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Can Hashimotos cause chronic fatigue syndrome?

Chronic fatigue: an immune dysfunction syndrome?

The exact cause of chronic fatigue syndrome is still unknown. But mounting evidence suggests that an underlying biological process, such as an immune dysfunction, triggered by an infection, plays an important role in the onset of disease.

Not surprisingly, CFS is often referred to as an immune dysfunction syndrome. It frequently appears in people who have been sick. An estimated 50% to 70% of patients with chronic fatigue syndrome report that their symptoms started after they had a viral-like illness 2 or infection. 3

Furthermore, a significant number of CFS patients have other immune or autoimmune diseases, such as fibromyalgia or Hashimoto’s disease. And, these individuals frequently have a family history of autoimmune disease. 4

In 2019 researchers reported, “For the first time, we have shown that people who are prone to develop a CFS-like illness have an overactive immune system, both before and during a challenge to the immune system.” 5

These findings add to the “growing weight of scientific evidence which indicates that the body’s immune system is playing an important role in the causation of CFS,” wrote Dr. Charles Shepherd, medical advisor at the ME Association. 5

For the first time, a study shows that people who “are prone to develop a CFS-like illness have an overactive immune system.” (5)

Immune system in overdrive

Other researchers have come to similar conclusions. Russell and colleagues have suggested that their study supports “the hypothesis that abnormal immune mechanisms are important in CFS.” 6

So, what would cause the immune system to malfunction and trigger CFS symptoms? There are multiple theories. The latest science indicates, however, that infections play a pivotal role. For some individuals, “infections throw a wrench in the immune system’s ability to quiet itself after the acute infection.” Instead, “the immune response becomes like a car stuck in high gear.” 7

This ongoing revving of the engine can be damaging, creating inflammation in the central and peripheral nervous system. An immune dysfunction may then trigger the onset of chronic fatigue syndrome symptoms, which can sometimes cause severe disability.

In fact, more than 25% of patients with CFS are so ill, they are confined to their homes or completely bedbound. 8 Women are impacted twice as often as men. And although the illness can manifest at any age, the incidence rate appears highest between the ages of 10-19 and 30-39. 9

CFS symptoms can fluctuate, vary in intensity and appear either suddenly or gradually. Many patients complain of “brain fog.” This is described as slow thinking, difficulty focusing, and forgetfulness.

Although there is no single laboratory test that can diagnose chronic fatigue syndrome, the Cunningham Panel™ has been utilized by clinicians to help determine whether symptoms associated with CFS could be due to an underlying infection-triggered autoimmune process.


  1. Franziska Sotzny, Julià Blanco, Enrica Capelli, Jesús Castro-Marrero, Sophie Steiner, Modra Murovska, Carmen Scheibenbogen. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease, Autoimmunity Reviews. Volume 17, Issue 6, 2018, Pages 601-609.
  2. Rasa, S. et al. Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Journal of Translational Medicine. volume 16, Article number: 268 (2018).
  3. Blomberg J, Rizwan M, Böhlin-Wiener A, et al. Antibodies to Human Herpesviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. Front Immunol. 2019;10:1946.
  4. Alice Russell, Nilay Hepgul, Naghmeh Nikkheslat, Alessandra Borsini, Zuzanna Zajkowska, Natalie Moll, Daniel Forton, Kosh Agarwal, Trudie Chalder, Valeria Mondelli, Matthew Hotopf, Anthony Cleare, Gabrielle Murphy, Graham Foster, Terry Wong, Gregor A. Schütze, Markus J. Schwarz, Neil Harrison, Patricia A. Zunszain, Carmine M. Pariante, Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. Volume 100, 2019, Pages 276-285.
  5. Nicola Davis. The Guardian. Chronic fatigue syndrome ‘could be triggered by overactive immune system.’ Dec. 17, 2018.
  6. Russel A. et al. Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. 2019 Feb;100:276-285.
  7. Scientists discover robust evidence that chronic fatigue syndrome is a biological illness. Columbia University’s Mailman School of Public Health. Press release. February 2015.
  8. Pendergrast T, Brown A, Sunnquist M, et al. Housebound versus nonhousebound patients with myalgic encephalomyelitis and chronic fatigue syndrome. Chronic Illn. 2016;12(4):292–307.
  9. Bakken I. et al. Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012. BMC Medicine. volume 12, Article number: 167 (2014).

