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Chronic Fatigue Syndrome

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome

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


  • 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


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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The above information is intended to be general, educational advice only, on topics which are of interest to us. It is not intended to represent specific or individual health or medical advice and is not specific to your situation. The below information is educative and is not intended to advertise any service.

Before making any decisions in relation to your health, you should always discuss your individual situation with your own health practitioners to ensure that any advice you have read is right for you.

Jarrod Cooper – ND

Jarrod Cooper – ND

Jarrod Cooper - ND is the founder of Advanced Functional Medicine Australia. He is a Naturopathic Doctor with extensive functional medicine training from leading practitioners in the USA and worldwide.

He is leading the way with advancements of functional medicine, clinically implementing worldwide best practices in Functional Medicine throughout Australia.

Jarrod consults in person from Perth, Western Australia and also online via Telehealth throughout Australia and worldwide.

If you are looking for personalised treatment, we highly recommend contacting Jarrod Cooper’s Advanced Functional Medicine clinic in Australia.

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