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Chronic Fatigue Syndrome: A Functional Medicine Guide

Feeling exhausted all the time, having a difficult time getting through the day, difficulty concentrating? You may be plagued with what has become known as chronic fatigue syndrome, a debilitating scenario, but one functional medicine can help with.

By far, one of the most common complaints that functional medicine patients walk through the door with is chronic fatigue. From young moms and middle aged women to working men, it does not seem to distinguish and can severely impact their day to day functioning and quality of life.

This guide will walk you through how functional medicine approaches chronic fatigue by addressing root causes, restoring your body and healing chronic fatigue from the inside out.

What is Chronic Fatigue?

Chronic Fatigue Syndrome is classified by extreme fatigue that reduces ones ability to perform activities of daily living for an extended period of time, regardless of bedrest and that has typically persisted for 6 months or more.

CFS or Chronic Fatigue Syndrome is known as myalgic encephalomyelitis or ME/CFS and is sometimes referred to as “adrenal fatigue”, though the two disorders are different. To address chronic fatigue, one must address adrenal fatigue and HPA axis dysfunction that is often associated with our hectic American way of life, the SAD (Standard American Diet) and lifestyle factors.

Adrenal fatigue is one of the latter stages of adrenal dysfunction and results in a reduction in cortisol production in the adrenals, whereas chronic fatigue syndrome can be present with or without an unhealthy balance of cortisol.

When looking at this from a functional medicine perspective, adrenal dysfunction and subsequent HPA axis dysfunction can contribute to chronic fatigue syndrome which now affects 836,000 to 2.5 million Americans, some so severely they cannot continue to work or have productive lives.

What Does Chronic Fatigue Feel Like?

  • Difficulty with energy first thing in the morning which continues through the afternoon with some energy kicking in in the evening.

  • Dizziness or lightheadedness

  • Inability to think clearly or make swift decisions

  • Memory issues

  • Lack of motivation

  • Loss of sex drive

  • Difficulty falling asleep and staying asleep

  • Hair thinning

  • Weight gain and inability to lose weight.

  • Anxiety, depression and moodiness

  • Chronic inflammation which can manifest as muscle and joint pain.

  • Chronically swollen lymph nodes

  • Blood sugar regulation problems which can lead to afternoon headaches.

  • Sugar and unhealthy food cravings

Symptoms will worsen with heightened exertion but unfortunately do not give the individual relief with rest alone. Chronic fatigue can be debilitating and extremely frustrating unless the underlying causes are adequately addressed.

Why Do Some Get Chronic Fatigue?

ME/CFS seems to be a bit of an enigma to the conventional medical community, however, like many illnesses, there are some underlying health weaknesses that can be related to the development of CFS. This is where functional medicine shines- in questioning and detecting root cause factors. These are some common areas we like to investigate when helping a patient with chronic fatigue.

History of viral infection. Sometimes ME/CFS develops after a viral infection, but not one virus in particular seems to be the culprit. Epstein-Barr virus (EBV), human herpesvirus 6, Ross River virus (RRV) and rubella virus have all been studied in relation fo CFS. In fact, 1 in 10 people with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that meets the criteria for a CFS diagnosis.

Mood disorders. Unaddressed mood disorders such as anxiety or depression negatively impact neurotransmitters, which are highly impactful to our ability to experience calm, happiness, pleasure, alertness and effective cognition. Functional medicine practitioners use neurotransmitter testing on patients to make sure the biochemical pathways that lead to optimal NT production are working optimally. Many times, the support needed for these pathways are simply vitamins like B’s, or minerals such as magnesium or molybdenum.

Poor gut health. From a functional medicine perspective, this area must be thoroughly investigated in cases of chronic fatigue. Researchers have found differences in the gut microbiomes of people with chronic fatigue syndrome (ME/CFS) compared to healthy controls. Findings from two studies, published in Cell Host & Microbe support the evidence that now connects one’s gut microbiome to ME/CFS.

“The microbiome has emerged as a potential contributor to ME/CFS. These findings provide unique insights into the role the microbiome plays in the disease and suggest that certain differences in gut microbes could serve as biomarkers for ME/CFS,” said Vicky Whittemore, Ph.D., program director at NIH’s National Institute of Neurological Disorders and Stroke (NINDS).

HPA Axis Imbalance. The common understanding is that chronic fatigue largely falls on the failure of the adrenal glands. This is not the case. The adrenals are one gland in a complex axis of glands and hormones and are actually directed by the hypothalamus and then the pituitary glands of the brain before a signal even reaches the adrenals! This is what we call the HPA axis (Hypothalamic-Pituitary-Adrenal). It refers to where all these glands meet and communicate.

