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Chronic Fatigue

By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr

Chronic Fatigue Syndrome (CFS), also called Adrenal Exhaustion,  refers to condition that is characterized by abnormal fatigue. When we work hard, or had strenuous exercises, or experience constant stress at work we may experience fatigue that we overcome by a period of rest or a by taking a holiday. Chronic fatigue does not always respond to rest or holidays. The person feels continuously exhausted to the point that some cannot get out of bed. It is a truly debilitating disease. Symptoms may include muscle and joint pain, headache, memory loss, mental confusion, lack of concentration, digestive problems, recurring infections, low grade fever, swollen lymph glands, food allergies and sensitivities and depression and a host more. The symptoms often fluctuate over periods of weeks, or from day to day. Days of well-being are followed by days of extreme fatigue and unwell-ness. The disease often emerges after the age of 40 and women are more affected than men for some unknown reason.

According to Dr Mercola, people suffering from Chronic Fatigue Syndrome (CFS), or more recently called Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) may have been infected with an XMRV virus or gammaretrovirus, responsible for prostate tumors and CFS. The key may be the failure of the immune system to function properly Mercola, Nov 2009

Psychological factors have been implicated in that mental-emotional stress, negative feelings and depression can lower the immune system. However most experts agree that there is an underlying physical condition that is mainly responsible.
Many CFS sufferers make the rounds of medical tests, neurologists, psychiatrist to be told there is nothing wrong, and sometimes “it’s all in the mind”, before they come before a complementary doctor or naturopath for treatment.
An estimated 3 million Americans may be affected. The diagnosis should be considered when the condition lasts for more than two months and in spite of taking a rest. In the past CFS sufferers were accused of being malingerers. Medical scientists have been at a loss of finding a single cause for CFS, sometimes linking it to the Epstein-Barr Virus, candidiasis, oral and genital herpes virus. Metabolic conditions such as anaemia, tuberculosis, lactose intolerance, sub-clinical coeliac disease, hypothyroidism, adrenal insufficiency, premenstrual disturbances, hormonal imbalances, toxic overload and uncontrolled diabetes can cause the fatigue.  See also Medicinenet.com. Often symptoms appear after a bout of the flue or some infection.
The term “syndrome” refers to a complex of ongoing symptoms or simultaneous infections that may weaken the immune system. Thus in CFS health professionals often find hidden concomitant parasite, yeast, fungal and viral infections.
Causes: nutritional deficiencies, acquired toxicity (from environment, food, drugs), excessive use of antibiotics (which kill the gut flora and its sources of vitamins and minerals), parasitic, fungal and viral infections (acne, sinusitis, cystitis), a vicious cycle of lowered immunity, alcoholism, drug, tobacco abuse even mercury toxicity from dental amalgam. And not to forget the influence of Genetically Modified Organism (OGM’s) in our diet. Lead poisoning often replaces zinc in many enzymes causing symptoms of hypoglycemia or CFS.

Hypoglycemia a likely candidate for CFS

Dr George Samra of Sydney Australia has found by taking Glucose Tolerance Tests for Hypoglycemia explained here, that many of his CFS patients have hypoglycemia, and it should be noted that the symptoms overlap. Hypoglycemia is an unfortunate term as it refers to low blood sugar levels whereas it should refer to a prediabetic condition marked by unstable fluctuations of sugar concentrations in the blood, also known as hyperinsulinism and insulin resistance. See another definition. The hypoglycemic syndrome is a likely candidate for CFS, because it means that the body has problems converting carbohydrates into adenosine triphosphate (ATP). The biological energy is essential as a major fuel for the biochemical machinery of the body and brain. Hence without that energy a person would have problems functioning normally!

Basically, it is mishandling of sugar by the body. When sugar levels drop from high to low, threatening the energy supply to the brain, stress hormones are released – among these adrenaline – which converts stored sugar (glycogen) back into glucose. This may lead to adrenal insufficiency. Hypoglycemia weakens the immune system.
Dr Samra estimate that 5% of the population may have hypoglycemia. However different studies estimate that about 35% of of US adults ages 20 and older had pre-diabetes. Recent studies have shown that there is an equal number of diagnosed and undiagnosed diabetics. The sugar diseases is typically found among the upper class of the Western world – the high sugar consumers – hence it is no accident that CFS is often called a yuppy disease.
Doctors often prescribe antidepressant drugs. It appears that the SSRI drugs (Specific Serotonin Reuptake Inhibitors, such as Prozac, Erocap, Luvox, Cipramil) may be useful to some patients. These drugs inhibit the re-uptake of serotonin (a neurotransmitter often said to be the happy hormone) that the body produces, so that it remains available for a longer period. However it should be noted that anti-depressant medications have a poor reputation in treating depression and other mood disorders.

