The Causes of CFS


Having made a careful diagnosis of CFS, the next step is to diagnose in which category of CFS does the patient belong? This is crucial to develop a correct treatment plan. Preliminary categorisation is made in this way:

  1. Simple, single cause CFS.
  2. Complex, multi cause / multiple disease layer CFS.

Once this appraisal has been made, next it is useful to elucidate a precise cause, or causes, since this will give us the most accurate treatment plan. We have divided the causes of CFS into the categories, from the most simple to the most complex causes. We have not included emotional or psychic causess in the list below because it is a mistake to assume that CFS can be reduced to a ‘psychosomatic’ cause. Many CFS patients have doubted their own perceptions and the reality of their disease because of the sceptical attitudes of their health practitioners. If conventional medical tests fail to return evidence of abnormal pathology, practitioners unaware of CFS and insensitive to its implications, can dismiss the patient as ‘hysterical’.

We can assure you that CFS patients are not hysterical and that their disease is real. Patients with chronic disease whose illness is dismissed as “all in the head” can soon become depressed or anxious. Once the CFS has been correctly treated, these emotional states improve.

Here are the categories of CFS which we have ascertained:

Category 1: Post Viral

In these simple cases of CFS there is a clear disease event which has triggered the symptoms. Often, it is Glandular Fever (Infectious Mononucleosis), Cytomegalovirus or some other viral pathogen.

In most cases the patient will be able to tell you that their symptoms are never well since having contracted the virus. The usual acute viral symptoms present as:

  • Fever
  • Swollen lymphatic glands
  • Sore throat
  • Body ache
  • Malaise

Once the acute phase has passed, the malaise does not improve. More chronic symptoms develop such as these:

  • Cognitive disorders eg confusion, difficulty in concentration
  • Post-exertion myalgia
  • Recurring sore throats
  • Recurring fevers.

This type of CFS is very common in  people from the age of late teens to mid 30s. CFS patients in this category respond the most quickly to treatment.

Category 2: Gut Dysbiosis: Yeast, Fungal or Bacterial Overgrowth

Since the mid 1970s and the rise in use of broad spectrum antibiotics, such as amoxycilin, the inclusion of antibiotics such as vancomycin in agriculture, plus the widespread use of the oral contraceptive pill (OCP), we have seen a progressive dimunition in quality of the human gut flora with each generation: this is one reason why children now have so many allergies and food sensitivities.

This also gives rise to a syndrome called gut dysbiosis which results from a decrease in the normal benevolent bacteria in the gut and an increase in the population of gut yeast called candida albicans and others. Other pathogens include non-Candida yeasts, and bacterial overgrowths, such as klebsiella and citrobacter. This can set up chronic inflammation, which can lead to increased gut permeability, commonly called 'Leaky Gut Syndrome'. When this occurs a syndrome arises which essentially becomes a systemic disturbance. Here are the typical symptoms:

  • Foggy head
  • Mood swings
  • A ‘wired’, anxious feeling in the body
  • Fatigue
  • Aggravation from sugar
  • Oral, vaginal or rectal thrush.

CFS patients who report strong gut symptoms may also have been diagnosed with Irritable Bowel Syndrome, and our experience is that often CFS and IBS have combined to form a disease complex. It is for this reason that we have dedicated a separate web site for the discussion of Irritable Bowel Syndrome at .

Category 3: Pathogenic

Some pathogens, if not correctly diagnosed, cause symptoms which appear like CFS. One of the earliest of these was gonorrhoea, which causes an inflammatory musculo-skeletal disease called Reiter’s Syndrome.

However, there are other more obscure pathogens than this. One of these is Borrelia infections, or Lyme disease, which is a bacterial infection transferred by the tick. If incorrectly diagnosed and treated, it will cause symptoms suggestive of CFS, notably:

The disease has three distinct phases of manifestation:

  1. Acute phase: following the tick bite, there is a bulls’ eye type rash soon after or many weeks after the initial bite. The rash is called erythema migrans.  The patient may have forgotten about the bite by the time symptoms appear. However, there may also be non-specific symptoms such as vague flu-like symptoms, fatigue, lymph swelling, etc. The rash usually lasts for a few weeks and is then often completely forgotten.
  2. Later – and it may be many years later – the joint inflammatory stage begins. Still the patient may make no actual connection between his joint pain and an old tick bite, particularly if he has on many occasions been bitten. Some patients only develop vague symptoms of malaise and fatigue, thus it is easy to confuse Lyme with CFS. Some patients may go on to develop fibromyalgia.
  3. The last stage centres on the nervous system. The cognition is affected. As in this case, there is difficulty in concentration. There may be memory loss or distorted or exaggerated sense reception. Ther may be paralysis, vertigo, neuralgia. Cases of meningo-encephalitis, cranial neuritis (especially Bell’s palsy) and motor radiculo-neuropathies have also been reported.

