Chronic Fatigue Syndrome Testing

What is Chronic Fatigue Syndrome? 

Chronic Fatigue Syndrome is a condition of profound fatigue, sleep abnormalities, pain and other symptoms that are made worse by exertion. The extreme fatigue lasts for at least 6 months and cannot be fully explained by an underlying medical condition. The fatigue worsens with physical or mental activity, but doesn’t improve with rest. The fatigue is often immobilizing.

People with Chronic Fatigue Syndrome may not look sick. But they usually cannot function ‘normally’. With Chronic Fatigue Syndrome, it can be difficult to do daily tasks, like take a shower or prepare a meal. It is usually hard for sufferers to have a job, go to school and take part in family and social life.

It is also sometimes called Myalgic Encephalomyelitis or ME for short. ME or Chronic Fatigue Syndrome occurs more commonly in women.

What are the Causes & Symptoms of Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome is thought to be triggered by various factors including infections, major life stress, toxin exposure, immune system deficiency, nutritional deficiencies, genetic susceptibility and issues with ATP production (CDC, 2021) and (Esfandyarpour R, 2019).

Chronic Fatigue Syndrome often comes on after a viral or bacterial infection. Common viral triggers can be EBV (Epstein-Barr or mononucleosis), Herpes virus, stomach viruses or other viruses (Esfandyarpour R, 2019). Bacterial infection can also be a trigger. Some researchers think that the source of the illness is viral (Esfandyarpour R, 2019).

Chronic Fatigue Syndrome is also characterized by mitochondrial dysfunction and depleted levels of adenosine triphosphate (ATP) (Morris G, 2014). Mitochondria are the energy powerhouses of the cells that produce ATP. ATP is cellular energy. It provides the energy needed for all activities in the body, cells, muscles, nerves, etc. Low mitochondrial function results in low ATP, which results in fatigue.

Chronic Fatigue Syndrome might also have an autoimmune component, as it does often involve changes in the immune system. Low ATP production and mitochondrial dysfunction can be a source of autoimmunity, by inhibiting apoptosis (natural and healthy cell death) and stimulating necrotic cell death (Morris G, 2014). This can lead to spilling cellular material into the tissue causing inflammation. Necrosis is a much more harmful way for a cell to die than apoptosis.

The full list of symptoms include: flu-like symptoms, fatigue, muscle /joint pain, unrefreshing sleep, cognitive issues and high sensitivity to light and sound. Patients often feel tingling and numbness in different parts of the body. They may have other symptoms like rapid heartbeat at times (tachycardia), light-headedness, digestive issues (nausea and abdominal pain), headaches, poor temperature regulation, cold or heat intolerance and recurring sore throats (Esfandyarpour R, 2019).

Chronic Fatigue Syndrome Testing

Chronic Fatigue Syndrome is a complicated condition that is not fully understood. In fact, most medical schools in the US do not have Chronic Fatigue Syndrome as part of their physician training (CDC, 2021). Chronic Fatigue Syndrome is often misunderstood and might not be taken seriously by some healthcare providers (CDC, 2021).

There is currently no single biomarker or medical test to diagnose or confirm Chronic Fatigue Syndrome (Esfandyarpour R, 2019) and (CDC, 2021). Chronic Fatigue Syndrome may appear to be similar to other illnesses. This makes Chronic Fatigue Syndrome difficult to diagnose.

It can be unpredictable. Symptoms may come and go, or they may change in severity over time. Because it is difficult to diagnose, treatment is often delayed until the correct diagnosis is made (Esfandyarpour R, 2019).

While Chronic Fatigue Syndrome tests have a way to go, the good news is that we can still test for the root causes. In our clinic, we often find that Lyme disease, other chronic hidden infections and environmental toxins can lead to Chronic Fatigue Syndrome. When we find the root cause, we can work to reverse it!

Chronic Fatigue Syndrome Testing: What do we do if there is currently no test for Chronic Fatigue Syndrome? How do we diagnose it?

