There are two onset patterns seen with most CFS: sudden and gradual onset.
- Sudden onset is associated strongly as a post-infection retaining of an altered microbiome. The gut bacteria did not return to normal after being farmed by the infection. A patient did recover from the infection, NOT — the organism causing the disease was eliminated, but the trauma to the gut bacteria stayed on.
- Gradual onset lacks this ability to identify a point of time (or the point of time was sufficiently insignificant that memory of it is lost).
Yesterday I spent the afternoon talking with a very long term colleague and friend about career opportunities and paths. He is a very successful professional in the early 40’s. He has been giving 200+% to his employer for a decade. He mentioned:
- 6 months ago becoming gluten sensitive,
- 3 months ago: lactose intolerant
- There is no history of either sensitivity in his family
- He has noticed a significant drop in his energy and ability to focus for extended time
- Lab tests have shown very low vitamin D and B-12 levels
- He is still able to work a full days.
All of the above, are characteristics I have seen time and again in people with auto-immune conditions such as FM or CFS. Low vitamin D, low B12, cognitive issues, and food insensitivity are seen in over 80% of CFS and FM patients. Having those conditions is not diagnostic, other condition present with them. A CDC-strict CFS diagnosis or FM diagnosis require additional criteria to be satisfied.
My Speculation (I’m not a MD so I can’t diagnose)
We know that random mutation of bacteria and stress resulted in some bad bacteria becoming established. We know:
- “Neurobehavioral factors, such as stress and depression, also influence the risk of IBD (Irritable Bowel Disease).
- “Also, food intolerances are very frequent, but usually inconsistent among IBD patients, and therefore no general dietary recommendations can be made in these patients.”
- “Vitamin D3 deficiency is rampant which may contribute to increased risk of many diseases including cancer, cardiovascular disease and autoimmune disorders. ”  this article goes on to describe alteration of RNA due to Vitamin 1,25D and 25D.
A search of PubMed finds some 2200+ articles on stress and autoimmune.
Testing for most autoimmune conditions early is unknown — usually diagnosis is made when the condition is well established. Often symptoms are blown off by medical profession as “aging”, or in the case of women as typical of “pre-menopause, menopause or post-menopause”.
Personally, I believe that testing for Vitamin 1,25D levels is likely the best early test to indicate the auto-immune direction. Vitamin 1,25D levels appear to be independent of Vitamin D (D3, 25D) levels which is what is normally tested for.
- “Results showed a strong positive association between these autoimmune conditions and levels of 1,25-D >110 pmol/L.” 
My own experience is that 1,25-D went very high with onset and dropped down to the normal range with successful treatment. A value near the top of the normal range should be of significant concern.
These are suggestions for him to discussion with his medical professionals. Since the symptoms are dominantly gut associated (food intolerance) then the two probiotics associated with successful treatment of Irritable Bowel Syndrome would be an excellent starting point — two weeks on one, and then two weeks on the other.
- Easiest to obtain: Align, in many pharmacies and on Amazon (98 capsules ~ $70 is best buy) – B. infantis 35624 ONLY; IBS effective, see my earlier post.
- Prescript-Assist: on Amazon (90 capsules ~ $60 is best buy) – 28 species, none are Lactobacillus. IBS effective. See my earlier post.
Because of the low B-12 levels, L. Reuteri also appears to be a good choice as explained in this post. I suspect/speculate that it can be taken with the above without significant loss of effectiveness. See this post on how to take it. Sources:
- BioGala Protestic: on Amazon (30 sticks for $27) – Lactobacillus reuteri Protectis ONLY . From Sweden
- Jarrow Fem-Dophilus: on Amazon (120 capsules for $52) – Lactobacillus rhamnosus, GR-1® and Lactobacillus reuteri, RC-14 ONLY . From Denmark
Needless to say for old timers — changes of probiotics should occur on Fridays in case “die-off” happens from the battle betwen probiotics and the bad bacteria. Starting at a low dosage (sprinkling 1/2 capsule on yogurt for the first day) is also suggested to allow the war between bacteria to be more tolerable. Of course, we cannot predict if there will be a war.