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chronic fatigue immune dysfunction syndrome

This study provides “unequivocal evidence of immunological dysfunction in ME/CFS.” 7

Infections may cause chronic fatigue immune syndrome

How can an infection cause chronic fatigue immune dysfunction syndrome symptoms?

Learn more about how infections can trigger neuropsychiatric symptoms

Cunningham Panel helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Researchers describe a complex case involving a 15-year-old girl, who abruptly developed multiple neurologic and psychiatric symptoms.

Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

This nationwide, population-based, prospective cohort study examines the link between mood disorders, infections, and autoimmune disease.

Childhood infections can increase risk of mental illness in kids

Childhood infections can increase risk of mental illness in kids

Nationwide study finds both mild and severe infections can increase risk of mental disorders in children and adolescents.

Test Order Process

The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms.

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B. Robert Mozayeni, MD

Medical and Clinical Advisor

B. Robert Mozayeni MD

Dr. B. Robert Mozayeni was trained in Internal Medicine and Rheumatology at Yale and at NIH. He has had pre- and post-doctoral Fellowships in Molecular Biophysics and Biochemistry at Yale, and also at NIH where he was a Howard Hughes Research Scholar at LMB/DCBD/NCI and later, Senior Staff Fellow at LMMB/NHLBI/NIH. Editorial board of Infectious Diseases – Surveillance, Prevention and Treatment. Past President of the International Lyme and Associated Diseases Society (ILADS).

He is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently. He is a Fellow of the non-profit Think Lead Innovate Foundation and is a co-founder of the Foundation for the Study of Inflammatory Diseases. He is a Founder of the Foundation for the Study of Inflammatory Diseases to crowd-source medical solutions for complex conditions using existing knowledge, diagnostic methods, and therapies to meet patient needs immediately. He is the Chief Medical Officer of Galaxy Diagnostics, LLC. He is a Board member of the Human-Kind Alliance. Dr. Mozayeni has held admitting privileges (since 1994) on the clinical staff of Suburban Hospital, a member of Johns Hopkins Medicine and an affiliate of the National Institutes of Health Clinical Center.

Safedin Sajo Beqaj, PhD, HCLD, CC (ABB)

Moleculera Labs, Clinical Laboratory Advisor
Medical Database, Inc., President and CEO

Sajo Baqaj, PhD

Dr. Sajo Beqaj is board certified in molecular pathology and genetics and licensed as a Bioanalyst and High Complexity Laboratory Director. He has been practicing as a laboratory director since 2005.

Dr. Beqaj served as a technical director and was part of the initial management team for several well-known laboratories in the clinical lab industry including PathGroup, Nashville, TN; DCL Medical Laboratories, Indianapolis, IN, and Pathology, Inc, Torrance, CA. He is currently serving as off-side CLIA laboratory director for BioCorp Clinical Laboratory, Whittier, CA and Health360 Labs, Garden Grove, CA.

Dr. Beqaj received his Ph.D. in Pathology from Wayne State University Medical School, Detroit, Michigan. He performed his post-doctoral fellowship at Abbott Laboratories from 2001-2003 and with Children’s Hospital and Northwestern University from 2003-2005.

Dr. Beqaj has taught in several academic institutions and has published numerous medical textbook chapters and journal articles. He has served as a principal investigator in clinical trials for several well-known pharmaceutical and diagnostic companies such as Roche HPV Athena, Merck HPV vaccine, BD vaginitis panel, Roche (Vantana) CINtec® Histology clinical trials, and has presented various scientific clinical abstracts and presentations.

He is a member of several medical and scientific associations including the Association of Molecular Pathology, American Association of Clinical Chemistry and the Pan Am Society for Clinical Virology. He has served on a number of clinical laboratory regulatory and scientific committees, and has assisted several laboratories and physicians as a Clinical Laboratory Consultant.

