Moon I am empathetic to your description of this disease. Chronic fatigue simply means unrelenting fatigue. I do not know the statistics on how many people with chronic fatigue actually have immune dysfunction, but I agree with all of your points that the two are most often a package deal. I was equally frustrated in the past when I would hear people tell me that they were tired too - yet they managed to go to work and cook dinner and do things I could only dream of doing.
It is a chicken or egg problem though. Did the fatigue always come first or did the immune deficiency or did the infection or did self induced stress come first? The answer is probably a combination - and then when you throw in genetic factors all of those previous mentioned factors can possibly be thrown out the window.
The fact is is that there are so many things going wrong at once that you could easily diagnose the average "chronic fatigue" patient with 10 diseases, so I agree with you that it is much more complex than just unrelenting fatigue. The only way I can even begin to see this disease as treated is to start plugging holes like on a sinking ship.
To me the most salient symptom of most of us is orthostatic intolerance. I bet probably most of us have had it at one point. And that most likely points to an imbalance in the renin-angiotensin system. An overactive "hyperadrenergic" sympathetic nervous system seems to cause this. In this study they are using an angiotensin receptor blocker (high blood pressure drug) to attenuate symptoms of orthostatic intolerance, which in a sense is paradoxical.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765216/?tool=pmcentrez
Yet, I know CFS patients that also have high blood pressure. So it is a misnomer to think that be simply increasing blood pressure this so called orthostatic intolerance is going to completely disappear.
I was reading a chiropractic book and it was said that an overactive sympathetic nervous system will decay the immune response in addition to producing fatigue.
You can go to this website for example where a guy supposedly cures many people by focusing on decreasing the hyperactivity of the sympathetic nervous system.
www.actionlove.net Excuse some of the sexual/medical content (only click it if you are over 18).
Ultimately my method is to address the hormone deficiencies, populate the gut with soil based organisms (not lactic acid bacteria), and enhance the functioning of the parasympathetic nervous system. This has been working for me. YMMV
The most important point I can personally mention is the connection between the nervous system, the immune system, and the gut. It is essentially one component. The gut produces neurotransmitters. The immune system produces cytokines. Everything is constantly interacting. So if one of those is hyperactive or infected/dysfunctional the whole system will show symptoms - and that is why this disease IMO is so perplexing to doctors because by the time the chronic fatigue has set in all three of those variables are corrupted most likely. There is a gut infection - the sympathetic/parasympathetic control of the nervous system is not functioning properly, and the immune system is going crazy dealing with bad bacterial overgrowth and or falsely activating itself from the hyperactive sympathetic nervous system. I'm not saying this is every case of CFS I am just saying this is an example of how something can go wrong. And then you throw in hormone deficiencies and those in themselves can cause these 3 components to self destruct.
The nervous system imbalance can be an esoteric concept - but we can all confess to having the tired but wired feeling at times. It is ironic how many claims I see of no energy during the day but insomnia at night.
