Chronic Fatigue Syndrome (CFS) is a physical illness, it is complex, but it does not have to be a life sentence…

In this blog I’ll be answering the question of “What is Chronic Fatigue Syndrome?”, from different perspectives. Then, most importantly, we’ll look at what you can do if you have this diagnosis.

The Conventional Medical Perspective

If you search the NHS (National Health Service, UK) website, you will find CFS described as a list of symptoms. To explain the ‘technical speak’, a syndrome is simply a cluster of symptoms for which conventional medicine cannot pinpoint a pathogenic cause. (In other words, it is not a virus or bacteria, or toxin).

The symptoms listed are pretty diverse, and not every single patient suffers from all of them. So, on the surface, this looks like a really complex, inexplicable illness. And that appearance has led people to question whether it is in fact an illness at all.

Is Chronic Fatigue Syndrome “made up” or “all in the head”?

Sadly, you will still find a lot of people (and, unfortunately, in my experience, this does include people in the medical profession), asking this question.

The answer is very clearly, NO. CFS is a real, very physical, illness. (The World Health Organisation currently classifies it as a disease of the nervous system). And anyone experiencing this set of symptoms knows first-hand that they are not imagining all of this – it is very real, very confusing, frustrating and can be very scary.

So, it is beyond time to let go of the labels that people with CFS are lazy, or hypochondriacs, or attention seeking.

In the interests of staying on topic in this blog post, I’m not going to go deep into the science and causes of the symptoms. But you can find all that information at this link.

How is Chronic Fatigue Syndrome diagnosed?

Short answer: by testing for – and ruling out – all major diseases that could fit your symptoms. Your doctor will give a CFS diagnosis if the persistent debilitating fatigue continues beyond six months.

It is worth noting what a blood test can and cannot do. When you test a sample of blood in a lab, you are basically asking a question. Is a specific marker (substance) present, or absent? Or possibly, how much of this marker is present or absent?

That answer is then linked to a diagnosis. For example, if a doctor suspected a patient’s symptoms were caused by a mal-functioning thyroid, the blood test would start by checking the levels of specific thyroid hormones. In this instance, we are looking at a clear issue (thyroid gland) that has clear markers (related hormone levels).

(Aside: for anyone who is suffering from thyroid disease, I am aware that the testing and treatment for this disease is imperfect and creates its own specific set of problems. So, I do not mean to suggest that is a perfect system).

But, at this point, there is no consensus on a single system, or organ, laying at the root of Chronic Fatigue Syndrome. So, it has not (yet) been possible to pinpoint a single biomarker to test and give a diagnosis.

That may change in time, with further research. In fact, this blog post explaining the link between CFS and mitochondria might be key. I worked with two separate Functional Medicine clinics who were both able to test certain markers related to my Mitochondria. Those tests revealed reduced function and provided clear evidence of a specific physical issue that I was then able to set about resolving. Again, this is something to which I will return.

What is the treatment for CFS?

Without being able to identify the source of the symptoms, conventional medicine is not able to provide a treatment.

There may be some pharmaceutical drugs that can be used to suppress some symptoms in order to make life more tolerable.

Your doctor may offer Cognitive Behavioural Therapy. This acknowledges that stress plays a role in the illness. But it is also about developing strategies to cope with living with CFS.

Prior to 2021, Graded Exercise Therapy (GET) was also recommended. Unfortunately, that caused many patients to experience worsening symptoms, rather than improvement. So, the list of recommended treatments no longer includes GET. (And I will add a blog post to explain why, so you might want to join my mailing list if you’re keen to hear when that is available).

Functional Medicine Perspective

So, that brings me neatly to ask the question: What is Chronic Fatigue Syndrome from a functional medicine perspective?

What is functional medicine?

In order to explain the difference in perspective between conventional and functional medicine, let me take you back to that thyroid example I gave above.

A conventional doctor would be checking whether a thyroid hormone (e.g., TSH) falls within a specific range. The doctor will only diagnose a thyroid condition if the TSH level falls outside the desired range. A diagnosis of a thyroid condition will likely be treated by prescribing appropriate (synthetic) thyroid hormones. A patient may be presenting with a range of symptoms that correspond to a thyroid condition, but the diagnosis and treatment will only be given if the TSH level falls outside the expected ‘normal’ range. Even though the patient might still struggle with symptoms.