Can Hashimotos cause chronic fatigue syndrome?

August 31, 2018 Josh Redd, DC —>

If you struggle with Hashimoto’s low thyroid, chronic exhaustion, insomnia, poor immunity, and low blood sugar symptoms, you may have poor function of the adrenal glands, or adrenal fatigue. These glands sit atop the kidneys and secrete stress hormones. However, your doctor likely told you there is no such thing as adrenal fatigue, thanks to guidance from The Hormone Foundation. However, there is a continuum of adrenal function and the brain plays a role in adrenal fatigue.

The debate around adrenal fatigue and primary adrenal insufficiency

  • Weakness
  • Fatigue
  • Muscle aches
  • Loss of appetite with weight loss
  • Craving salty foods
  • Dizziness, low blood pressure
  • Feeling lightheaded when standing up
  • Gastrointestinal symptoms such as nausea, vomiting, and abdominal discomfort

Adrenal fatigue describes when lab tests don’t support a diagnosis of primary adrenal insufficiency but a person still experiences symptoms of adrenal fatigue such as:

  • Excessive fatigue and exhaustion
  • Non-refreshing sleep
  • Feeling overwhelmed by or unable to cope with stress
  • Craving salty foods
  • Difficulty concentrating
  • Brain fog
  • Poor digestion

Adrenal fatigue is diagnosed by considering symptoms and running a 24-hour saliva cortisol test.

The role of the brain in adrenal fatigue

The brain plays an important role in adrenal fatigue. This is why nutrients to support your adrenal glands may not be helpful when the real problem is happening in the brain.

Adrenal fatigue stems from poor function in the hypothalamus-pituitary-adrenal (HPA) axis. The HPA axis is the feedback loop between your body and parts of the brain that governs adrenal function. Chronic stress fatigues this entire system, including the brain.

How the adrenals become fatigued

When our bodies experience stress, no matter how small or large, our adrenals pump out hormones such as adrenaline and cortisol to help us fight or take flight. Our bodies are designed to return to baseline after a stressor so the nervous system can return to a “rest and digest” state necessary for daily function.

However, in our chronically stressed modern lifestyles, our bodies are constantly reacting to stressors, many we are not even aware of, such as dietary triggers, toxins, even electromagnetic frequencies, and undiagnosed autoimmune diseases such as Hashimoto’s hypothyroidism.

This constant state of high stress hormones damages tissues in the body and brain and is linked to:

  • Suppressed immunity
  • Low energy
  • Depression
  • Insomnia
  • Insulin resistance and diabetes
  • High blood pressure
  • Heart problems
  • Increased belly fat

Removing all stressors in life is impossible, but there is much we can do to support adrenal function and buffer the damage of stress.

Adrenal adaptogens and phosphatidylerine are two natural routes that especially support the HPA axis and the brain’s ability to handle stress.

Contact my office for more support in taking care of your Hashimoto’s hypothyroidism, adrenals, HPA axis, and your ability to become more resilient to stress.

How to learn if you have Hashimoto’s low thyroid


Many patients are not diagnosed with hypothyroidism or Hashimoto’s until after several years and going through several doctors. It is a demoralizing journey richly illustrated in my book The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto’s Low Thyroid Disease, through real-life stories from patients in my practice. Managing Hashimoto’s goes far beyond using thyroid medication as you must work to stop the immune system from attacking the thyroid. For more information on identifying and managing Hashimoto’s low thyroid, contact my office.

About Dr. Josh Redd, Chiropractic Physician — Utah, Nevada, Arizona, Idaho, and New Mexico functional medicine

Dr. Joshua J. Redd, DC, MS, DABFM, DAAIM, author of The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto’s Low Thyroid Disease, is a chiropractic physician and the founder of RedRiver Health and Wellness Center with practices in Utah, Arizona, and New Mexico. He sees patients from around the world who suffer from challenging thyroid disorders, Hashimoto’s disease, and other autoimmune conditions. In addition to his chiropractic degree, Dr. Redd has a BS in Health and Wellness, a BS in Anatomy, and a MS in Human Nutrition and Functional Medicine. He speaks across the nation, teaching physicians about functional blood chemistry, low thyroid, Hashimoto’s, and autoimmunity. You can join his Facebook page here.

