Infection and Chronic Fatigue

People with chronic fatigue syndrome (CFS) may have trouble explaining why they are exhausted or in pain. CFS is not a new disorder. In the 19th century the term neurasthenia, or nervous exhaustion, was applied to symptoms resembling CFS. From the 1930s through the 1950s, outbreaks of disease marked by prolonged fatigue were reported in the United States and many other countries. Beginning in the early to mid-1980s, interest in chronic fatigue syndrome was revived by reports in America and other countries of various outbreaks of long-term debilitating fatigue.

Unexplained chronic fatigue describes fatigue that lasts for more than 6 months, impairs normal activities, and has no identifiable medical or psychological problems to account for it. In addition to fatigue, people may complain of other problems, such as difficulty with memory or concentration, headaches, or sore muscles or joints.

Recent research has linked infection to CFS, which is medically known as myalgic encephalomyelitis (ME). This is due to the infection triggering an immune response in the body. Researchers at Columbia University conducted a study identifying changes in a person’s immune system that can lead to the disorder.

“This study delivers what has eluded us for so long: unequivocal evidence of immunological dysfunction in ME/CFS and diagnostic biomarkers for disease,” Dr. W. Ian Lipkin, director of the Center for Infection and Immunity and professor of neurology and pathology at Columbia’s Mailman School, said.  

The researchers found distinct biomarkers created by the immune system in those with CFS. They also found differences in those who have had the disease for less than three years and those who have had it more than three years. Those who had the disease for a shorter extent of time had higher amounts of different types of cytokines, or molecules that regulate your body’s defensive response to inflammation and infection.

Studies examining the microecology of the gastrointestinal (GI) tract have identified specific microorganisms whose presence appears related to disease.  In CFS, a role for altered intestinal microbiota in the pathogenesis of the disease has recently been suggested. Mucosal barrier dysfunction promoting bacterial translocation has also been observed. Finally, an altered mucosal immune system has been associated with the disease. Candida, Epstein Barr, and Lyme Disease have been linked to CFS, all of which alter the microbiota and mucosal barrier. 

The takeaway is this: if you are struggling with CFS, healing the gut by clearing any infections will be enormously helpful in your recovery. If you are displaying symptoms, ask to be tested for infections at your next appointment.