Have you dealt with unrelenting fatigue that is unaffected by a good night’s sleep? Do you need to lie down after taking a shower or find it exhausting to make dinner? While everyone gets run down from time to time, unshakeable, severe fatigue that lasts for months may indicate something more is going on. According to the Centers for Disease Control and Prevention (CDC), “Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, long-term illness that affects many body systems.”
What is Chronic Fatigue Syndrome (CFS)?
Chronic Fatigue Syndrome is a chronic medical condition based on three diagnostic criteria outlined by the CDC on a printable PDF. This list comes from a report published by the Institute of Medicine in 2015: Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Here are the three criteria doctors will look for:
- Not being able to participate in routine activities that were possible before becoming ill, such as work, school, social life, and/or personal life, lasting for more than six months and is accompanied by fatigue.
- Post-exertional malaise (PEM). Refers to worsening symptoms after physical, mental, or emotional effort that would not have caused a problem before the illness.
- Unrefreshing sleep. People with ME/CFS may not feel better even after a full night of sleep.
If you have these three symptoms plus at least one of the following, a medical professional will likely give you a diagnosis of ME/CFS:
- Impaired memory or ability to concentrate.
- Orthostatic intolerance (symptoms that occur when standing upright)
These symptoms are used to diagnose CFS, but there are many other symptoms that may or may not accompany those listed above.
Additional Common Symptoms of CFS
Some additional CFS symptoms that may cause a person to seek out medical care include:
- Daily tiredness or extreme fatigue not improved by bed rest
- Tender lymph nodes
- Neurological issues
- Joint pain
- Muscle pain
- Frequent sore throats
- Frequent headaches
- Autonomic dysfunction (damaged nervous system affecting the function of the heart, bladder, sweat glands, pupils, blood vessels, and more)
- Visual problems (blurry eyes, light sensitivity, eye pain)
- Mood swings
- Irritable bowel syndrome (IBS)
- Chills or night sweats
- Allergies, multiple chemical sensitivities, and other sensitivities
- Other sleep problems (difficulty falling asleep, staying asleep, or waking too early)
You may also experience symptoms beyond these listed. In Europe, chronic fatigue syndrome is called myalgic encephalomyelitis (ME), which refers to the symptoms of muscle pain combined with brain inflammation. Together, these syndromes are referred to as ME/CFS. Often CFS goes along with a fibromyalgia diagnosis as well.
Another recently proposed name for this condition is systemic exertion intolerance disease (SEID) due to the worsening of symptoms that occurs with physical activity. However, it’s not just a response to physical exertion; mental activity may also aggravate symptoms.
The severity of fatigue and cognitive impairment can impact quality of life and mental health. Many turn to their healthcare providers for answers but are simply given medications for depression or anxiety or encouraged to try behavioral therapy, deep breathing, or yoga.
While those practices can help, symptoms of CFS may continue for weeks, months, or even years –until the underlying causes are addressed.
Who Gets Chronic Fatigue Syndrome
While CFS affects people of all ages and all walks of life, it’s more often reported by middle-aged women. However, it’s beginning to become much more common in adolescents. In fact, The Mayo Clinic has stated that fatigue in teens is at “near-epidemic proportions.” Mayo Clinic Pediatrician and professor Philip R. Fischer, M.D. wrote a Tired Teens to explore autonomic dysfunction and chronic fatigue syndrome in teenagers.
There may be a genetic component to chronic fatigue syndrome, as twin studies indicate, but genetics are only a “loaded gun.” Environmental factors (both inside and outside the body) pull the trigger.
What Really Goes Wrong in Chronic Fatigue Syndrome
To really know what’s going on, healthcare professionals need to get a thorough medical history to know some of the risk factors or possible causes. At The Wellness Way, we always go back to the Swiss watch principle of health, which states that every cell, tissue, organ, and system of the body affects all the others.
An initial trauma, exposure to toxins, or mental stress ultimately may lead to low energy production and a diagnosis of CFS. The “three Ts” cause distress to the nervous system and translate throughout the body.
