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What You Need To Know

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating condition characterized by extreme fatigue that is not improved with rest and is accompanied by a range of other symptoms. 

There are several factors that can contribute to the development of SIBO, including:

  • Impaired Gut Motility: Conditions that slow down or disrupt the normal movement of food through the digestive system can promote the growth of bacteria in the small intestine.

  • Structural Abnormalities: Certain anatomical or surgical changes to the gastrointestinal tract can create an environment more prone to bacterial overgrowth.

  • Poor Immune Function: A weakened immune system may fail to regulate the balance of bacteria in the small intestine, leading to an overgrowth.

  • Medications and Medical Conditions: Prolonged use of certain medications (such as proton pump inhibitors or antibiotics) and medical conditions like diabetes or autoimmune diseases can increase the risk of SIBO.


CFS is a diagnosis of exclusion, meaning other potential causes of fatigue and similar symptoms must be ruled out. There are several conditions that can mimic the symptoms of Chronic Fatigue Syndrome (CFS) or contribute to similar fatigue and other related symptoms. See below for more details.


While CFS is not classified as an autoimmune disorder itself, there is evidence to suggest that autoimmunity may play a role in some individuals with CFS.

Here are some key points regarding the connection between CFS and autoimmunity:

  • Autoimmune Markers: Studies have found certain autoimmune markers, such as elevated levels of specific autoantibodies, in a subset of individuals with CFS. These markers suggest the presence of an autoimmune response in some cases.

  • Overlapping Symptoms: CFS and autoimmune conditions can share common symptoms, including fatigue, pain, cognitive difficulties, and immune-related symptoms. 

  • Immune Dysregulation: Both CFS and autoimmune conditions involve dysregulation of the immune system. In CFS, there may be abnormalities in immune function and heightened immune activation, indicating immune system dysfunction. This immune dysregulation may contribute to the development of autoimmune responses in some individuals.

  • Autoimmune Conditions Co-occurring with CFS: Some individuals with CFS may also have other autoimmune conditions. This suggests a potential link between CFS and autoimmunity, although it's important to note that not all individuals with CFS have underlying autoimmune conditions.

  • Autoimmune Triggers: In some cases, CFS symptoms may be triggered or exacerbated by certain infections, including viral infections. It is thought that the immune response to these infections could potentially contribute to the development of autoimmune processes in susceptible individuals.

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  • Fatigue: The main symptom of CFS is severe fatigue that lasts for at least six months. The fatigue is often described as profound and debilitating, significantly impacting daily activities and functioning.

  • Post-Exertional Malaise (PEM): Individuals with CFS often experience a worsening of symptoms after physical or mental exertion. This post-exertional malaise can lead to an increase in fatigue, pain, cognitive difficulties, and other symptoms.

  • Cognitive Difficulties: CFS can cause problems with memory, concentration, and overall cognitive function. 

  • Sleep Disturbances: Many individuals with CFS experience disrupted or unrefreshing sleep. They may have trouble falling asleep, staying asleep, or waking up feeling rested.

  • Muscle and Joint Pain: Chronic muscle and joint pain are common in individuals with CFS.

  • Headaches: Recurrent headaches, including tension-type headaches and migraines, are frequently reported by individuals with CFS.

  • Flu-Like Symptoms: Some individuals with CFS experience symptoms similar to those of the flu, such as sore throat, swollen lymph nodes, low-grade fever, and general malaise.

  • Digestive Issues: Digestive symptoms, including nausea, bloating, abdominal pain, and irritable bowel syndrome (IBS)-like symptoms, can be present in individuals with CFS.

  • Sensitivities: Heightened sensitivity to light, noise, odors, and certain foods or chemicals is reported by some individuals with CFS.

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There are several conditions that can mimic the symptoms of Chronic Fatigue Syndrome (CFS) or contribute to similar fatigue and other related symptoms. It's important to consider these conditions during the diagnostic process to ensure an accurate diagnosis and appropriate management.