  • When the HPA axis is off balance, this can cause improper signaling to the adrenal glands, resulting in over or under functioning of the adrenals and then cortisol, other adrenal hormones as well as thyroid function.

  • HPA axis dysfunction and subsequent adrenal and thyroid imbalances are frequently brought on by long-term stress, either emotionally or physically. If left unaddressed, this can be an underlying risk factor for CFS.

Thankfully, functional medicine practitioners have a large selection of HPA axis and adrenal function tests we can utilize to properly understand how your adrenals are working for you.

The Functional Medicine Approach to Healing From Chronic Fatigue

Functional medicine takes a whole-person approach to healing . This means we look at both the physical and emotional health. We don’t compartmentalize systems but appreciate and take into account how they are all interrelated.

1. Test, Don’t Guess

Guessing about what may be wrong is not effective medicine. We must test to know for sure and to develop an effective path to healing. Your functional medicine doctor will peel back the layers of your overall health through a series of state-of-the-art diagnostic tests. These test will likely include;

  • HPA axis function or adrenal stress tests

  • Neurotransimitter production and levels

  • Underlying infections

  • Methylation or detoxification channels

  • Condition of your gut microbiomes.

All patients are different, meaning no two patients will follow the same regimen for healing. The most common lifestyle changes prescribed to heal chronic fatigue are:

2. Nutritional Support

Nutritional support for healing of chronic fatigue will be guided by your test results and current eating habits but will need to include anti-inflammatory foods, gut-healing nutrients and nutrient-filled whole foods. These foods will include;

  • Cruciferous vegetables like broccoli, cauliflower and brussel sprouts

  • Green tea

  • Turmeric and other anti-inflammatory spices

  • Colorful vegetables and some fruits- ‘eat the rainbow!’

  • High quality fats like avocado, walnuts, coconut oil and flax seeds

  • Bone broth

  • Lean clean protein like grass fed beef, turkey, chicken and fish.

  • *Any targeted supplements your FM practitioner recommends for healing and repair. This may include B vitamins, methylation support, L-glutamine for gut lining repair, mineral co-factors for brain health, mitochondrial repair for energy and more.

3. Movement Guidelines

A quality holistic wellness plan must include some form of movement. While this doesn’t necessarily mean intense exercise, it does mean that some daily movement is needed. If you are completely inactive or in a de-conditioned state, maybe as a result of ME/CFS, it is imperative to move even if it’s just walking laps around your house. Movement is vital to all components of healing and repair, including from chronic fatigue.

4. Stress Management

Chronic stress can lead to anxiety, depression, weakened immune response, insomnia, disruption in the gut brain connection ( there’s that microbiome again!) It can accelerate aging, and lead to death from cardiovascular disease. It matters.

There are many ways to creatively find a strategy that suits you. The importance of managing stress can not be understated where chronic fatigue is concerned.

  • Turn off social media and/or the news. It is designed to elicit an emotional response from you!

  • Practice sleep hygeine. Maintain a routine by going to sleep at the same time each night. Ayurvedic medicine believes a schedule of 10pm-6am most closely follows the human circadian rhythm. Follow other sleep hygeine recommendations such as shutting off electronics an hour before bed and sleep in a dark, cool room.

  • Diffuse or apply calming essential oils such as lavender, ylang ylang or chamomile.

  • Read or meditate just before bed

  • Get in nature. Go for a walk, hike on the weekends, walk barefoot on the earth whenever possible. Nature is healing.

  • Avoid caffeine but replace it with some calming herbal teas such as chamomile, lavender or Rooibos.

  • Set healthy boundaries in your personal and professional life. This can take some time and practice, but it is well worth it!

  • Journal. Take some time each day to write down some thoughts, ideas, struggles and victories.

  • Practice yoga. Youtube has some wonderful yoga instructors that allow you to try and grow your practice from the privacy of your home. Studies show that yoga reduces blood pressure, reduces the stress response and even helps with impulse control.

If you think you may be suffering from CFS or just long standing fatigue, the most important thing is to understand where the breakdown is in your body. Is it an underlying infection? Is it poor gut health? Is it an HPA axis dysfunction? Understanding your root cause is the key to successful recovery.

Are You Chronically Fatigued?

If you would like more information and want to get back to feeling like yourself, give Dr. Noonan and Well Body Chiropractic and Functional Medicine a call or you can start by filling out our health assessment forms! When we receive your forms, we will know you are ready and we’ll contact you with next steps.


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