Chronic Fatigue Syndrome

Last Updated: 04 July 2019

Chronic fatigue syndrome is a disease or disorder characterized by frequent exhaustion that cannot be solved with resting (Englebienne & Meirleir, 2002). It cannot be described by any underlying health condition. Its cases can be worse during mental and physical activity. Researchers believe chronic fatigue syndrome is caused by a combination of several factors: Many theories have emerged from psychological stress to viral infections as explanations to the causative agents if this disorder (Cooper & Miller 2010). There has been no discovery of any test that can confirm chronic fatigue syndrome. Its treatment also is through suppression of the symptoms (Myhill 2014). The onset of symptoms of this disorder occurs at the age of early 20s to mid-40s, with a higher group reporting the onset of their symptoms at their early 30s. They can also occur in children aged between 13 and 15 years. Anyone is prone to this syndrome no matter the sex. However, it appears that females are more prone and have a greater chance of ailing this disease; 60-70% are female. The ratio of females to males suffering CFS is 3:1. In the UK, some research reports indicated that the illness was present in 0.5-2% of the population; this estimates about 250000 people in the UK with chronic fatigue syndrome (Thew & Mckenna 2009).


Mitochondrial Dysregulation


Mitochondrial dysregulation is the impairment of the mitochondrial physiological processes (Lalsh, 1993). As we know, the role of mitochondria in the cells of a human body is to provide energy for the body that helps humans to do work. Once these regulatory processes are interfered with, the process of energy manufacturing is also affected: there may be less energy produced or more or imbalanced regarding the time that it is needed. It may be related to chronic fatigue syndrome in the sense that, it may be a causative agent. Lack of enough energy that the body needs is what makes one feel tired hence fatigued (Lalsh, 1993).


Therefore, those having chronic fatigue syndrome are likely to have mitochondrial dysfunction. Oxidative stress can be described as the constant imbalance between the manufacturing of the reactive oxygen species, also known as the free radicals, and their neutralization by the antioxidants. The unstable nature of the reactive oxygen species makes them very reactive and renders them the ability to cause great cell damage through breaks and DNA mutation (Shankar & Srivastava, 2012). This phenomena often leads to irreparable cellular damage. The mitochondrial respiratory cycle plays an important role in the production of pro-oxidants or the reactive oxygen species (Myhill, et al., 2009). Hence, as we discussed the mitochondrial dysregulation and determined its effects, we can now establish that mitochondrial dysregulation is related to oxidative stress in the sense that mitochondrial dysfunction leads to oxidative stress (Cui, et al., 2012).



It is argued that mitochondrial dysregulation may play a major role in chronic fatigue syndrome symptoms, for example, the lowered ATP manufacturing by the mitochondria (Cui, et al., 2012). Lowered ATP production leads to low energy being produced for the body to use hence causing fatigue. Another way this relationship may be explained is through the production of the reactive oxygen species by the mitochondrial respiratory cycle. These pro-oxidants may cause oxidative stress that has adverse effects on tissue destruction of the body since the imbalance does not make it easy to repair the tissues damaged (Rose, et al., 2014). This explains the muscle pain and reduced pain threshold found in chronic fatigue syndrome’s patients. The energy levels of the patients suffering from this illness are low. This is due to the low ATP (Adenosine Tri-Phosphate) produced as a consequence of the mitochondrial dysfunction. Furthermore, the maximum usage of this usage to counter the deficit hence a low energy level is maintained when someone is suffering from CFS. Mitochondrial dysregulation and oxidative stress lead to decreased health as their consequences. Some of the symptoms of these are the CFS, low cardiac output, chest pains, reduced sensitivity and response on the skin (Levine & Bradley, 2012). Muscle effects due to the accumulation of lactic acid, inefficient digestion, poor short-term memory, poor exercise tolerance, and kidney failure are also effects of these two physiological abnormalities.


