Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is a debilitating condition that is associated with various trigger events, such as viral infections ( Epstein-Barr virus COVID-19, etc.), bacterial infections such as Lyme, fungal infections such as Candida, and physical or psychological trauma.

However, association does not prove causation, and conventional Western (allopathic) medical practitioners (MD, DO, NP, etc.) do not recognize a mechanism for a causal link; they therefore tend to attribute the symptoms of CFS to depression and treat according to that model CDC

Chronic fatigue syndrome is a functional diagnosis, for which conventional medicine has identified no causative mechanism; its cause is most likely multifactorial, with multiple contributing factors which make each individual case unique and requiring an individualized treatment plan, rather than a "by-the-book" approach.

Although chronic fatigue syndrome, long COVID-19, Myalgic Encephalomyelitis (ME), and fibromyalgia appear to share many of the same symptoms and causative factors, they appear to be distinct disorders with different but partially overlapping treatments. It is also possible that a patient may present with diagnoses of more than one of these disease patterns, and may also benefit from the naturopathic protocols used for CFS plus additional naturopathic interventions.

Hence, careful differential diagnosis based on history, signs, and symptoms is necessary for effective treatment [Liptan2016].

As Dr. Weyrich is a board Certified Health Practitioner Diplomate in the Clinical Science of Anti-Aging by The American Board of Anti-Aging Health Practitioners (ABAAHP), he approaches treating CFS from the point of view of optimizing mitochondrial function, diet, and detox.

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complimentary and Alternative treatments that may be considered include:

Among the theories that have been advanced, mitochondrial dysfunction and neurotoxins produced by dysbiotic Clostridium 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-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA) and other markers of dysbiotic overgrowth with Clostridium spp. are common in chronic fatigue syndrome [GP2008].
• Elevated urinary levels of tartaric acid and other markers of dysbiotic overgrowth with yeasts and fungi are associated with chronic fatigue syndrome [Shaw2008].
• 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.

Symptom picture:

• Decreased concentration and short-term memory
• Headaches
• Muscle and joint pain without inflammation
• Tender lymph nodes
• Sore throat
• Unrefreshing sleep
• 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].

Diagnostic Testing:

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  Organic Acid Test (elevated markers for gut dysbiosis or mitochondrial dysfunction).
•        Basal Body Temperature (depressed if hypothyroid or mitochondrial dysfunction)
•        Heavy metal urinalysis with provocation (possible cause of mitochondrial dysfunction).

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  fibromyalgia [Liptan2016].
•        Vitamin B12 deficiency [Pacholok2011].
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  Lyme Disease.
•        Copper toxicity can cause fatigue and exhaustion; this may especially be a problem in "red-rock" areas of Arizona, where the soil/water may be high in copper.

Naturopathic, Complimentary and Alternative Treatments

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].