The CDC acknowledges that scientists have not identified one clear cause of chronic fatigue syndrome. Rather, they admit that ME/CFS could result from several different causes, which correspond with The Wellness Way concept of trauma, toxins, and thoughts contributing to chronic illness.
Trauma and Chronic Fatigue
Chronic fatigue is a result of physical and mental stressors that take away from our energy production. It often begins after a major traumatic event or an infection. Common viral infections linked to chronic fatigue include Epstein Barr Virus (EBV), human herpesvirus 6, or rubella virus. Some viruses enter the body through the end of a needle –in a vaccine. Traumatic events can set the nervous system off in a way that can be difficult to turn back off:
- Physical traumas to the spine
- Traumatic loss of a loved one (loss in general)
- Sexual assault/rape
- Major surgery
- Being a victim of violence
Wellness Way doctors have seen a correlation between a loss of curvature in the neck and chronic fatigue with a fibromyalgia diagnosis. Some of these traumas may be coupled with toxins, such as a viral infection from a vaccine combined with adjuvants in the shot.
Toxins and Chronic Fatigue
Chronic fatigue may also be triggered by other toxic exposures, whether biological, chemical, or electromagnetic. These may include mold toxins, synthetic chemicals, non-native electromagnetic frequency (EMF) exposure, heavy metals, man-made blue light sources, or even toxins released by parasitic or other infections.
Exposure to toxins in the surrounding environment can lead to chronic fatigue syndrome. In Sick Building Syndrome (SBS) and multiple chemical sensitivity, toxic exposure leads to chronic inflammation and illness with accompanying fatigue.
Mold sickness may be misdiagnosed as chronic fatigue or fibromyalgia. According to our experience with patients at The Wellness Way, addressing mold toxicity by identifying the toxic source and supporting the body’s detox pathways often restores energy levels.
Lyme disease is a classic infection that is linked to chronically low energy levels. Doctors may run a Lyme panel to rule out this debilitating infection before looking for other contributors to chronic fatigue and increased pain levels.
Medications may also act as toxins in the body. Just look at the side effects listed on medication labels, and you’d be surprised how many of them have “fatigue” as a side effect. Top medications that may contribute to fatigue include antianxiety meds, antidepressants, high blood pressure medications, allergy medications, pain meds, cancer treatments, and more.
Thoughts and Chronic Fatigue
Chronic stress is very much associated with chronic fatigue syndrome. It makes sense because stress impacts our thoughts and the subsequent hormones (like cortisol) and neurotransmitters (like histamine and adrenalin) that our body produces. This impacts the immune system and creates inflammation throughout the body.
Here are some things that serve as emotional stressors, creating inflammation and oxidative stress and lowering energy production:
- Emotional stress from marriage, financial, family, or other issues
- Social isolation
- Tuning in to news sources, whether on TV, on the internet, or through alternative news apps (fear/worry)
- Overwhelm due to major life changes, whether good or bad: marriage, a new baby, graduation, divorce, or even moving to a new city.
- Holding grudges/pent-up anger
- Grief/feelings of loss
At The Wellness Way, when we talk about trauma, toxins, and thoughts, the main point is that everything is connected. We are very much affected by the physical, emotional, and spiritual environments surrounding us. Trauma impacting the central nervous system, toxins burdening our liver, and the thoughts making our hearts race… are all interconnected.
The Swiss Watch and Chronic Fatigue
The systems of your body work together like the gears of a Swiss Watch. Each gear affects all the others. That means if something is out of balance in one area of the body, it will have consequences for other areas. Everything affects energy levels, so if there are multiple imbalances, it just may lead to chronic fatigue syndrome.
When the body is inflamed and tired, it’s hard to heal. Sleep suffers, the muscles suffer, the brain suffers, and life seems harder. Caffeine and supplements may help us get through the day, but ultimately, we aren’t addressing the problem.
