Bayou Health | Chronic Fatigue

Real Diagnosis or A Symptom of an Undiagnosed Problem?

BY DR. NATHAN MORRIS, MD

I am always amazed at the “catch all diagnoses” that medicine has created because of our lack of knowledge, or our inability to get down to the root cause of why people have symptoms. Chronic fatigue is one of those diagnosis which is not a diagnosis at all but rather a handy label to give to people. A medical description is “chronic fatigue syndrome (CFS), is a complex, long-term illness characterized by profound fatigue that is not improved by rest and worsens with physical or mental activity, often accompanied by sleep disturbances, cognitive impairment, and orthostatic intolerance.” It is estimated that 3.3 million individuals have the CFS (chronic fatigue syndrome) label with up to 90% of people going undiagnosed, which is 33 million Americans. This is a huge issue which medicine has limited conventional treatments to address. What is important here is to understand this label is just the beginning of the medical exploration of the why and is not something you are saddled with for the rest of your life.

A principle that is essential in functional medicine is the understanding that very rarely does the body act in random ways. The body does not one day decide, “I am going to make it difficult for this person to even have the energy to brush their teeth or take a shower.”  It does not say, “I am going to require a Herculean effort to make dinner for their family.”  The body does not work this way. It has signals that tell it to act in this way and that is what it all comes down to for the person with chronic fatigue, what signals from the environment have told the body to be just so dang tired?

An overriding principle to remember is the body will do anything to survive. When the body feels it is under constant threat, it will go into a “safe mode” which is what CFS basically is. It is about surviving and not thriving. We must figure out the input(s) that are telling the body it is no longer safe. The biggest input is chronic inflammation. Chronic inflammation is a prolonged, persistent immune response in the body, where the immune system remains activated for extended periods. The immune system is supposed to protect us but when turned on to long it turns on us. 

The body’s best defense of chronic inflammation is to reset the body to do less. It does this through resetting our energy thermostat. This “thermostat” is officially called the HPA (Hypothalmus-Pituitary-Adrenal) Axis. When the body has chronic inflammation, it quits producing the signals to be happy and make plenty of energy. It resets to the survive mode and tells us to rest as much as possible as it perceives you are “under attack.”

One of the biggest signals causing chronic inflammation is stress. Unhealthy stress is the most under appreciated health destroyers out there. We know that prolonged stress increases risk of cancer, heart disease, autoimmune disease, and many other conditions. It does this through its activation of our immune system and causing, yep you guessed it, chronic inflammation. Stress is a normal part of life so there is no escaping it, but unhealthy prolonged stress is not. Managing stress is about being aware and noticing and managing it with prayer, meditation, counseling, healthy activities like exercise, and supplements like Ashwagandha.

Another source of chronic inflammation that is resetting our body’s thermostat is our diet. Why is an ultra-processed, high sugar diet so bad for us? It causes inflammation through its effects on our gut bacteria, or microbiome, and they send signals to our immune system that we are not well and to increase inflammation. Two other foods that are noticeably big instigators of inflammation in our gut are gluten and dairy products. They are not the same as they were 100 years ago and almost all CFS patients in my practice improve with removing these two foods. Removing foods that are ultra-processed and high sugar, along with eliminating possibly inflammatory gluten and dairy are a good start to addressing one contributor of chronic fatigue but they are other offenders to consider as well.

In functional medicine it is important to look for inflammatory causes that are common but not commonly considered. Here is a list of things that need to be looked at as possibly being causal in CFS.

• Lyme Disease, an overlooked issue that is not just in the Northeast
• Mold toxicity from work or the home, which is very, very inflammatory to our bodies.
• Mercury toxicity which affects your mitochondria by stopping energy production
• Hormonal changes like menopause which has been shown to have a definite role in chronic fatigue syndrome. 
• Sleep is the most often overlooked cause of CFS and very few people have had sleep studies and dental correction.

These are a lot of the reasons for chronic fatigue syndrome and not all of them are listed here. The important idea to take away is that usually it is not one thing causing issues but several factors working in tandem to make people sick through causing chronic inflammation. That is where have an in-depth evaluation becomes so beneficial and to do this with someone who sees the “diagnosis” of chronic fatigue syndrome as a beginning and not a destination in your medical journey.