What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis, or ME, has such strange physical manifestations—everything from severe and unexplained physical and mental fatigue to memory loss, nervous system problems and even flu-like symptoms—that some scientists go as far as to label it the twenty-first century polio.

For a swathe of the medical profession, what can’t be explained is often dismissed as psychological, and in the case of chronic fatigue, it’s been disparaged as all in the sufferer’s head, with an antidepressant and some talking therapy the usual prescription.

This view became more entrenched with the publication, in 2011, of the influential PACE study—the largest treatment trial of CFS ever attempted. It was largely orchestrated by researchers who’d already published articles concluding that after some sort of viral trigger, patients with CFS develop “unhelpful beliefs” that prevent them from resuming a normal life.

The study’s conclusion was that patients needed talking therapy like cognitive behavioral therapy (CBT) to get rid of these limiting beliefs, and then to launch into a graded exercise program to help them to overcome their “fear avoidance” of physical exercise.

After the study’s publication, the UK press started haranguing CFS sufferers to get out of bed and into the gym, and the US Centers for Disease Control and Prevention (CDC) recommended that CBT should be adopted as the standard treatment for CFS.

Not surprisingly, the study provoked a great outcry from CFS sufferers and researchers alike. Although the PACE team resisted, eventually a team of researchers got access to the original data. After reviewing it, they concluded that the PACE team had inflated the benefits of CBT and exercise three-fold.

There’s no doubt that chronic fatigue causes massive physical symptoms right down to the cellular level. WDDTY panel member Dr Sarah Myhill, one of the UK’s experts who has successfully treated some 5,000 patients with chronic fatigue, has amassed an abundance of scientific and clinical evidence demonstrating that CFS is a disorder of the mitochondria, the tiny power packs that supply energy to every cell.

She and others have found that, often, the condition is indeed set off by one or more triggers, whether a bacteria or virus, some sort of biological or chemical insult, such as exposure to heavy metals, or even stress.

But in most instances, the ongoing problem mainly has to do with your gut, and the state of your digestion, where foods are fermented rather than digested.

Thanks to evidence from Cornell University researchers, who analyzed the gut bacteria and blood samples of patients with chronic fatigue, we now know that ME/CFS patients have an abnormal gut microbiome, leading to gastrointestinal and inflammatory symptoms.

Those with CFS have fewer types of gut bacteria than do healthy controls—with DNA signatures similar to patients suffering from Crohn’s disease and ulcerative colitis—and they’re likely to have a leaky gut, too. Dr Myhill finds that the most successful treatment involves a full package of dietary and lifestyle measures including supplements that repair the gut and power up the mitochondria. But there can be something more as the ultimate cause. Angela Johnson, for instance (see “How I beat CFS”), suffered from chronic fatigue from the time she was a senior in high school.

After all the usual recommendations of relaxation, exercise and antidepressants, she discovered tapping, or Emotional Freedom Technique (EFT). In the process of working with a therapist, she found that the main trigger had been chronic stress, and her path to wellness was “peeling the emotional layers” of fear, anxiety and other areas of emotional distress that had contributed to the stress and eventually the illness.

In the main, medicine fails to appreciate the intricate and multifactorial nature of illness and the power of emotion to exacerbate it. Despite the lip service paid to the “mind-body connection,” medical therapies seldom address the profound link between the mind and the body’s illness or healing.

Plenty of scientific evidence shows that levels of the immune system’s natural killer cells dip during even minor conflicts, along with dysfunction in the hypothalamus-pituitary-adrenal gland axis, which regulates stress hormones.

The fact that addressing these emotionally laden stresses got Angela well does not mean that CFS was “all in her head.” Her physical symptoms were genuine—as they are with virtually all sufferers.

But the solution to Angela’s condition ultimately lay in recognizing this connection and addressing the unfinished business in her emotional life.

American integrative practitioner Dr Leo Galland has long claimed that there are four pillars to healing. While diet, detox and environmental factors are important, relationships and community are the greatest triggers to health or wellness, and negative emotion are perhaps the body’s greatest virus—powerful enough to set off debilitating illness that is not, in any way, imaginary.

Once medicine finally appreciates this delicate interconnection, doctors may discover the way to finally help patients suffering from CFS—or indeed anything else—get better.