Category 4: Heavy Metal toxicity

Heavy metal accumulation is a common (not uncommon) phenomenon. Your hair colouring contains lead. Your deodorant contains aluminium. The water you drink contains copper from your pipes. The rainwater you drink contains aluminium and zinc from your water tank and roof. The old amalgam fillings in your mouth leak mercury every time you eat. The heavy industry in the next suburb belches particles of cadmium into the air.

We are all exposed to heavy metals every day. We all excrete heavy metals every day. Some of us are better at excreting them than others. The more acidic your body pH is, the less able are you to excrete them. Poor diet, inadequate (and demineralized) drinking water, insufficient clean air, are just a few factors which influence heavy metal accumulation. Heavy metals can produce all the symptoms of CFS, especially cadmium, mercury and aluminium.

What are the heavy metals?


CFS patients whose symptoms are caused by heavy metal toxicity are most likely to have one or more of these toxic elements in their tissues:





Category 5: Single or Multiple Chemical Exposure

Chemical exposures are one of the most damaging shocks to humans. Chemicals which are designed to destroy life, such as insecticides, pesticides, fungicides and herbicides can also destroy human life. This can happen insidiously over many years. This complex human body which we call ‘me’ is home to millions of micro-organisms, all of which play a vital role in our homeostasis. As they are destroyed by chemicals, so is the internal flora and fauna of our body. Some chemicals have the capacity to reach beyond this to our mitochondria and cause permanent damage there.

Chemical exposure can occur while in utero. It can occur to one’s parent before conception. In these cases identifying the precise chemical can be difficult. Ongoing small exposures to chemicals are also unfortunately a part of our modern world. Vapour from the spray gun of a neighbour treating his vegetable garden with legally registered herbicides may end up in your kitchen. Another neighbour uses solvents in his garage. A farmer’s crops are sprayed and the pesticide is carried on the breeze hundreds of kilometres. In one case, the patient’s husband was involved in the manufacture of Agent Orange. Her indirect exposure through him was sufficient to produce multiple chemical sensitivity and CFS.

Here are some of the common implicated chemicals in Australia:

Common Household Chemicals once used in Australia, all of which are Persistent Organic Pollutants (they do not degrade and are still found in soil decades after use)

Ant killer
Blackberry spray
2-4-5-T; 2-4-D
Cabbage Dust
Lindane or DDT
Cockroach bomb
Chlordane; Heptachlor
Ear Drops (Veterinary)
Flea Shampoo
Dieldrin, Lindane
Fly spray
Lindane or DDT
Personal Insect Repellant
Rose Dust
Seed Dressing
Sheep or cattle dip
Lindane; Dieldrin
Snail and slug killer
Termite spray
Chlordane, Heptachlor, Dieldrin
Tomato dust
Vegetable Dust
DDT, Lindane
Wood preservative
Wood Preserving Oil

Category 6: Constitutional

The patient’s individual, genetic factors are intimately involved in the onset and presentation of the CFS. Some of these patients have had some profound emotional shocks.

The energy of these shocks is recorded and remains exerting an influence on the mind and body until this energy is recognised and integrated. This may be achieved through counselling and psychotherapy but it may also be achieved through the use of homeopathic medicine. That is not to say that the emotions one feels around the emotional shock will necessarily change. What is important is that the energy of the shock no longer has the ability to create any functional disturbance. Unhealed emotional shock indeed creates functional disturbance in the form of ‘disease’. It also provides the fuel for other disease processes to grow. To use the analogy I gave above, the emotional shock is one of the fertilisers in our garden of weeds.

Emotional shock may include:

  • Anxiety (as in the example below of Fred)
  • Grief
  • Resentment
  • Depression.

Unhealed emotional shock is evident in so far as the patient behaves, usually unconsciously, as though event associated with the shock is still present. His perceptions of the world are coloured by, and his body behaves as though, the event is still occurring.

Eg Sophie Yon


In the same way that emotional injuries leave their impression, physical injuries or traumas, including the emotional energy which may be attached to them, persist until the effect of the injuries is adequately treated. For example, a woman who required emergency surgery as she approached labour and later delivered a stillborn child, may require a homeopathic medicine both for the surgery and another for the emotional impact of that surgery and death of her baby. Another patient injured in a car fatality may require one medicine for his whiplash and another for the shock of the accident.

Category 7 : CIRS

Much work has been done by Dr Ritchie Shoemaker in the discussion of mould biotoxins and the potential health risks to patients exposed to them. He has particularly drawn attention to the problem with water damaged buildings, whose roofs may have been repaired many years ago, but whose leakage has left behind a mould legacy in the building which is not necessarily visible or smellable.  The moulds may be in the roof cavity, between the walls, under the carpet or in the ventilating system.

