What Is CFS?
Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and may be worsened by physical, emotional or mental stress. Patients report various nonspecific symptoms, including weakness, chemical sensitivities, allergies, poor immune function, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue lasting more than 24 hours. In some cases, CFS can persist for years.
The cause, or causes, of CFS have not been identified and no specific diagnostic tests are available. Moreover, since many illnesses have incapacitating fatigue as a symptom, care must be taken to exclude other known and often treatable conditions before a diagnosis of CFS is made.
Diagnostic Criteria for Chronic Fatigue Syndrome
- new onset of fatigue causing 50% reduction in activity for at least six months
- exclusion of other illnesses that can cause fatigue
- presence of eight of 11 symptoms, or
- presence of six of 11 symptoms and two of three signs:
- mild fever
- recurrent sore throat
- painful lymph nodes
- muscle weakness
- muscle pain
- migratory joint pain
- prolonged fatigue after exercise
- recurrent headaches
- neurological or psychological complaints, such as:
- excessive irritability
- sensitivity to bright light
- inability to concentrate
- sleep disturbances
- sudden onset of symptom complex
- low-grade fever
- non-exudative pharyngitis (sore throat)
- tender lymph nodes
Similar Medical Conditions
A number of illnesses have been described that have a similar spectrum of symptoms to CFS. These include fibromyalgia syndrome, myalgic encephalomyelitis, neurasthenia, multiple chemical sensitivities, and chronic mononucleosis. Although these illnesses may present with a primary symptom other than fatigue, chronic fatigue is commonly associated with all of them.
Other Conditions That May Cause Similar Symptoms
In addition, there are a large number of clinically defined, frequently treatable illnesses that can result in fatigue. Diagnosis of any of these conditions would exclude a definition of CFS unless the condition has been treated sufficiently and no longer explains the fatigue and other symptoms. These include hypothyroidism, sleep apnea and narcolepsy, major depressive disorders, chronic mononucleosis, bipolar affective disorders, schizophrenia, eating disorders, cancer, autoimmune disease, hormonal disorders*, subacute infections, obesity, alcohol or substance abuse, and reactions to prescribed medications.
Other Commonly Observed Symptoms in CFS
In addition to the eight primary defining symptoms of CFS, a number of other symptoms have been reported by some CFS patients. The frequencies of occurrence of these symptoms vary from 20% to 50% among CFS patients. They include abdominal pain, alcohol intolerance, bloating, chest pain, chronic cough, diarrhea, dizziness, dry eyes or mouth, earaches, irregular heartbeat, jaw pain, morning stiffness, nausea, night sweats, psychological problems (depression, irritability, anxiety, panic attacks), shortness of breath, skin sensations, tingling sensations, and weight loss.
Possible Causes of CFS
Due to weakened immunity, individuals with chronic fatigue have terrible problems with energy as well as reoccurring bouts with the flu, colds, sinusitis, and other immune problems. As with so many complex chronic illnesses, CFS may be aggravated by a wide variety of environmental and physiological challenges. Food allergies, environmental sensitivities (odors), heavy metal toxicity (mercury, aluminum, etc.), yeast overgrowth, parasites, and vitamin/mineral deficiencies can all contribute to CFS.
Infections Most Likely Play Major Role In CFS
Because most of the features of CFS resemble those of a lingering viral illness, many researchers have focused on the possibility that a virus or some other infectious agent causes the syndrome in some cases.
Here is what the Centers for Disease (CDC) Control has to say about Infectious Agents. “Due in part to its similarity to chronic mononucleosis, CFS was initially thought to be caused by a virus infection, most probably Epstein-Barr virus (EBV). It now seems clear that CFS cannot be caused exclusively by EBV or by any single recognized infectious disease agent. No firm association between infection with any known human pathogen and CFS has been established.
CDC’s four-city surveillance study found no association between CFS and infection by a wide variety of human pathogens, including EBV, human retroviruses, human herpesvirus 6, enteroviruses, rubella, Candida albicans, and more recently corona viruses and Mycoplasma.
Taken together, these studies suggest that among identified human pathogens, there appears to be no causal relationship for CFS. However, the possibility remains that CFS may have multiple causes leading to a common endpoint, in which case some viruses or other infectious agents might have a contributory role for a subset of CFS cases.”
