Chronic Fatigue Syndrome – Cutting Through the BS

In this episode of Cutting Through the B.S. series we tackle Chronic Fatigue Syndrome. We discuss the different causes of this very confusing conditions as well as the many different treatment options that are out there and why many of them fail. We will then further delve into what is causing the condition in many patients, and treatment options we have found to work in our clinic. Enjoy.

1. Glucocorticoid receptor gene (NR3C1) methylation processes as mediators of early adversity in stress-related disorders causality: A critical review.
Palma-Gudiel H, Córdova-Palomera A, Leza JC, Fañanás L.
Neurosci Biobehav Rev. 2015 Aug;55:520-35. doi: 10.1016/j.neubiorev.2015.05.016. Epub 2015 Jun 11. Review.
PMID: 26073068 [PubMed – indexed for MEDLINE] Free Article
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2. Maternal psychosocial stress during pregnancy alters the epigenetic signature of the glucocorticoid receptor gene promoter in their offspring: a meta-analysis.
Palma-Gudiel H, Córdova-Palomera A, Eixarch E, Deuschle M, Fañanás L.
Epigenetics. 2015;10(10):893-902. doi: 10.1080/15592294.2015.1088630. Review.
PMID: 26327302 [PubMed – indexed for MEDLINE] Free PMC Article
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3. Effects of the Social Environment and Stress on Glucocorticoid Receptor Gene Methylation: A Systematic Review.
Turecki G, Meaney MJ.
Biol Psychiatry. 2016 Jan 15;79(2):87-96. doi: 10.1016/j.biopsych.2014.11.022. Epub 2014 Dec 13. Review.
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4. The role of hypocortisolism in chronic fatigue syndrome.
Nijhof SL, Rutten JM, Uiterwaal CS, Bleijenberg G, Kimpen JL, Putte EM.
Psychoneuroendocrinology. 2014 Apr;42:199-206. doi: 10.1016/j.psyneuen.2014.01.017. Epub 2014 Jan 30.
PMID: 24636516 [PubMed – indexed for MEDLINE]
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5. Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research.
Borsini A, Hepgul N, Mondelli V, Chalder T, Pariante CM.
Psychol Med. 2014 Jul;44(9):1809-23. doi: 10.1017/S0033291713002468. Epub 2013 Oct 7. Review.
PMID: 24093427 [PubMed – indexed for MEDLINE]
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6. Stress management skills, cortisol awakening response, and post-exertional malaise in Chronic Fatigue Syndrome.
Hall DL, Lattie EG, Antoni MH, Fletcher MA, Czaja S, Perdomo D, Klimas NG.
Psychoneuroendocrinology. 2014 Nov;49:26-31. doi: 10.1016/j.psyneuen.2014.06.021. Epub 2014 Jul 6.
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7. Lower methylation of glucocorticoid receptor gene promoter 1F in peripheral blood of veterans with posttraumatic stress disorder.
Yehuda R, Flory JD, Bierer LM, Henn-Haase C, Lehrner A, Desarnaud F, Makotkine I, Daskalakis NP, Marmar CR, Meaney MJ.
Biol Psychiatry. 2015 Feb 15;77(4):356-64. doi: 10.1016/j.biopsych.2014.02.006. Epub 2014 Feb 17.
PMID: 24661442 [PubMed – indexed for MEDLINE]
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8. Chronic Fatigue Syndrome and DNA Hypomethylation of the Glucocorticoid Receptor Gene Promoter 1F Region: Associations With HPA Axis Hypofunction and Childhood Trauma.
Vangeel E, Van Den Eede F, Hompes T, Izzi B, Del Favero J, Moorkens G, Lambrechts D, Freson K, Claes S.
Psychosom Med. 2015 Oct;77(8):853-62. doi: 10.1097/PSY.0000000000000224.
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9. Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses.
Oberlander TF, Weinberg J, Papsdorf M, Grunau R, Misri S, Devlin AM.
Epigenetics. 2008 Mar-Apr;3(2):97-106.
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10. Self-critical perfectionism predicts lower cortisol response to experimental stress in patients with chronic fatigue syndrome.
Kempke S, Luyten P, Mayes LC, Van Houdenhove B, Claes S.
Health Psychol. 2016 Mar;35(3):298-307. doi: 10.1037/hea0000299. Epub 2015 Dec 21.
PMID: 26690635 [PubMed – indexed for MEDLINE]
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11. Methylation at the CpG island shore region upregulates Nr3c1 promoter activity after early-life stress.
Bockmühl Y, Patchev AV, Madejska A, Hoffmann A, Sousa JC, Sousa N, Holsboer F, Almeida OF, Spengler D.
Epigenetics. 2015;10(3):247-57. doi: 10.1080/15592294.2015.1017199.
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12. Ontogeny of hypothalamic glucocorticoid receptor-mediated inhibition of the hypothalamic-pituitary-adrenal axis in mice.
Laryea G, Arnett M, Muglia LJ.
Stress. 2015;18(4):400-7. doi: 10.3109/10253890.2015.1046832. Epub 2015 Jun 11.
PMID: 26068518 [PubMed – indexed for MEDLINE]
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13. A systematic review of the comorbidity between Temporomandibular Disorders and Chronic Fatigue Syndrome.
Robinson LJ, Durham J, Newton JL.
J Oral Rehabil. 2016 Apr;43(4):306-16. doi: 10.1111/joor.12367. Epub 2015 Nov 9. Review.
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14. Increased Vulnerability to Pattern-Related Visual Stress in Myalgic Encephalomyelitis.
Wilson RL, Paterson KB, Hutchinson CV.
