Fibromyalgia / Chronic Fatigue Syndrome What Is It?...What To Do About It
By Henry C. Sobo, MD
ibromyalgia and Chronic Fatigue Syn- drome are poorly understood condi- tions for both doctors and for the pub- lic, their potential patients. There is not one clear symptom or test that makes the diag- nosis of either Chronic Fatigue Syndrome or Fibromyalgia. The list of associated possible symptoms are long and varied and there is a great overlap between the two. Many people clearly would satisfy the criteria for both diagnoses and can be said to have Fibromy- algia/ Chronic Fatigue Syndrome. To be diagnosed with Chronic Fatigue syndrome a person is said to have severe fatigue for at least 6 months or longer that is not relieved by rest and not due to medical or psychiatric conditions associated with fa- tigue. Suffering from this unexplained fatigue means that the patients who seek medical care are often told by their doctors that they can find nothing wrong with them, and that their tests are normal. When a doctor is presented with a patient who complains of fatigue they check for a host of medical problems that are known to cause fatigue. Two of the most common are anemia,
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and hypothyroidism (underactive thyroid gland). The problem arises for both the pa- tient and the doctor, when the doctor runs a series of tests and does not find that anything is abnormal. The doctor doesn’t have a treat- ment plan, and the patient is left without
cation even if they insist that they are not depressed. Many people are caught up in a cycle of testing and retesting, and even try- ing other antidepressant medications when the first one does not have any beneficial effect, all without benefit. To further establish a diagnosis of
Chronic Fatigue syndrome, the patient is said to suffer from a number of the following symptoms: unrefreshing sleep, fatigue pres- ent before the day’s activities, impairment in short-term memory or concentration, post- exertional malaise (prolonged exhaustion following physical activity that lasts more than 24 hours), muscle pain, multi-joint pain without swelling or redness, headaches, recurring sore throats, tender cervical or axillary lymph nodes.
As pain is among the symptoms listed
an understanding of what might be wrong, and often that results in the patient seeking yet another doctor’s opinion. But there is no test that defines chronic fatigue syndrome, and so a common scenario is that a person seeks care from a variety of different health- care providers only to wind up just where they started…being told that nothing can be found. Very often these patients are told that
they must have an underlying depression which can be manifested as fatigue. The patient will be offered antidepressant medi-
from chronic fatigue syndrome, one may logically ask, what is it that distinguishes someone as having fibromyalgia? There are two particular characteristics of fibromyalgia pain that make the diagnosis as laid out by the American College of Rheumatology in 1990. Fibromyalgia sufferers have a history of widespread pain for at least three months. Widespread pain means that there is pain on both sides of the body, and also above and below the waist. And they have tender “trig- ger points.”
A doctor can perform an exam showing
36 Natural Nutmeg January 2012
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