Essential Molecules


Every cell in a human body requires four essential molecules; water glucose, oxygen, and glutathione for energy production (Alberts, 2008). If one of the components is not present, energy production would stop, hence making the body stop when there is n energy supply that comes from the cells. Glutathione is a protein produced by human cells and is the body’s master antioxidant (Pall, 2010). It can also function as an anti-toxin and a vital defense system against aging and illness. Glutathione only can regenerate other antioxidants like vitamin C, vitamin and alpha-lipoic. More than 5% of all the energy made by the body may be used to regulate and synthesize glutathione levels (Pall, 2010). It is the only antioxidant that does not become a free radical after it has neutralized another free radical (reactive oxygen species). Reduced glutathione levels lead to lower energy, a greater pose to cellular damage and inflammation hence its elevated levels results to the opposite of this (Berne, 2011); therefore can help improve chronic fatigue syndrome.



Coenzyme Q10 (CoQ10) is an antioxidant and helps in enhancing energy output of every cell in a human body. CoQ10 helps to prevent and treat mitochondrial dysregulation (Rakel, 2012). Mitochondrial dysregulation, as we had discussed earlier, results to challenges of creating energy, hence chronic fatigue. Improving the levels of CoQ10 would assist in improving the production of energy and therefore CFS. Omega 3, from fish oil, also has an effect in the level of energy in our body since it is a fatty acid (Bridgeford, 2013). Just like any other fatty acid or fats, it can be a source of energy to the body. Oxidation of fatty acids by the body’s physiological processes renders production of energy which is important in chronic fatigue syndrome (Mayo Clinic, 2014), as it improves the energy levels in patients suffering from this condition hence improving it.



Sugar content has numerous detrimental effects on the health of CFS patient; we will concentrate on its effect on the energy levels. High sugar content in the blood results in a rapid increase in blood sugar, which is then followed by hypoglycemia (Fuhrman, 2012). Hypoglycemia is a phenomenon that is characterized by not enough sugar content, which is essential in energy conversion in the blood (Shima, 2014). This hypoglycemia is what causes fatigue. This can be explained in the following dimension; High sugar levels in the blood triggers the production of insulin to counter it, which further leads to a significant drop in blood sugar resulting in hypoglycemia. Metabolic syndrome is closely related to insulin resistance. Insulin is a hormone that takes blood sugar or glucose into the cells for energy production. Insulin resistance counters this process hence there is more of enough blood sugar but production of energy does not occur (Craft, 2010). Lack of energy causes fatigue in chronic fatigue syndrome.



Exercise or physical activity has some significant effect in increasing energy levels, contrary to what people may think. Physical activity benefits the energy level in two ways; namely boosting the body’s fitness and mood. Physical activity results in a raised endorphin level (Ekkekkis, 2013). Endorphins are natural hormones released by human bodies. They are released when a person is doing an activity that requires a great load of energy to occur. Endorphins motivate one to perform, they keep someone going when doing these types of activities. Physical activities tend to raise the levels of endorphins. Physical activity can also help in raising the energy level in some other dimension. This is where it causes a rise in the heart rate; an increased heart rate results in a high blood flow which ensures distribution of oxygen and nutrients to the cells effectively (Graham, 2012). Oxygen helps in the breakdown of sugars for the production of energy consequently raising its levels. Also through physical activity, the ability to recruit and use muscles are raised hence one requires less effort to carry out any physical activity, which if one had not done any physical activity would feel fatigued. Through physical activity, one builds muscles and becomes stronger, so does a person’s immune system. A good immune system reduces illnesses that as we know drains our energy levels and makes us feel fatigued (Sali, et al., 2011). Physical activity is an important factor in raising our energy levels that help in cases of chronic fatigue syndrome. Fiber is a compound that is only found in plant materials. The human body cannot digest it but it is considered a very important constituent in our diet. A detoxification diet aims at cleansing all the body’s system; including your respiratory, urinary, gastrointestinal and lymphatic while also regaining the lost energy (Hassed & Phelps, 2012). Fibre reduces the rate at which substance from digestion enters the circulatory system- blood. It also increases the rate at which food material leaves the gastrointestinal tract (Goodacre, et al., 2013). These two processes reduce the amount of toxins that may make their way to the blood and also the digestive tract.



