Infection Intensive Care in CFS & Fibromyalgia

Published: June 7, 2022

Infections in CFS and FMS

For those of you with CFS/FMS, welcome to the Infection of the Month Club. Many of you have noticed that there seems to be a regular flow of new infections that get blamed for CFS and fibromyalgia. I have watched this occur over and over in the last forty years, with literally dozens of different infections being blamed as "the cause." Post-COVID Long Haulers is simply one more.

So let me start by simply stating the obvious: CFS/FMS is generally not occurring from a single infection—but rather most people have many infections that are dragging them down.

In this part 15 of my series "Fatigue & Fibromyalgia Are Optional," I discuss the various kinds of infections common in people with CFS/FMS.

BFF Summary

  1. There are literally dozens of infections implicated in CFS/FMS.
  2. I treat virtually everybody who comes to me with CFS/FMS for Candida overgrowth.
  3. If their history is suggestive (foul-smelling gas, bloating, and diarrhea that persists despite antifungal treatment), I do stool testing at Genova Diagnostics for SIBO and parasites. I find that parasite testing at most standard labs is inadequate.
  4. Next I consider viral infections, especially if the illness began after a viral infection or chronic flu-like symptoms are present. I prefer to consider antivirals first because they are much safer than long-term antibiotics. These are the three main antiviral protocols I consider:
    1. A combination of 500 to 750 milligrams of famciclovir (Famvir) three times a day plus 200 milligrams of celecoxib (Celebrex) twice a day can be very helpful after four months, especially if the Epstein-Barr or HSV-1 IgG viral tests are very high. Simply being elevated just says that the person had the infection in the past, and 95 percent of the healthy adult population are positive for these tests.
    2. If the cytomegalovirus (CMV) or HHV-6 (human herpesvirus 6) IgG antibody levels are very elevated and the person doesn't respond to famciclovir (Famvir), I consider 900 milligrams of valagancicyclovir (Valcyte) a day for six months.
    3. Work by the infectious disease specialist John Chia suggests that enteroviruses (e.g., Coxsackievirus) is active in a very high percent of cases of CFS and fibromyalgia. A supplement called Equilibrant can be very helpful in these situations. Regular lab testing is not helpful. I treat this without doing the lab testing.
  5. Next, I consider antibiotic-sensitive infections:
    1. For Lyme disease and coinfections, I do not find most testing to be especially reliable (although it can point in helpful directions). I find that most labs are either almost always negative and others almost always positive. Because of this, I consider it reasonable to treat empirically based on symptoms and simply see if the person improves.
    2. If taking antibiotics for an extended period, it is critical that the person be on antifungal support as well.
    3. Simply treating with the antibiotics without treating the hypothalamic circuit breaker by following the S.H.I.N.E.® protocol is far less likely to work.
    4. If somebody has a history of being allergic to three unrelated antibiotics, this suggests that it was not an allergy, but rather flaring your symptoms from killing off an antibiotic-sensitive bacteria that was contributing to the CFS/FMS.
    5. Also, when a person reports that they took an antibiotic for a week or two and their CFS/FMS improved markedly while they were on it, it simply makes sense to put them back on that antibiotic for an extended period.

From My New Edition of From Fatigued to Fantastic

From Fatigued To Fantastic! 4th Edition

To remind you, BFFs (Brain Fog Friendly Summaries) are just the short summaries I include at the beginning of each chapter in my newest edition of From Fatigued to Fantastic. I added these to my new edition to help readers with brain fog quickly get the main points of a topic. Then, as able and interested, they can dive into each topic to get far more detail. I invite you to get the book. It will rock your world!

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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