I have good news for you and I have bad news for you….

These words are the beginning of a classic CFS joke. The good news is “You are not going to die”, the bad news is “You are not going to die”.

There are two diseases that can present almost identically, both have no diagnostic tests, both have SNP associated with incidence (SNP means a gene mutation). I have been unable to find out if any of the SNPs overlapped… The two conditions are Alzheimer’s Disease(AD) and Chronic Fatigue Syndrome(CFS).

The easiest way to tell them apart is the presence of post-external-fatigue (PEM). Unfortunately, PEM is not always present and actually forms a research subset. So, for CFS patients without PEM, there can be a bit of an unresolved question. CFS is characterized by a 1% decrease in gray matter volume per year of the disease, as well as decreasing white matter volume. Similar are seen in AD.


The interesting thing is that AD, CFS and chronic lyme all show hypo-perfusion in the same areas of the brain. With chronic lyme, the right course of antibiotics results in SPECT becoming normal in 1-2 years according to PubMed studies.  The term right is very significant because it is not just a single antibiotic but several. My KISS model is that the SPECT results originates from gut bacteria dysfunction. The use of the right antibiotics would correct (or at least ameliorate) this. This would be in keeping this Philipe Bottero who found that many patients in psychiatric hospitals recovered fully when given the rotating antibiotics protocol for Rickettsia.

My interesting speculation is whether the progress of AD is significantly determined by gut bacteria dysfunction. I have been unable to find any studies on gut bacteria in AD.  Without such information, antibiotics are as likely to worsen instead of improve.

Life Expectancy

To return to the humor (or attempt there of), the other difference between CFS and AD is life expectancy.  AD has a greatly reduced life expectancy, CFS may have a slightly reduced life expectancy. If you are alive 10 years after onset, you likely have CFS and not AD.