What is Chronic Fatigue: A Persistent Pain or Complex Condition?

If your body chronically hurts in places for no particular reason, or you find yourself constantly exhausted (wanting to sleep anytime, anywhere), you may be experiencing the effects of chronic fatigue syndrome (CFS). CFS is a complex illness characterized by long-term fatigue and many other disabling complaints (see below). This condition is difficult to pinpoint because there is no standard testing and a diagnosis depends on a rule-in / rule-out process.

Most symptoms of CFS are not outwardly visible to others. This makes it hard even for practitioners, family members, or friends to understand what the patient is experiencing. Some of the health challenges those with CFS endure include:

  • Lack of restoring sleep
  • Extreme, unrelenting fatigue
  • Extended recovery time after exertion
  • Widespread aches and pains
  • Symptoms similar to flu
  • Cognitive malfunction (brain fog)
  • Sensitivity to light
  • Visual issues
  • Digestive issues
  • Sensitivity to various chemicals
  • Autoimmune system malfunction

Causes of Chronic Fatigue Syndrome

Fatigue, a non-specific symptom of many illnesses, is often a CFS sufferer’s chief complaint.  Fatigue is tricky. Figuring out its cause is like putting together a puzzle.  It can be caused by a myriad of dietary, lifestyle and environmental exposures. At Grossman Wellness, we look to the primary mechanisms that underly CFS:

  • Health history of chronic illness: especially Lyme’s or Epstein-Barr virus
  • Gut dysfunction: poor digestion, dysbiosis, hypochlorhydria
  • Nutrient imbalance
  • Stress load: HPA axis plus personal stress load
  • Toxic load or exposures: metals, chemicals, molds, biotoxins
  • Hormone imbalance
  • Chronic immune system up-regulation due to illness, allergens, metals
  • Genetic polymorphisms (SNPs) that may decrease energy production or affect mitochondrial health

When your immune system is continually up-regulated due to previous illnesses like Epstein-Barr or Lyme’s Disease or to prolonged exposure to allergens or toxins, your body invisibly shifts into a state of high alert (a.k.a. stress) and never fully turns off. In this situation, the immune system continues to draw upon resources and energy at the expense of overall vitality. This invisible stress, in turn, upsets endocrine health, digestion, and hormonal cell-to-cell signaling, causing further fatigue.

Gut dysfunction, digestive issues and hidden gastrointestinal illness, along with poor absorption of nutrients, also tax the body of its resources. Low nutrient status can affect energy production in many systems. Identifying and healing underlying food sensitivities, bacterial or microbiome imbalance, and malabsorption issues should be your first steps to addressing your fatigue. By working with our nutritionists to remove problematic causes, to repair your GI tract and to replace lost nutrients, your energy, mood, and immune health should begin to improve.

Another underlying cause important to investigate is the health of your mitochondria. Research on patients with CFS has found they have fewer mitochondria and that many are damaged. Mitochondria are the powerhouses of your cells. So if less exist to produce energy that can start and sustain cell function, the body fatigues. Studies have found that CFS patients also have elevated blood levels of lactate, indicating suboptimal energy production that often leads to fatigue and muscle aches. Impairment of existing mitochondria is often a reality in CFS patients. This damage can be due to diet, lifestyle, and toxin exposures as well as to genetic polymorphisms.

Genetic polymorphisms (SNPs) are genetic mutations that are either inherited or environmentally induced and can affect many areas of physiology and biochemistry, including the mitochondria. Also, your ability to process toxins and spent hormones and the health of your digestive system can be influenced by genetic SNPs. SNPs include, but are not limited to, MTHFR, CBS, SOD, PON1, MTRR, COMT, VDR, and HLA polymorphisms.

Additional “energy depleters” can include hormone imbalance. Hormones are chemical messengers secreted by glands in the endocrine system including the pituitary, thyroid, adrenal, hypothalamus, pancreas, ovaries and testes. These glands work in conjunction with the nervous system to regulate the rhythms of life, from digestion and metabolism to circadian rhythms, stress response, sexual desire, and cellular communication, among others. Imbalances in this system can translate into low energy. Click here to learn about our hormone replacement therapy programs.

The final piece to the fatigue puzzle is learning how to manage stress. Stress is an insidious and unavoidable facet of modern life. When uncontrolled, stress can impact digestion, nutrient uptake, toxins and hormone clearance, cellular communication, and immunity— leading to fatigue. Some stressors are easy to identify: emotional and mental chatter, horrible commute to work, stressful co-worker, or the death of a loved one. Other sources can be hidden: chronic immune up-regulation, sitting too long, prolonged exposure to toxins, unknown food sensitivities, are harder to detect.

It is important to identify stressors in your life and commit to finding solutions, from removing the stressor entirely to learning how to calm the body to handle the stress. At Grossman Wellness, our nutrition team can help guide such lifestyle changes

Treating Complex Conditions

It can be very difficult to diagnose patients with chronic fatigue. The best option for combating this disorder is to look for a physician who approaches treatment with a multi-system, functional methodology. Treatment of complex conditions, like chronic fatigue syndrome, requires special training and persistent investigation to locate its root cause. This treatment can be found in healthcare providers that focus on preventative health care.

Once diagnosed, patients might be interested in enrolling in a chronic fatigue syndrome therapy program. and receive coaching from our nutrition team. We have seen our patients experience dramatic recoveries through alterations in diet, supplementation, and medication.

Changing Criteria For Chronic Fatigue Syndrome

In 2015, a study was performed to better understand the disorder, and to help facilitate the timely diagnosis and care for those with CFS. The Department of Health and Human Services along with a multitude of other government organizations saw many of those diagnosed not take treatment seriously, due to the name of the disorder. The name “Chronic Fatigue Syndrome” makes it very easy to trivialize the seriousness of the condition. As a result, the organizations recommended switching the name to “Systemic Exertion Intolerence Disorder” (SEID).

In changing the name of the illness, they also needed new diagnostic criteria, and new terminology in order to help researchers understand the illness with more clarity. See below for the newly proposed diagnostic criteria for Systemic Exertion Intolerence Disease.

  • 5 primary symptoms (must be present for 6 months or more)
    • Reduction or impairment to carry our normal daily activities, accompanied by profound fatigue
    • Post-exertional malaise (worsening of symptoms after physical, cognitive, or emotional effort
    • Unrefreshing sleep
    • Cognitive impairment
    • Orthostatic intolerance (symptoms worsen when a person stands upright and they improve when the person lies down)

Click here to see a factsheet on CFS, and click here to watch “Beyond Myalgic Encephaolomyelitis/Chronic Fatigue Syndrome: Redefining an Illness.”

Grossman Wellness focuses on treatment for your whole person and not just the presenting symptom(s). Just as the illness presents differently from one person to the other, our treatment plans are bio-individually unique and specific to each patient. Understanding is the chief component necessary to the restoration of health.

If you or someone you know might be affected by chronic fatigue syndrome, please don’t hesitate to schedule a consultation with us so we can help you get on track to a healthier tomorrow.


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