There seems to be a lot of people with similar symptoms and I for one matched very closely to yours (slowly improving).
The problem with this cocktail of symptoms is that it is hard to pinpoint one single cause, specially with limiting testing available.
CFS/FM/IDS are labels that have similar root cause but manifest in different ways and/or at different stages of disease progression.
Chronic diseases are usually a combination of events that have pushed the body into a vicious cycle. Toxicity and nutrition deficienies are always the root causes, but it's the timing and combination of several variables that sends one into a seemingly never ending diseased cycle.
Personally I think a person with these symptoms is incapable of fighting off infections and reduce toxic load due to nutritional deficiencies.
Your body needs proper raw materials to function and detoxify itself constantly.
If these nutrients are not available, the toxins will acumulate and this will invite pathogens in.
For one reason or the other, digestion is weakened (specially with so many people on antacids and the wrong diet and foods without nutrition, infections that demand more nutrition ) up to a point where your body may no longer be able to absorb the nutrients it requires.
According to Dr Vickery, 9 out of 10 people are protein deficient - not because they don't consume enough protein, but because they have impaired digestive function.
With gradual nutritional deficiencies (specifically aminoacids), the production of digestive juices (HCl, enzymes, bile) suffers, and this can result in a vicious cycle, because if you are not able to digest due to of nutritional deficiencies, then you progressively get worse because you can't absorb the nutrients.
Weak digestion is probably the first layer of aminoacid deficiencies. Then comes tissue dissolution as the body attempts to get aminoacids from anywhere it can, and this can cause collagen breakdown, muscle tissue thinning, leaky gut syndrome, inflamed gut etc (allergies may develop at this time). The next layer of deficiency probably is hormonal production as the endocrine system may not have enough raw materials to provide the right hormones - anxiety, fatigue, insomnia, irritability and even heart rates (palpitations, irregular heartbeats) are partially hormonal dependent.
At this point is where some testing can be done to measure endocrine responses and can get an indication that something may be out of whack (adrenal fatigue, hypoglycemia, hypo/hyper thyroid, etc). Blood tests may be useless because the blood chemistry is the single most important factor so only when the body is severly discontented is when people may see weird blood tests.
With protein sitting in the gut undigested, it allows pathogens to make a feast out of it, resulting in dysbiosis. This further increases the toxin overload as some of the metabolic waste products made by patohgens can be harmful. Indican presence indicates some form of gut dysbiosis, and yes
Acne is a direct symptom of this.
So strengthing digestion may be the best way to reverse things. It is well known that as we age the stomach production and other digestive juices diminish, and with the processed food and prescriptions drugs it will only impair it even further.
At this stage taking free form essential aminoacids can do amazing things - these are the raw materials for every single process in the body that a body at this stage is begging for. So by taking good amounts of eaas it feeds the body without relying on digestion (which may be impaired) - these are readily absorbed. It is a good idea to obtain other nutrients in readily absorbable form as well.
As aminoacids get absorbed it replenishes the stock and now hormone production can be normalized so anxiety and other symptoms may be diminished (it did this for me immediately). Then with time, it gets to the last layer (digestion strengthning) as it allows enzymes, HCl production to restart at normal levels.
This is where you want to be at since you may now be able to absorb your food and no longer need to rely on supplements.
Infections, waste acumulation may be naturally taken care of - heavy metal acumulation can be decreased now that the liver has sufficient AAs to handle toxicity (AA are essential to detoxification of the liver).
It certainly may be a good idea to bowel cleanse, liver ,
kidney cleanse to speed up recovery, specially now that your body is able to detoxify properly so it's getting rid of a lot of junk accumulated over the diseased period (my liver ducts appeared to be blocked temporarily (yellow stools, slight pain), probably as it got rid of toxins in the liver).
Also supplementing with HCl and enzymes if needed may strengthen the digestion faster while AAs supplementation is primarily used to feed other layers of the system first.
I encourage you to read on Dr Brice Vickery work
Mike