Chronic Fatigue
There is significant evidence indicating that chronic fatigue syndrome is a biological illness, which may be caused, in part, by an overactive immune system, often triggered by an infection.

Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a severe and chronic disease. The hallmark symptom, of what some researchers believe is an immune dysfunction syndrome, is extreme and unrelenting fatigue that lasts longer than 6 months. Patients typically suffer from persistent exhaustion, cognitive impairment, flu-like symptoms, autonomic dysfunction, and chronic pain.
Multiple factors are believed to play a role in causing the syndrome, including hormonal imbalances, bacterial and viral infections, and an immune dysfunction. In fact, chronic fatigue syndrome “is often reported to be triggered by infections and the link between infections and autoimmune diseases is well established.” 1

Chronic fatigue: an immune dysfunction syndrome?

The exact cause of chronic fatigue syndrome is still unknown. But mounting evidence suggests that an underlying biological process, such as an immune dysfunction, triggered by an infection, plays an important role in the onset of disease.

Not surprisingly, CFS is often referred to as an immune dysfunction syndrome. It frequently appears in people who have been sick. An estimated 50% to 70% of patients with chronic fatigue syndrome report that their symptoms started after they had a viral-like illness 2 or infection. 3

Furthermore, a significant number of CFS patients have other immune or autoimmune diseases, such as fibromyalgia or Hashimoto’s disease. And, these individuals frequently have a family history of autoimmune disease. 4

Get treated for treatment-resistant symptoms

In 2019 researchers reported, “For the first time, we have shown that people who are prone to develop a CFS-like illness have an overactive immune system, both before and during a challenge to the immune system.” 5

These findings add to the “growing weight of scientific evidence which indicates that the body’s immune system is playing an important role in the causation of CFS,” wrote Dr. Charles Shepherd, medical advisor at the ME Association. 5

Immune system in overdrive

Other researchers have come to similar conclusions. Russell and colleagues have suggested that their study supports “the hypothesis that abnormal immune mechanisms are important in CFS.” 6

So, what would cause the immune system to malfunction and trigger CFS symptoms? There are multiple theories. The latest science indicates, however, that infections play a pivotal role. For some individuals, “infections throw a wrench in the immune system’s ability to quiet itself after the acute infection.” Instead, “the immune response becomes like a car stuck in high gear.” 7

This ongoing revving of the engine can be damaging, creating inflammation in the central and peripheral nervous system. An immune dysfunction may then trigger the onset of chronic fatigue syndrome symptoms, which can sometimes cause severe disability.

In fact, more than 25% of patients with CFS are so ill, they are confined to their homes or completely bedbound. 8 Women are impacted twice as often as men. And although the illness can manifest at any age, the incidence rate appears highest between the ages of 10-19 and 30-39. 9

CFS symptoms can fluctuate, vary in intensity and appear either suddenly or gradually. Many patients complain of “brain fog.” This is described as slow thinking, difficulty focusing, and forgetfulness.

Although there is no single laboratory test that can diagnose chronic fatigue syndrome, the Cunningham Panel™ has been utilized by clinicians to help determine whether symptoms associated with CFS could be due to an underlying infection-triggered autoimmune process.

  1. Franziska Sotzny, Julià Blanco, Enrica Capelli, Jesús Castro-Marrero, Sophie Steiner, Modra Murovska, Carmen Scheibenbogen. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease, Autoimmunity Reviews. Volume 17, Issue 6, 2018, Pages 601-609.
  2. Rasa, S. et al. Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Journal of Translational Medicine. volume 16, Article number: 268 (2018).
  3. Blomberg J, Rizwan M, Böhlin-Wiener A, et al. Antibodies to Human Herpesviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. Front Immunol. 2019;10:1946.
  4. Alice Russell, Nilay Hepgul, Naghmeh Nikkheslat, Alessandra Borsini, Zuzanna Zajkowska, Natalie Moll, Daniel Forton, Kosh Agarwal, Trudie Chalder, Valeria Mondelli, Matthew Hotopf, Anthony Cleare, Gabrielle Murphy, Graham Foster, Terry Wong, Gregor A. Schütze, Markus J. Schwarz, Neil Harrison, Patricia A. Zunszain, Carmine M. Pariante, Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. Volume 100, 2019, Pages 276-285.
  5. Nicola Davis. The Guardian. Chronic fatigue syndrome 'could be triggered by overactive immune system.’ Dec. 17, 2018.
  6. Russel A. et al. Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. 2019 Feb;100:276-285.
  7. Scientists discover robust evidence that chronic fatigue syndrome is a biological illness. Columbia University's Mailman School of Public Health. Press release. February 2015.
  8. Pendergrast T, Brown A, Sunnquist M, et al. Housebound versus nonhousebound patients with myalgic encephalomyelitis and chronic fatigue syndrome. Chronic Illn. 2016;12(4):292–307.
  9. Bakken I. et al. Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012. BMC Medicine. volume 12, Article number: 167 (2014).
chronic fatigue immune dysfunction syndrome

This study provides “unequivocal evidence of immunological dysfunction in ME/CFS.” 7

Infections may cause chronic fatigue immune syndrome
How can an infection cause chronic fatigue immune dysfunction syndrome symptoms?

Learn more about how infections can trigger neuropsychiatric symptoms

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Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

This nationwide, population-based, prospective cohort study examines the link between mood disorders, infections, and autoimmune disease.