A Chronic Fatigue Syndrome diagnosis is based on symptoms, such as exhaustion, sensitivity to light, unexplained pain or others.

The two criteria that must be met for a diagnosis of Chronic Fatigue Syndrome are:

• Severe fatigue lasting six months or longer and
• Having four other symptoms typical of Chronic Fatigue Syndrome, such as mild fever, sore throat, tender lymph nodes, muscle pain and weakness, joint pain, headache, sleep disorders, confusion or memory loss

The diagnosis can only be made after other diseases are ruled out clinically. It is important to check for other conditions that cause similar symptoms. These other conditions might be treatable. Getting treatment for these other conditions might help someone with Chronic Fatigue Syndrome feel better.

New Research on Chronic Fatigue Syndrome Testing

Researchers have looked into potential biomarkers to identify Chronic Fatigue Syndrome. The immune system is often the focus for Chronic Fatigue Syndrome research, given that a viral infection often triggers the start of Chronic Fatigue Syndrome. It is thought that ATP is deficient in Chronic Fatigue Syndrome patients (Esfandyarpour R, 2019).

To explore this low-ATP hypothesis and to test whether they could use ATP consumption to identify individuals with Chronic Fatigue Syndrome, scientists did an experiment. In 2019, they created a blood test that correctly identified Chronic Fatigue Syndrome patients from people without Chronic Fatigue Syndrome (Esfandyarpour R, 2019). The test looked at people’s blood cells, and specifically at a type of immune cell that is easy to isolate from blood samples.

The subjects’ blood cells were “stressed”, using salt. The cells were put in a high salt environment. This creates a type of stress that cells can usually fix using ATP. The researchers then watched how the cells reacted. Any big change in cell behavior shows that the cells are struggling with the stress and cannot process it well.

All of the blood samples from the people with Chronic Fatigue Syndrome showed the cells were clearly stressed (Esfandyarpour R, 2019). The results from the healthy controls in the experiment showed cells that reacted in a stable manner, indicating that their cells managed the stress better than those of people with Chronic Fatigue Syndrome (Esfandyarpour R, 2019).

The scientists don’t know exactly why the cells reacted as they did but there was a clear difference in how healthy and Chronic Fatigue Syndrome immune cells process stress.

This is a good start. However, more studies are needed to confirm these findings. More research will hopefully provide a reliable biomarker to identify Chronic Fatigue Syndrome and distinguish it from other conditions with similar symptoms.

In the meantime, how can Functional Medicine help with Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome is a complicated, multi-system disease, often misdiagnosed as being caused by psychological issues. But the onset of a multi-system illness is rarely due to psychological issues (Bransfield RC, 2019). Many complex conditions that have been described as “all in your head” are actually immune-mediated infections (Bransfield RC, 2019). They are most likely related to the immune system and/or the microbiome. Complex diseases require complex explanations. A disease is caused by something. When clinical findings are confusing, the Functional Medicine approach is to find the root causes, rule out other diseases and address the problem at its root. We have extensive experience in our clinic addressing Chronic Fatigue Syndrome and other complex diseases (medicinewthheart.com).

Whether Chronic Fatigue Syndrome (or something else) is the main cause of a person’s fatigue, we use Functional Medicine principles to find the root causes. We would look for a previously undiagnosed underlying chronic infection, as this can often be a root cause of Chronic Fatigue Syndrome. Other potential root causes include gut dysfunction or infections, autoimmune tendencies, HPA axis issues, mitochondrial issues or reduced cellular metabolic function, thyroid or other hormonal imbalances, toxic overload (particularly metals) and nutrient deficiencies.

We may uncover other reasons for the fatigue. In Functional Medicine, we can look into these other issues and treat them alongside the Chronic Fatigue Syndrome. This would improve symptoms of overall fatigue. In our clinic, we have expertise in treating a range of complicated, difficult-to-diagnose conditions like Chronic Fatigue Syndrome. We regularly treat and resolve chronic infections, fatigue and other complex conditions in patients in our Functional Medicine clinic.

** Please stay tuned for our next Blog!  **