Chronic Fatigue Syndrome (CFS) is described as a severe, debilitating fatigue, lasting at least six months (of new and definite onset), associated with at least 4 of the following symptoms: impaired memory or concentration, sore throat, lymphadenopathy, muscle pains, joint pains, new headaches, unrefreshing sleep, and malaise after exertion. Other medical and psychiatric conditions that can produce fatigue should be ruled out, including Lyme's disease. After demanding physical exercise, CFS patients show impaired cognitive processing.

Fibromyalgia Syndrome (FM) is a pain disorder associated with multiple tender points, sleep disturbances (insomnia and nonrestorative sleep) and fatigue. Hypothalamic dysfunction, immune dysfunction, and nutritional inadequacies can all cause or perpetuate this sometimes severe syndrome. CFS and FM may be opposite ends of the same disorder, with the emphasis on fatigue in CFS and pain in FM. The key symptoms are disabling fatigue, diffuse achiness that is worse with exercise, disordered sleep, brain fog (decreased memory and/or concentration), and perhaps increased thirst, all for more than six months. If these symptoms are persistent and not caused by other untreated organic problems such as anemia, cancer, diabetes, lupus, polymyalgia rheumatica, or a chronic infection such as sinusitis or Lyme’s disease, then a comprehensive treatment approach will likely help. CFS and FM are not "all or nothing" problems. Like arthritis and many other illnesses, they occur in varying degrees of severity.

No single causative agent has been found. Many viruses have been considered and may play a role in CFS including the Epstein Barr virus (EBV) and Cytomegalovirus (CMV). Human Herpes Virus 6 (HHV6) is under investigation.

Based on a study by the University of Washington of over 1400 individuals, it was found that those who drank well water on a regular basis during childhood were 10 times more likely to develop FM than those who did not. Since many wells contain environmental toxins such as pesticide run off, we feel there could be a definite link, especially since FMS seems to be a central nervous system disease.

In one study, 75% of urine specimens obtained from CFS patients contained elevated levels of 5HIAA, (5 hyroxyindole acetic acid), a breakdown product of serotonin. This finding also showed that 70% of those taking NADH returned to normal levels of 5HIAA, while 70% of placebo patients continued to show elevated or increasing levels of 5HIAA. The urinary measurement of 5HIAA may help predict which CFS patients respond to NADH therapy. However, if a person is taking guaifenesin, levels of 5HIAA may be falsely elevated.

Both CFS and FM can be difficult to diagnose. There are currently no lab tests to confirm this clinical diagnosis. Many doctors encourage a comprehensive approach. There are many treatment choices available in alternative medicine so it is necessary to find what works best for you. Fibromyalgia develops slowly over many years, making the condition very difficult to diagnose in the early stages. It usually is well advanced before it is suspected. Educating yourself about this condition is the best way to catch it early. If any other family members have it, your chances of having it are increased. This is an important clue, for successful early diagnosis and treatment.

All underlying problems should to be treated simultaneously; otherwise a vicious cycle can be kicked into action in which each problem can trigger the others. Some call this the "fatigue cycle."

Since the treatment of this disorder requires a careful review of several body systems and the use of many nutrients, you may wish to participate in an established program of supplements. The Fibromyalgia Recovery Program offers a comprehensive natural approach to the complex problem of Fibromyalgia. Their home page can be viewed at fibrofree.com

A randomized, double-blind, placebo-controlled study by Teitelbaum et al. validates the work of Drs. Travell and Simons. Titled "Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia - a Randomized Double-blind Placebo-controlled Study" [The Journal of Chronic Fatigue Syndrome. Volume 8(2), 2001,pgs.3-28], the study found that treating Fibromyalgia patients for the perpetuating factors below resulted in a dramatic improvement vs. placebo (P<0.0001):

1 - Hormonal deficiencies. Dr. Teitelbaum postulated that hypothalamic dysfunction is a key process in the etiology of Fibromyalgia. Patients with lab tests for thyroid, adrenal and ovarian/testicular function that fell in the normal range were still treated if their clinical picture suggested a hormonal deficiency.

2 - Opportunistic infections. As a number of infections can perpetuate MPS, and since FMS is associated with immune dysfunction and opportunistic infections, possible parasitic and fungal infections were treated.

3 - Sleep disorders. Lack of adequate deep sleep has been shown to be a factor in chronic pain disorders and FMS. Dr. Teitelbaum treated this very aggressively.

4 - Nutritional inadequacies. Nutritional deficiencies were suspected to contribute to chronic, pathologic muscle shortening despite lab testing sometimes being in the normal range. In this study, nutritional needs were aggressively considered and treated.