Last updated 2005 October 21
The following is intended to be a succinct list of proposed causes of chronic fatigue (and Chronic Fatigue Syndrome) along with corresponding treatments. It is meant to help patients who need to enumerate the possible causes of their illness. Each entry in the list contains the following information:
Proposed cause: A terse but convenient description of the supposed source of chronic fatigue (or the supposed source of indicated symptoms). The list is sorted by this field.
Typical history or symptoms: To help patients determine if this entry might apply to them.
Diagnostic test: To confirm presence of the condition. Sometimes unavailable.
Treatment: Might only relieve symptoms, as opposed to treating the underlying cause of illness. Sometimes unavailable.
Reference: Where more details about this theory can be found. Not necessarily the first, latest, or best document available.
Notes: Additional information.
Either diagnostic test or treatment must be available for inclusion in this list, otherwise the proposed cause is considered too theoretical for practical consideration by patients. Do not assume symptoms, diagnostic test, and treatment are accurate (or that diagnostic test and treatment are reliable) without consulting the listed reference and any notes. Note that it is often unclear when a given condition is actually a cause or a symptom. Much of the information listed here is controversial and unconfirmed. Separate theories might actually be manifestations of a single, undiscovered cause. This list is not medical advice; it is a compilation of reports and resources. If you're sick, consult a doctor.
This list undoubtedly contains errors and omissions. Send your corrections, additions, improvements or comments to help@semaphorecorp.com
Proposed cause: adrenal under-stimulation
Typical history or symptoms: altered adrenal gland size
Diagnostic test: adrenocorticotropin (ACTH) stimulation, computer tomography (CT)
Treatment:
Reference: Psychoneuroendocrinology 1999 Oct 24(7):759-68, Small adrenal glands in chronic fatigue syndrome: a preliminary computer tomography study. Scott L V, Teh J, Reznek R, Martin A, Sohaib A, Dinan T G [8 patients tested]
Proposed cause: albumin deficiency
Typical history or symptoms: liver disease, inflammation, malabsorption, malnutrition, renal disease
Diagnostic test: albumin in plasma
Treatment:
Reference: The Liver Disorders Sourcebook, H J Worman, Lowell House ISBN 0737300906
Notes: liverfoundation.org
Proposed cause: antibiotics overdose
Typical history or symptoms: ailments treated with excessive antibiotics, resulting in immune system suppression
Diagnostic test:
Treatment: less aggressive use of antibiotics
Reference:
Notes: anecdotal report from Kirsten Svare
Proposed cause: asparagine
Typical history or symptoms: chronic fatigue
Diagnostic test: urinalysis
Treatment:
Reference: Biochemical Abnormalities in Chronic Fatigue Syndrome, P C Bligh, S Niblett, L Hoskin, R H Dunstan, G Fulcher, N McGregor, J Dunsmore, T K Roberts, H L Butt, K King, I Klineberg, 1999 Sydney ME/CFS Conference
Proposed cause: brain hyperintensities
Typical history or symptoms: cognitive impairment
Diagnostic test: MRI
Treatment:
Reference: J Neurol Sci 1 1999 Dec 1 171(1):3-7, Brain MRI abnormalities exist in a subset of patients with chronic fatigue syndrome, Lange G, DeLuca J, Maldjian J A, Lee H, Tiersky L A, Natelson B H
Proposed cause: carbon monoxide
Typical history or symptoms: headache, chronic fatigue
Diagnostic test: breath
Treatment: oxygen
Reference: Amitai Y, Zlotogorsk Z, Golan-Katzav V, Wexler A, Gross D; Neuropsychological impairment from acute low-level exposure to carbon monoxide. Arch Neurol 1998 55:845-848
Notes: mcsrr.org (link failed when tested 4/16/2002)
Proposed cause: carnitine deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: blood
Treatment: carnitine supplementation
Proposed cause: chiari malformation