A functional medicine test would still check the level of TSH in the blood. But rather than asking if the level is within a range, it would ask, what is the level? It would also consider the patient’s symptoms. So, the TSH could be sitting within the ‘normal’ range, but very near the edge of the range. When combined with the symptoms, this could lead to an acknowledgement that there is a problem.

However, it may not be appropriate to simply administer a thyroid hormone. It may be necessary to investigate further and look at other systems related to the thyroid. These investigations might reveal something like (for example) an abnormal level of a vitamin or mineral linked to the body’s ability to produce or absorb one of the thyroid hormones. So, treatment would involve correcting the level of that vitamin/mineral and allowing the body to then self-correct.

In other words, the body can (theoretically) maintain optimal health if it is supported by an optimal environment.

What is Chronic Fatigue Syndrome in this model?

Looked at in this way, CFS is a malfunction across a number of different systems within the body. Those malfunctions produce a set of symptoms. And the variation in symptoms can be explained by the degree to which an individual’s systems are malfunctioning. Or perhaps by which systems are malfunctioning.

Underlying all of this would be the body’s energy production system – the Mitochondria. (I explore that in detail in this blog post). This system provides every single cell with the energy it requires to carry out its tasks.

So, if the mitochondria are not functioning optimally, each cell in the body will have restricted access to fuel (energy). With limited resources, it’s ability to function is going to decrease. So, for example, the liver may not be eradicating as many toxins as it should. The digestive system may not be absorbing nutrients from food correctly. The Central Nervous System may be ‘overstimulated’ so that it has a dysregulated reaction to everyday stress. Any of these issues would cause fatigue, along with a specific symptom (or set of symptoms).

Basically, the body is complex. Systems are inter-related. So, when one system becomes imbalanced or dysregulated, it affects a host of other systems.

The body is naturally set up with ‘safety mechanisms’ to try and bring us back into balance. A certain degree of dysregulation is normal and the body can cope with that. But when it becomes overwhelming – either across too many systems (to a minor degree) or in fewer systems (to a major degree), the result is CFS. (Or possibly other health conditions – this principle applies more broadly too).

How does functional medicine treat CFS?

Broadly, by going back to the roots of what creates a healthy body. The theory is, if you can put the body in a supportive environment, it will naturally heal itself. And, as long as its environment remains supportive, the body will remain healthy.

Again, I will go into the science behind this theory in other places.

How does that look in terms of actual treatment?

You will be altering your lifestyle habits. That could be changing your diet, using supplements, reducing your exposure to toxins, resetting your circadian rhythm. Basically, creating a supportive environment for yourself.

Does this work? In my experience – and the experience of many others – yes. But it is not a guarantee of a complete cure. For some people, it does bring about a return to normal life. For others it creates a significant improvement in symptoms and energy levels.

So, it is not a magic bullet. And it does take effort to put in place and maintain. Although that ‘effort’ becomes surprisingly easy when you start to see major improvements.

This type of treatment relies on you taking responsibility for your health, rather than waiting for someone else to come along and give you a magic pill.

Some of you will find that idea empowering. Some will find it terrifying, or simply too difficult to follow. And, for those of you who feel like this is too difficult, that doesn’t mean you’re a failure – there is actually a very good reason for feeling that way.

The simple answer to the question: what is Chronic Fatigue Syndrome?

Taking into account all the science and also how this feels, I like to think of CFS as a simple equation. Rather like a bank account. Your body’s energy usage is greater than its energy supply.

That can be because you are not getting enough of the raw materials to make energy. (For example, poor diet, poor quality sleep, and various other factors).

Or, it can be because something is blocking the energy from getting to where it needs to go. (For example, impaired digestive function preventing the body from absorbing all the nutrients it is receiving).

Then again, it can be because your body’s demands are excessive. (For example, your immune system is constantly fighting a lingering infection, or even attacking your body’s own cells).

Let’s bring back the bank account analogy. If your bank account had become overdrawn, you would have a choice: earn more money, or spend less money.

In order to save money, you have two options: buy fewer things. Or, buy the same number of ‘things’, but at a lower price.

So, you can translate this directly into your body. How can you get more energy from your environment? Or use less energy in your body? (You are probably doing this instinctively by taking the forced rest that CFS demands). Or, is there a way to use your existing energy more efficiently?

The happy news is that there are answers to all of those options. So, that is what we will be exploring on the Find My Energy website. You are welcome to click here and explore on your own.

Or, if you would like to see how I managed to solve all those issues, follow this link.