Chronic Fatigue Syndrome

A paucity of autoimmune disease and hypertension in CFS

There is little true autoimmune disease seen in CFS as distinct from autoantibody formation without organ destruction which is more common. Also, there is a significant paucity of hypertension seen in my CFS cohort at less than 1% of all patients with CFS in my practice.

Antibiotics and Dysbiosis

I would agree that some sort of gut dysbiosis strategy is appropriate but more as part of a larger strategy which also addresses redox control points as well as human phenotypic and genotypic corruption. There is as yet, no clear consensus on treating this gut dysbiosis, so I take a pretty conservative approach that follows a 3R strategy (remove, repair and replace) as well as a modified elimination diet and especially fructose elimination.

CFS and the absence of autoimmune disease – ? NO elevation

Very interesting is the relationship of high nitric oxide (NO) to a low incidence of autoimmune disease. In CFS patients, actual autoimmune disease is very rare as is hypertension.

Antibiotics in CFS

To me, CFS is best viewed as a very complex terrain issue and that microbes are simply taking advantage of this fact so that reductionism to drugs or pharmaceuticals directed against single agents or pathways will be a poor therapeutic choice except perhaps early in the illness and in the occasional patient who is much less complex.