49 year old f. with cfids able to eat only chicken,potatoes. multiple wu negative. 60 pound wt loss,pain, dysautonomia, absent gi gm- bugs, ?bx

Very tough: we all have difficulty experiencing the suffering along with our CFIDS patients...no easy solutions. With regard to diet, the SIBO-directed FODMAP diet is where I start (http://www.ibsdiets.org/fodmap-diet/fodmap-food-list/). True food allergy is rare. An extensive immune screen (for T-cell/Treg function, humoral or specific Ab deficiency, combined deficiency, and phagocyte fxn my be fruitful

Details: Never quite sure what CFIDS entails, but has patient been assessed for depression? What are the manifestations of the dysautonomia - just GI, or other organ systems, viz. is there a small fiber neuropathy present? Is this a motility problem or absorption?

Further evaluation: Many with CFIDS have undiagnosed Lyme,Babesia, Bartonella,Mycopplasma, Intestinal parasites and other infections. Often the standard tests give false negatives. The food intolerances suggest GI inflammation. Might have mercury, lead, aluminum, mold toxicity etc. If you're not experienced in treating/evaluating such complex cases advise you refer to an integrative Dr. with experience in this area.