Nutritional treatment has to be individualized because of the nature of the disease. A thorough medical investigation should exclude many diseases that cause chronic fatigue.
Most complementary doctors would target the underlying nutritional causes of CFS and would recommend a sugarless diet, similar to that of a diabetic diet. This should be accompanied by vitamin/mineral supplements that should include: vitamin B12 (preferably injections of B12 initially), folic acid, zinc, calcium, chromium and magnesium; may be iron and copper. Dr Samra suggest that magnesium deficiency is very common among CFS sufferer. Thus usual supplements are:
Magnesium orotate or chelate, Vitamin B12 & folic acid, DHEA, melatonin, high dose B-complex, high doses of vitamin C, Coenzyme Q10 (an energy transport vitamin), Evening Primrose Oil, Fish Oil or Max EPA. Doses should be taken with meals and tailored to individual patient and should be under the supervision of a properly qualified health practitioner (medical or naturopath).

Sensitivities to food items is a common element among CFS sufferers as it is among hypoglycemics. Sufferers should avoid their allergies and the detection of allergies can be made by professionals or by a systematic investigation of the patient himself. This is a vast topic. See:

“The Food and Disease Paradigm” by Dr George Samra

I would recommend that one read books on allergies, such as The Allergy Connectionby Dr George Samara.

If a patient wants to become aware of his allergies he should start a dietary diary. This is a notebook with pages representing the days, for instance Saturday, Sunday etc. Each page should show three columns: (See article on FINDING YOUR ALLERGIES on this site)
1) time of day
2) details of food taken,
3) reaction to the food after taking the food (at the next recording).

A cytotoxic test by a doctor is one short cut to revealing allergies, but these tests are not always accurate or valid.

He should pay attention to common sources of allergies which are listed in the order of frequency: cow’s milk and dairy products, wheat, chocolate, eggs, orange, benzoic acid, cheese, tomato. But each patient has idiosyncratic allergies and also an allergic person tend to become allergic to a wider range of foods. In some cases digestive enzymes may help.

By filling in the dietary diary he should soon become aware of reactions in a matter of weeks or months. Often it shows that the patient does not has a snack within three hours of the last snack which is essential if he foes on a hypoglycemic/diabetic diet.


Because of the individual uniqueness of the disease treatment should PREFERABLY be under the supervision of a health practitioner. Please adopt the Hypoglycemic Diet together with supplements such as zinc, vitamin C, L-carnitine, NADH, vitamin B12 (ask for injections), DHEA, Fish Oil, magnesium and herbs; Asian ginseng, Eleuthero, Licorice.

Please discuss this article with your health care worker, doctor or nutritional doctor or therapist.


Index to Specific Topics and Research

References to Mood Disorders and Nutrition

Dr Sarah Myhill MB, BS “Diagnosing and treating Chronic Fatigue Syndrome (CFS), Pub Sarah Myhill Limited

Samra, Dr George, New Theories of Chronic Fatigue Syndrome,—> page 2
Vayda, Dr William, Chronic Fatigue: The Silent Epidemic —> page 3

Vayda , Dr William Chronic Fatigue Syndrome – Is environment making you ill? —> page 3

Chronic Fatigue Syndrome Treatment by Herbs2000

2 Responses

  1. Hello. Would you mind changing your reference here please to chronic fstigue syndrome? CFS is not the same as chronic fatigue or adrenal exhaustion, though both of those things are encompassed in CFS. But CFS has many extra symptoms, such as neurological, muscular, cognitive, immunological symptoms, mwking it an even more complex and hellish condition than CF and AE both can be. It’s taken a long time for our condition to be taken seriously but it is finally starting to happen. The less confusion there is in the public about what is CFS and what is CF, the easier it will be for us to find a cure. Thanks!

    • jur says:

      I am not inclined to even make the illness more complicated by making these distinctions. But your comments will be preserved for other people to read.

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