Typical history or symptoms: headache, vision changes, dizziness, weakness, numbness and tingling, chronic fatigue, tinnitis, speech impairment, hearing loss, irritable bowel syndrome, frequent urination, difficulty swallowing
Diagnostic test: MRI scan
Treatment: surgery
Reference: Can Spinal Cord Compression Cause the Fibromyalgia Syndrome? D S Heffez et al, Abstracts from the National Fibromyalgia Research Foundation Conference in Portland Oregon, September 26-27, 1999
Notes: chiari.com Also see "Proposed cause: spinal cord compression" below
Proposed cause: cirrhosis of the liver
Typical history or symptoms: chronic fatigue, jaundice
Diagnostic test: globulin
Treatment:
Reference: The Liver Disorders Sourcebook, H J Worman, Lowell House ISBN 0737300906
Notes: liverfoundation.org
Proposed cause: corticotopin-releasing hormone (CRH) deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: ovine CRH (oCRH) and desmopressin (DDAVP)
Treatment:
Reference: Biol Psychiatry 1999 Jun 1 45(11):1447-54, Desmopressin augments pituitary-adrenal responsivity to corticotropin-releasing hormone in subjects with chronic fatigue syndrome and in healthy volunteers. Scott L V, Medbak S, Dinan T G
Proposed cause: coxiella burnetii (Q fever)
Typical history or symptoms: chronic fatigue
Diagnostic test: ELISA
Treatment: antibiotics
Reference: Prevalence of Coxiella burnetii in Chronic Fatigue Syndrome, B Liedtke, B Paspaliaris, 1999 Sydney ME/CFS Conference
Proposed cause: cytokines
Typical history or symptoms: severe fatigue, muscle pain, headache, lymphodynia
Diagnostic test:
Treatment: etanercept (tumor necrosis factor blocker)
Reference: CFS-NEWS 100 2/28/2001
Proposed cause: cytokine response imbalance
Typical history or symptoms: severe fatigue
Diagnostic test:
Treatment: lymph node removal and radiation
Reference: CFS-NEWS 100 2/28/2001
Proposed cause: dehydration
Typical history or symptoms: vomiting, diarrhea, Addison's disease, diabetic acidosis
Diagnostic test: total protein concentration in plasma
Treatment:
Reference:
Proposed cause: dehydroepiandrosterone sulfate (DHEA-S) deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: adrenal hormone levels
Treatment:
Reference: Int J Mol Med 1998 Jan 1(1):143-6, Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Kuratsune H, Yamaguti K, Sawada M, Kodate S, Machii T, Kanakura Y, Kitani T
Notes: 1995 proposal. Also see "Proposed cause: glucocorticoid deficiency", "Proposed cause: HPA-axis dysfunction"
Proposed cause: diabetes mellitus
Typical history or symptoms: chronic fatigue
Diagnostic test: elevated blood glucose
Treatment:
Reference: Int J Mol Med 1998 Jan 1(1):143-6, Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Kuratsune H, Yamaguti K, Sawada M, Kodate S, Machii T, Kanakura Y, Kitani T
Proposed cause: enterovirus
Typical history or symptoms: chronic fatigue
Diagnostic test: muscle biopsy, PCR
Treatment:
Reference: Clin Infect Dis 1994 Jan 18 Suppl 1:S126-9, Studies on enterovirus in patients with chronic fatigue syndrome. Gow J W, Behan W M, Simpson K, McGarry F, Keir S, Behan P O
Notes: In contrast to a previous smaller study, the above reference concludes "that it is unlikely that persistent enterovirus infection plays a pathogenetic role in CFS, although an effect in initiating the disease process cannot be excluded."
Proposed cause: enzyme deficiencies
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: diet, vitamin B2
Reference: Medical Hypotheses 54:5 853-854, Chronic fatigue syndrome: A matter of enzyme deficiencies?, W J van der Steen
Proposed cause: Epstein-Barr virus
Typical history or symptoms: mononucleosis
Diagnostic test: blood
Treatment:
Reference: Straus S E, Tosato G, Armstrong G, Lawley T, et al. Persisting illness and fatigue in adults with evidence of Epstein-Barr infection. Ann Intern Med 1985 102:7-16
Notes: Disputed as a requirement for CFS since subsequent studies showed some patients have had no exposure to Epstein-Barr. See [1] Buchwald D, Sullivan J L, Komaroff A L. Frequency of "chronic active Epstein-Barr" virus infection in a general medical practise. JAMA 1987 257:2303-7.
