Causes, Symptoms, Treatment of Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is a medical disorder that is generally defined by unexplained, chronic or relapsing fatigue, accompanied by other symptoms, which is persistent for six months or more. Many of our patients in Perth and Australia wide suffer some degree of chronic fatigue

The fatigue is not due to ongoing exertion or other medical conditions, not substantially relieved by rest, and results in a significant reduction in previous levels of activity.

Onset is usually sudden and often accompanied by flu-like symptoms.

Diagnosis is made after exclusion of recognisable diseases. Four or more of the following symptoms must be concurrent and persistent for six months or more:

Chronic, often severe, mental and physical exhaustion
Sore throat
Impaired short-term memory and concentration
Tender cervical or axillary lymph nodes
Widespread muscle or joint pain without arthritis
Headache of a new type, pattern or severity
Unrefreshing sleep
Post-exertional malaise lasting for more than 24 hours

CFS is also referred to as myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS), or chronic fatigue immune dysfunction syndrome (CFIDS). Milder forms are also known as Adrenal Fatigue.

Causes of Chronic Fatigue Syndrome

The cause of Chronic Fatigue Syndrome is poorly understood and may have multiple causes, including biological, genetic, infectious, environmental and psychological.

It is thought to be the end result of multi-system dysfunction. It is considered an immune disorder as the Epstein-Barr virus is found in the majority of cases but can only take hold once the immune system becomes compromised.

A Functional Medicine approach will investigate multiple body systems and correct underlying imbalances to return the body back to balance.

Contributing factors of Chronic Fatigue Syndrome

Viral or bacterial infection (e.g. glandular fever, Epstein-Barr virus, cytomegalo virus, Ross River virus, lyme disease)
Severe stress: a significant number of cases start within several months of severe adverse stress
Long-term sub-clinical nutritional deficiency
Hypothalamic-pituitary-adrenal (HPA Axis) abnormalities
Long term gut dysbiosis and intestinal permeability
Immune dysfunction
Toxic chemical exposure
Vaccinations
Genetic predisposition
Oxidative stress
Food intolerance and malabsorption
SIBO
Imbalance in melatonin secretion

Signs and symptoms of Chronic Fatigue

Apart from the above signs and symptoms, sufferers may also experience:

Muscle weakness
Increased sensitivity to light, sound and smells
Orthostatic intolerance
Digestive disturbances
Depression
Multiple chemical sensitivity
Cardiac and respiratory problems

Investigations – Medical testing for Chronic Fatigue Syndrome

There are no tests for CFS, but some useful investigations may include:

Comprehensive Blood Chemistry Panel, including thyroid, full blood count, blood sugar, C- reactive protein, Iron studies, IgE testing, liver function etc
Advanced Stool analysis
Organic Acids Test (OAT test)
Methylation assessment
Hair tissue mineral analysis
Salivary hormone testing
SIBO breathe test
Food reactivity assessment

TREATMENT STRATEGY FOR CHRONIC FATIGUE SYNDROME

Investigate and address underlying body system dysfunction
Address gut dysbiosis and remedy intestinal permeability
Reduce inflammation and oxidative stress
Optimise mitochondrial function
Optimise methylation
Support immune function
Support adrenal function
Support thyroid function
Support digestive function
Support liver function
Restore nutritional status
Identify / eliminate triggering foods
Manage stress

Diet plan guidelines for Chronic Fatigue Syndrome

Fresh, unprocessed, wholefood diet, high in fruit and vegetables and moderate levels of healthy fats and proteins. An Autoimmune Paleo diet (AIP) is often very beneficial for sufferers of Chronic fatigue / adrenal fatigue
Reduce antigenic load: in particular, gluten and casein. (AIP diet excludes these antigens)
Identifying other food sensitivities may be useful e.g. IgG/IgA testing
Support liver function: bitter greens, lemon juice, beetroot, sulphur-containing foods, brassica vegetables, dandelion coffee, grapefruit
Reduce exposure to toxins / household chemicals etc.

Supplements that support Chronic Fatigue Syndrome

CoQ10: support mitochondrial function, antioxidant
Magnesium: support mitochondrial function, reduce muscle tension, intracellular antioxidant, manage stress response
Acetyl-l-carnitine: needed for cellular energy production and may be beneficial in chronic fatigue
B-complex: cellular energy production, manage stress response
Tyrosine: support adrenal and thyroid function; often low in people with chronic fatigue
Vitamin D3 (depending on status): needed for immune regulation
Antioxidant complex: Vitamins A, E, zinc, selenium, n-acetyl cysteine, alpha-lipoic acid, CoQ10, etc.
Mushroom extracts (reishi, shitake, cordyceps, maitake, etc): for immune regulation

Herbal Medicine treatment that supports Chronic Fatigue Syndrome

Immune regulation: echinacea, astragalus, reishi, shitake
Anti-inflammatory: turmeric, ginger, boswellia, licorice, bupleurum
Anti-microbial: goldenseal, pau d’arco, olive leaf, barberry, licorice, lomatium
Antioxidant / tissue repair: turmeric, St. Mary’s thistle, rosemary, schisandra, green tea, bilberry, gingko, gotu kola, grapeseed
Adrenal tonics: licorice, rehmannia, codonopsis, withania, rhodiola
Thyroid tonics: withania, rehmannia, coleus, bladderwrack (if iodine deficient)
Nervines: oats, skullcap, passionflower, lemon balm, St John’s wort, lavender

Lifestyle / Physical measures to improve Chronic Fatigue Syndrome

Stress management techniques: exercise, yoga, relaxation, meditation
Pacing: key strategy for management of CFS. Pace daily activities rather than ‘push and crash’.
Gentle exercise – start slowly and gradually and build up
Daily exposure to sunshine
Acupuncture for muscle and joint pain
Reduce exposure to environmental toxins e.g. cleaning products, personal care products
Regular detoxification

FUNCTIONAL MEDICINE TREATMENT FOR CHRONIC FATIGUE SYNDROME

Chronic Fatigue Syndrome and a milder version in Adrenal fatigue are both multifaceted illnesses that require a comprehensive and investigative approach.

The functional medicine model is best equipped to deal with such diseases.

Rather than treating symptoms, investigating and addressing underlying body system dysfunction such as gut dysbiosis, SIBO, HPA axis dysregulation, viral load, nutrient imbalances and methylation are key to resolving long term fatigue. Dietary and lifestyle measures will also need to be incorporated with patients to make a full recovery.

At our Perth clinic of Advanced Functional Medicine we are experienced in treating patients with chronic fatigue syndrome and adrenal fatigue. We also treat many other syndrome illnesses such as fibromyalgia.

If you or a family member are suffering from chronic fatigue syndrome, adrenal fatigue or fibromyalgia we would love to hear from you, what conditions have you been diagnosed with? What treatments and practices have worked best for you? Please write a comment below.

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Chronic Fatigue Syndrome