CFS is a syndrome that describes a varying combination of symptoms such as:

• Chronic Fatigue,  lethargy,  physically and mentally
• Recurrent sore throat, swollen  glands and lymph nodes, fever
• Headaches, blurred vision, poor concentration
• Muscle and joint pain, stiff neck
• Intestinal discomfort, bloating, flatus, constipation/diarrhoea
• Emotional roller coaster, mood swings, depression, anxiety
  
  In the 'old days',  i.e. l980s CFS, also called the Yuppy flu, was mainly suspected to be the result of  infection by  Epstein-Barr virus (EBV). EBV is a member of the herpes group, which includes Herpes simplex types 1 fever blisters)  and 2 (genital) (HSV 1,2) , Varicella (chickenpox), zoster (shingles) , Cytomegalovirus  and pseudoarbo (Ross River fever, Barmah Forest) virus.
  
  A common aspect of these viruses is their ability to establish a lifelong latent infection after first attack. In other words, once you have them, they stay! Blood tests taken after many years still show elevated antibodies from  previous infections. This latent infection can be kept in check by a normal immune system. When the immune system is in any way compromised, these viruses become active as viral replication and spread. 
  
  This is commonly the case with herpes infection in AIDS, cancer, and drug-induced immuno-deficiency (medical and recreational drugs). Viruses are the smallest intracellular pathogens and live a parasitic existence. They cannot replicate outside of a living cell. The lack organized cell structure and simply consist of a protein coat (capsid) surrounding a nucleic acid core (genome) of either RNA or DNA - never both.
  
  Persistent viral infections not only cause the above health problems, but have also been implicated as the cause of neurological diseases such as Multiple Sclerosis (MS), Parkinson's Disease, presenile dementia, depressions, schizophrenia, as well as cancer, diabetes, birth defects, inflammatory bowel disease (Crohn's disease, IBS),  rheumatoid arthritis (RA), systemic lupus erythematosus (SLE).
  
  What starts up as 'simple' viral infection can turn into a virtual nightmare for sufferers, especially when their immuno-competence was is undermined by other factors such as chemical exposure, poor eating habits, smoking, drugs, vaccines, allergies, heavy metal toxicity, nutrient deficiencies, digestive problems and malabsorption.
  
  Multiple Chemical Sensitivity  (MCS)
  Sufferers from MCS are often also suffering from post-viral syndrome or CFS. Many patients who were diagnosed with CFS develop MCS due to their overloaded immune system. Their system is under constant adrenal stress, producing excess amounts of the stress hormone cortisol. Under normal healthy conditions the adrenal glands secrete both cortisol and dehydroepiandrosterone (DHEA) in quantities that counterregulate each other, forming a feedback loop that keeps cortisol at an optimal level.
  Large amounts of cortisol are released in response to physical stress (exercise), physiological stress (illness, surgery, burns, infection);  and psychological stress (lost job, relationship problems, work stress). Prolonged stress damages the feedback loop and causes over-secretion of cortisol which exhaust the body. It inhibits normal immune function, slows protein synthesis (wound healing, cell repair), leads to neuronal loss, brain damage, bone loss, muscle wasting, premature aging - and in extreme cases death.  The combination of CFS/MSC is more common than we may think. Many of these patients are too ill to do anything at all and have given up hope of a cure. Certainly, our medical colleagues have very little to offer in the cure department. There are too many facets of the illness to  consider and this needs specialist training and adoption of a very broad view. It not only frustrates the practitioner, but also taxes the co-operation of a fatigued, lethargic, ill, weak, and depressed patient.  When dealing with  CFS and/or CFS/MCS patients we need to make it clear from the onset that this is a long-term involvement for both! Relatively simple food and environmental sensitivities can turn into full-blown allergies to just about anything a sufferer comes in contact with. These people lead a miserable life and must wear a mask when leaving the safety of their home.
  
