The Non-Mystery of Chronic Fatigue Syndrome

 
The Non-Mystery of Chronic Fatigue Syndrome

My wife gave me an article from Hadassah Magazine entitled “The Mystery of Chronic Fatigue Syndrome”, by Carol Saline, about the 2017 documentary on Jennifer Brea called “Unrest”.  The film documents her experience with severe chronic fatigue.(1-3)  Jennifer Brea was a previously healthy robust young women until the onset of immune dysfunction with six different infections, followed by debilitating fatigue and brain fog.  The article goes on to state there is no known cause and no known cure for “chronic fatigue syndrome” also called “ME/CFS”.  This has changed. The mystery has been unraveled by a group from Stanford.  Above image courtesy of Jennifer Brea Unrest Movie.

 

Leaky Gut – Incriminating the GUT Microbiome

Dr Montoya’s group at Stanford found elevated pro-inflammatory cytokines in chronic fatigue patients, implicating chronic inflammatory up regulation. (4-5)   In an accompanying editorial in PNAS, Dr Anthony Komaroff  explains it nicely with this quote:(5)

“Another way of incriminating infection in CFS (Chronic Fatigue Syndrome) involves the gut microbiome. Several recent studies have reported dysbiosis accompanied by low-grade inflammation and increased permeability of the gut mucosa. This allows bacterial lipopolysaccharide to enter the circulation, possibly activating innate immunity both systemically and in the brain.”

Notice Jennifer Brea’s story includes six different infections, yet the story says nothing about the antibiotics used to treat these infections.  Many of these patients have history of multiple long term antibiotic use implicating gut dysbiosis and leaky gut.   The use of NSAIDS for fibromyalgia pain worsens the leaky gut pathology as discussed in my previous article.

Leaky gut causes low grade endotoxemia which then upregulates inflammatory cytokines which travel to the brain causing upregulated microglia, depression and HPA (hypothalamic pituitary axis) dysfunction, which then causes adrenal, thyroid and gonadal hormone dysfunction leading to severe fatigue and fibromyalgia.  On top of this there is usually a variable element of mitochondrial dysfunction.

Pre-Existing Genetic Defects and Aggravating Conditions

Symptoms are worse in patients with pre-existing genetic defects in methylation pathways such as MTHFR, or COMT (catechol -o-methl-tranferase), or B12 transport protein defects (detected with elevated MMA levels)   Symptoms are worse if there is an aggravating medical condition such as low thyroid, menopausal transition, gluten sensitivity, stressful workplace or home life etc.

The Mystery Becomes Unraveled

The reason why this disease is a mystery is because the mainstream conventional physician does not bother to test for any of these abnormalities.  Nor do they treat them. We do, and most of our patients eventually get better. That is why Chronic Fatigue/Fibromyalgia is a non-mystery.

Jeffrey Dach MD
7450 Griffin Road Suite 180-190
Davie, Florida 33314
954-792-4663

Book Announcement
Articles with Related Interest
Low Level Endotoxemia, Depression and Endocrinopathy
NSAIDS, Small Bowel Damage and Leaky GUT

Links and References

 see original article:   https://jeffreydachmd.com/2018/04/the-non-mystery-of-chronic-fatigue-syndrome/