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Chronic Fatigue Syndrome: Behind The Science

man sleeping on the seat of a subway train

Chronic fatigue syndrome (CFS) impacts between one to two million people in the United States and yet, it’s still a commonly misunderstood condition.¹ It wasn’t that long ago that people struggling with this perplexing condition were dismissed by their doctors regularly. Due to its complex nature and generic symptoms, patients were often erroneously told their symptoms were psychosomatic. In fact, this unfortunate situation is still happening at an alarming rate and patients often come to us being told their symptoms are ‘all in their head.’

Chronic fatigue syndrome has been incorrectly classed as a psychological disorder or sometimes a condition of poor discipline. The recommended treatment was often to exercise more because it was thought that laziness and not exercising enough was compounding the issue. We now know that not only is this counterproductive, but it’s also downright devastating for anyone affected by chronic fatigue syndrome.

Movement is crucial in the healing process, but recommending that someone begin a strenuous exercise regimen when they can’t brush their teeth without it bringing them to their knees, makes little sense – but that is precisely what doctors were doing.

Fortunately, huge strides have been made in understanding this condition. Much of the research on CFS have only been released in the past year or two, but they all indicate one thing – Chronic fatigue syndrome is very real. It’s time we shine a light on this debilitating illness.

book open to a chapter on chronic fatigue syndrome

What Is Chronic Fatigue Syndrome?

We now know that chronic fatigue syndrome is simply a label for the symptoms of a much more complex condition. It is characterized by extreme fatigue, sleep dysfunction, brain fog, and muscle pain. The underlying cause of chronic fatigue can vary and includes infections (such as Epstein-Barr virus, better known as Mononucleosis), mold-related illness, and autoimmunity.

The running theme with chronic fatigue is that there is a dysfunctional immune system response alongside brain and spinal cord inflammation. Another name for chronic fatigue syndrome is myalgic encephalomyelitis (ME), which directly refers to this distinctive inflammation.

Research papers now often refer to the condition as ME/CFS.² This is important because it reveals the shift that is occurring within the medical world in treating this condition with the seriousness it deserves.

woman bracing herself against a wall with a hand on her forehead and her eyes closed

Common Chronic Fatigue Syndrome Symptoms

If you struggle with debilitating fatigue that is completely unresponsive to any form of intervention, it could be chronic fatigue syndrome. The most common symptoms include:

  • Extreme fatigue
  • Not feeling rested after sleep
  • Dysregulated sleep patterns – both insomnia and excessive sleeping
  • Brain fog
  • Memory loss
  • Becoming lightheaded or dizzy after standing
  • Weakness
  • Muscle pain
  • Joint pain
  • Digestive issues
  • Tender lymph nodes in throat or armpit
  • Headaches
  • Sore throat
  • Chills
  • Night sweats
  • Allergies

Furthermore, lab work will indicate high cytokine (cell signaling molecules that aid in communication between cells) levels and an abnormal T-cell (a type of white blood cell) function. A recent study identified 17 cytokines that can be considered biological markers for ME/CFS.³ Interestingly, this same study found that 13 of these cytokines are proinflammatory, which adds weight to the idea that chronic inflammation plays a major role in chronic fatigue syndrome.

9 Chronic Fatigue Syndrome Causes

While we are still discovering the causes of chronic fatigue syndrome, a common factor links them all – immune system dysregulation. There are a number of things that can cause immune dysfunction, which then results in chronic fatigue.⁴ Currently, it’s thought that in many cases an infection triggers an immune system response that causes symptoms, even after the infection is gone.

Causes of chronic fatigue syndrome include, but are not limited to:

  1. Epstein-Barr virus (Mononucleosis)
  2. Ross River virus (An infection spread by mosquitoes that is characterized by joint pain and typically found in Australia, Papua New Guinea and other islands in the South Pacific)
  3. Coxiella burnetii bacteria (otherwise known as Q Fever – found in farm animals as well as humans – likely more common in individuals exposed to these animals)
  4. Cytomegalovirus
  5. Mycoplasma sp.
  6. Human herpes virus
  7. Parvovirus B19 (Otherwise known as fifth disease, an illness that typically involves a rash, fever, and joint pain)
  8. Borrelia Burgdorferi (The spirochete involved in Lyme disease)
  9. Biotoxin exposure

Of those with ME/CFS, one in 10 experienced this condition following an infection of the first three infections listed above.⁵

Genetics also seem to play a role in whether or not an infection will cause a strong response in the immune system. One study found that those with ME/CFS were more likely to have a single nucleotide polymorphism (SNP) in a certain cell receptor – transient receptor potential melastatin 3 (TRPM3).⁶ These receptors are important in transferring calcium, which helps regulate protein production and genetic expression. More research needs to be done on this, but it certainly explains part of the mystery behind why some people develop chronic fatigue after an infection and others do not.

patient model getting an mri

Diagnosing & Treating CFS

Chronic fatigue syndrome is notoriously tricky to diagnose. It’s not uncommon for someone with chronic fatigue to go years, even decades without a proper diagnosis and treatment. This is because it requires careful investigation and thorough examination of a patient’s history, cognitive analysis, laboratory work, MRIs, and elimination of other potential conditions. Other reasons for extreme fatigue can be thyroid issues or nutrient deficiencies and these must be ruled out.

There isn’t one test for this condition and therefore requires deliberate diagnostics with an experienced doctor. Chronic fatigue syndrome is a condition we see in our practice regularly because we specialize in complex medical conditions and medical mysteries. In fact, we designed our proprietary process called Fully Functional® specifically to help patients through the complicated process of getting their life back when affected by conditions such as chronic fatigue syndrome.

Here’s how the Five Pillars of Fully Functional® would work in someone with chronic fatigue:

IDENTIFY – First, we run diagnostics to ensure that there aren’t other imbalances causing fatigue. We also check for any underlying infections and ensure they are treated.

REDUCE – Reducing triggers, toxicity, infections, and inflammatory processes are key to reducing the impact of chronic fatigue syndrome.

OPTIMIZE – Through optimizing detoxification pathways and biological processes, we can make your body run more efficiently which will help you feel better.

SUPPORT – When you have CFS, your body, immune system, and spirit require support. Part of this process is ensuring you know what the next step is so you never feel lost and can continue to improve.

PERSONALIZE – Everyone is different and requires a treatment plan unique to them. So often, doctors don’t have the time to create personalized treatments, but you won’t find that in our practice because we know it is essential for building a Fully Functional® life. Our goal is to empower you with information about your body and give you the tools to help navigate and manage much of your health moving forward.

Finding a Functional Medicine Doctor for Your CFS

With a complex condition like chronic fatigue syndrome, you absolutely should see someone who specializes in it, like a functional medicine practitioner. It’s a condition that’s still widely misunderstood. We have helped over 1700 patients through the Fully Functional® process so they can have their life back.

A chronic diagnosis can feel daunting but you don’t have to do it alone. You can book an appointment by clicking here. We are also happy to speak with you at (317) 989-8463, Monday-Thursday, from 8AM – 5PM Eastern time.


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The Center for Fully Functional Health® is led by a team of award-winning, internationally recognized physicians, committed to providing personalized, life-changing care.

40 North Rangeline Rd. Carmel, IN 46032

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