Childhood infections can increase risk of mental illness in kids

Childhood infections can increase risk of mental illness in kids

Nationwide study finds both mild and severe infections can increase risk of mental disorders in children and adolescents.

  • Test Order Process
    The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms.

B. Robert Mozayeni, MD

Medical and Clinical Advisor

B. Robert Mozayeni MD

Dr. B. Robert Mozayeni was trained in Internal Medicine and Rheumatology at Yale and at NIH. He has had pre- and post-doctoral Fellowships in Molecular Biophysics and Biochemistry at Yale, and also at NIH where he was a Howard Hughes Research Scholar at LMB/DCBD/NCI and later, Senior Staff Fellow at LMMB/NHLBI/NIH. Editorial board of Infectious Diseases – Surveillance, Prevention and Treatment. Past President of the International Lyme and Associated Diseases Society (ILADS).

He is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently. He is a Fellow of the non-profit Think Lead Innovate Foundation and is a co-founder of the Foundation for the Study of Inflammatory Diseases. He is a Founder of the Foundation for the Study of Inflammatory Diseases to crowd-source medical solutions for complex conditions using existing knowledge, diagnostic methods, and therapies to meet patient needs immediately. He is the Chief Medical Officer of Galaxy Diagnostics, LLC. He is a Board member of the Human-Kind Alliance. Dr. Mozayeni has held admitting privileges (since 1994) on the clinical staff of Suburban Hospital, a member of Johns Hopkins Medicine and an affiliate of the National Institutes of Health Clinical Center.

Safedin Sajo Beqaj, PhD, HCLD, CC (ABB)

Moleculera Labs, Clinical Laboratory Advisor
Medical Database, Inc., President and CEO

Sajo Baqaj, PhD

Dr. Sajo Beqaj is board certified in molecular pathology and genetics and licensed as a Bioanalyst and High Complexity Laboratory Director. He has been practicing as a laboratory director since 2005.

Dr. Beqaj served as a technical director and was part of the initial management team for several well-known laboratories in the clinical lab industry including PathGroup, Nashville, TN; DCL Medical Laboratories, Indianapolis, IN, and Pathology, Inc, Torrance, CA. He is currently serving as off-side CLIA laboratory director for BioCorp Clinical Laboratory, Whittier, CA and Health360 Labs, Garden Grove, CA.

Dr. Beqaj received his Ph.D. in Pathology from Wayne State University Medical School, Detroit, Michigan. He performed his post-doctoral fellowship at Abbott Laboratories from 2001-2003 and with Children’s Hospital and Northwestern University from 2003-2005.

Dr. Beqaj has taught in several academic institutions and has published numerous medical textbook chapters and journal articles. He has served as a principal investigator in clinical trials for several well-known pharmaceutical and diagnostic companies such as Roche HPV Athena, Merck HPV vaccine, BD vaginitis panel, Roche (Vantana) CINtec® Histology clinical trials, and has presented various scientific clinical abstracts and presentations.

He is a member of several medical and scientific associations including the Association of Molecular Pathology, American Association of Clinical Chemistry and the Pan Am Society for Clinical Virology. He has served on a number of clinical laboratory regulatory and scientific committees, and has assisted several laboratories and physicians as a Clinical Laboratory Consultant.

Rodney Cotton, MBA

Moleculera Labs Board Member

Rodney Cotton, MBA

Rodney Cotton, MBA is an entrepreneurial thought leader in the pharmaceutical/biotech industry who is known for his holistic perspective, bias for action in the face of challenges, and commitment to agile processes.

Rod is an independent director for Orchard Software, a private equity-backed health technology company owned by Francisco Partners; an advisory board member to Flo2 Ventures, a venture capital-backed healthcare and health equity accelerator; and a member of the board of directors and three board committees (Audit, Compliance & Finance; Governance & Equity; and Quality of Care) for Community Health Network.

He built a successful career at Roche spanning more than two decades and culminating in the role of SVP, Head of Strategy & Transformation, and Chief of Staff to the CEO for Roche Diagnostics, the North American headquarters of the world’s largest ($17B) diagnostics company.

While at Roche, Rod led key enterprise initiatives, such as milestone corporate communications, health equity coalitions, the US/Roche Group audit, and global/US acquisition integrations. With 40+ years of experience, he drove the financial turnaround and cultural transformation of four global healthcare companies, led teams of up to 280 total reports, managed P&L of more than $1 billion, and served as a key member of the senior leadership team executing the most significant restructuring of the company in two decades.

In the face of the COVID-19 pandemic, Rod and his team at Roche accelerated six ground breaking products in 11 months, including the first launch of the market’s most accurate and in demand molecular diagnostic test. He also solved extraordinary challenges of product scarcity, supply chain, product allocation, and logistics to achieve accelerated global sourcing and self manufacturing in line with testing guidelines.

A frequent public speaker on health equity and other topics, Rod was named one of the Most Influential Black Executives in Corporate America by Savoy Magazine and one of the Top Blacks in Healthcare by He also received The Sagamore of the Wabash Award, one of the highest Indiana State honors, bestowed by Indiana Governor Eric J. Holcomb.

Rod holds an M.B.A. from California State University, Dominguez Hills, an M.S. in Strategic Management from the University of Southern California, and a B.A. in Biological Sciences & Technology from the University of California at Santa Barbara.