Here are some conditions that can mimic or overlap with CFS:

  • FIBROMYALGIA: Fibromyalgia is a chronic pain condition characterised by widespread musculoskeletal pain, fatigue, and sleep disturbances. Many individuals with fibromyalgia also experience symptoms similar to CFS, such as cognitive difficulties and heightened sensitivity to stimuli.

  • AUTOIMMUNITY: Some individuals with CFS may have elevated levels of certain autoimmune markers, such as autoantibodies.

  • HYPOTHYROIDISM: An underactive thyroid gland (hypothyroidism) can lead to fatigue, cognitive impairment, and other symptoms that resemble those of CFS. Thyroid function tests can help determine if hypothyroidism is contributing to the symptoms.

  • ADRENAL INSUFFICIENCY: Adrenal insufficiency occurs when the adrenal glands do not produce enough cortisol. Symptoms may include fatigue, muscle weakness, dizziness, and low blood pressure. Adrenal function tests can assess the function of the adrenal glands.

  • LYME DISEASE: Lyme disease is caused by a bacterial infection transmitted through tick bites. Fatigue, muscle and joint pain, cognitive difficulties, and flu-like symptoms are common in Lyme disease and can be mistaken for CFS. Testing for Lyme disease may be necessary, especially in areas where the infection is prevalent.

  • SLEEP DISORDERS: Conditions such as sleep apnea, restless legs syndrome (RLS), and insomnia can cause significant fatigue and sleep disturbances that mimic or overlap with CFS. Sleep studies or evaluations by sleep specialists may be necessary to identify and address these conditions.

  • DEPRESSION AND ANXIETY: Mental health conditions, particularly major depressive disorder and generalised anxiety disorder, can cause fatigue, cognitive difficulties, and other symptoms similar to CFS. 


A Functional Medicine Approach to Chronic Fatigue Syndrome

Our approach to Chronic Fatigue Syndrome (CFS) aims to identify and address the underlying factors that contribute to the condition. This approach takes into account the interconnectedness of various body systems and focuses on personalised care.

Here are key elements of a functional medicine approach to CFS:

  • COMPREHENSIVE ASSESSMENT: A thorough evaluation is conducted to gather detailed information about medical history, symptoms, lifestyle factors, and potential triggers. This may include a review of laboratory tests, specialised testing, and assessments of various body systems.

  • IDENTIFYING TRIGGERS: We explore potential triggers that may contribute to CFS, such as viral infections, hormonal imbalances, gut dysbiosis, nutrient deficiencies, environmental toxins, and chronic stress.


  • DIET AND NUTRITION: Personalised dietary recommendations are made to support overall health and reduce inflammation. This may involve eliminating potential food triggers, adopting an anti-inflammatory diet, and ensuring optimal nutrient intake. supplementation plans may be recommended to address specific nutrient deficiencies or support immune function, energy production, and overall well-being. This may include vitamins, minerals, antioxidants, and other targeted supplements.

  • GUT HEALTH SUPPORT: Since the gut plays a crucial role in overall health and immune function, addressing gut health is an important aspect. Strategies may include addressing dysbiosis, supporting the gut microbiome with probiotics, and addressing intestinal permeability ("leaky gut").

  • DETOXIFICATION SUPPORT: Detoxification pathways may be supported to address potential toxin overload and enhance the body's ability to eliminate toxins effectively.

  • STRESS MANAGEMENT: Chronic stress can exacerbate CFS symptoms. Stress management techniques such as mindfulness practices, relaxation exercises, and stress reduction strategies are incorporated to support the body's stress response and overall well-being.

  • IMPROVING SLEEP: Adequate and restorative sleep is essential for recovery. Strategies for improving sleep quality and addressing sleep disturbances are implemented.

  • LIFESTYLE ADJUSTMENTS: Lifestyle factors, such as physical activity, stress management, work-life balance, and self-care practices, are considered and modified as needed to support recovery and overall health.

To take a proactive role in managing your health, we encourage you to reach out to our team. We have extensive experience assisting individuals with complex conditions such as lupus.



 We offer a range of appointments in-person or online. 
You will receive the same service and expertise from us through our virtual, online clinic, just as you would if you visited us at our London clinic.

To discuss how we can assist you, call us on 020 3886 1339, or email us at


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