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Latest Chronic Fatigue and Irritable Bowel Research Shows Surprising Parasite Problem

Tim Boyer's picture
Tired man

Recently, gastroenterologist Robynne Chutkan, MD appeared on TV and explained to viewers how that in many cases chronic fatigue syndrome is attributed to infection by harmful parasites that thrive in the digestive system. She explained how that parasites pose a hidden health hazard in the human gut by stealing nutrients, releasing toxins and reproducing for many years, which can lead to internal bleeding, anemia and chronic fatigue syndrome.

Parasites, she explains, come from many sources including the meat and fish you buy at the market, produce from overseas and in many cases out of our water supply system. In fact, the 1993 Milwaukee Cryptosporidium outbreak is the single largest drinking water-related parasite epidemic in the U.S.

CDC officials determined that the Milwaukee outbreak was caused by a tiny protozoan called Cryptosporidium that managed to get past the city’s water treatment plant filtratration system. During a period of two weeks, over 400,000 residents became infected and suffered severe stomach cramps, diarrhea, fever and dehydration. Of those infected, a little over 100 residents died. Cryptosporidium infection in humans was first discovered in 1976 and is primarily found in the elderly and immunocompromised people such as AIDS patients.

Cryptosporidium begins its life cycle as an oocyst that is introduced to the human body by eating contaminated food or water. Once the oocyst reaches the gut, the oocyst breaks open releasing sporozite larvae that then attach to and begin feeding on the gut epithelial cells causing a disease known as Cryptosporidiosis, Typically, the first sign of infection is watery diarrhea. There is no cure other than treatment of the symptoms and allowing the body’s immune system time to respond and recover.

The 1993 contamination of Milwaukee’s water supply is attributed to sources that include cattle along the two rivers that flow into the Milwaukee harbor above the treatment plant, local slaughterhouses and human sewage. Analysis following the infection discovered at least six species of Cryptosporidium living in water samples from the region.

Dr. Chutkan also discusses one other microscopic parasite that is a potential source of chronic fatigue syndrome—Giardia (a.k.a. Traveller’s diarrhea).

Giardia lamblia is another waterborne protozoan that lives in both developed and underdeveloped nations where the water supply has become contaminated with sewage. Campers and hikers who drink from what seems like clear, clean streams are often drinking from water that possesses Giardia deposited by wild animals such as beavers and muskrats. However, it can also be passed on person-to-person and is often a problem in nursing homes, daycare centers and people having unprotected anal sex.

Once infection occurs, symptoms of stomach cramps, bloody diarrhea, bloating, headache, low-grade fever, nausea, vomiting and a swollen or distended abdomen may appear in about a week and will last for 2-4 weeks.

Giardia is typically diagnosed following microscopic examination of a stool sample for the presence of eggs and parasites. Giardia infection tends to go away on its own; however, the infection can persist and will then require antibiotic treatment. Complications of Girardia include dehydration, weight loss and malabsorption of nutrients from your food while infected.

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Since the early 1990’s, the medical community has come around to recognizing that there is a strong association between chronic fatigue syndrome and parasite infection. In one study looking at 200 patients diagnosed with unexplained chronic fatigue syndrome, 46 percent were found to be infected with Giardia. After receiving treatment for Giardia infection, 70 percent recovered from their previously unexplained chronic fatigue while the rest either found some reduction in their fatigue symptoms or failed to recover after treatment for Giardia.

For those who failed to recover from their chronic fatigue, researchers may have discovered the reason why—recent research posits that unexplained chronic fatigue can result and persist long after a parasite infection has cleared from the body.

In a recent paper published in the journal Gut, researchers studying patients experiencing unexplained chronic fatigue syndrome and irritable bowel syndrome were surprised to find that many of them had previously suffered and recovered from Giardia infections up to 3 years prior to their fatigue and irritable bowel symptoms began. Their findings complement a previous 2009 study that also drew an association between parasitic infection with Giardia and resultant chronic fatigue and irritable bowel syndrome following infection.

