Inflammation and Autoimmunity

One possible explanation is that ME/CFS is the result of an abnormal or misguided immune response to an initial infection that has turned into a long-term autoimmune disease through molecular mimicry (known as the hit and run hypothesis) [23]. When our immune system is triggered, such as during viral illnesses or times of stress, inflammatory cells are mobilized. However, the intensity and duration of this response determine whether it helps with healing or harms our normal bodily functions (20). Short-term inflammation is beneficial in eliminating threats, but in cases like ME/CFS, inflammatory cells and cytokines continue to react inappropriately even when there is no longer any external danger (21). Chronic inflammation can lead to various symptoms like pain, fatigue, fever, and rashes. Inflammation is well-known to be associated with common diseases such as Alzheimer’s disease, multiple sclerosis, cancer, heart disease, diabetes, and rheumatoid arthritis (22). In ME/CFS, chronic inflammation disrupts the body’s balance, and neuroinflammation contributes to ongoing systemic inflammation and immune dysfunction.
To put it simply, inflammation occurs when our immune cells gather in a specific area outside of our cells to address damage or infection (21). For example, in the case of SARS-CoV-2 infection, inflammation can occur in the lungs, although it can also be more widespread throughout the body.
There is a growing body of evidence suggesting that ME/CFS is linked to immune system dysregulation [33,45–49]. However, none of the activated mechanisms seem to be directed towards an autoimmune response.
ME/CFS, also known as chronic fatigue syndrome, shares certain similarities with autoimmune illnesses. These are diseases where the immune system mistakenly attacks healthy tissues within the body, just like in rheumatoid arthritis. Interestingly, both ME/CFS and most autoimmune diseases tend to affect women more frequently, and they are both characterized by heightened inflammation. However, unlike autoimmune diseases, ME/CFS does not exhibit signs of tissue damage in patients. 

Autoimmunity Biomarkers

Autoimmunity biomarkers play a crucial role in detecting autoimmune responses within the body. In the case of chronic fatigue syndrome, identifying these biomarkers can provide valuable insights into the condition’s underlying mechanisms, leading to better diagnostic and treatment approaches. It’s important to note that not all CFS/ME/SEID patients develop autoimmunity, so it’s wise to check for these biomarkers before considering immunosuppressive treatments. However, incorporating natural adaptogens for immune support can be beneficial. Some autoimmunity biomarkers associated with the syndrome that you may want to consider testing for include anti-nuclear antibodies (ANA), anti-mitochondrial antibodies (AMA), and anti-cardiolipin antibodies (ACA).

Inflammation Markers:

Inflammation markers in CFS have been a subject of research, although findings are not consistent across studies. Some potential inflammation markers associated with CFS include:

-Cytokines:Elevated levels of pro-inflammatory cytokines, such as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), have been reported in some studies.
-Chemokines:Increased levels of certain chemokines, which are signaling proteins involved in immune cell recruitment, have been observed in some individuals with CFS.
-C-reactive Protein (CRP):Elevated CRP levels, an acute-phase protein indicative of inflammation, have been reported in some studies involving CFS patients.
-Interferons:Studies have suggested alterations in interferon signaling, with increased levels observed in some cases.
-Transforming Growth Factor-beta (TGF-β):TGF-β is a multifunctional cytokine, and both elevated and decreased levels have been reported in different studies of CFS.

Oxidative Stress Markers:

Increased levels of oxidative stress markers, such as malondialdehyde (MDA) and reactive oxygen species (ROS), have been observed in some individuals with CFS.
-Nitric Oxide (NO):Dysregulation of nitric oxide metabolism has been suggested in CFS, with some studies reporting elevated levels.
-Heat Shock Proteins:Changes in the expression of heat shock proteins, which play a role in cellular stress responses, have been noted in some research.
Neopterin:Elevated levels of neopterin, a marker of immune system activation, have been reported in certain studies involving CFS patients.
-Kynurenine Pathway Metabolites:Alterations in the kynurenine pathway, leading to changes in metabolites such as kynurenine and quinolinic acid, have been observed in CFS.

It’s important to note that findings regarding inflammation markers in CFS can vary, and not all individuals with CFS exhibit the same patterns. Additionally, the heterogeneity of the condition and the lack of specific diagnostic markers make it challenging to establish a clear link between inflammation and CFS.

Research in this field is ongoing, and more studies are needed to understand the underlying mechanisms of CFS and identify reliable inflammation markers. Currently, there is a consensus among experts that inflammation is the culprit behind the symptoms of CFS. These symptoms include cognitive issues, cardiovascular problems, pain, fatigue, and issues with energy-producing cells called mitochondria. It’s all interconnected!
So, to sum it up, ME/CFS and autoimmune diseases have some things in common, but they also have their differences. Inflammation seems to be the key player in CFS, causing a range of unpleasant symptoms.


