Autoimmune/rheumatology Autoimmune hepatitis Rheumatoid and other inflammatory arthritis Sjogren syndrome Systemic lupus erythematosus Wegener’s granulomatosis Cardiovascular/autonomic Aberrant coronary artery, coronary aneurysms Cardiomyopathy Coarctation of the aorta Patent foramen ovale Primary dysautonomia Pulmonary hypertension Rheumatic fever Valvular disease (congenital and acquired) Endocrine/Metabolic Addison’s disease Gonadal dysfunction syndromes Hyper- and hypo-thyroidism Hyper- and hypo-calcemia Inborn errors of metabolism Metabolic syndrome Pituitary tumors or disorders Gastrointestinal/nutritional Celiac Disease Chronic liver disease Eosinophilic gastroenteritis Inflammatory bowel disease Pancreatic insufficiency Vitamin D and B12 deficiency

Hematological/immunological Anemias Common variable immunodeficiency Leukemia/lymphoma Post-cancer fatigue Infections Acute mononucleosis (Epstein-Barr virus, CMV) Brucellosis Coxsackie virus Giardia and other intestinal parasites Hepatitis B or C HIV Leptospirosis Lyme and other tick-borne infections Babesia microti anaplasma phagocytophilum Ehrlichia chaffeensis Mycoplasma pneumoniae Parvovirus B19 Post-infectious fatigue syndrome Q fever Toxoplasmosis Tuberculosis Neuromuscular/neuroanatomic Cervical spine stenosis Chiari I malformation Cranio-cervical instability Tethered spinal cord Inflammatory myopathies Mitochondrial disorders Multiple Sclerosis Muscular dystrophy syndromes Myasthenia gravis Neuropathies Post-concussion syndrome

Psychiatric Anorexia Nervosa Bipolar disorder Chronic psychosocial stress Generalized anxiety disorder Major depressive disorder Personality disorder Post-traumatic stress disorder Respiratory Aspergillosis Asthma/allergies Chronic sinusitis Cystic fibrosis Sarcoidosis Sleep disorders Central apnea Klein-Levin syndrome Narcolepsy Obstructive apnea Periodic leg movements Toxic substances Alcohol or drug misuse Ciguatera poisoning Lead or mercury poisoning Organophosphate poisoning Reactions to medications, e.g., antihistamines, antipsychotics, sedatives, tricyclic antidepressants Other conditions Athletic overtraining or underperformance syndrome Marfan syndrome Mast cell activation syndromes