Chronic Fatigue Syndrome

Chronic Fatigue Syndrome is a debilitating condition that affects up to 2% of the population.

Before being diagnosed with Chronic Fatigue, other medical causes of fatigue must be excluded. You must have:

Persistent or relapsing fatigue of new onset (ie not lifelong) for 6 or more consecutive months.

4 more of the following symptoms concurrently present for over 6 months:

  • Impaired memory or concentration
  • Sore throat
  • Tender cervical (neck) or axillary (armpit) lymph nodes
  • Muscle pain
  • Multi-joint pain
  • New headaches
  • Unrefreshing sleep
  • Post-exertion malaise


  • Fatigue, especially after exertion
  • Forgetfulness
  • Confusion
  • Poor concentration
  • Headaches
  • Irritability
  • Depression
  • Mood swings
  • Sleep disturbances
  • Palpitations
  • Faintness
  • Problems with balance
  • Chills
  • Mild fever
  • Sweating
  • Sore throat
  • Painful, swollen glands in the neck or armpits
  • Muscle weakness
  • Joint swelling and pain

Contributory factors

The cause or causes of CFS remain unknown despite many years of research.

While a single cause for CFS is yet to be identified, one possibility is that CFS represents a common endpoint of disease resulting from a multitude of different causes. 

Nutrient deficiency: certain nutrients are essential for ensuring that the energy production process in the body runs properly. These include the B-vitamins and the mineral magnesium: the nutrients that are most often lacking in our modern processed diets. Other nutritional deficiencies which have been found in people with CFS include: Coenzyme Q10, L-carnitine, L-tryptophan, folic acid and zinc.

Low nutrient status can be identified by the NutrEval Test, which looks at oxidative stress, genomics, B vitamin, fatty acids, minerals and amino acids to give a comprehensive picture of your nutrient status.

Infectious agents: due in part to its similarity to acute or chronic infections, some cases of CFS are thought to be caused by a virus or other infectious agent.

Recent research suggests that infection with Epstein-Barr virus (EBV), Ross River virus and Coxiella burnetti can lead to a post-infective condition that meets the criteria for CFS. EBV and related viruses produce lifelong latent infections which the person’s immune system normally keeps in check. However, a compromised immune system can lead to reactivation of the virus and recurrent or chronic infection.

An EBV test is a blood test for past, present, and reactivated EBV infections. 

Immune dysfunction: CFS may be caused by an immunologic dysfunction,  such as inappropriate production of inflammatory chemicals by immune cells, or altered capacity of certain immune functions. One hypothesis is that this may be triggered by an outside situation, such as stress or a viral infection.

If you feel that immune dysfunction may be a factor in your condition, a consultation with Smart Nutrition includes a longterm programme of diet, lifestyle and supplements to rebuild and re-educate your immune system. Please use the link at the bottom of this page to find out more.

Abnormality in the energy production cycle: the body’s energy is generated by a cycle of special chemical reactions that occur within every cell in the body. The energy factories of the cells called the mitochondria sometimes do not function properly in CFS patients. This can be for a variety of reasons – one is a lack of certain minerals.

Adrenal hormone imbalance: the central nervous system may play a vital role in CFS.

Physical or emotional stress, which is commonly reported as a pre-onset condition in CFS patients, activates a chain of events that result in release of stress hormones such as cortisol from the adrenal glands. These hormones influence the immune system and many other body systems. If this system is working hard for a long period of time, for example during chronic stress, the adrenal glands can “burn out”. This means they can no longer sustain production of normal levels of cortisol and other hormones.

Recent studies show that CFS patients often produce lower levels of cortisol than people who don’t have CFS. Cortisol suppresses inflammation and cellular immune activation, so reduced levels can lead to inflammation and immune dysfunction.

Cortisol levels can be measured by the Adrenal Stress Test.

Low thyroid function: fatigue is a very common symptom of hypothyroidism (underactive thyroid).

The thyroid gland controls the body’s metabolism – so it has a huge influence on how energised we feel. Hypothyroidism also slows down many of the body’s other systems. This can result in constipation, cold hands and feet, weight gain and depression.

If you think hypothyroidism may be a factor in your condition, a Thyroid Test can detect this for you.

Detoxification problems: the livers of CFS sufferers are often very effective at chopping up toxic chemicals, but much less so at packaging them up so they can be removed from the body. This build up of waste products and toxins can lead to fatigue.

Oxidative Stress: oxidative stress is caused by unstable, highly reactive molecules called free radicals. They can damage the energy-producing mechanisms inside the body’s cells, leading to fatigue.

Free radicals are made in the body, by the environment and from pollution. Normally the body has very good mechanisms for mopping them up before they do us any damage, but constant exposure to high levels can overwhelm the body’s defence mechanisms.

If you’re concerned about  exposure to free radicals, an Oxidative Stress Test can give you information about how effective your body is at managing them.

Heavy metal toxicity: exposure to heavy metal toxins can impair energy production and burden the detoxification system, paving the way for the development of chronic fatigue. Toxic metals are rife in the modern environment, occurring in everything from pollution, pesticides and mercury fillings, to tap water.

Heavy metal toxicity can be effectively measured by two tests – you can choose whether to test hair or urine to discover whether this factors is playing a role in your symptoms.

Food allergies or intolerance: fatigue is a common symptom of food intolerance, especially for people with an intolerance to grains, such as wheat.

If your fatigue is accompanied by digestive symptoms, or you suspect a food sensitivity you should consider having a Food Allergy or Intolerance Test. If you find out you do have an issue with a particular food Smart Nutrition can help you to change your diet and find tasty alternatives.

Candida infection: a Candida infection occurs when there is an overgrowth of the pathogenic yeast Candida albicans in the gut. This can be caused by poor dietary habits, compromised levels of friendly bacteria in the gut and poor immunity. Some cases of chronic fatigue are exacerbated by intestinal overgrowth of Candida yeast and the toxins the yeast produces. In addition to the typical CFS symptoms, Candida sufferers often also have digestive disturbance, sweet cravings and difficulty losing weight. 

If you think you may have a Candida infection, it can be confirmed by a simple Candida Saliva Test.

Leaky gut syndrome: this is also known as intestinal permeability.  A normal healthy digestive lining allows certain molecules to pass across into the bloodstream such as vitamins, minerals and digested foods.  It also acts as a barrier to prevent entry of larger damaging molecules, foreign particles and bacteria.  Chronic intestinal irritants, parasites and Candida overgrowth can all damage the gut lining allowing toxins to pass from the gut into the blood stream, triggering inflammation and fatigue.

A Leaky Gut Test is a simple and easy way to identify this condition, which can then be addressed with the help of Smart Nutrition.

Digestive dysfunction: fatigue may be triggered by malabsorption of important nutrients caused by poor digestive function, or by an overgrowth of intestinal yeasts, bacteria or parasites.

A Comprehensive Digestive Stool Analysis is a full screen for gut flora balance, parasites and digestive function, so is an excellent screen for anyone who feels that a digestive imbalance is a key factor in their condition.

Useful Links

Please do not return samples to the laboratories that may arrive after Wednesday 27th March and up to and including Monday 2nd April.

The laboratories are closed from the 28th March – 2nd April for the Easter Holiday.