Fibre also helps in maintaining blood sugar levels and cholesterol. The liver is responsible for the detox process as all the blood goes through this organ for toxin elimination (Hassed & Phelps, 2012). Fibre is crucial in this process as bile from the liver attaches itself to many toxins that are fat-soluble in nature. This requires fibres from the diet, especially those from the vegetables and fruits, to remove these toxins from the body, as without them the toxins may be reabsorbed.
Soluble fibre forms gel when it is dissolved in the stomach after absorbing water from the constituents of the bowel. It slows down the digestive process hence regulating the bowel movement (Wardle & Sarris, 2010). This firms the stool in case of mild diarrhoea or loose stool. Insoluble fibre forms the bulk in stool thereby softening it to avoid constipation and relieve it if present. Increasing the bowel movement through the bulk caused by fibres is another effect. They also stimulate bacteria in the large intestines that hasten the bowel movements, as well as bloating, abdominal discomfort and gut gas (Aimutis & Paeschke, 2011). Fibres help improve gut health and eliminates any disorders that are associated with the health of the gut such as constipation, colon cancer and irritable bowel syndrome. A high-fibre diet reduces the risk associated with haemorrhoids development in the colon, a condition referred to as diverticular disease (Gibson, 2009). Fibre slows down carbohydrate break down and the absorption of sugar (Brooker, et al., 2013). This consequently raises the blood sugar levels which ensures the production of energy by the cells. Fibre intake may help patients suffering from chronic fatigue syndrome as it boosts their energy levels making them less fatigued.



Growing of organic foods is done mainly in cases where a person needs to avoid contact with agricultural chemicals. These chemicals especially pesticides are in numerous ways harmful to human health. Focusing on the mitochondria, ingesting organic foods may help improve cellular health since the pesticides used to grow other forms of foods have shown negative effects on mitochondrial function (Dr. Melletis, 2001). They do this by increasing the permeability of the mitochondrial membrane, which risks damaging of the mitochondria through the free radicals- reactive oxygen species (Dori Luneski RNND, 2012). This inhibits coupling, an essential process in the production of ATP. Chemicals in the pesticides that are responsible for these activities are parathion, paraquat, 2-4-D and dinoseb.



Inefficient production of ATP leads to insufficient production of energy by the mitochondria. If this occurs in CFS patients, the symptoms of feeling tired will be severe. Intake of organic foods therefore can help solve this problem since they do not contain these chemicals. Production of ATP will be normal, this will improve the efficiency of free radical neutralisation hence the mitochondrial damage present will be repaired and prevent further damage thus improving it (Robbins & Robbins, 2013). Through this, the energy levels will rise as there is no interference in the energy manufacturing. CFS patients are advised to eat organically grown foods.



Emotional freedom technique (EFT) is psychological acupressure technique that involves tapping of energy points on our body especially the face (Night & Bates, 2011). It has an effect of improving the flow of energy throughout the body and clearing all the blockages that may prevent this flow (Salomon, 2011). These blockages and lack of free flow of energy through the body can make someone feel exhausted which signifies imbalance of body energy. Someone may confuse EFT to counselling. The difference between the two is that EFT is solves the energetic imbalance caused by the thought patterns of the patient whereas counselling solves the thought patterns. EFT eliminates the emotions that make one feel bad which are referred to as the energy disturbances (Bruhn & Zaejian, 2012). After they are eliminated, the patient’s health improves and energy levels are raised since the blockages are cleared. This technique may be effective in chronic fatigue syndrome patients as they may relieve some symptoms.



The methylation cycle is a biochemical process that occurs in almost every cell in the body. It involves methionine, an amino acid, and S-adenosylmethionine, homocysteine (some of it is converted to methionine thus completing the process) and S-adenosylhomocystein (Dr Myhill, 2013). Methylation cycle has many effects on the human body including control of its response to oxidative stress. It does this by determining how much homocysteine is diverted into trans-sulfuration pathway. This contributes in establishing the rate of glutathione synthesis (Davies, 2012). As we had discussed earlier, glutathione is an important antioxidant which assists in eliminating he free radicals that cause the oxidative stress. Oxidative stress can have degenerative effects on the mitochondria in the cells interfering with energy production leading to low energy levels that make someone feel tired in case of chronic fatigue syndrome.


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