Some of these bio-chemical factors include mitochondrial dysfunction, hpa-axis dysfunction/hypocortisolism, autonomic nervous system dysfunction, microbial infections(viral, fungal, parasitical, bacterial), toxic metal overload, methylation disorders, increased intestinal permeability(leaky gut syndrome), gut flora imbalances, micro-nutrient deficiencies and even thyroid disorders.
Most typical general practitioners don't run more than the basic blood tests, however i feel the tests described below can be helpful to give a bigger picture to the possible root causes of an individuals chronic fatigue syndrome.
Western medicines approach to "treating" chronic fatigue syndrome/ME is typically anti-depressant medication, cognitive-behavioral therapy and paced exercise. I don't believe the research is there to indicate that these are effective treatments for individuals with CFS at the current time, especially those with many of the proven physical causes such as described below.
No amount of anti-depressant medication is likely to compensate for mitochondrial dysfunction caused by co-enzyme q10 deficiency for example. Infact i believe there is some research which shows that certain types of anti-depressants(tri-cyclics) actually inhibit co-enzyme q10 synthesis.
As someone who has battled these type of chronic health problems myself, i feel the tests below are well worth researching and discussing with your medical professional.
There is now significant scientific research there which confirms the importance of these micro-nutrient deficiencies such as co-enzyme q10 and how low levels are a risk factor for developing heart disease in those with CFS.
1. Co-Enzyme Q10
Scientific research has shown that individuals with Chronic Fatigue Syndrome have lower blood plasma levels of Co-enzyme Q10 than compared to healthy controls.
Co-enzyme Q10 deficiency can be indicative of mitochondrial dysfunction and as the studies have shown low levels of Co-Q10 are related to the fatigue, autonomic and neuro-cognitive symptoms that CFS patients suffer from.
The study also found that Co-Enzyme Q10 deficiency is a risk factor for early mortality due to cardiovascular disorder in individuals with chronic fatigue syndrome and conditions such as major depression.
I believe due to the mounting level of research on the importance of co-enzyme Q10 and its relation to the development of cardiovascular disorder, that physicians should identify at risk groups such as individuals with chronic fatigue syndrome, major depression, those on statin(cholesterol) lowering drugs, heart disorders and regularly test these individuals blood plasma co-enzyme q10 levels.
Personally i was completely deficient in Co-Enzyme Q10 from a blood plasma test and taking Ubiquinol did clinically improve my condition and CFS/autonomic symptoms. Not only that, but restoring co-enzyme q10 levels also improved my ability to be able to exercise again and thus improved my exercise tolerance and reduced the shortness of breath on exertion.
If your healthcare professional is not aware of the importance of Co-Enzyme Q10 and its relation to CFS, then you can share this study linked here - Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder.
2. Red Cell Magnesium
Many CFS patients have found that whilst their blood serum magnesium tests were normal, red blood cell tests indicated low levels and deficiency.
Many experts believe that red blood cell mineral testing to be much more accurate indicator of one's true levels of minerals such as magnesium, zinc and copper.
Studies have found that individuals with CFS to have lower levels of the mineral magnesium and the good news is that research has found that treatment with magnesium helps to improve CFS symptoms.
Magnesium deficiency can wreck havoc with health causing a wide variety of different symptoms from heart palpitations, anxiety, fatigue to muscle tension. Magnesium deficiency may help to explain some of the cardiovascular symptoms that those with CFS complain of such as shortness of breath, palpitations, tachycardia and mitral valve issues.
I feel a red blood cell magnesium test is helpful to check if levels are low or deficient in this very essential nutrient.
When i had CFS, i found that i was magnesium "dependant" and used up my stores of magnesium very quickly most likely due to the intense stress of living with CFS. Without additional magnesium supplementation id often find that my cardiovascular symptoms, anxiety and even fatigue would worsen, symptoms could be significantly reduced by rubbing a small amount of transdermal magnesium oil(ancient minerals magnesium) in the arms.
3. Adrenal Gland Function Tests (Saliva Adrenal Stress Test, DHEA etc)
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is known as "adrenal fatigue" in the alternative health field. I prefer HPA-axis dysfunction or dysregulation as it is the term used to describe this condition in scientific literature.
HPA axis dysfunction is also a term that most doctors and psychiatrists should be able to relate too, as it is well documented finding in many health problems ranging from chronic fatigue syndrome to post traumatic stress disorders.
One study review concluded that Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been found in a high proportion of chronic fatigue syndrome (CFS) patients and includes enhanced corticosteroid-induced negative feedback, basal hypocortisolism, attenuated diurnal variation, and a reduced responsivity to challenge.
The saliva adrenal stress test from Genova Diagnostics is a decent test for detecting imbalances in the circadian rhythm and gives a look at levels of stress hormones cortisol and DHEA over the day.
Hypocortisolism is extremely common in individuals with chronic fatigue syndrome and was a major problem of my own for years. My adrenals were constantly dysregulated with low cortisol levels over the day, but i believe this is merely an end result, rather than a primary problem with the adrenal glands. Autonomic nervous system dysfunction and sympathetic "fight or flight" nervous system dominance preceeds adrenal burnout. The adrenals simply cannot cope with the constant demand for more stress hormones such as cortisol and adrenaline. The sympathetic "fight or flight" system was meant to be used infrequently in times of stress, unfortunately due to an imbalance in autonomic function, those with CFS are often constantly stuck in fight or flight mode.
