DEFINITION: a syndrome defined by a cluster of non-specific symptoms with a dominant feature of ongoing fatigue

What is fatigue?       In a physical sense, fatigue is the failure to maintain muscular output/force. In a mental sense, fatigue is the deterioration in ability to perform certain mental tasks. The mechanism of fatigue varies from person to person, but it relates to four underlying possibilities:

  • Build-up of a factor
  • Depletion of a substrate
  • A cognitive perception
  • A blocked energy pathway

The CDC criteria of major and minor criteria that are often spoken of were only intended for research purposes.  They were not meant to be requirements to establish the diagnosis.  It is important to point out the fatigue is not a diagnosis but is a symptom, which is reflective of another causative or contributing factor (s).

POSTULATED CAUSES: Although many blame CFS on EBV and other viruses, there is no evidence that a single virus or agent is responsible. Rather the condition develops as a result of the body's inability to cope with an insult (surgery, viral infection, injury, etc.). People with CFS and CFS-like conditions seem to be the ones that do not recover in a reasonable amount of time.

TRIGGERS/CAUSES/CONTRIBUTORS: Most cases begin after a significant life event/illness that occurred during or after a period of prolonged situational stress... The degree of disability/dysfunction that results from the "straw that broke the camel's back" often correlates with the basic health and nutritional status of the individual prior to the stress. Some contributors to chronic fatigue states include:

  • Endocrine dysfunction (primarily thyroid, adrenal, pituitary, ovaries/testes, hypothalamus)
  • Intoxication (heavy metals, organic toxins, medications)
  • Nutrient deficiency (imbalances or deficiencies of amino acids, essential fats, minerals, vitamins)
  • Psychologic-psychiatric conditions (anxiety, depression, failure to cope)
  • Cancer (I have never found a case of CFS that was due to cancer, however)
  • Immune dysfunction          (allergies, T cell immune deficiency, hypogammaglobulinemia, autoimmunity)
  • Infection (chronic sinusitis, tuberculosis, candida/yeast overgrowth, gastrointestinal bacteria)
  • Metabolic disorders            (genetic, food related rejectivity syndromes, chemical sensitivities)

DIAGNOSTIC APPROACH: It is important to perform tests that give answers vs tests that just give data. The search should always be to find the root causes while the symptoms are alleviated by strengthening or balancing the pathway the body has used to manifest symptoms.


    • TOXIC - chemical toxins, irritants, heavy metals
    • NUTRITIONAL - trace elements, vitamins, fats, amino acids
    • IMMUNOLOGIC - allergy, immune deficiency
    • PSYCHOEMOTIONAL - stressful events and situations
    • INFECTIOUS - viral, fungal, bacterial, parasitic


    • METABOLIC - acid/alkaline, impaired metabolism
    • NEUROMUSCULAR - autonomic nervous system, muscles, nerves
    • IMMUNOLOGIC - hypersensitivity, autoimmunity, immune insufficiency
    • INFLAMMATION - prostaglandins, oxidation
    • ENDOCRINE - thyroid, adrenal, ovary/testes, pituitary, pancreatic gland function and hormone effects, hypothalamic control
    • PSYCHOLOGIC - belief systems, coping (control, perception)


  • Supply nutrients/metabolites needed to heal
  • Avoid those situations/agents that block health or interfere with recovery
  • Eliminate toxins or infections the body has accumulated.  This may include Microdose Biomodulation injections.
  • Remove any interfering scars, emotions, or infections that prevent healing. This may include Neural Therapy.
  • Release any Neuro-Emotional Complexes that sabotage success or impede progressive recovery.

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Jeremy E. Kaslow, MD, FACP, FACAAI Physician and Surgeon
Board Certified Internal Medicine

Medical Doctors are licensed and regulated by the Medical Board of California
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