According to the CFS case definition published in the Dec. 15, 1994 issue of the Annals of Internal Medicine, diagnosing CFIDS requires a thorough medical history, physical and mental status examinations and laboratory tests to identify underlying or contributing conditions that require treatment. Chronic fatigue can be classified as Chronic Fatigue and Immune Dysfunction Syndrome if the patient meets both the following criteria:

1. Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e., not lifelong) is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social or personal activities.
2. The concurrent occurrence of four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without joint swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours. These symptoms must have persisted or recurred during six or more consecutive months of illness and must not have pre-dated the fatigue.

Can it be treated?
Treatment for CFIDS is intended primarily to relieve specific symptoms. One third of the patients who develop CFIDS report resolution of symptoms over time. Another one third cycle between periods of good health and wellness and some gradually worsen. What is required is an integrative, step-wise approach. Each patient requires an individualized protocol.

Is CFIDS the same thing as Fibromyalgia?
No, but patients can have both simultaneously.

Briefly, how do you treat CFIDS?
With an integrated, step-wise approach to address:

• food allergies
• Sleep disorder--if the body can get adequate sleep, it may improve pain issues
• Immune dysfunction/Infections
• Endocrine disorders - thyroid, hGH, adrenal, sex hormonal imbalances
• Metabolic disturbances - blood volume depletion, mineral deficiency, especially magnesium, acid-base imbalance, DNA and mitochondrial damage, antioxidant depletion, mercury detoxification, brain protection and restoration, autonomic nervous system imbalance, oxygen transport difficulty, adrenal insufficiency and pain management.

Depending on the current status of a patient in the step-wise protocol, we can carefully progress through an individualized plan of treatment. As the body begins to repair itself and heal, the next step is implemented. This allows time to assess what is most beneficial in a partnership between physician and patient.

Why do lab results my doctor orders so often have no abnormalities?
Routine lab tests that measure blood count, blood sugar, kidney, liver function and cholesterol are often normal in CFIDS patients, some patterns emerge such as low sed rate, low uric acid and low white cell count as well as upregulated cholesterol levels. These tests are too general to find functional defects in CFICS patients.

What laboratory tests are helpful?
There are many specialty tests

1. RNAase L level - often upregulated indicating active viral infections
2. Low NK (Natural Killer) cell count and function
3. Abnormal Comprehensive Digestive Stool Analysis - indicating gut dysbiosis and/or inflammation
4. Chronic Viral Infections - measured by PCR technology, indicating smoldering infections with HHV6, Cytomegalovirus, Mycoplasma, Chlamydia infections. I look for active viral infections, not antibody titers.
5. 24-hour urine Amino Acid analysis - can pinpoint specific vitamin, mineral and protein deficiencies.
6. Abnormal salivary melatonin level - often a CFIDS patient will not secrete melatonin at midnight, but will secrete a quantity of melatonin at 6:00AM. This inhibits sleep, and then creates difficulty in waking.
7. Genetic screening -  genetic panels for detoxification and Immune dysfunction. With this information, I can pinpoint genetic predisposition to CFIDS and direct phenotypic manipulation to shut off genes expressing inflammation, liver toxicity problems, etc.
8. ISAC panel - (Immune System Activation of Coagulation)  looks for hypercoagulation problems which
   1. allow pathogens to persist in the bloodstream
   2. interfere with O₂/CO₂ transport - and thus cause fatigue and muscle pain.
9. Testing for Human Growth Hormone deficiency
10. Other hormone analysis: DHEA, Estrogen, Progesterone, Testosterone and Cortisol imbalances.

Please keep in mind that treatment for each patient is individualized, based on the results of a patient’s symptoms, physical exam and laboratory analysis.

Do some CFIDS specialists recommend shots?
Shots may be helpful; :

• Magnesium + Taurine injections
• B12 (hydroxy form)
• Glutathione
• Kutapressin
• Human Growth Hormone - very low dose
• Growth Factors
• IVIg

Does Imunovir (Isoprinosine) Work?
It is a powerful immune modulator that can be very helpful, although not currently available in the U.S. it can be imported utilizing a correct prescription. This is one of the safest, most cost effective and helpful drugs at our disposal. Ongoing studies in Canada and Europe have proven this drug to raise NK cell count and function and correct TH1/TH2 imbalances. It is a non-specific antiviral compound.

Does insurance pay for treatment, laboratory testing, and office visit?
Most insurance covers some of the above. We will  furnishes claim forms and documentation to allow filing with most insurance companies. In addition, we can write a letter of appeal to your insurance carrier if they deny payment which may help coverage benefits.