Many individuals with CFS will benefit from mind-body calming therapies such as meditation, deep breathing exercises, low intensity tai chi, nervine herbs etc, all of which activate the parasympathetic(rest and digest) system, which is where we regenerate and heal. Disrupted sleep is another common factor in CFS.
Other tests that can be helpful for assessing adrenal gland function include DHEA-Sulphate, which measures blood levels of the adrenal steroid hormone DHEA.
Urine 24 hour and blood cortisol tests can also be helpful, although i feel the saliva adrenal stress test is a good starting point and isn't too expensive. The saliva adrenal stress test can also be done from home, which is a huge plus for those who are house bound and disabled.
For more information on the role of the hypothalamic-pituitary-adrenal(HPA) axis role in those with CFS, check this great review study here - A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome
4. Vitamin D
Recent research has once again found that a wide percentage of the British population still suffer from sub-optimal Vitamin D levels and deficiency. Simply put we are not getting enough quality sunlight to maintain healthy Vitamin D status and it may be leaving us vulnerable to developing many serious diseases and health problems.
Many individuals with CFS are often house bound and thus don't spend much time out-doors to get adequate sunlight to stimulate vitamin D production.
Vitamin D is one of the tests which your NHS doctor should be able to do for you for free, however if not then its not too expensive to have done private.
Vitamin D is a fat-soluble nutrient, as such in high amounts it can build up and become toxic in the body. As such i always recommend that an individual has their blood levels tested before jumping into high dose Vitamin D supplementation as is sometimes recommended on other websites for treating CFS, auto-immune disease, MS etc and always have a professional monitoring you.
5. Red Cell Zinc & Copper
One study found that the more deficient one was in zinc, the more severe their chronic fatigue syndrome was.
The study showed that zinc deficiency causes increased oxidative stress, immune dysfunction and inflammation, all of which are common pathologies in many individuals with chronic fatigue syndrome/ME and could well be the root bio-chemical causes of this condition.
More and more research is starting to be focused in the area of copper/zinc balance and its role in conditions such as autism spectrum disorders. Chronic fatigue syndrome shares many of the symptoms of Autism spectrum disorders. Toxic metal overload is one shared aspect, as is GABA-ergic dysfunction. Glutathione depletion is another common shared etiology between those with CFS and individuals with Autism. All of of which are heavily dependant on having healthy levels of zinc in the body and a good balance of zinc/copper.
I believe in the years to come we will see more and more research on copper/zinc imbalances and its role in many conditions such as CFS, autism spectrum disorders, violent behavior, mental health conditions, anxiety/panic disorders and much more.
Nutritional balancing expert Dr Lawrence Wilson has alot of articles and information on copper/zinc imbalances and their role in common health conditions such as adrenal burnout syndrome/CFS. His information is well worth a read for anyone with CFS.
To read more on lower serum zinc and chronic fatigue syndrome, check the study at - Lower serum zinc in Chronic Fatigue Syndrome (CFS): relationships to immune dysfunctions and relevance for the oxidative stress status in CFS.
6. Spectracell Micronutrient Test
Spectracell is a test which examines the white blood cell portion for various micro-nutrients(vitamins, minerals, antioxidants, amino acids etc).
Deficiencies in various micro-nutrients has been proven in scientific research to be related to many of the symptoms that those with CFS complain of.
The spectrallcell looks at the usual B-complex vitamins, which is very handy for those with genetic defects such as pyrrole disorder who may have functional Vitamin B6 and Zinc deficiency issues. I'll discuss the importance of Vitamin B12 and CFS below.
Spectracell also measures antioxidants/mitochondrial energy nutrients such as co-enzyme q10, alpha lipoic acid and l-carnitine, all of which have been found to be common deficiencies in those with CFS and can cause low energy/chronic fatigue.
The test can be very illuminating and give a wider picture of what is going on and many have noticed clinical improvement by rectifying these micro-nutrient deficiencies.
Although spectracell is a fairly new type of testing and is expensive, i believe what it has the potential to unearth in regards to ones health, can be very helpful.
For example, it can detect functional deficiences in various micro-nutrients such as Vitamin B12, when serum B12 tests have come back normal and missed this very serious issue. Functional Vitamin B12 deficiency can wreck havoc with ones health and lead to the development of a variety of serious health problems, including irreparable nervous system damage and cardiovascular disease through elevated homocysteine levels.
Many individuals with CFS complain of Vitamin B12 deficiency symptoms such as shortness of breath, chronic fatigue, MS-like neurological symptoms and disability, despite having normal blood serum levels of Vitamin B12. Experts such as Dr Myhill have seen clinical improvement in many individuals chronic fatigue syndrome with B12 and Magnesium injections.
Scientific research has found that individuals with Chronic Fatigue Syndrome have elevated homocysteine levels in their cerebrospinal fluid and this was indicative of Vitamin B12 deficiency, despite serum blood B12 tests coming back normal for many.
Spectracell tests so many things at once that it will likely eliminate your need to use red cell mineral testing, as spectracell also looks at functional mineral deficiencies(calcium, selenium, zinc, magnesium and copper).
Always consult a professional before making any dietary or lifestyle changes.
The information in this article has not been evaluated by the FDA and should not be used to diagnose, cure or treat any disease, implied or otherwise.