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Given that chronic fatigue originates in the gut, the gut is the first place to start with regards to treatment: Step 1 Nutritional Therapy for gut healing Studies have shown that CFS is associated with an underlying increased incidence of microbial translocation (leaky gut) due to chronic inflammation and breakdown of the gut lining proteins.This leads to an ongoing drain on the immune system, immune dysfunction, increased production of inflammatory cytokines and signals and ultimately HPA dysregulation (hypothalamus pituitary adrenal glands)