[2] Holmes G P, Kaplan J E, Stewart J A, et al. A cluster of patients with a chronic mononucleosis-like syndrome. JAMA 1987 257:2297-302
Proposed cause: fibromyalgia/phosphate reabsorption
Typical history or symptoms: hard lumps or lesions in muscles, pain in muscles
Diagnostic test: "mapping" of hard lesions
Treatment: guaifenesin, salicylate avoidance, low carbohydrate diet
Reference: "What Your Doctor May Not Tell You About Fibromyalgia: The Revolutionary Treatment That Can Reverse The Disease", R P St Amand, C C Marek, ISBN 0446675121
Proposed cause: folic acid deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: serum folate levels
Treatment:
Reference: Neurology 1993 Dec 43(12):2645-7, Serum folate and chronic fatigue syndrome, Jacobson W, Saich T, Borysiewicz L K, Behan W M, Behan P O, Wreghitt T G
Proposed cause: gastro-intestinal dysfunction
Typical history or symptoms: chronic fatigue
Diagnostic test: stool analysis, intestinal permeability
Treatment: elimination diets
Reference: CFS-NEWS 102 3/2/01
Notes: gsdl.com (CDSA) gsdl.com (IP)
Proposed cause: genetic mutation
Typical history or symptoms: chronic fatigue, worst in morning
Diagnostic test: low cortisol binding globulin
Treatment:
Reference: CFS-NEWS 99 11/30/2000
Proposed cause: genetic predisposition
Typical history or symptoms: chronic fatigue
Diagnostic test: mannose-binding protein
Treatment:
Reference: CFS-NEWS 101 3/1/01
Proposed cause: glucocorticoid deficiency
Typical history or symptoms: low cortisol levels
Diagnostic test: adreno-corticotropic hormone (ACTH) stimulation
Treatment:
Reference: Horm Metab Res 1999 Jan 31(1):18-21, Dehydroepiandrosterone (DHEA) response to iv ACTH in patients with chronic fatigue syndrome. De Becker P, De Meirleir K, Joos E, Campine I, Van Steenberge E, Smitz J, Velkeniers B
Notes: Also see "Proposed cause: DHEA-S deficiency", "Proposed cause: HPA-axis dysfunction"
Proposed cause: growth hormone deficiency
Typical history or symptoms: low growth hormone secretion
Diagnostic test: insulin-induced hypoglycemia
Treatment: growth hormone
Reference: Berwaerts J, Moorkens G, Abs R. Secretion of growth hormone in patients with chronic fatigue syndrome. Growth Horm IGF Res 1998 Apr 8 Suppl B:127-9.
Reference: Moorkens G, Berwaerts J, Wynants H, Abs R. Characterization of pituitary function with emphasis on GH secretion in the chronic fatigue syndrome. Clin Endocrinol (Oxf) 2000 Jul 53(1):99-106
Proposed cause: heart virus
Typical history or symptoms: cardiomyopathy
Diagnostic test: ECG, biopsy
Treatment: antivirals
Reference: Dworkin H J, Lawrie C, Bohdiewicz P, Lerner A M, Abnormal left ventricular myocardial dynamics in eleven patients with chronic fatigue syndrome, Clin Nucl Med 1994 Aug 19(8):675-7
Proposed cause: hemochromatosis
Typical history or symptoms: arthralgia, chronic fatigue
Diagnostic test: serum iron levels, total iron binding capacity (TIBC)
Treatment: phlebotomy
Reference: Edwards C Q, Kushner J P. Screening for hemochromatosis. N Engl J Med 1993 328:1616-20
Notes: irondisorders.org
Proposed cause: HHV-6
Typical history or symptoms: chronic fatigue
Diagnostic test: blood
Treatment: antivirals
Reference: Buchwald D; Komaroff A; Cheney P; et al.; "A chronic illness characterized by fatigue, neurologic and immunologic disorders and HHV-6 infection". Ann Int Med 116:103-112 Jan 1992
Notes: viracor.com
Proposed cause: hypercitricemia
Typical history or symptoms: chronic fatigue
Diagnostic test: urinalysis
Treatment:
Reference: Hypercitricemia in Chronic Fatigue Syndrome, A Young, 1999 Sydney ME/CFS Conference
Proposed cause: hypercoagulability
Typical history or symptoms: genetic defect in proteins, fibrin in capillaries
Diagnostic test: immune system activation of coagulation (ISAC) panel
Treatment: heparin, bromelain
