Chronic fatigue syndrome (CFS) is also referred to as myalgic encephalomyelitis chronic fatigue syndrome (ME) and is described as a multiple of symptoms characterized by severe fatigue unrelieved by rest. Many explanations have been put forward, from environmental toxins, and viruses, to adverse childhood experiences (unhealed trauma) - but a cause has not yet been definitively proven.
There isn't an exact test for chronic fatigue syndrome yet, however, there are important guidelines set out to assist medical professionals with a diagnosis for the condition. A doctor should talk with you about your prior medical history and any physical or mental stresses you may have had in your life to date.
The Centers for Disease Control and Prevention (CDC) define CFS as a “self-reported persistent or relapsing fatigue for at least six consecutive months.” People suffering from symptoms tend to experience four or more of the following problems: impaired memory and concentration, post exertional malaise, unrefreshing sleep, joint pain, muscle pain, tender cervical or axillary lymph nodes, headache, migraines, and sore throat. The symptoms must have persisted or recurred during six months or more consecutive months and must not have predated the fatigue. 
A 2003 review of the condition stated that, “Patients with chronic fatigue syndrome experience significant functional impairment. Pathophysiological abnormalities exist across many domains, suggesting that chronic fatigue syndrome is a heterogeneous condition of complex and multifactorial etiology. Evidence also is beginning to emerge that chronic fatigue syndrome may be familial. Although chronic fatigue syndrome has significant symptom overlap and comorbidity with psychiatric disorders, several lines of research suggest that the illness may be distinct from psychiatric disorders. Patients’ perceptions, attributions, and coping skills, however, may help perpetuate the illness. Treatment for chronic fatigue syndrome is symptom-based and includes pharmacological and behavioral strategies. Cognitive behavior therapy and graded exercise can be effective in treating the fatigue and associated symptoms and disability.” 
Researchers continued, “Chronic fatigue syndrome is unlikely to be caused or maintained by a single agent. Findings to date suggest that physiological and psychological factors work together to predispose an individual to the illness and to precipitate and perpetuate the illness..." 
Researchers finished with, "the assessment and treatment of chronic fatigue syndrome should be multidimensional and tailored to the needs of the individual patient.”
International speaker and author with books published in multiple countries and languages, Dr Gabor Mate, in his book titled “When The Body Says No” shares in chapter 1 (free excerpt available on his website) that, “In my private family practice I observed these same patterns in people I treated for multiple sclerosis, inflammatory ailments of the bowel such as ulcerative colitis and Crohn’s disease, chronic fatigue syndrome, autoimmune disorders, fibromyalgia, migraine, skin disorders, endometriosis and many other conditions. In important areas of their lives, almost none of my patients with serious disease had ever learned to say no. If some people’s personalities and circumstances appeared very different from Mary’s on the surface, the underlying emotional repression was an ever-present factor.” 
The endocannabinoid system (ECS) is a complex system of physiology inside the body that is responsible for maintaining order and balance across every bodily system, from the reproductive, lymphatic, and circulatory, to the cardiovascular and nervous system. The ECS is vulnerable to high-levels of chronic-long-term stress that can eventually render it dysfunctional; leading to conditions of dysfunction across various parts of the body. Stress can come in the form of both emotional and physical, and if left unchecked, will wreak complete havoc on the body and person. The endocannabinoids produced by the endocannabinoid system around found in breast milk and are used to support and nourish a baby and its own ECS into healthy optimal development. When breast milk is not available, there’s phytocannabinoids abundantly found in cannabis such as CBD, THC, and CBG. These phytocannabinoids act in a similar way to our bodies own endocannabinoids produced by the ECS, that act to help support and restore normal healthy functioning to the ECS. Is it no wonder then that in patients suffering from CFS, they display an overactive immune system, and hyper-inflammation? An immune system out of balance, and an inflammatory response eroding normal functioning leading to pain and dysfunction. This is why there are many anecdotal reports of symptom relief with CBD and cannabis products across online social groups that you can find with a quick search.  Though mixed results of cannabis products effectiveness is mixed, and no formal studies are yet to be conducted. For more health information visit our blog, or read The Endocannabinoid System Explained.
A 2008 study revealed a potential connection between a key enzyme and exposure to organophosphate pesticides. The link is tenuous, but exposure to these pesticides has been shown to interfere with enzymes that the body uses to break down endocannabinoids (which could lead to an imbalance in the ECS).  Another theory is that chronic fatigue is the result of oxidative stress. This involves the toxic byproducts of reactive oxygen, which include peroxides and free radicals that attack and damage cellular components, and is thought to disrupt endocannabinoid signaling. Other research has also focused on the role of cellular mitochondria dysfunction in CFS, noted in research involving three female family members who were diagnosed with CFS and were found to share higher blood lactate, higher mitochondrial mass, lower mitochondrial DNA content and enzymatic activities, and lower oxygen consumption capacities than found in healthy women.   This finding could be of great importance because of the recent finding of how cannabinoid receptors modulate neuronal activity through controlling cellular respiration on a mitochondrial level.  Cannabis products that contain cannabidiol (CBD) have been found to be effective in reducing the symptoms directly linked to oxidative stress.  As such, it could be possible that CBD can also reduce the damage of oxidative stress in mitochondria.
The information contained in this article is for informational purposes only and does not constitute medical advice. Prior to making changes to your lifestyle or treatment plan, always consult with your doctor.
High-CBD cannabis products are ideal, such as in a 1:1 ratio or higher of CBD to THC (20:1 ratios are worth experimenting with). When ratios are low in THC, higher doses can typically be tolerated. Doses of up to 40 mg of CBD are not uncommon for CFS.
As with all cannabis products, always start with a micro dose to test for sensitivity, and titrate your way up slowly until symptoms subside. As with all cannabis products, you can always take more, but you can’t take less.
In order to avoid the first-pass liver metabolism, sublingual CBD should be considered over oral CBD for better absorption. Vaporized, high-CBD cannabis flowers and concentrates are also advantageous.
Cannabis strains with CBD to THC ratios of at least 3:1, including ACDC, Deadlights, and Harlequin are of value for chronic fatigue syndrome, as are strains rich in terpenes; such as low-myrcene Type II hybrids that produce both THC and CBD.
In time we hope more information comes to the limelight, but for now visit our blog to stay updated on the latest research around cannabis, endocannabinoids, and the endocannabinoid system.
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