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The Villages
Friday, February 23, 2024

Chronic fatigue syndrome and fibromyalgia may be the same disease

Dr. Gabe Mirkin

A recent study found that that fibromyalgia and chronic fatigue syndrome (also known as myalgic encephalomyelitis) may actually be the same diseases (Annals of Medicine, December 2023;55(1):2208372). It is easy to understand the similarity of the two conditions with different names. Both are characterized by extreme muscle fatigue and tiredness as if a person had just run a marathon, even though they walked only a few feet. Both also involve sleep and memory problems. However, chronic fatigue syndrome is characterized mostly by extreme tiredness, while fibromyalgia is characterized primarily by body pain, particularly in muscles.

When you go to your doctor with specific complaints, the doctor usually does a lot of tests to try to find a cause. When all of the tests come back normal, the doctors rarely tell you that they don’t know why you feel so bad. Instead they give your muscle pain a fancy name such as myalgic encephalomyelitis. You say “thank you” and leave without knowing anything more than before you came to the doctor.

The Study
These researchers analyzed the cerebrospinal fluid in 15 patients with chronic fatigue syndrome, 15 patients with fibromyalgia and a control group with no complaints. The patients had an average age of 41. The researchers chose to study spinal fluid because many previous studies have shown no difference in any blood tests between the two conditions. They identified about 2,100 proteins and 1,800 were the same for both conditions. The researchers felt that the slight difference in some proteins would not lead to any significant effects that would divide them into two diseases.

My Recommendations
Even though doctors may not know the causes of chronic fatigue syndrome or fibromyalgia, if you have these symptoms, there is plenty you can do to help alleviate them. Patients who suffer from fibromyalgia or chronic fatigue syndrome are at significantly increased risk for heart attacks (Isr Med Assoc J, 2023;25(9):627-630) and diabetes (Sci Rep, 2021; 11:2978; Rheumatologia, 2018;56:275-8). Therefore, all the lifestyle rules for alleviating and preventing heart attacks and cancers also apply to these conditions. For example, having high blood sugar, high blood pressure and high LDL cholesterol levels are associated with increased risk and symptoms for most diseases. If you are tired all the time or have diffuse body pain, ask your doctor to help you and instruct you on a healthful lifestyle that includes:
• a plant-based diet
• regular sleep lasting at least eight hours a night
• avoiding smoke and alcohol
• an exercise program that is safe for you
When you exercise, you are not supposed to work through pain. When you start to hurt, stop exercising immediately and try again on the next day.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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