fibromyalgia & chronic fatigue

FIBROMYALGIA AND THE RELATIONSHIP
TO CHRONIC FATIGUE SYNDROME

Chronic Fatigue Syndrome

After graduating from Yale, Dr. George Beard received his MD from the College of Physicians and Surgeons of New York just after the Civil War ended.  A neurologist by specialty, Beard’s Wikipedia bio states, “He is remembered best for having defined a medical condition with symptoms of fatigue, anxiety, headache, impotence, dyspepsia, neuralgia, insomnia, and depression, as a result of exhaustion of the central nervous system’s energy reserves. Physicians who agreed with Beard associated neurasthenia with the stresses of urbanization and the increasingly competitive business environment. Stated simply, people were attempting to achieve more than their constitution could cope with.”   Although we like to think that our’s is the first true ‘pedal-to-the-metal’ society, think about what these recent urbanites were going through just to put food on the table.  What’s interesting, however, is that this description of neurasthenia was not talking about the people working 16 hours a day in sweat-shop factories.

According to an article from the University of Virginia (Neurasthenia & the Culture of Nervous Exhaustion), neurasthenia was “afflicting the leading families of the United States. The best educated, most cultured Americans were suffering from a new, distinctly American condition that was destroying their health… in alarming numbers.”  According to this same article, “Beard saw neurasthenia as created by the hectic, fast-paced life in American cities – he even called it ‘American nervousness’. The nation’s leaders in business, government, and the arts were made ill by the stress and strain of modern life. The only cure was withdrawal from the pressures of urban life, rest, and a simpler, healthy lifestyle.”  Think about it folks — the “CURRENT RIVER CURE-ALL“!   But I regress.

Stop and ponder for a moment — while you look at the therapeutic pictures found in the previous link — it’s no wonder we as a society are suffering from many of the same problems Beard described 150 years ago (HEADACHES & MIGRAINES, ANXIETY & DEPRESSION, DIGESTIVE ISSUES (not to mention all manner of problems with the “GUT,” including IRRITABLE BOWEL SYNDROME), SEXUAL DYSFUNCTION, a perpetual state of SYMPATHETIC DOMINANCE, CHRONIC PAIN, and above all, an overwhelming fatigue that despite the continual exhaustion, produced an inability to get quality SLEEP).   Beard essentially claimed that “nervousness” (what we would today call stress) was consuming people’s “VITAL RESERVES“.  What does this sound like to you?  Although many would argue that it sounds like classic PTSD, it’s an almost verbatim description of what we today refer to as ADRENAL FATIGUE (aka FIBROMYALGIA).  Enter Dr. Don Goldenberg.

The current issue of Practical Pain Management which I received in the mail a few days ago carried an article written by medical doctor and expert on the subject, Don Goldenberg, called Fibromyalgia, Chronic Fatigue, and Chronic Fatigue Syndrome.  Goldenberg writes that, “Chronic fatigue, like chronic pain, is a common symptom in the general population, with prevalence estimates between 10% and 40%.  Chronic pain and chronic fatigue are strongly associated.”  As to what Goldenberg says causes this problem; “chronic medical or psychiatric illnesses account for 70% of chronic fatigue in the general population. However, at least 30% of the time no specific cause is found.” 

All of this is helpful to know, but doesn’t really mean much if we can’t answer two specific questions; what really causes chronic fatigue syndrome (i.e. what causes chronic illness?) and what can be done to solve it?  To start to answer these questions, let’s look at the diagnostic criteria Goldenberg laid out for determining whether or not you or someone you love might be labeled as having Chronic Fatigue Syndrome (CFS).

  • Physical exertion that leaves you feeling exhausted for more than 24 hours.
  • An inability to sleep or an inability to achieve quality (refreshing) sleep.
  • Brain fog (an inability to concentrate) and a failure of STM — short term memory.
  • Pain in muscles and / or joints for no good reason, and without visible signs of inflammation or injury.
  • Chronic headaches.
  • Chronic sore throats and / or lymph node involvement in the neck and / or armpits.
  • Decreased ability to perform your job or engage in social activities and hobbies (sex included).
  • Symptoms that get worse when standing errect and improve when sitting or especially laying down.

And here’s the rub; it may not matter anyway.  According to the author, “The diagnostic criteria do not offer clinicians the ability to distinguish chronic fatigue syndrome from overlapping functional somatic syndromes, and in particular fibromyalgia.”  In other words, call it whatever you want, you are going to be treated the same.  Although treatments for chronic fatigue syndrome were not discussed in this paper, 99 out of 100 practicing physicians (maybe more) are going to load you up with “THE BIG FIVE“.

As far as what’s actually causing CFS, Goldenberg nor anyone else for that matter (self included) are really sure.  He talked about things like Epstein-Barr (mono), stress, childhood stress, sexual abuse, psycho-social issues, as well as a few others — most of which are rather vague.  But the truth is, no one knows for sure, and it’s likely there are multiple causes (as I said earlier, he mentioned “CHRONIC DISEASES“, which are almost always related to chronic inflammation in one way or another —- even when discussing many of the so-called “GENETIC DISEASES“).

One of the more interesting things he mentioned was that, “Fatigue has been associated with inhibition of basal ganglia function in neurologic disorders as well as in patients who suffer from chronic immune stimulation.”  One of the things I hear people constantly talking about in my clinic is that they are taking (______________ insert your SUPPLEMENT DUJOUR here) in order to “boost their immune system“.  The problem is, stress tends to ramp up the immune system in ways that it shouldn’t — actually inhibiting TREGS from functioning properly, which invariably leads to AUTOIMMUNITY — while leaving you susceptible to every little infection that comes down the pike (which you will likely be given UNNECESSARY ANTIBIOTICS for).

And as for the BASAL GANGLIA, mess with this part of your brain and you’ll end up with all sorts of problems, including various forms of movement disorders (PARKINSON’S, Huntington’s, RESTLESS LEG SYNDROME, dystonia, etc), emotional and mood issues, as well as problems with cognition. It also happens to be a chief part of the brain fried by hard drugs, which helps explain why so many addicts and abusers end up with severe depression. 

Bottom line: You want to get your life back?  You’ll have to do it yourself.  The cold, hard truth is that you’ll probably have to take matters into your own hands if you want to begin solving this and other chronic health conditions.  It’s time you wake up to the fact that your doctor and the drugs that he or she is continually feeding you are not solving your problem(s).  I’m not suggesting for one minute that you stop taking whatever your doctor has prescribed you. 

I am, however, suggesting that you start asking some questions, doing your own research, and creating a plan to get off the medical merry-go-round — an “EXIT STRATEGY” if you will.  Fortunately for you, I’ve provided you A GREAT RESOURCE for learning about the factors that might be driving your chronic pain, illness, and your fatigue.

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