Susceptibility to mould biotoxins (mycotoxins) varies from person to person. However the level of susceptibility can be measured by a genetic test: HLA DQ/DR with 4-3-52B and 4-3-53 SNPs . Elevations in Complement C3a, C4A, TGF Beta-1, Matrix Metallopeptidase and Vascular Endothelial Growth Factor, can point towards mould susceptibility and the relative likelihood of past exposure.  Then Mycotoxin panels via urine sample can be done to confirm the amount of, and which types of, mould, are in the patient’s body. These Mycotoxin panels give a reliable indicator about mould biotoxins, combined with relevant patient history.

Patients with mould biotoxins, depending on the type of mould, may have respiratory or allergic symptoms at one end of the spectrum, all the way up to Chronic Fatigue Syndrome and Chronic (CFS) Inflammatory Response Syndrome (CIRS) at the other end. There is some evidence that certain mould biotoxins are carcinogenic, others neurotoxic.

Patients who are Copper toxic are more susceptible to moulds and this is in part because high Copper itself becomes neurotoxic and hepatotoxic, and mould biotoxins have a proclivity to burden these two body systems.

Category 8: Combination of all ….most complex disease causations

However, a majority of cases of CFS are complex and require a comprehensive treatment plan. In these cases we require from the patient a detailed time line of all of the disease events which they feel  have impacted negatively on their health. This timeline starts in the in utero stage of the lifespan and continues up to the present day. All events which have contributed to the diseases state are listed carefully. These events may include:

  • Viruses
  • Emotional shocks
  • Injuries
  • Toxic chemical exposures
  • Vaccination reactions
  • Other drug dyscrasias: long term use of the oral contraceptive pill, antibiotics, cortisone, etc.
  • Illicit drug use

A curative approach in these cases is to take the methodology described by Dr Jean Elmiger in his ‘Real Medicine’. One must identify each of the relevant disease events in the patient’s timeline and then sequentially antidote them in the reverse order to which they occurred. It is important to both (i) identify the causative factors and (ii) remove them in the correct order (the reverse order to which they appeared in the time line). Getting the order wrong is a common mistake amongst practitioners in this challenging area. Let me illustrate this method with a simple example.

Fred develops food intolerances shortly after his second vaccination at 4 months of age. He is exposed to significant amounts of 2-4-5 T, an insecticide, at age 6. At age 13 he is given antibiotics for 18 months to treat his acne. At 20 he is a victim in a bank hold up and has a gun pointed at him, resulting in severe anxiety. At 22 he contracts a severe bout of salmonella poisoning. He presents at your clinic with CFS at age 26. Ruling out any other disease causations, a treatment plan would then proceed along these lines:

  1. Give the remedy which we would have given at the time of the salmonella
  2. Give the remedy which we would have given at the time of the shock on his nervous system from being held at gunpoint.
  3. Remove the side effects of the antibiotics he was given at age 13.
  4. Give a detoxification protocol for the chemical insecticide.
  5. Finally Fred is given an antidote to the vaccine to which he reacted at 4 months.

After this sequential therapy our expectation is that Fred will be significantly better. If further medicine is needed to bring about a cure, the symptom picture will be clearer and we can safely prescribe either on the totality of symptoms or a constitutional medicine. In many complex cases of CFS it is insufficient to prescribe solely on the totality of symptoms or to give the so-called constitutional medicine, because neither of these approaches will necessarily cover the causation of the disease. If one does not adequately cover the causation of the disease, then that remains an obstacle to cure. Dr Hahnemann has made this point very clearly in his Organon in Aphorism 3: clearly perceive what is to be cured (knowledge of disease) and Aphorism 4: be aware of the causes of disease (pathophysiology). Too many cases of CFS unfortunately slip through the therapeutic fingers of many competent practitioners because there is too much emphasis placed on ‘finding the simillimum’ and not enough on causation. CFS remains one of the significant, complex disease challenges of the modern age, yet it can also be unwound in a complete and permanent manner if one uses the methods described here.

In cases of multiple causation, the presenting symptom picture is unreliable on which to base a ‘totality’ prescription. There are too many roots buried in the soil, several of which may be poking their shoots up at once. Trying to find a similimum in the in amongst these will only cause confusion to the practitioner and in some cases, long lasting aggravation to the patient.


To reuse our previous analogy: all the above causative factors can be present in terrain of CFS. As a general rule, the more the disease process is

  • Longstanding
  • Debilitating
  • Involving more than one body system
  • Presents complex symptom pictures

the more of the causative factors from the above list are present. As these factors are effectively neutralised by sequential homeopathy, the patient becomes progressively better. Any factors which are not neutralised, remain an obstacle to cure.