Health rising blog post, by Cort Johnson, 25 March 2018: Toxic brains, frozen spines and the Perrin Point: Ray Perrin, ME/CFS and Fibromyalgia

This is the second of three blogs examining the possibility that upper body/head issues play a role in chronic fatigue syndrome (ME/CFS) and/or fibromyalgia (FM). The first blog examined the possibility that high blood pressure in the brain was present in ME/CFS and FM.

In this blog, Health Rising examines Ray Perrin’s hypothesis that a toxic overload in the brain is causing ME/CFS and FM.

Ray Perrin PhD, D.O. a U. K. osteopath, has been digging into chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) for almost three decades.  His journey with ME/CFS began when a professional cyclist suffering from ME/CFS walked into his sports medicine clinic way back in 1989 and then walked out five treatments later healthy again.

Perrin wasn’t trying to treat the cyclist’s chronic fatigue syndrome; he was trying to fix his posture, but on the way to fixing his posture – which required using a variety of techniques – he ended up curing his ME/CFS. That cyclist provided Perrin with a clue that he’s been following up on for almost 30 years: the cyclist was experiencing a “mechanical strain” on his spine in the chest area. When Perrin improved the movement in his upper back, the cyclist was able to return to cycling.

“You’ve got to find out what you’ve done because you got me better and nobody else has.” I thought it was just a coincidence. But then I was a bit inquisitive. I’ve always been inquisitive and I wanted to find out what I had done. And that’s when I started looking at other patients who had the symptoms then and I noticed there were physical signs in all these patients, especially in the spine. That’s what set me on this long road and then I came up with my ideas and a hypothesis of what ME is and then the rest is history, as they say. 28 years on…Ray Perrin – the Ari Whitten interview.

Perrin comes from an osteopathic tradition in the U.K. which is very focused on reading physical signs and manipulating the body. He was the first medical professional I know of to propose that a unique physical structural problem is present in ME/CFS/FM. Perrin believes that the practice of reading the body is something of a lost art in the medical field. Perrin’s PhD thesis ended up being on ME/CFS.

They (doctors) look at what tests they can do and what their scan shows, but they don’t actually look at the person, feel the person. And I, as an osteopath, do. And this is what we do and I started looking for more and more signs that these patients all shared.  The Ari Whitten Interview

Personally, his general thesis doesn’t surprise me at all. My pain begins at the chest area and proceeds upwards. Trying to relieve my neck tightness with frequent stretching exercises resulted in nausea, flu-like symptoms and pain. After walking or exercising – it’s my chest and upper body which are in pain – not my legs. Touching virtually any part of my face will elicit pain. Whether or not Perrin’s hypothesis has found the or a cause of ME/CFS/FM, something is going on in my upper body.

A Toxic Brain
Perhaps only an osteopath – a doctor specializing in structural problems – could have come to Perrin’s conclusion. He believes that toxic overload in the brain, caused by a malfunctioning sympathetic nervous system, causes distinct physical signs in the upper bodies of ME/CFS/FM patients.

The Brain’s Lymphatic System
The lymphatic system in our body serves to collect and process large toxins, but no such system was believed to exist in the brain.  For hundreds of years, researchers have wondered how the brain effectively gets rid of its waste. The cerebral spinal fluid is one avenue but it seemed a poor second to the role the lymphatic system plays in the body.

The brain’s lymphatic system was rediscovered in 2017 by NIH researchers (two hundred years after an Italian anatomist reported that he’d spied lymphatic tissues in the brains of mice. Sometimes the medical system takes a long, long time to catch up :))  That finding is spurring new research into diseases like multiple sclerosis, Alzheimer’s and other neuroinflammatory disorders.  Perrin believes the buildup of amyloid proteins in Alzheimer’s could result from poor lymphatic drainage. (Avindra Nath, the lead investigator in the NIH’s intramural study believes ME/CFS may be an neuroinflammatory disorder.)