Managing inflammation may be a part of a holistic approach to addressing symptoms. Here is a list of natural agents with potential anti-inflammatory properties that may be considered in the context of chronic inflammation and CFS:

Omega-3 Fatty Acids:Found in fatty fish (salmon, mackerel, sardines) and flaxseeds, omega-3 fatty acids have anti-inflammatory effects.
Turmeric (Curcumin):The active compound in turmeric, curcumin, has potent anti-inflammatory and antioxidant properties.
Ginger (Gingerol):Ginger contains bioactive compounds, such as gingerol, known for their anti-inflammatory effects.
Green Tea (Epigallocatechin Gallate – EGCG):Green tea is rich in antioxidants, particularly EGCG, which has anti-inflammatory properties.
Quercetin:Found in foods like onions, apples, and berries, quercetin has anti-inflammatory and antioxidant effects.
Resveratrol:Found in red grapes and berries, resveratrol exhibits anti-inflammatory and antioxidant properties.
Boswellia (Frankincense):Boswellia serrata contains compounds with anti-inflammatory effects and is used in traditional medicine.
Cat’s Claw (Uncaria tomentosa):Cat’s claw has anti-inflammatory and immunomodulatory properties.
Bromelain:An enzyme found in pineapple, bromelain has anti-inflammatory effects.
Probiotics:Beneficial bacteria in the gut can modulate the immune response and reduce inflammation.
Aloe Vera:Aloe vera has anti-inflammatory and wound-healing properties.
Ashwagandha (Withania somnifera):An adaptogenic herb, ashwagandha has anti-inflammatory and immune-modulating effects.
Vitamin D:Plays a role in immune regulation and may help modulate inflammation.
Vitamin C:An antioxidant that can help combat oxidative stress and inflammation.
Vitamin E:Another antioxidant that can contribute to reducing inflammation.
Magnesium:Involved in anti-inflammatory processes and supports overall cellular function.
Lycopene:Found in tomatoes and watermelon, lycopene has antioxidant and anti-inflammatory properties.
Selenium:An essential mineral with antioxidant and anti-inflammatory effects.
Milk Thistle (Silymarin):Milk thistle has antioxidant and anti-inflammatory properties and supports liver health.
N-Acetyl-Cysteine (NAC):Precursor to glutathione, NAC has antioxidant and anti-inflammatory effects.
Andrographis (Andrographis paniculata):An herb traditionally used in Ayurvedic medicine, andrographis contains andrographolides, which have anti-inflammatory and immunomodulatory properties.
Baicalin (Scutellaria baicalensis):Found in the roots of Chinese skullcap, baicalin exhibits anti-inflammatory and antioxidant effects.
Feverfew (Tanacetum parthenium):Traditionally used to treat fevers, feverfew contains parthenolide, which has anti-inflammatory properties.
Bilberry (Vaccinium myrtillus):Rich in anthocyanins, bilberry has antioxidant and anti-inflammatory effects.
Guggul (Commiphora wightii):Used in traditional Ayurvedic medicine, guggul contains compounds with anti-inflammatory and lipid-lowering properties.
Bupleurum (Bupleurum chinense):An herb in traditional Chinese medicine, bupleurum has anti-inflammatory and liver-protective effects.
White Willow Bark (Salix alba):Contains salicin, a natural compound with anti-inflammatory properties similar to aspirin.
Coptis (Coptis chinensis):Used in traditional Chinese medicine, coptis contains berberine, which has anti-inflammatory and antimicrobial properties.
Arnica (Arnica montana):Applied topically, arnica has anti-inflammatory properties and is commonly used for bruises and inflammation.
Pycnogenol (French Maritime Pine Bark Extract):Rich in proanthocyanidins, pycnogenol has antioxidant and anti-inflammatory effects.
Wormwood (Artemisia absinthium):Contains compounds like absinthin and artemisinin with potential anti-inflammatory properties.
Tart Cherry (Prunus avium):Rich in anthocyanins, tart cherries have antioxidant and anti-inflammatory effects.
Bromelain (from Pineapple):An enzyme with anti-inflammatory properties, often used as a supplement.
Corydalis Yanhusuo (Corydalis yanhusuo):An herb in traditional Chinese medicine, corydalis has anti-inflammatory and analgesic effects.
Myrrh (Commiphora spp.):Used in traditional medicine, myrrh resin has anti-inflammatory and antimicrobial properties.
Chaga Mushroom (Inonotus obliquus):Contains betulinic acid and other compounds with anti-inflammatory and antioxidant effects.
Thunder God Vine (Tripterygium wilfordii):Used in traditional Chinese medicine, thunder god vine has anti-inflammatory and immunosuppressive properties.
Diosmin:A flavonoid found in citrus fruits, diosmin has anti-inflammatory and vascular-protective effects.
Bee Propolis:A resinous substance produced by bees, propolis has anti-inflammatory and antimicrobial properties.
Pennyroyal (Mentha pulegium):Traditionally used in herbal medicine, pennyroyal has potential anti-inflammatory effects.

Anti-inflamation Summary

Chronic Inflamation Symptoms:

  • Muscle Pain
  • Headaches
  • Multi-joint Pain
  • Muscular Tension
  • Fatigue
  • Tender Lymph Nodes
  • Sleep Disturbances
  • Cognitive Impairment
  • Gastrointestinal Issues
  • Sensitivity to Stimuli

Anti-inflamatories and Imuno-modulators:

  • Omega-3 Fatty Acids
  • Palmitoylethanolamide (PEA)
  • Turmeric
  • Ginger
  • Quercetin
  • Resveratrol
  • Boswellia
  • Vitamins D,C,E
  • Magnesium
  • Lycopene
  • N-Acetyl-Cysteine (NAC)
  • Feverfew
  • Pycnogenol
  • Tart Cherry
  • Bromelain