Reference: D Berg, L H Berg, J Couveras, H Harrison, "Chronic Fatigue Syndrome and/or Fibromyalgia as a Variation of Antiphospholipid Antibody Syndrome (APS): An Explanatory Model and Approach to Laboratory Diagnosis", Blood Coagulation and Fibrinolysis 10, 435-38 (1999)
Notes: hemex.com
Proposed cause: hyperparathyroidism
Typical history or symptoms: abnormal calcium levels
Diagnostic test: parathyroid hormone (PTH)
Treatment:
Reference:
Notes: Also see "Proposed cause: hyperthyroidism"
Proposed cause: hyperthyroidism
Typical history or symptoms: chronic fatigue
Diagnostic test: thyroid stimulating hormone (TSH)
Treatment:
Reference:
Notes: Also see "Proposed cause: hyperparathyroidism"
Proposed cause: hypothalamic-pituitary-adrenal axis (HPA-axis) dysfunction
Typical history or symptoms: chronic fatigue
Diagnostic test: cortisol and serotonin levels
Treatment:
Reference: Demitrack M, Dale J, Straus S, et al. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab 73:1224:1234
Notes: Also see "Proposed cause: DHEA-s deficiency", "Proposed cause: glucocorticoid deficiency"
Proposed cause: inflammation
Typical history or symptoms: chronic fatigue
Diagnostic test: erythrocyte sedimentation rate (ESR)
Treatment:
Reference:
Proposed cause: Krebs cycle functional blocks
Typical history or symptoms: chronic fatigue
Diagnostic test: hhv6, cellular energy
Treatment: antivirals
Reference: America Exhausted, E J Conley ISBN: 0-9652544-1-0
Notes: gsdl.com
Proposed cause: lactate excess
Typical history or symptoms: chronic fatigue
Diagnostic test: hand-held lactate analyzer
Treatment:
Reference: Hargreaves M, Finn J P, Withers R T, Halbert J A, Scroop G C, Mackay M, Snow R J, Carey M F. Effect of muscle glycogen availability on maximal exercise performance. Eur J Appl Physiol Occup Physiol 1997 75(2):188-92
Notes: fact-canada.bc.ca
Proposed cause: liver/bile duct disorders
Typical history or symptoms: chronic fatigue, jaundice
Diagnostic test: alkaline phosphatase (ALP), ruine bilirubin
Treatment:
Reference: The Liver Disorders Sourcebook, H J Worman, Lowell House ISBN 0737300906
Notes: liverfoundation.org
Proposed cause: liver disease/viral hepatitis
Typical history or symptoms: chronic fatigue, jaundice
Diagnostic test: alanine aminotransferase (ALT)
Treatment:
Reference: The Liver Disorders Sourcebook, H J Worman, Lowell House ISBN 0737300906
Notes: liverfoundation.org
Proposed cause: low blood volume
Typical history or symptoms: orthostatic intolerance
Diagnostic test: blood pressure and pulse while sitting/standing
Treatment: same as neurally mediated hypotension?
Reference: Am J Med Sci 2000 Jul 320(1):1-8, The roles of orthostatic hypotension, orthostatic tachycardia, and subnormal erythrocyte volume in the pathogenesis of the chronic fatigue syndrome, Streeten D H, Thomas D, Bell D S
Notes: Also see Midodrine treatment for adolescents in CFS-NEWS 102 3/2/01
Proposed cause: lupus
Typical history or symptoms: chronic fatigue
Diagnostic test: blood cell abnormalities, autoimmunity, kidney disease
Treatment: nonsteroidal anti-inflammatories, antimalarials, corticosteroids, immunosuppressives
Reference: Von Feldt J M. Systemic lupus erythematosus: recognizing its various presentations, Postgraduate Medicine 1995 97(4):79-94
Reference: Taylor J, Skan J, Erb N, Carruthers D, Bowman S, Gordon C, Isenberg D. Lupus patients with fatigue-is there a link with fibromyalgia syndrome? Rheumatology (Oxford) 2000 Jun 39(6):620-623
Notes: lupus.org
Proposed cause: Lyme disease
Typical history or symptoms: tick bite
Diagnostic test: Borreliacidal antibody, ELISA, Western Blot
Treatment: antibiotics
Reference: Dennis D T. Epidemiology, ecology, and prevention of Lyme disease. Rahn D W, Evans J eds. Lyme disease. Philadelphia, PA: American College of Physicians 1998 7-34
Reference: Burrascano J J, The overdiagnosis of Lyme disease, JAMA 1993 Dec 8 270(22):2682
