Chronic Fatigue Syndrome and Fibromyalgia
Any detailed discussion of fibromyalgia is incomplete without also talking about chronic fatigue syndrome. In this post, we’ll break break down what chronic fatigue syndrome is and its relationship to fibromyalgia.
What exactly is Chronic Fatigue Syndrome, or CFS for short? Well, it is a bit hard to define, but generally speaking, it’s a complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue is especially bad after physical or mental activity, but can’t simply be fixed with rest. It lasts a long time and limits your ability to do ordinary daily activities.
It is also referred to as myalgic encephalomyelitis – ME – and since doctors can’t agree on an official term sometimes the two are blended together as ME/CFS. But I’m just going to keep calling it CFS in this video for simplicity’s sake. This is a serious illness that affects an estimated 800,000 – 2.5 million Americans, though most of them have not been diagnosed.
Diving a bit deeper, some symptoms experienced by those with CFS, besides the crippling fatigue, are sleep problems, muscle or joint pain, headaches, sore throat, problems thinking, enlarged lymph nodes in your neck or armpits, dizziness, and heart palpitations. One distinctive quality is that over-exercising makes these symptoms worse in a very direct way.
Diagnosing CFS is difficult because the symptoms are so similar to other conditions. There are no specific tests that can definitively prove CFS, so the diagnosis is based on a combination of what you tell your doctor and tests that rule out other conditions. Besides fibromyalgia itself, the other conditions could be sleep disorders, anemia, diabetes, underactive thyroid, heart and lung impairments, or mental health issues.
The cause of CFS is unknown. Researchers think that some people are born with a predisposition to the disorder, and their CFS is then triggered by a particular event. These events can include viral infections such as the Epstein-Barr virus, bacterial infections such as pneumonia, immune system problems, hormonal imbalances, and mental health problems such as depression or emotional trauma.
CFS is most common among people in their 40s and 50s and affects women at more than twice the rate of men.
Similarities to Fibromyalgia
Ok, so how does CFS relate to fibromyalgia? If you watched our foundational fibro videos, you’ll notice a lot of similarities between the two conditions. In fact, some people classify them as the same disorder. However, this is not actually correct. They are two distinct conditions and only about 15 percent of fibro patients also truly meet the diagnosis for CFS.
They are like twins in the sense that they share the same structure, but each has its own expression, or personality if you will. CFS’s personality is more defined by fatigue and fibro’s personality is more defined by pain.
What diagnosis you receive partly depends who you talk to…primary care doctors are more likely to lean towards a CFS diagnosis first whereas rheumatologists might lean towards a fibromyalgia diagnosis if pain is your number one complaint.
Differences from Fibromyalgia
There are some subtle differences between the two conditions. CFS is frequently triggered by an infectious illness whereas fibro is more commonly triggered by trauma. Even though women are much more likely to suffer either, those affected by CFS have a more even gender distribution at 7 women for every 3 men. In contrast, fibromyalgia has a 9-to-1 ratio of women to men.
Another subtle difference has to due with the neurotransmitters affected. RNaseL, a cellular antiviral enzyme, is frequently elevated in CFS but not fibromyalgia. Substance P, a neurotransmitter responsible for the transmission of pain, is higher in people with fibro but not CFS. This might explain why pain is a key symptom for fibro, but less important for CFS.
Finally, intolerance to exercise is more prominent for CFS patients. While this is certainly a problem for fibro folks too, it is less common for them to be completely and utterly drained by exercise the way people with CFS are.
If you want to learn more about CFS, I’d highly recommend watching the documentary called Unrest by Jennifer Brea. She does a really good job of giving you a lens into the day-to-day life and struggles of those with the condition, including herself.
Do you have chronic fatigue syndrome? How does it affect your daily life? What things help you get through the day when your CFS is at its worst? Let us know in the comments below.