Interestingly, blocking that lymphatic drainage in mice results in a buildup of fluids in three areas of the brain associated with ME/CFS: the hypothalamus, the thalamus and the basal ganglia.

Decades ago, Perrin was on a similar trail. He believed lymphatic drainage from the brain was occurring but he didn’t know from where. He did know that the cerebral spinal fluid drains toxins from the brain through a bony plate (cribriform plate) situated above the nose. From there, the toxins drain into lymphatic vessels around the nasal sinuses and the optic, auditory and trigeminal nerves in the eye, ear and cheek and along the spine. From there they flow to the thoracic duct and finally into the blood, where they end up at the liver.

Perrin’s osteopathic training taught him that the main drainage point of the lymphatic system was found at the thoracic duct in the chest area. This thoracic duct has a pumping mechanism controlled by a system – the sympathetic nervous system – that researchers have long found to be dysregulated in ME/CFS and fibromyalgia.

Perrin hypothesized that blocked or congested lymphatic drainage pathways in ME/CFS and FM were causing toxins to build up in the central nervous system. That toxin buildup was disturbing the hypothalamus, which, in turn, was causing sympathetic nervous system problems.  The hypothalamus is the only part of the brain with direct access to the blood. It needs this access to regulate insulin levels in the blood but it comes at a cost  – less protection from toxins.

Those SNS problems were, in turn, blunting the pumping action of the key lymphatic drainage point – the thoracic duct. In fact it’s worse than that. Perrin believes the pump in ME/CFS/FM is working backwards – instead of pumping lymphatic fluid to the body, it’s actually pumping lymphatic fluids back towards the brain – and Perrin believes this can push toxins into the brain. (That retrograde pumping mechanism shows up in odd-looking varicose veins in the chest area.) Those toxins then destabilize the hypothalamus and sympathetic nervous system – which, in turn, whacks the pumping mechanism. In short, a vicious circle which maintains high toxin levels in the brain is present.

Perrin now believes that the entire brain is probably affected by increased toxin levels with the limbic system (hypothalamus, thalamus, basal ganglia) most affected. That’s enough of the brain to easily produce the movement, sleep, fatigue and cognitive problems found in ME/CFS/FM. Because the lymphatic drainage from the brain mostly occurs during the delta stages of sleep, it’s possible that the sleep problems in ME/CFS – which have been linked to autonomic nervous system dysfunction – are reducing drainage as well.

Physical Signs of ME/CFS and Fibromyalgia
Perrin is the first to postulate that direct physical evidence of ME/CFS and FM exists in the form of frozen or limited spinal mobility, particularly in the middle and upper back, swollen lymph vessels and specific tender points. He’s said he’s never seen an ME/CFS patient who doesn’t have a thoracic (upper and middle) spine problem.

The Perrin Point is a tender point about 2 to 3 cm to the left and 2 to 3 cm above your left nipple. It’s also generally found between in the third intercostal space between the third and fourth ribs (counting from the top).

Each of these physical findings, Perrin believes, relates to problems with fluid drainage from the brain. Each, Perrin also asserts, can be manipulated using cranial osteopathic techniques to stimulate renewed flow of cerebral spinal and lymphatic fluids, thus relieving the buildup of toxins in the brain and relieving the symptoms of ME/CFS/FM.

Once toxin levels drop and normal lymphatic drainage resumes, Perrin states the patient is free of chronic fatigue syndrome (ME/CFS). Throughout the book, Perrin refers to numerous recovery stories.

Success Story
One young ME/CFS patient who was virtually carried into his office had a strong curvature in her mid-upper back region, tender points in certain areas, lymphatic congestion and a very sluggish “cranial rhythm”. Perrin reported that an intensive course of soft tissue massage and spinal articulation improved her lymph drainage and the girl was able to successfully return to school, gain a degree and remained healthy at the time of the book’s printing.“.

Read more about the history of this hypothesis and the Perrin Treatment protocol