Notes: lymenet.org
Proposed cause: magnesium deficiency plus fluoride excess
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: See part II of the Reference
Reference: A Nutrient/Toxin Interaction Theory of the Etiology and Pathogenesis of Chronic Pain-Fatigue Syndromes, J A Laylander, Journal of Chronic Fatigue Syndrome 5:1 1999
Proposed cause: mercury
Typical history or symptoms: dental fillings
Diagnostic test: blood/urine/hair
Treatment: chelation therapy, removal of fillings
Reference: Bergman B, Bostrom H, Larsson K S, Loe H. Potential Biological Consequences of Mercury Released from Dental Amalgam. State of the Art Conference in Stockholm 9-10 April 1992 ISBN 91 85546 77 1
Reference: Lorscheider F L, Vimy M J, Summers A O, Mercury exposure from "silver" tooth fillings: emerging evidence questions a traditional dental paradigm, FASEB J 9:504-508 1995
Notes: quackwatch.com (chelation)
Proposed cause: metabolic immunodepression
Typical history or symptoms: chronic fatigue
Diagnostic test: hhv6
Treatment: diet
Reference: The Downhill Syndrome, P Yutsis, M Walker ISBN: 0-89529-758-2
Proposed cause: mitochondrial dysfunction
Typical history or symptoms: chronic fatigue
Diagnostic test: muscle biopsy
Treatment:
Reference: Clin Sci (Colch) 1999 Nov 97(5):603-8 McKully K K, Natelson H
Reference: Behan W M, More I A, Behan P O. Mitochondrial abnormalities in the postviral fatigue syndrome. Acta Neuropathol (Berl) 1991 83(1):61-5
Notes: umdf.org
Proposed cause: mold
Typical history or symptoms: chronic fatigue
Diagnostic test: microscopic examination
Treatment: mold removal, ozone generators
Reference:
Notes: moldlab.com sonozaire.com
Proposed cause: multiple chemical sensitivity/allergies
Typical history or symptoms: allergic reactions
Diagnostic test: exposure
Treatment: avoidance
Reference: Buchwald D, Garrity D. Comparison of patients with chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities. Arch Intern Med 154:2049-2053 1994
Notes: mcsrr.org (link failed when tested 4/16/2002)
Proposed cause: mycoplasma
Typical history or symptoms: chronic fatigue
Diagnostic test: PCR
Treatment: antibiotics
Reference: Identification and treatment of Chronic Infections in Cfids, Fibromyalgia and Rheumatoid Arthritis, G L Nicolson, CFIDS Chronicle 1999 12(3):19-21
Proposed cause: nanobacteria
Typical history or symptoms: calcification deposits
Diagnostic test: nanobacTEST
Treatment: NanobacTX/UroBac
Reference: Vainshtein M, Kudriashova E. Nanobacteria. Mikrobiologiia 69(2):163-74 2000.
Notes: nanobaclabs.com
Proposed cause: neurally mediated hypotension
Typical history or symptoms: hypotension, syncope
Diagnostic test: tilt table
Treatment: florinef, sodium
Reference: Rowe P C, Bou-Holaigah I, Kan J S, Calkins H, "Is neurally mediated hypotension an unrecognized cause of chronic fatigue", Lancet 1995 345:623-4
Proposed cause: neuroendocrine-immune communication deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: glucocorticoid agonist dexamethasone sensitivity
Treatment:
Reference: Journal of Clinical Endocrinology & Metabolism 85:692-696 2000, Disturbed Neuroendocrine-Immune Interactions in Chronic Fatigue Syndrome, A Kavelaars, W Kuis, L Knook, G Sinnema, C J Heijnen
Proposed cause: neurological dysfunction
Typical history or symptoms: chronic fatigue
Diagnostic test: physical exam
Treatment: "immersion" drug trials
Reference: Goldstein J A, Sandman C, Hetrick W, van der Wal E, "Decreased event-related potential N-100: A possible neurologic marker for CFS impairment" Journal of Musculoskeletal Pain 3 Suppl 1:115 1995
Notes: drjgoldstein.com
Proposed cause: nitric oxide
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: glutathione, vitamin C
Reference:
Notes: usp.co.za (link failed when tested 4/16/2002)