Fatigue, Weight Gain Could Indicate Hashimoto’s Disease

By Kathy Hubbard “I have not changed my diet, but I’ve been gaining weight like crazy,” a woman in her mid-fifties told me. “And, I just don’t have any energy; I’m constantly tired.” I thought she sounded like a lot of us since the pandemic hit. Gaining weight and feeling lethargic seems to be familiar to those of us isolating. However, I noticed that she kept rubbing her neck and asked her why she was doing that. She said she could feel a little lump but that it didn’t hurt. “Aha,” said I. “You should go to your healthcare provider for a look-see; it might be a thyroid issue.” Most people don’t listen to me when I give them medical advice and for the excellent reason that they shouldn’t. My medical expertise is limited to what I read online. In this case, the woman did see her doctor and was diagnosed with Hashimoto’s thyroiditis, also known as Hashimoto’s disease, chronic lymphocytic thyroiditis, or autoimmune thyroiditis. “Hashimoto’s thyroiditis occurs when your body attacks the thyroid as if it were a virus,” explains. “This leads to a decrease in thyroid function and hormone production.” As we all know, the thyroid is a butterfly-shaped gland attached to the front of our windpipes and is part of the endocrine system, which produces and stores hormones. The thyroid regulates our metabolism, growth, temperature, and energy. When the thyroid gland produces too much hormone, it’s called hyperthyroidism, and too little is hypothyroidism. According to The American Thyroid Association, Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. “It is an autoimmune disorder involving chronic inflammation of the thyroid. Over time, the ability of the thyroid gland to produce thyroid hormones often becomes impaired and leads to a gradual decline in function and eventually, an underactive thyroid (hypothyroidism).” Hashimoto’s thyroiditis is a disease; hypothyroidism is a condition that occurs because of the disease. It’s most common in women. It affects about seven times as many women as men suggesting that sex hormones may be a factor. And, although its onset is typical during middle age, it can occur in younger people and children of both sexes. According to WebMD, some women may experience thyroid problems during the first year after giving birth. Although the symptoms go away, up to twenty percent of these women will develop Hashimoto’s years later. “People who get Hashimoto’s often have family members who have thyroid disease or other autoimmune diseases, suggesting a genetic component to the disease,” WebMD says. Often, the first sign is an enlarged thyroid called a goiter. It may cause the front of your neck to look swollen; if it’s large, it may make it hard to swallow. As the thyroid becomes underactive, symptoms such as weight gain, fatigue, a pale or a puffy face; joint and muscle pain; constipation; inability to get warm; difficulty getting pregnant; hair loss or thinning brittle hair; irregular or heavy menstrual periods; depression; memory lapse, and slowed heart rate may occur. Yeah, all these symptoms could be something else, so it’s essential to see a medical professional get a proper diagnosis. “Diagnosis of Hashimoto’s disease is based on your signs and symptoms and the results of blood tests that measure levels of thyroid hormone and thyroid-stimulating hormone (TSH) produced in the pituitary gland,” Mayo Clinic says. “In the past, doctors weren’t able to detect an underactive thyroid until symptoms were fairly advanced. But by using the sensitive TSH test, doctors can diagnose thyroid disorders much earlier, often before you experience symptoms.” Healthline says that the good news is that Hashimoto’s thyroiditis can be managed with the correct dose of the prescription drug levothyroxine and a careful diet. “While dosage and medication timing are different for everyone, levothyroxine is the first line of defense against hypothyroidism. It mimics the hormone (thyroxine) the thyroid produces,” they say. There are pages and pages of information online about what to eat to optimize the amount of iodine, selenium, and zinc your body needs. I know this because my friend reads them all to me. Turn around is fair play. Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at

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