Currently, the researchers do not know why and how chronic fatigue and gastrointestinal problems develop after Giardia infection, but believe that a protracted and severe Giardia infection can cause lasting damage and inflammation to the GI tract that persists long after the parasite has been removed. If the association between Giardia infection and chronic fatigue and irritable bowel syndrome proves to be true, then the authors state that an early diagnosis and treatment for Giardia infection is needed to reduce the risk of developing chronic fatigue and abdominal complications later in life.

To protect yourself from the risk of developing chronic fatigue and/or irritable bowel syndrome, health authorities advise that prevention is still the best medicine from a protozoan parasitic infection and that you should use a water purification method such as boiling, filtration, or iodine treatment before drinking surface water; use good hand washing and hygiene techniques when going from child to child or patient to patient in nursing homes and daycare centers; and, practice safer sexual practices, especially regarding anal sex to decrease the risk of contracting or spreading giardiasis.

Follow this link to find out why taking Wormwood tea to treat a parasite infection can be hazardous to your health.

Image Source: Courtesy of MorgueFile


“Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after” Bio Med Central Infect. Diseases 2009, 9: 206.; Kristine Mørch, Kurt Hanevik, Guri Rortveit, Knut-Arne Wensaas, Geir Egil Eide, Trygve Hausken and Nina Langeland.

“Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study” Gut 2012 Feb; 61(2):214-9; Wensaas KA, Langeland N, Hanevik K, Eide GE, and Rortveit G.



I have recently recovered from 25 years of Chronic Fatigue Syndrome using Xifaxin or Rifaxamin on a maintenance dose of 550 mg 2 times a day. Xifaxin doesn't have side effects and was safe to try. My gastrointestinal symptoms were still undiagnosed, but giardia was ruled out, when my doctor decided to try a short-course treatment dose of 550 mg 3X day. A couple of days into it, my CFS symptoms, both physical and cognitive, receded and I felt much better, only to relapse when the treatment ended. We used the Xifaxin 3 times in this way and each time I got dramatically better until the treatment ended and my CFS symptoms returned. So I looked up using maintenance doses of Xifaxin and discovered it was being given for one particular condition. I asked my gastroenterologist and my infectious disease CFS doctor and they both agreed to give it to me and both of them are following me closely. I email my CFS doctor/researcher weekly to report on my condition. I no longer feel sick and have a life again after 25 years of being bedridden or housebound much of the time! I would love for people who might be appropriate candidates for this treatment to try it on a maintenance dose after treatment so we could discover if this could have wider application. I was eventually diagnosed when more symptoms presented themselves with gastroparesis which prevents normal timely processing of food, allowing it to accumulate in the stomach and small intestine undigested and rotting, causing an overgrowth of bacteria that sends toxins to the brain that apparently (I'm guessing) cause the symptoms of CFS in some of us. I encourage people with gastro symptoms accompanying their CFS to discuss this with their gastroenterologists to see if it would be worth trying for them. I don't want to be the only one who benefits from this amazing treatment.
Thank you so much for sharing this information. I hope others will see it too and can benefit from your experience and input.
Could you please share with me the name of our doctor? I have been plagued with CFS for 13 years now and am so tired of being tired. I will post my email address if you prefer to keep your doctor's name private.
The CFS doctor and researcher I'm working with is Dr. Andreas Kogelnik of Open Medicine Clinic in Mountain View, CA. I don't share my gastro doc's name but he was the one who first gave me the Xifaxin. Dr. Peterson is also using it but from what I read from one of his patients, he hasn't made the leap from treatment Xifaxin to maintenance. I continue to be amazingly well and it's been 9 months total now. I encourage CFS patients with gastro symptoms, even mild ones, to discuss this treatment with their doctors. And I'd love to hear if it is helping others which would be my greatest joy!
I had what a doctor thought was guardian 6 years ago (he had worked in a third world country and recognized symptoms). Albendazole is better than flatulent according to him. Giardia might not show up in tests. Mine did not show it but did show cdiff. I am lactose intolerant and underweight ever since. Also allergies and ind symptoms along with fatigue. I am convinced that I do not absorb all nutrients and do not produce needed enzymes in my gut and never will again unless more research is done for lasting damage. The gi doctor did not believe my claims of guardian induced lactose intolerance so I am glad to see more nonlinear now than six years ago.
This is awesome information - I read our comments here and had to jump in! :)