Proposed cause: nutritional deficiencies
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: glyconutritional products, phytogenins
Reference: Altern Med Rev 2000 Apr 5(2):93-108, Nutritional strategies for treating chronic fatigue syndrome, Werbach M R
Reference: CFS-NEWS 102 3/2/01
Proposed cause: obesity
Typical history or symptoms: chronic fatigue
Diagnostic test: [weight in kilograms/(height in meters, squared)] equal or greater than 45
Treatment: weight reduction
Reference: Bray G A. Pathophysiology of obesity. Am J Clin Nutr 1992 55(2 Suppl):488S-94S
Proposed cause: oxidative molecular injury
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: antioxidant vitamins and minerals, hydrogen peroxide
Reference: The canary and chronic fatigue, Ali M, 1994 ISBN 1879131048
Notes: majidalimd.com
Proposed cause: oxidative stress from excess free radicals
Typical history or symptoms: chronic fatigue
Diagnostic test: methaemoglobin level
Treatment:
Reference: Richards R S, Roberts T K, McGregor N R, Dunstan R H, Butt H L. Blood parameters indicative of oxidative stress are associated with symptom expression in chronic fatigue syndrome. Redox Rep 2000 5(1):35-41
Proposed cause: pancreatic disease
Typical history or symptoms: chronic fatigue
Diagnostic test: amylase
Treatment:
Reference:
Proposed cause: perforin deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: cytotoxicity, IgG, cytokines, delayed hypersensitivity
Treatment:
Reference: CFS-NEWS 100 2/28/2001
Proposed cause: peroxynitrite excess
Typical history or symptoms: viral or bacterial infection
Diagnostic test:
Treatment: multiple pharmacological approaches
Reference: M Pall, Medical Hypotheses [ISSN 0306-9877] 2000 Jan 54(1):115-25
Proposed cause: pesticides
Typical history or symptoms: prior exposure
Diagnostic test: organochlorines, organophosphates
Treatment: choline and ascorbic acid mixture
Reference: Journal of Chronic Fatigue Syndrome, 2000 6(2):11-21, J Richardson
Reference: The Medical Journal of Australia 9/18/1995 163:294-297 R H Dunstan, M Donohoe et al
Proposed cause: physical trauma
Typical history or symptoms: onset of fibromyalgia
Diagnostic test: see "fibromyalgia"
Treatment:
Reference:
Notes: anecdotal report from Kirsten Svare
Proposed cause: post-polio syndrome
Typical history or symptoms: chronic fatigue
Diagnostic test: elimination of other causes
Treatment: human growth hormone (Humatrope), bromocriptine mesylate (Parlodel), recombinant human insulin-like growth factor I (rhIGF-1)
Reference: Jubelt B, Agre J C, Characteristics and management of postpolio syndrome JAMA 2000 Jul 26 284(4):412-4
Reference: Bruno R L, Creange S J, Frick N, Parallels between post-polio fatigue and chronic fatigue syndrome: a common pathophysiology? Am J Med 1998 Sep 28 105(3A):66S-73S
Notes: post-polio.org
Notes: A reader reports he found a daily mix of 30g d-ribose,
6g L-carnitine fumerate, 600mg CoQ10, 1mg methyl (not cyano) B12, and 1g vitamin C significantly reduced his symptoms
Proposed cause: potassium deficiency
Typical history or symptoms: chronic fatigue
Diagnostic test: blood
Treatment:
Reference: Serum Potassium and Hormone Responses to Exercises in Chronic Fatigue Syndrome, R Burnet, G Scroop, B Chatterton, B Yeap, 1999 Sydney ME/CFS Conference
Proposed cause: psychiatric
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: doxepin (psychotropic antidepressant; for symptoms only)
Reference: Prim Care 1991 Jun 18(2):397-419 Chronic fatigue and depression in the ambulatory patient. Gorensek M J
Proposed cause: red blood cell morphology
Typical history or symptoms: impaired capillary blood flow
Diagnostic test: blood
Treatment: primrose oil, salmon oil, ginkgo biloba
Reference: Journal of Orthomolecular Medicine 12(2) 1997
Notes: 4biz.net (link failed when tested 4/16/2002)
Proposed cause: reduced glutathione depletion
