Dr. Weyrich's Naturopathic Functional Medicine Notebook
Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest
to Dr. Weyrich that may be of interest to the world wide audience.
Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is
Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of
non-free access journal articles for him to review on a topic.
Constructive criticism is also welcome.
Overview of Chronic Fatigue Syndrome (CFS)
Chronic fatigue syndrome is a functional diagnosis, for which conventional medicine has
identified no causative mechanism; its cause may be multifactorial, with multiple contributing factors.
Although chronic fatigue syndrome and fibromyalgia appear to share many of the same symptoms
and causative factors, they appear to be distinct disorders with different treatments.
Hence, careful differential diagnosis based on history, signs, and symptoms is necessary for effective treatment
It is also possible that a patient may present with diagnoses of both fibromyalgia and chronic fatigue syndrome.
Complimentary and alternative treatments for chronic fatigue syndrome that are considered below include:
Immune System Balancing
Low Dose Naltrexone
Neuro-Gen High Performance Neuromodulation (HPN)
Etiology of Chronic Fatigue Syndrome (CFS)
Among the theories that have been advanced,
and neurotoxins produced by dysbiotic Clostridia spp.,
yeasts, and fungi appear most credible.
Evidence suggesting that dysbiosis is associated
with chronic fatigue syndrome includes the following:
Elevated urinary levels of 3-hydroxyphenyl-3-hydroxypropionic acid (HPHPA)
and other markers of dysbiotic overgrowth with
Clostridia spp. are common in chronic fatigue syndrome [GP].
Elevated urinary levels of tartaric acid and other markers of dysbiotic
overgrowth with yeasts and fungi are associated with chronic fatigue syndrome
However, note that hypothyroidism is associated with
Functional Immune Deficiency, so addressing
hypothyroidism may help clear the dysbiosis.
Another often-overlooked cause of chronic fatigue is sleep apnea.
Diagnosis of Chronic Fatigue Syndrome (CFS)
Decreased concentration and short-term memory
Muscle and joint pain without inflammation
Tender lymph nodes
Post-exertional malaise lasting 24 hours or longer
Note that most of the above are also commonly seen in hypothyroidism
[Starr2005, pg 148], although other authors attribute these symptoms to overgrowth of
Candida [Crook], [Starr2005, pg 150].
[McCulley2018, pp 35, 89, 219-222] reports that chronic fatigue syndrome is a
TH2-dominant autoimmune disorder.
However, [McCulley2018, pg 180] also reports states that chronic fatigue syndrome
is not an autoimmune disease because there are no antibodies.
Dr. Weyrich has considerable interest in this topic, but has
not treated any cases of chronic fatigue syndrome
with Immune System Balancing.
According to the Low Dose Naltrexone home page [LDN], LDN has been seen to benefit
chronic fatigue syndrome, which is considered to be an autoimmune disease.
[LDN] reports that all patients with autoimmune processes who were treated by the
late Dr. Bihari [Bihari2003] using LDN "have experienced a halt in progression of
In many patients there was a marked remission in signs and symptoms of the disease."
Dr. Bihari suggests a 50% to 70% overall response rate [Bihari2003].
Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN).
However, Dr. Weyrich has not treated any cases of Chronic Fatigue Syndrome with LDN.
HPN has been reported to be useful for treating chronic fatigue syndrome
Dr. Weyrich has been trained in the use of Neuro-Gen High Performance Neuromodulation
system by it's inventor, Corey Snook.
However, Dr. Weyrich has not treated any cases of chronic fatigue syndrome
with this technique.
Elevated levels of tartaric acid (3-hydroxymalic acid or
2,3-hydroxy-succinic acid) are associated with chronic fatigue syndrome.
Tartaric acid is an analog of the Krebs cycle intermediate malic acid that
inhibits the Krebs cycle enzyme fumarase that converts fumaric acid to
malic acid [Shaw2008] [Russell1995].