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  • Tony-Boggess

    Dr. Boggess (Medical Director)

    Dr. Tony Boggess is a Physical Medicine and Rehabilitation (PM&R) physician, speaker, and writer who specializes in Nutritional and... read more

Myalgic Encephalomyelitis (ME)


Often patients seeking our clinic’s help become very educated about what their doctors can’t seem to figure out. For this reason I am often required to offer my thoughts about diagnosis such as Myalgic Encephalomyelitis (ME), Chronic Fatigue and Immnune Dysfunctions Syndrom (CFIDS), Fibromyalgia, Neuro Immune Syndromes, Undermethylaion, Adrenal Fatigue, and the list goes on. While these terms are merely descriptive and the conditions themselves “waste baskets” for the doctor’s “failed search,” these conditions are real and significantly reduces ones quality of life.

Not too long ago research concluded that the best approach for conditions such as Myalgic Encephalomyelitis and other Neuro-Immune Syndromes was gradient physical exercise and cognitive behavioral psychotherapy. And while this is true, there is also much more to it.

Our clinic attracts patients from all over the country with condition such as ME, Chronic Fatigue, and types of Neuro Immune abnormalities. For patients ranging from child to senior, our primary goal is to improve ones constitutional baseline by addressing genetic susceptibilities, repairing brain inflammation, improving immune regulation, addressing neurochemistry collapse, and rebalancing the Hypothalamus-Pituitary-Adrenal-Gonadal-Thyroid (HPAGT) axis. Our approach is intensive, but for the motivated patient it can truly increase the quality of ones life and reverse the impending health collapse.

There are other ways to look at “therapy” as well. For example, reframing one’s understanding of the situation, transforming the “hopeless” to “hopeful” through group education sessions, and encouraging full understanding of ones genetics IS, in fact, “therapeutic.” Cognitive Behavioral approaches have value, but there are also other approaches. Energy kinesiology, emotional release techniques, self-directed approaches to reversing PTSD, all are worthy of ones consideration. Our clinic performs a number conventional and functional medicine diagnostic tests to identify the root cause of illness. We cross references single nucleotide polymorphisms (genetic susceptibilities) with blood, urine, and stool test; use Neuroimaging, brain electrical testing, survey assessments, and any number of tools to help us solve the puzzle. We encourage our patients not to give up.

While many conditions we treat do not have clear diagnostic criteria, Myalgic Encephalomyelitis does. Please note: I have provided the conventional description as well as the diagnostic and treatment focus that often leads to reprieve and reversal of symptoms.

Diagnostic Criteria for ME/CFS

In order to be diagnosed with ME/CFS, you must have “postexertional neuroimmune exhaustion.” This means unexplained and severe fatigue after simple activities, not otherwise explainable by medical conditions like anemia, hypothyroidism, etc. In addition a patient needs to present with at least one symptom from each of the following 3 categories:

Neurological problems: For example, short-term memory loss, difficulty concentrating or thinking, pain, unrefreshing sleep, problems focusing vision, sensitivity to light or noise, problems with depth perception, muscle weakness, poor coordination.
Diagnostic and treatment focus: Neurotransmitter collapse, vaso-cognitive impairment, histamine abnormalities, glial cell activation, infectious etiologies, innate immunity pathway abnormalities, chronic inflammatory response syndrome (CIRS), neurotransmitter interpathway genetic susceptibility, et cetera.

Immune, stomach, or bladder problems: For example, flu-like symptoms, nausea, food sensitivities, frequent urination
Diagnostic and treatment focus: Sympathetic / parasympathetic imbalance, Th1-Th2 shift, IgA deficiency or excess, malabsorption, eosinophilic inflammation, gastrointestinal dumping, GI permeability problems, food sensitivity/allergy, et cetera.

Problems with energy production or energy transportation within the body: For example, dizziness or lightheadedness, difficulty breathing, difficulty regulating body temperature
Diagnostic and treatment focus: Stressed or injured mitochondria, copper toxicity, metalothionine abnormality, cell membrane health, fatty acid deficiency, methylation genetic susceptibility, cellular oxidative stress, inflammatory stress, HPAGT axis problems, etc.

Regardless of the reason for ME, CFS, CFIDS, onset: stealth infection, vaccine reaction, brain injury, trauma, toxicity, stress, or simply genetic susceptibility meets environmental factors, patients can get their lives back if they play their (genetic) cards right. These are treatable conditions and a ‘Precision Functional Medicine’ clinic well versed in genomics often has many tools and approaches to offer patients in this regard.