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A Functional Medicine Approach to Chronic Fatigue Syndrome (CFS): Integrative & Functional Medicine - Dr. Kim Quincy, IL

Updated: Aug 6

A functional medicine approach to Chronic Fatigue Syndrome (CFS) focuses on identifying and addressing the root causes of illness, rather than simply managing symptoms. This patient-centered, systems-based model takes into account the dynamic interaction of genetics, environment, lifestyle, and biochemistry.

Below is a comprehensive breakdown of how functional medicine can support individuals with CFS, based on current understanding and clinical practice.

1. What Is Chronic Fatigue Syndrome (CFS)?

CFS, also known as myalgic encephalomyelitis (ME/CFS), is a complex, chronic illness defined by:

  • Fatigue lasting 6 months or more

  • Post-exertional malaise (PEM)

  • Unrefreshing sleep

  • Cognitive dysfunction (e.g., “brain fog”)

  • Pain, including muscle aches, joint pain, and headaches

Functional medicine views ME/CFS as a multifactorial condition, often involving:

  • Immune dysregulation

  • Mitochondrial dysfunction

  • Gut imbalances

  • Hormonal abnormalities

  • Environmental triggers

2. Core Principles of Functional Medicine in CFS

Functional medicine practitioners prioritize:

  • 🔬 Comprehensive AssessmentDeep evaluation of medical history, lifestyle, diet, stressors, and lab results.

  • 🧬 Personalized Treatment PlansTailored interventions based on each person’s unique biology and circumstances.

  • 🔄 Systems Biology ApproachAddressing imbalances across multiple systems—gut, immune, endocrine, detox, and nervous.

3. Functional Medicine Strategies for CFS

A. Identify and Address Root Causes

Functional medicine practitioners investigate a wide range of potential contributors:

1. Mitochondrial Dysfunction

Low cellular energy is a hallmark of CFS.Support strategies:

  • CoQ10 (100–300 mg/day)

  • L-carnitine (1–2 g/day)

  • D-ribose (5–10 g/day)

  • Magnesium (200–400 mg/day)

  • Clean, nutrient-dense diet - consider keto diet

  • Avoid mitochondrial toxins (e.g., heavy metals, pesticides)


2. Immune Dysregulation

Chronic immune activation may result from latent infections like EBV.Support strategies:

  • Test for viral reactivation, cytokines, NK cell function

  • Omega-3 fatty acids, curcumin, resveratrol

  • Adaptogens: ashwagandha, rhodiola


3. Gut Health and Dysbiosis

Leaky gut or microbiome imbalance can drive inflammation.Support strategies:

  • Stool analysis or food sensitivity testing

  • Anti-inflammatory or elimination diet

  • Probiotics (10–50 billion CFU/day), L-glutamine, zinc carnosine

  • Eliminate gluten, dairy, and ultra-processed foods if reactive


4. Hormonal Imbalances

Dysregulation of the HPA axis and thyroid dysfunction are common.Support strategies:

  • Test cortisol and thyroid hormones (TSH, free T3/T4, RT3)

  • Vitamin C, B vitamins, and adaptogens

  • Selenium and iodine (only if deficient)


5. Environmental Toxins

Toxins such as mold or heavy metals can worsen fatigue.Support strategies:

  • Mycotoxin and heavy metal testing

  • Glutathione, NAC, high-fiber detox support

  • Improve indoor air quality and avoid toxic exposures


6. Nutrient Deficiencies

Deficits in B12, vitamin D, or iron can fuel fatigue.Support strategies:

  • Test levels of B12, 25(OH)D, ferritin

  • Supplement with:

    • Vitamin D3 (2,000–5,000 IU/day)

    • Methyl-B12 (1,000–5,000 mcg/day)

    • Iron (only if deficient)

B. Optimize Diet and Nutrition

Diet is foundational in a functional medicine plan for CFS.

  • Eat more:

    • Vegetables, fruits, lean proteins (wild fish, pastured meats), healthy fats (olive oil, avocados, nuts), and complex carbs (quinoa, sweet potatoes) or low carb vegetables

  • Avoid:

    • Processed foods, sugar, artificial sweeteners, and known food triggers (gluten, dairy, soy, etc.)

  • Hydrate:

    • Drink 8–10 cups of water daily

    • Use electrolytes (magnesium, potassium) as needed

  • Consider:

    • Elimination diet (4–6 weeks) to identify intolerances

    • Frequent small meals to stabilize blood sugar and energy

C. Lifestyle Modifications

🛏️ Sleep

  • Aim for 7–9 hours/night

  • Support with melatonin, magnesium glycinate

  • Keep a consistent bedtime/wake routine

🧘 Stress Management

  • Reduce HPA axis strain through:

    • Meditation

    • Breathwork

    • Yoga

    • Vagal stimulation (gargling, humming, cold showers)

🚶 Gentle Movement

  • Avoid triggering PEM (post-exertional malaise)

  • Begin with tai chi, stretching, or short walks

  • Use pacing: balance activity with rest


D. Emotional and Psychological Health

Chronic illness can impact mental wellness.

  • Work with therapists trained in mind-body approaches (CBT, somatic experiencing)

  • Journaling or support groups can ease emotional strain and reduce isolation


E. Advanced Testing and Personalized Protocols

Testing often used by functional medicine practitioners:

  • Blood work: hs-CRP, vitamin D, thyroid, ferritin

  • Stool test: microbiome, inflammation, digestion

  • Organic Acids Test (OAT): mitochondrial function, detox pathways

  • Viral panels: EBV, HHV-6

  • Genetic testing: MTHFR, COMT, and more


4. Safety and Considerations

  • ✅ Personalize everything — no single protocol fits all

  • ⚠️ Avoid supplement overload — work with a clinician

  • 🔄 Introduce changes gradually — especially diet and movement

  • 🧠 Don’t neglect mental health — consider therapy or group support

. Backed by Clinical Evidence:

  • Mitochondrial support: CoQ10 and D-ribose shown to improve energy

    Journal of Clinical Biochemistry and Nutrition, 2016

  • Gut health: Probiotics reduce inflammation in ME/CFS

    Nutrients, 2018

  • Adaptogens: Effective for stress and HPA axis regulation

    Journal of Alternative and Complementary Medicine, 2014


LDN: A Promising Adjunct for CFS

Low Dose Naltrexone (LDN) is gaining attention for its role in CFS management due to its:

  • Immune-modulating effects

  • Anti-inflammatory properties

  • Neuroprotective actions

"In my experience, while LDN’s anti-inflammatory benefits are consistently reliable, its results in CFS are less predictable. However, due to its favorable risk-to-benefit ratio, I often recommend considering it as a trial therapy for individuals with CFS."— Dr. Yoon Hang Kim, MD

5. Resources and Support

📘 Books

  • From Fatigued to Fantastic by Dr. Jacob Teitelbaum


Dr. Yoon Hang Kim, MD is a board-certified physician specializing in integrative and functional medicine, dedicated to uncovering root causes and providing personalized healing for chronic and complex conditions. He is a recognized expert in Low Dose Naltrexone (LDN) therapy and offers telemedicine services across multiple states—including Quincy, IL and throughout Illinois, San Antonio and all of Texas, Missouri, Florida, and Atlanta as well as the rest of Georgia.


 
 
 

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