Perception. 2015 Dec;44(12):1422-6. doi: 10.1177/0301006615614467. Epub 2015 Nov 3.
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15. An assessment of fatigue in patients with postural orthostatic tachycardia syndrome.
Wise S, Ross A, Brown A, Evans M, Jason L.
J Health Psychol. 2015 Nov 4. pii: 1359105315613624. [Epub ahead of print]
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16. Pain in people with chronic fatigue syndrome/myalgic encephalomyelitis: the role of traumatic stress and coping strategies.
Krzeczkowska A, Karatzias T, Dickson A.
Psychol Health Med. 2015;20(2):210-6. doi: 10.1080/13548506.2014.951370. Epub 2014 Sep 2.
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17. [Conditions, controversies and contradictions between Central Sensitivity Syndrome and Depressive Disorders].
Maresca T, Covini E, Mato AM.
Vertex. 2013 Sep-Oct;24(111):373-91. Spanish.
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18. Lifetime post-traumatic stress symptoms are related to the health-related quality of life and severity of pain/fatigue in patients with fibromyalgia.
Dell’Osso L, Carmassi C, Consoli G, Conversano C, Ramacciotti CE, Musetti L, Massimetti E, Pergentini I, Corsi M, Ciapparelli A, Bazzichi L.
Clin Exp Rheumatol. 2011 Nov-Dec;29(6 Suppl 69):S73-8. Epub 2012 Jan 3.
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19. Cumulative life stress in chronic fatigue syndrome.
Nater UM, Maloney E, Heim C, Reeves WC.
Psychiatry Res. 2011 Sep 30;189(2):318-20. doi: 10.1016/j.psychres.2011.07.015. Epub 2011 Aug 15.
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20. A prospective, proof-of-concept investigation of KPAX002 in chronic fatigue syndrome.
Kaiser JD.
Int J Clin Exp Med. 2015 Jul 15;8(7):11064-74. eCollection 2015.
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21. Mitoprotective dietary approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric restriction, fasting, and ketogenic diets.
Craig C.
Med Hypotheses. 2015 Nov;85(5):690-3. doi: 10.1016/j.mehy.2015.08.013. Epub 2015 Aug 21.
PMID: 26315446 [PubMed – indexed for MEDLINE]
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22. The many roads to mitochondrial dysfunction in neuroimmune and neuropsychiatric disorders.
Morris G, Berk M.
BMC Med. 2015 Apr 1;13:68. doi: 10.1186/s12916-015-0310-y.
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23. Metals as a common trigger of inflammation resulting in non-specific symptoms: diagnosis and treatment.
Stejskal V.
Isr Med Assoc J. 2014 Dec;16(12):753-8.
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24. The glutathione system: a new drug target in neuroimmune disorders.
Morris G, Anderson G, Dean O, Berk M, Galecki P, Martin-Subero M, Maes M.
Mol Neurobiol. 2014 Dec;50(3):1059-84. doi: 10.1007/s12035-014-8705-x. Epub 2014 Apr 22. Review.
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25. Mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome explained by activated immuno-inflammatory, oxidative and nitrosative stress pathways.
Morris G, Maes M.
Metab Brain Dis. 2014 Mar;29(1):19-36. doi: 10.1007/s11011-013-9435-x. Epub 2013 Sep 10.
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26. Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.
Maes M, Leunis JC, Geffard M, Berk M.
Neuro Endocrinol Lett. 2014;35(6):445-53.
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27. The hypothalamic-pituitary-adrenal stress axis in fibromyalgia and chronic fatigue syndrome.
Crofford LJ.
Z Rheumatol. 1998;57 Suppl 2:67-71. Review.
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28. The HPA axis and the genesis of chronic fatigue syndrome.
Cleare AJ.
Trends Endocrinol Metab. 2004 Mar;15(2):55-9. Review.
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29. The hypothalamo-pituitary-adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome.
Tanriverdi F, Karaca Z, Unluhizarci K, Kelestimur F.
Stress. 2007 Mar;10(1):13-25. Review.
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30. Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction.
Heim C, Nater UM, Maloney E, Boneva R, Jones JF, Reeves WC.
Arch Gen Psychiatry. 2009 Jan;66(1):72-80. doi: 10.1001/archgenpsychiatry.2008.508.
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31. Foundations of posttraumatic stress disorder: does early life trauma lead to adult posttraumatic stress disorder?
Pratchett LC, Yehuda R.
Dev Psychopathol. 2011 May;23(2):477-91. doi: 10.1017/S0954579411000186. Review.
PMID: 23786690 [PubMed – indexed for MEDLINE]
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32. The neuropsychiatric and neuropsychological features of chronic fatigue syndrome: revisiting the enigma.
Christley Y, Duffy T, Everall IP, Martin CR.
Curr Psychiatry Rep. 2013 Apr;15(4):353. doi: 10.1007/s11920-013-0353-8. Review.
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33. Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome.
Papadopoulos AS, Cleare AJ.
Nat Rev Endocrinol. 2011 Sep 27;8(1):22-32. doi: 10.1038/nrendo.2011.153. Review.