Subluxations are misalignments in the spine that interfere with the nervous system. Misalignments of the vertebrae can irritate the surrounding nerves causing a sympathetic (“fight-or-flight”) response. The body then responds by releasing inflammatory chemicals, which may disrupt the natural electrical current in the body and affect blood flow. The disruption of energy current and decreased nutrient delivery can lead to chronically low energy levels.
Immune Responses to Food
Another common contributor to chronic inflammation and fatigue is unknown food allergies. Eating foods you’re reactive to creates an immune response and the inflammation that goes along with it. This puts the body into an emergency state where it struggles to maintain balance and heal. There’s no energy left to exercise or get work done.
Dietary & Nutritional Factors
Certain nutritional deficiencies have been linked to chronic fatigue syndrome, including low levels of vitamins (B complex, folate, and C), minerals (sodium, magnesium, zinc), amino acids (l-carnitine, l-tryptophan), essential fatty acids, and coenzyme Q10. Nutritional deficiencies may occur because of a poor diet, nutrient-depletion due to modern farming practices, but also may be due to gut dysbiosis or inflammation leading to poor absorption.
Electrolytes are a huge element to consider when it comes to fatigue. You need 7-10 cups of vegetables a day to get enough potassium for healthy energy levels. Iron deficiency anemia may also contribute to symptoms of chronic fatigue syndrome.
Scientists proposed a new hypothesis, “The Dysbiotic March,” which they published in 2020 in the journal, Medical Hypotheses. This hypothesis states that digestive symptoms are often associated with chronic fatigue syndrome. The dysbiotic march starts with excessive antibiotic use during childhood. That leads to digestive complaints like IBS. Finally, it develops into chronic fatigue syndrome (CFS), fibromyalgia (FMS), and/or myalgic encephalitis (ME) years later. “All disease begins in the gut,” so the gut is a good place to start with testing.
Overgrowth of some bacteria species, a deficiency of certain good species, or an infection of some kind (bacteria, yeast, fungus, parasites) can also create imbalances in the gut leading to chronic fatigue syndrome and other symptoms. That’s why it’s important to do a stool test to find out what’s going on in the gut.
Cortisol is our major stress hormone. When under mental stress for long periods, we deplete cortisol and deplete our energy levels. This especially affects women as stress hormones are tied to normal cycling hormones. You can measure your cortisol levels throughout the day as they fluctuate with your circadian rhythm. Depleted hormones due to poor adrenal function is known to cause chronic fatigue syndrome. Low thyroid hormones can also play a major role in low metabolic function and energy production.
The Wellness Way Can Help!
Chronic fatigue syndrome has many potential causes. The only way to know those causes for each patient is by testing. That’s why we always say, “We don’t guess –we test!” Between food allergy, gut, hormone, viral infection, neurotransmitter, nutrient-deficiency testing, and more, Wellness Way doctors are prepared to help you get to the bottom of your chronic fatigue. Reach out to one of our clinics today and get the support you need. We are here to help!
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC
- Could You Have ME/CFS? (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) (cdc.gov)
- Chronic Fatigue Syndrome – StatPearls – NCBI Bookshelf (nih.gov)
- Autonomic Dysfunction – StatPearls – NCBI Bookshelf (nih.gov)
- Approach to Fatigue: Best Practice – PubMed (nih.gov)
- Chronic fatigue syndrome | Office on Women’s Health (womenshealth.gov)
- Mayo Clinic Press
- A twin study of chronic fatigue – PubMed (nih.gov)
- [Environmental medical syndromes] – PubMed (nih.gov)
- Why Fibromyalgia Patients Should Consider Mold Toxicity as a Cause of Their Illness
- Chronic Lyme disease: misconceptions and challenges for patient management – PubMed (nih.gov)
- Top Medications That Can Make You Tired | U.S. News (usnews.com)
- Neurobiological basis of chiropractic manipulative treatment of the spine in the care of major depression – PMC (nih.gov)
- Food Allergies: The Basics – PMC (nih.gov)
- Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach – PubMed (nih.gov)
- From IBS to ME – The dysbiotic march hypothesis – PubMed (nih.gov)