Typical history or symptoms: infections, physical trauma, surgery, lack of sufficient sleep over a long period, excessive physical exertion, emotional stress, exposure to toxins or oxidants, excessive use of alcohol, excessive use of drugs
Diagnostic test: heavy metals, citrate and lipid peroxides, alpha ketoglutarate
Treatment: eggs and dairy products; orally supplemented nondenatured whey protein concentrates
Reference: G Bounous, J Molson, "Competition for Glutathione Precursors between the Immune System and the Skeletal Muscle: Pathogenesis of Chronic Fatigue Syndrome", Med Hypotheses 53, 347-49 (1999)
Proposed cause: renal disease
Typical history or symptoms: chronic fatigue
Diagnostic test: blood urea nitrogen (BUN), creatinine
Treatment:
Reference:
Proposed cause: rickettsia
Typical history or symptoms: chronic fatigue
Diagnostic test: micro-agglutination
Treatment: long term rotating antibiotics
Reference: Rickettsial Approach in Treatment of Patients for CFS, Firbromyalgia, Rheumatoid Arthritis, Neurological Dysfunction; C L Jadin, 1999 Sydney ME/CFS Conference
Proposed cause: roundworm (nematode)
Typical history or symptoms: chronic fatigue
Diagnostic test: sputum
Treatment:
Reference: L Klapow, Roundworm (nematode) like specimens in the sputum of CFS patients in an analysis with blood controls, 4th Intl AACFS Conference, October 10-12, 1998
Proposed cause: sleep apnea
Typical history or symptoms: chronic fatigue
Diagnostic test: intermittent breathing during sleep
Treatment: weight reduction, surgery, continuous positive
airway pressure mask
Reference: Med Hypotheses 2000 May 54(5):734-8, Chemical sensitivity and fatigue syndromes from hypoxia/hypercapnia, Ross P M
Proposed cause: somatization
Typical history or symptoms: chronic fatigue
Diagnostic test: psychiatry
Treatment: increasing exercise
Reference: "Chronic Fatigue and its Syndromes", S Wessely, M Hotopf, M Sharp, ISBN 0-19-262181-5
Proposed cause: spinal cord compression
Typical history or symptoms: chronic fatigue
Diagnostic test: x-rays
Treatment: chiropractic realignment of vertebrae
Reference:
Notes: nucca.org Also see "Proposed cause: chiari malformation" above
Proposed cause: stealth virus
Typical history or symptoms: chronic fatigue
Diagnostic test: specialized blood cultures
Treatment: chemokines
Reference: W J Martin, African Green Monkey Origin of the Cytopathic 'Stealth Virus' Isolated from a Patient with Chronic Fatigue Syndrome, Clinical and Diagnostic Virology, Elsevier Science BV 1995 4:2 93-103
Notes: ccid.org
Proposed cause: substance abuse
Typical history or symptoms: chronic fatigue
Diagnostic test:
Treatment: abstinence
Reference:
Proposed cause: thyroid hormone deficiency
Typical history or symptoms: low body temperature
Diagnostic test: thermometer
Treatment: triiodothyronine (T3)
Reference: Barsky A J, Borus J F. Functional somatic syndromes. Ann Intern Med 1999 130:910-21
Notes: quackwatch.com wilsonssyndrome.com
Proposed cause: trans-fatty acids
Typical history or symptoms: altered connective tissue turnover
Diagnostic test: vision
Treatment: diet
Reference: CFS-NEWS 101 3/1/01
Proposed cause: tumors
Typical history or symptoms: chronic fatigue
Diagnostic test: tumor necrosis factor (TNF)
Treatment:
Reference:
Notes: MGN-3 can cause postive TNF tests. See Ghoneum M, Anti-HIV activity in vitro of MGN-3, an activated arabinoxylane from rice bran. Biochem Biophys Res Commun 1998 Feb 243:1 25-9
Proposed cause: 2-5A synthetase/RNase L pathway
Typical history or symptoms: chronic fatigue
Diagnostic test: blood
Treatment: ampligen
Reference: Biochemical Dysregulation of the 2-5A Synthetase/RNase L Antiviral Defense Pathway in Chronic Fatigue Syndrome, R J Suhadolnik, D L Peterson, P R Cheney, et al, Journal of Chronic Fatigue Syndrome ISSN 1057-3321 1999:5:3/4 223-242