were to support stress management, improve symptom management, and to improve suspected nutrient deficiencies. The long term goals were to maintain symptom management, decrease inflammation, improve immune response to stress, and to detox and support optimal liver function and hormonal balance. The dietary changes in the treatment plan included switching to a keto diet and incorporating additional root vegetables and meats into her meals. Lifestyle changes included massaging her sore muscles daily with an arnica trauma oil blend made at Modern Apothecary.

The herbal protocol we selected included immunomodulators, adaptogens, anti-inflammatory, alterative, and antirheumatic herbs. To support the client, I used tinctures with a mix of formulations that could address all the symptoms concurrently. This included tinctures made with chaga, skullcap, shatavari, lemon balm, milky oats, and licorice. She also took kinkeliba leaves in a tea, a traditional African alterative and antirheumatic treatment. Other supplements I suggested she incorporate into her plan included magnesium, zinc, D3 and selenium.

The client has a three month supply of the tinctures and herbs. At the two week mark, the client reports feeling better with increased energy and diminished symptoms. The remaining part of the treatment plan is to continue to seek medical diagnosis. The client reported that her request to be treated by a physician was denied by her insurance company which will be a frustrating barrier to work through. I suspect there are other issues at-play and I am continuing to support the client and suggested that she explore testing for chronic fatigue syndrome, Epstein Barr and Sjorden's Syndrome as her symptoms show markers for these conditions.

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