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34. Depression and anxiety correlate differently with salivary free cortisol in the morning in patients with functional somatic syndrome.
Mutsuura H, Kanbara K, Fukunaga M, Yamamoto K, Ban I, Kitamura K, Nakai Y.
Appl Psychophysiol Biofeedback. 2009 Dec;34(4):291-8. doi: 10.1007/s10484-009-9110-5. Epub 2009 Aug 7.
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35. Concurrent and prospective associations between HPA axis activity and depression symptoms in newlywed women.
Ge F, Pietromonaco PR, DeBuse CJ, Powers SI, Granger DA.
Psychoneuroendocrinology. 2016 Nov;73:125-132. doi: 10.1016/j.psyneuen.2016.07.217. Epub 2016 Jul 22.
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36. Glucocorticoid receptor DNA methylation, childhood maltreatment and major depression.
Bustamante AC, Aiello AE, Galea S, Ratanatharathorn A, Noronha C, Wildman DE, Uddin M.
J Affect Disord. 2016 Dec;206:181-188. doi: 10.1016/j.jad.2016.07.038. Epub 2016 Jul 19.
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37. Acute cortisol reactivity attenuates engagement of fronto-parietal and striatal regions during emotion processing in negative mood disorders.
Peters AT, Van Meter A, Pruitt PJ, Briceño EM, Ryan KA, Hagan M, Weldon AL, Kassel MT, Vederman A, Zubieta JK, McInnis M, Weisenbach SL, Langenecker SA.
Psychoneuroendocrinology. 2016 Nov;73:67-78. doi: 10.1016/j.psyneuen.2016.07.215. Epub 2016 Jul 22.
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38. Chinese herbal medicines promote hippocampal neuroproliferation, reduce stress hormone levels, inhibit apoptosis, and improve behavior in chronically stressed mice.
Sun GG, Shih JH, Chiou SH, Hong CJ, Lu SW, Pao LH.
J Ethnopharmacol. 2016 Dec 4;193:159-168. doi: 10.1016/j.jep.2016.07.025. Epub 2016 Jul 11.
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39. Male-specific effects of lipopolysaccharide on glucocorticoid receptor nuclear translocation in the prefrontal cortex of depressive rats.
Brkic Z, Petrovic Z, Franic D, Mitic M, Adzic M.
Psychopharmacology (Berl). 2016 Sep;233(18):3315-30. doi: 10.1007/s00213-016-4374-y. Epub 2016 Jul 7.
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40. Relative hypocortisolism is associated with obesity and the metabolic syndrome in recurrent affective disorders.
Maripuu M, Wikgren M, Karling P, Adolfsson R, Norrback KF.
J Affect Disord. 2016 Nov 1;204:187-96. doi: 10.1016/j.jad.2016.06.024. Epub 2016 Jun 21.
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41. Neuroendocrine Regulation of Anxiety: Beyond the Hypothalamic-Pituitary-Adrenal Axis.
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42. Cortisol and Brain-Derived Neurotrophic Factor Levels Prior to Treatment in Children With Obsessive-Compulsive Disorder.
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43. Resveratrol Ameliorates the Anxiety- and Depression-Like Behavior of Subclinical Hypothyroidism Rat: Possible Involvement of the HPT Axis, HPA Axis, and Wnt/?-Catenin Pathway.
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44. Hypothalamic-pituitary-adrenal axis hyperactivity is associated with decreased brain-derived neurotrophic factor in female suicide attempters.
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45. Genetic predisposition for high stress reactivity amplifies effects of early-life adversity.
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46. Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways.
Morris G, Anderson G, Maes M.
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47. The emerging role of autoimmunity in myalgic encephalomyelitis/chronic fatigue syndrome (ME/cfs).
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48. Dysregulated stress signal sensitivity and inflammatory disinhibition as a pathophysiological mechanism of stress-related chronic fatigue.
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49. Altered neuroendocrine control and association to clinical symptoms in adolescent chronic fatigue syndrome: a cross-sectional study.
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50. Getting better, but not well: A 1.5 year follow-up of cognitive performance and cortisol levels in clinical and non-Clinical burnout.
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2 Comments

  1. Is there anyone in NM who follows your protocols?

  2. The short answer to your question is we unfortunately don’t know of anyone in your area. The longer answer is that we have married two disciplines (functional medicine and chiropractic neurology) to put together what we feel is the most comprehensive program for chronic problems available today. While there are others who claim to do similar treatments we have not met any who practice exactly how we do and have made referrals in the past where the results were less than stellar. We have patients that we have worked with from all over the world. If you would like to find out how you can schedule a consultation with Dr. Rutherford to go over you particular case you can find out more at http://powerhealthreno.com/brochure

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