Opinion Volume 4 Issue 3
Flatiron Functional Medicine, USA
Correspondence: Jill C Carnahan, Flatiron Functional Medicine, USA, Tel 303.993.7910
Received: July 01, 2016 | Published: October 3, 2016
Citation: Carnahan JC (2016) Is a Hidden Infection Causing your Fatigue?. Int J Complement Alt Med 4(3): 00119. DOI: 10.15406/ijcam.2016.04.00119
Are you suffering from unrelenting fatigue that doesn't seem to respond to any intervention? Perhaps you've asked your doctor to check your thyroid function and it came back normal. Perhaps you've been testing for iron-deficiency anemia this, too, was normal. Or perhaps you've been told by an integrative medical doctor that your adrenal function is suboptimal. Maybe what you haven't thought of is the fact that you could be harboring hidden pathogens in your body that are robbing your energy and stealing your steam!
If basic testing fails to reveal a cause of your fatigue, you may want to have your doctor test for occult infection. More sophisticated investigations can reveal the presence of all kinds of pathogens capable of colonizing the body and evading the immune system. Some of them include: Parvoviruses, HHV6, Epstein-Barr, Cytomegalovirus, Mycoplasma, and Borrelia burgdorferi. Other patients have a history of chronic fungal infections or biotoxin exposure. A history of chronic mold exposure is a feasible explanation for such symptoms, as is the presence of B. burgdorferi.
Chronic fatigue syndrome is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.1
Chronic fatigue syndrome has eight official signs and symptoms, plus the central symptom that gives the condition its name:
If you see a good medical detective, a physician trained in functional medicine, they can work with you to test for any of these underlying causes of the fatigue, A study of 375 patients with apparently no cause for their disabling fatigue revealed pathological stimulation of white blood cells with abnormally elevated patterns of natural helper and natural killer cells, important infection fighting agents in the immune system in 53% of patients. It showed depleted levels of IgG subclass three in 59% of the study population. More than 50% had circulating immune complexes and many tested positive for ANA antibodies, usually seen in autoimmune diseases like lupus.
It appears that part of the answer lies in the genetic polymorphisms or variances in our body’s response to infection and inflammation. For those who develop severe fatigue in response to toxic exposure, like mold or infection, their immune systems respond more robustly to the threat with massive production of cytokines, like IL-ß1 or TNF-alpha. Moreover, polymorphisms in TNF-alpha,IL-1β, interferons (IFNs), IL-6, and IL-10, acting together or separately can make the severity and response of immune system more profound in response to infection.2 Why does this happen? Well these pathogens can trigger TLR's (toll-like receptors) by either PAMPs (pathogen-associated molecular patterns) or DAMPs (damage associated molecular patterns). Activation of the TLRs causes a massive cytokine surge that becomes like a domino-effect and keeps on going unrelenting in susceptible individuals, contributing to the inflammation, depression and fatigue. This vicious cycle of pro-inflammatory cytokines that continue to trigger more inflammation and amplify the cycle, leading to more damage and inflammation.
The initial infection followed by chronic inflammation of the immune system could explain the cause of fatigue in these genetically susceptible individuals. Some patients also suffer from cognitive dysfunction, memory loss, or brain fog as well.
Chronic fatigue syndrome is just a label. It's useful to identify a group of symptoms that causes significant fatigue and may affect one's life dramatically causing inability to function or hold a job. It does not represent one clincial entity but the cause may be multi-factorial and different in each individual. It may share a final common pathway of dysfunctional immune activation and inflammation that keeps on going in a self perpetuating manner (like the Energizer Bunny gone bad!) From a functional medicine perspective it's important to get to the root cause of the chronic fatigue symptoms and cognitive impairment Figure 1. Most of these infections, including the inflammatory response (CIRS) to mold and mycotoxins can be measured by ordering conventional lab testing through a knowledgeable practitioner. Ask your doctor to see if he can help you determine the root cause of your fatigue. Treating the root cause (or infection in this case) just might give you back your life!
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Author declares there are no conflicts of interest.
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