Chronic Fatigue

Chronic fatigue syndrome (CFS) is a late 20th century buzz word used to convey a constellation of symptoms that patients’ experience, but it is a NOT formal diagnosis. Extreme exhaustion, poor stamina coupled with difficulty concentrating and poor memory render patients nearly completely disabled.  Additionally, CFS may be accompanied by flu-like symptoms, joint and muscle aches, unrefreshing sleep, tender lymph nodes, sore throat and headache. This constellation of symptoms is similar to that which would be seen in many viral or bacterial infections such as walking pneumonia, strep throat, Borreliosis/ Lyme disease or even AIDS.  Another distinct set of symptoms associated with CFS includes: post-exertional malaise, a worsening of symptoms following physical or mental exertion that occurs within 24-48 hours of the exertion, and requiring an extended recovery period.  Neuroimmune and endocrine abnormalities are also frequently observed in CFS, and patients may require hormonal support including: thyroid, pregnenolone, DHEA, estrogen and/or progesterone and testosterone.  Patients are generally unable to appropriately respond to stress and may require low doses of cortisol or the natural equivalent as well.  Sleep disorders are also common in this patient population and may require natural sleep aids like melatonin or prescription sleep medication

The argument can be made that CFS is simply a set of symptoms particular to a patient that arises as the result of exposure to a specific pathogen(s). Proper identification of the infection causing the symptoms is the way in which patients can hope to find relief from this debilitating condition.  We believe that proper diagnosis requires extensive blood and possibly stool testing.  Additionally, when the infection is identified, extensive immune system support is necessary to help patient’s fight the infection(s), and also promotes inherent self-healing tendencies. Healing the immune system is JUST as important as identifying the pathogen then for recovery to occur. Also, various detoxification regimens may be required to cleanse the extracellular matrix of toxins and cellular debris.  A holistic approach to pathogen identification as well as treatment seems to be the most efficacious way to return patients to a functional life and optimal health.

Additionally, elevated proinflammatory cytokines cause disruption in the production of several neurotransmitter systems that are required for basic brain function.  Certain neurotransmitters that are characteristically low in Borreliosis/Lyme disease patients contribute significantly to excessive fatigue and mood disorders.  Talk to your doctor about urine/saliva neurotrasmitter testing and genetic testing through 23andme.com and geneticgenie.org.

One explanation for chronic fatigue involves mitochondrial metabolic dysfunction.  Mitochondria are organelles within the cell that are responsible for generating ATP.  ATP is the “power” molecule providing energy to cells, tissues and organs.  Mitochondrial damage may result from cellular hypoxia (lack of oxygen) or oxidative stress including peroxynitrite excess.