I think the rates of Chronic Fatigue Syndrome are on the rise because all the chronic immune activation we have with living emotionally physically stressful lives, a large increase in the amount of chemical exposures we are each exposed to compared to say our grandparents (such pesticides in food, chemical exposures in our self-care products, and persistent organic pollutants in the air we breathe) as well as the chronic irritation we have by eating a "standard diet" of processed prepackaged foods (food sensitivities on the rise as well.)
We are a culmination of all our bodies exposures and the immune system 70% of which is in the gut.
What is Chronic Fatigue:
Chronic fatigue syndrome has become a catch all term or anyone how has been experiencing unrelenting fatigue for >6 months that cannot be explained by another medical diagnosis.
Now there are two other terms that you may hear of also referring to the same condition, ME myalgic encephalomyelitis, and SEID systemic exertion intolerance disease. (These terms are used interchangeably societally, but we can go into the nuances of differential diagnosis is you think people would care, but I think it's not necessary.)
Chronic Fatigue Syndrome is a clinical diagnosis, so there currently isn't a laboratory test to do to get a diagnosis, so in order to meet diagnostic criteria for CFS besides suffering for greater than 6 months you also need have at least 4 of the following symptoms:
1. Substantial impairment in short term memory or concentration
2. Sore throat
3. Tender lymph nodes in neck or arm pits
4. Unexplained muscle pain
5. Joint pain w/o redness, heat or swelling
7. Un-refreshing sleep
8. Post exertional malaise lasting >24 hours
What’s not part of the criteria, but I see routinely are people with CFS who have dysautonomia, problems with body temperature maintenance, blood pressure and heart rate regulation, heart palpitations, POTS, orthostatic hypotension.
My possibly controversial hypothesis on why CFS presents with these symptoms:
Chronic Fatigue Syndrome patients often have symptoms that correlate with mitochondrial density in the various bodies tissues. The tissues with the greatest density of mitochondria are the skeletal muscle, heart, liver, and brain.
No one has published this yet, it’s my hypothesis, but I believe it is why they have the symptoms they do.
Classically it is believed that CFS is caused by viral infections such as Epstein-Barr, Lyme, enterovirus, mycoplasma spp, and many patients with CFS have high levels of immune complexes and auto-antibodies in their blood that could be triggers.
However, as in all medical conditions it a combination of genes plus environment. So I believe it is a susceptible individual who has had an environmental trigger, a virus, a lifetime of physical, emotional, environmental stressor (which may be food or chemical toxins) that have tipped the scales and resulted in this systemic break-down in function.
Chronic Fatigue Syndrome Prognosis:
The prognosis for people with CFS is considered in conventional medicine to be “poor” and at best “fair”. The therapies used are shortsighted and inadequate b/c they do not resolve the issues within a person that created the situation in the first place.
An AMAZING, I think potentially groundbreaking study recently published on Fatigue patients found that there is a dysfunction in the mitochondria of the vast majority of people with CFS. This defect in the mitochondria impairs their ability to do cellular respiration.
This is when the food you eat mixes with oxygen inside these organelles called mitochondria, to become energy for your entire body’s tissues, otherwise known as ATP.
During the study the mitochondria of the study participants were “stressed” meaning they were given low oxygen or high acid environments which is similar to when someone does “exercise.”
The mitochondria of the study participants with CFS made less ATP, or energy versus the control group without CFS. This helps explain a plausible physiological cause for chronic fatigue syndrome.
In addition, CFS/ME is linked to an imbalanced microbiome. There are abnormal amount of specific strains of gut bacteria found in CFS patients (faecalibacterium, roseburia, dorea, coprococus, clostridium, ruminococcus, coprobacillus) and not in the healthy controls, and thus could be a predictor of diagnosis of CFS/ME.
In ME/CFS subgroups,the severity of the patient’s symptom (including pain and fatigue,) correlated with the abundance of distinct bacterial types and metabolic pathways! Meaning one could predict how impacted one’s life was by looking at the quantity of these bacteria were present in the samples!
If all these look “okay”even by functional standards (ideal range for optimal tissue and organ function) time to look into adrenal and mitochondrial causes of chronic fatigue.
There are functional laboratory tests to aid in the identification of these conditions. In addition to the extensive history I take, I also use the “rhythm plus” (adrenal dysfunction,) “nutreval” (includes oxidative stress markers and mitochondria metabolites) with Genova diagnostics, and your data from 23&me to identify genetic SNPs impairing your body’s ability to detoxify and methylate (clean your blood and activate your food’s nutrients) as helpful tools to help confirm these contributing issues, and create a personalized treatment plan.
If you would like to know more about how I personalize treatment plans for Chronic Fatigue Syndrome, please schedule a free 15-minute consult.