When researchers find no consistent elevations of EBV antibody levels, they conclude that viruses do not play a role in CFS. “This is like firefighters who ignore the billowing smoke on the horizon, responding only to the blaze, the discovery of which inevitably follows.”
I, like many other specialists, do believe there is an infectious agent or agents involved in CFS. Whether this is a latent or acute viral, bacterial, fungal, or mycoplasma, or a combination of these, which is interacting with and compromising the immune system, is the question?
There are three basic theories for infection-related causes of CFS
Some researchers suggest that chronic fatigue syndrome might be the result of a virus or bacteria that infects the body, causes immune abnormalities, and is then eliminated. It leaves behind a damaged immune system, however, that continues to cause flu-like symptoms even in the absence of the virus. The flu-like symptoms are most pronounced when the person is under stress. The evidence for CFS having a viral cause is not based on hard evidence but on various observations that suggest an association, such as the following:
- In up to 80% of cases, chronic fatigue syndrome starts suddenly with a flu-like condition.
- In the US, outbreaks of CFS occurring within the same household, workplace, and community have been reported (but most have not been confirmed by the Centers for Disease Control).
- A large British study of people with both diagnosed CFS and idiopathic chronic fatigue also found no evidence of infection as a direct cause of either condition, but found that previous infections may play some role.
- Although no specific virus has been identified as a single cause, CFS patients typically have elevated levels of antibodies to many viruses that cause fatigue and other CFS symptoms, including Lyme disease, candida (“yeast infection”), herpesvirus type 6 (HHV-6), human T cell lymphotropic virus (HTLV), Epstein-Barr, measles, coxsackie B, cytomegalovirus, or parvovirus.
- In one study, some patients, particularly those with severe CFS symptoms, had higher-than-normal numbers of infection-fighting white blood cells known as CD8 killer T cells, which launch attacks on invading viruses and other disease-causing microorganisms. These same people had lower-than-normal levels of another white blood cell known as the suppressor T cell, which helps to shut down the immune response once the invading organisms have been killed. In such cases, the immune system becomes persistently overactive and produces fatigue, muscle aches, and other symptoms of CFS.
Several investigators have reported lower numbers of natural killer cells or decreased natural killer cell activity among CFS patients compared with healthy controls, but others have found no differences between patients and controls.
T-cell activation markers have also been reported to have differential expression in groups of CFS patients compared with controls, but again, not all investigators have consistently observed these differences. One intriguing hypothesis is that various triggering events, such as stress or a viral infection, may lead to the chronic expression of cytokines and then to CFS.
In one study of 20 female patients with CFS (who required bed rest following mild exercise), 80 percent were deficient in CoQ10. After three months of CoQ10 supplementation (100 mg/day), the exercise tolerance of the CFS patients more than doubled: 90 percent had reduction or disappearance of clinical symptoms, and 85 percent had decreased post-exercise fatigue.
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Other Immune Boosting Supplements
- Astragalus membranaceus, a Chinese herbal, is used to treat a wide variety of viral infections. Clinical studies in China have even shown it to be effective (with ongoing use) against the common cold. Research in animals has revealed that it apparently works by stimulating NK cells and T-cells. Astragalus appears particularly useful in cases where the immune system has been damaged by chemicals or radiation.
- Echinacea (purple coneflower) is one of the most popular herbal medicines in the United States and Europe. In 1994, German physicians prescribed echinacea more than 2.5 million times. There are over 200 journal articles written about echinacea. This herb, from the sunflower family, can be grown in your garden and is thought to stimulate the immune system by increasing the production of and activity of white blood cells, especially NK cells. Persons with autoimmune illnesses such as multiple sclerosis, lupus, or tuberculosis should not take echinacea.
- Goldenseal (Hydrastis canadensis) is a perennial herb native to eastern North America, and it has shown itself to be a potent immune stimulator. It increases the blood flow to the spleen and the number and activity of macrophages. A typical dose is 250–500 mg. one–three times daily.
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P.S. If you’ve registered https://TheFibroSummit.com make sure you check out my interview with Kasia Kines, Epstein Bar virus expert as we discuss fibromyalgia and chronic fatigue syndrome. TheFibroSummit a FREE online event starts September 28th and ends Oct 4th 2020. Don’t miss these life enhancing, from some life saving presentations.