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Chronic Fatigue Syndrome Imbalances & Treatment Protocol

Written by Joe Cohen, BS | Last updated:

People with chronic fatigue syndrome have high inflammation, unbalanced immunity, and low antioxidant status. Learn what to look for here.

Any kind of chronic inflammation will make you fatigued all of the time, so it may be hard to differentiate.

However, the first thing I look for is Th2 dominance, which is the immune profile in CFS.

What Causes CFS?

Chronic fatigue syndrome

It seems like CFS is a result of a viral infection and the body’s inability to control it. The result is oxidative stress.

This isn’t a post on how to combat CFS, but the general idea is to rebalance your immune system by increasing Th1, decreasing oxidative stress and reducing some kinds of inflammation.

This means that the mechanisms to control viruses are low and other kinds of inflammation might be high.

Your Doc Won’t Order These Tests

The problem is no doctor or will order these tests. As I understand it, doctors are under pressure from insurance companies and insurance companies are out for profit.

They don’t want to shell out thousands of dollars on tests if they don’t see a clear way to benefit from these tests.

People with CFS show elevated:

One must keep in mind that one test will not tell you if you have CFS. You need to take many of these tests to put a picture together.

  • CRP [1]
  • Oxidative stress (isoprostanes) [2]
  • Omega6 PUFAs, i.e. linoleic acid and arachidonic acid (AA), and mono-unsaturated fatty acids (MUFAs), i.e. oleic acid. Also omega9 fatty acids and one of the saturated fatty acids, i.e. palmitic acid [3].
  • IL-17 [4]
  • IL-10 [5]
  • IFN-γ/Th1 [5]
  • TNF-α [5]
  • TGF-beta [6]
  • IL-1 beta… LPS-stimulated [7]
  • IL-6… LPS and PHA-stimulated [7]
  • TNF… LPS-stimulated [7]
  • Tregs/CD4+CD25+ T cells [5]
  • CD8+ cytotoxic T lymphocytes [8]
  • Oxidized LDL [2]
  • FoxP3 and VPACR2 expression [5]
  • EBV IgM – in a subset [9]
  • Perforin [5]
  • CD38 and HLA-DR activation [8]
  • CD28+ [8]
  • CD20 [10] – rituximab had good effects in some CFS people
  • Lactate in ventricular cerebrospinal fluid (CSF) [11] (A marker of reduced energy metabolism)
  • Adenosine [12]
  • NPY [13]
  • Serotonin increase to tryptophan [14]
  • Eosinophil Protein X [15]

People with CFS show decreased:

  • EPA [3]
  • Zinc [3, 16]
  • DHEAS [17] – contradictory [18]
  • Glutathione/GSH (cortical) [11]
  • Natural Killer Cell Activity/Cytotoxic activity of NK and CD8+T cells [5]
  • LPS-stimulated TGF-b [7]
  • HDL [2]
  • CD56bright NK cells [5] – CD56 Bright NK Cells are also lower in Coronary Heart Disease, Asthma, Rhinitis [19]
  • Granzyme A and granzyme K [5]
  • CD11b [8]
  • CD69 activation marker on T cells (CD3+, CD3+CD4+, and CD3+CD8+) and on NK cells (CD45+CD56+) – Since induction of CD69 surface expression is dependent on the activation of the protein kinase C (PKC) activation pathway, it is suggested that in CFS there is a disorder in the early activation of the immune system involving PKC [20].
  • DPPIV/C26 expressed on T cells and NK cells [21]
  • Neutrophil respiratory burst [22]
  • White matter in the midbrain [23]
  • PM Cortisol and 24hr urine free cortisol [24]
  • Folinic acid/Folate/Methylation [25, 26]
  • Bilateral white matter volumes [27]


Gut Dysfunction – altered intestinal microbiota, mucosal barrier dysfunction [28].

Lesions in frontal white matter [29].

Corticotropin-releasing hormone (CRH) and neurotensin (NT), secreted under stress, activate mast cells (MC) necessary for allergic reactions to release inflammatory mediators that could contribute to CFS symptoms [30].

No difference in GPx [31].

“Almost every adolescent with CFS had orthostatic tachycardia (Stewart et al.,1999), but this was not the case with adults (Natelson et al., 2007) where rates appear to be lower ranging from 10% (Naschitz et al., 2006) to 27% (Hoad et al., 2008) with the higher rate found in UK patients who reported having the diagnosis of CFS rather than being directly diagnosed. In our own study of adult patients (Natelson et al., 2007), orthostatic tachycardia was not common, occurring in only 11% of patients, not significantly different from rates in healthy controls” [29].

“Finding subgroups of CFS suggests different underlying pathophysiological processes responsible for the symptoms seen” [29].

About the Author

Joe Cohen, BS

Joe Cohen, BS

Joe Cohen flipped the script on conventional and alternative medicine…and it worked. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. Frustrated by the lack of good information and tools, Joe decided to embark on a learning journey to decode his DNA and track his biomarkers in search of better health. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. Based on his own health success, he went on to found SelfDecode, the world’s first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs.
Joe is a thriving entrepreneur, with a mission of empowering people to take advantage of the precision health revolution and uncover insights from their DNA and biomarkers so that we can all feel great all of the time.


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