  Diagnosis
  When assessing a patient who complains of chronic fatigue, recurring flu-like symptoms, poor memory, inability to function, aches and pains, insomnia, digestive problems we really have to look no further. As a sufferer of CFS,  I have developed a protocol that includes comprehensive blood tests, including antibodies to EBV, CMV, HSV, RRV, liver function, full blood count, iron, B12, cortisol and DHEA levels, thyroid function, and if in doubt, also cancer embryonic antigens (CEA),  comprehensive patient assessment, including BIA body analysis. In most cases I recommend a tissue mineral analysis to evaluate the mineral and heavy metal status. This information combined is invaluable to assess treatment priorities
  
  Infective Agents
  Many infections have been associated with chronic disease, including:
  Klebsiella, Chlamydia (arthritis, CVD, MS), Helicobacter pylori (autoimmune disease), Rickettsia (CFS, MS, arthritis, CVD, schizophrenia and other mental disorders),  Mycoplasma (CFS, Chrohn,s disease, RA, infertility, PID). It has clearly been established that bacterial and viral infections lead to chronic disease, including CFS.
  
  Mycoplasma
  Mycoplasma is an unusual bacterium that does not possess a cell wall, is the smallest free living organism in within the normal human flora, and has the smallest genome of any bacteria. Research has shown it to be associated with a number of conditions such as pneumonia, urinary tract infections, inflammatory conditions and also plays a role in CFS, Crohn's Disease, cardiovasular disease, rheumatoid arthritis, infertility, and pelvic inflammatory disease (PID).  Mycoplasma can now be diagnosed with the help of polymerase reaction technology (PCR).
  Mycoplasma infection are no always symptomatic or are masked by other symptoms.
  
  
  
  Treatment
  
  The treatment of CFS involes a comprehensive host-centered approach. First priority is to improve immunity and reduce the susceptibility of reactivation of viruses. Introduce anti-viral remedies, and treat identified infective agents.
  
  Detoxification
  
  The elimination of toxins in the gastro-intestinal tract is priority. The first therapeutic step is to 'first remove all obstacles of cure' (Dr. Hahnemann's principle).  Some patients have totally clogged-up colons and dysfunctional enzyme systems and a long history of c.albicans/thrush, as well as intestinal parasites and inflammation.   An effective  detox program   includes liver cleanse, bowel detox, elimination of toxic heavy metals (Hg, Pb, Cd, As, Ni, Cu) . Fasting is not recommended for CFS. However, fresh vegetable juices - preferably organic - are very beneficial. Even a compromised small intestine can absorb some of the nutrients with the help of digestive enzymes.
  Detox also includes stimulating the eliminative organs (bowel, liver, biliary tract, kidneys, lymphatic system, lungs, and skin).  Practitioners of different modalities use a range of proven and useful methods (TCM, accupuncture, Ayurvedic medicine, homeopathic detox, herbal medicine, bio-chemical detox with amino acids,  hydrotherapy, massage  for lymphatic stimulation, and other methods.).
  
  Diet
  Check for food allergies and sensitivities, eliminate all foods that discomfort, bloating, indigestion. Eliminate all sugars, refined foods, soft drinks, chlorinated water.  Diet suitable to metabolic type, ethnic habits (i.e. mediterranean, asian,  german, etc.), emphasise fresh, nutrient-rich foods, preferably organic.
  
  Immune support
  Optimal immune function requires an optimal diet suitable for the individual metabolic type, filtered water (no chlorine), and high quality nutrition supplements. CFS sufferers often find it difficult to exercise in the beginning, especially if they have been ill for a long time. Include yoga, relaxation, meditation, and sufficient sleep. Counseling and hypnotherapy has proven to be of benefit.
  Nutritional supplements have shown to reverse some of the age-related defects in cell mediated immunity commonly found in the elderly. Many of them have suffered from CFS for years. It is interesting to note that the baby boomer generation have increased levels of antibodies to EBV due to decreases cellular immune response.
  
  CFS sufferers often also have elevated antibody levels of HSV 1 and 2, which are related to immunologically stressed and compromised conditions. This can lead to further immunological problems if not addressed. Attention must be given to stress reduction. The frequent bursts of the stress hormone cortisol suppresses DHEA and increases viral re-activation.