Food intolerance: an unrecognised cause of chronic fatigue

Brenda was a forty-year-old housewife with all the symptoms of a Chronic Fatigue Syndrome. Her trouble started, two years ago, with a viral infection of the thyroid gland. She was perfectly well before this, but never right since. In particular, she complained of bouts of extreme fatigue, recurrent sore throats, pains in the arms and legs, stiffness across the shoulders, swollen glands in her neck, headaches and unrefreshing sleep. She had not been symptom-free for a single day in the past two years. She consulted her doctor frequently, first with one thing and then with another. She found this hard to cope with for, as she said of herself, she took pride in the fact that she hardly ever 'bothered the doctor'.

Everything was normal on physical examination. The blood tests were also normal; and so, in view of the ongoing symptoms, her doctor referred her to the Allergy Clinic. Brenda went on the Low Allergy Diet and within ten days all of her symptoms abated. Two years of abject misery came to an end simply by changing her diet! Subsequent food challenges revealed that she had multiple food intolerance. She reacted very badly to wheat, especially, but also to a host of 'otherwise harmless' foods, including bananas, onion, yeast, mushrooms, rice and oats. Because it would have been very difficult to avoid all of these foods, and to prevent the development of other food intolerance, she was offered a course of desensitisation. She has never looked back.

I would also like to introduce you to Gerry. He was a young lad in his early teens who complained of constant fatigue. His mother told me that he had never really recovered from a glandular fever three years previously. She described him as lethargic, always sitting down, with no real energy or interest in anything. For his part, Gerry also complained of frequent bellyaches, recurrent sore throats, and dizzy spells. He too was placed on the Low Allergy Diet, and he too lost all of his symptoms. He reacted badly to wheat, rye and oats — all gluten-containing foods. He had a biopsy test to exclude coeliac disease, and this was negative. We can safely say, therefore, that Gerry had a post-glandular fever fatigue prolonged by food intolerance — in his case, non-coeliac gluten intolerance.

In both of these cases there is a clear history of viral onset. One had a thyroid infection; the other a glandular fever. In each case, the patient slid imperceptibly from a state of viral infection into one of food intolerance. Patients have been known to develop IgE allergies, such as hay fever and asthma, in the wake of viral infection; but the development of food intolerance under similar circumstances has received less attention. This is a pity because, as these cases so clearly demonstrate, postviral food intolerance can cause years of suffering.



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