M.E.S.S. - About ME/CFS

What is Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a problem very well known to physicians. In 1869, a physician described undue fatigue which he termed neurasthenia. This was the first time it had been described in medical literature. This is interesting, since medical history goes back many more centuries. Could it be that the changes in the environment brought about by the industrial revolution had something to do with it? Why wasn't this "chronic fatigue syndrome" state described in the "books" of the 16th or 17th centuries?

ME/CFS is neither a psychosomatic nor a psychiatric disorder. It is a clinical or medical condition. It should be noted that Chronic Fatigue Syndrome is different from "chronic fatigue". Chronic fatigue is a symptom of any number of disease processes and is simply the condition of being constantly tired. It is not as debilitating as ME/CFS, or in the same way. In a person with ME/CFS, days of fatigue can be triggered by a minimal amount of exercise, physical or mental, despite the absence of any organic disease or clinical depression.

In 1988, a group at the Center for Disease Control (CDC) formulated a set of criteria for the diagnosis of ME/CFS, plus what is now called Chronic Fatigue and ImmunoDysfunction Syndrome (CFIDS). These criteria have done very little to elucidate the true cause of the problem. In December of 1994, CDC updated its case criteria and published them in The Annals of Internal Medicine. The CDC bulletin says, in part:

A thorough medical history, physical examination, mental status examination, and laboratory tests must be conducted to identify underlying or contributing conditions that require treatment. Diagnosis or classification cannot be made without such an evaluation.

Clinically evaluated, unexplained chronic fatigue cases can be classified as CFS if the patient meets certain criteria.
 
 

December 15, 1994 - The Annals of Internal Medicine: Vol. 121, No. 12, Pg. 953-959
 
Tell me more about the CDC criteria for diagnosis
Tell me what my physician should know

It appears that ME/CFS will be the dominant health disorder of the 21st century. A quarter of all patients presenting to their physicians do so with a complaint of "chronic fatigue." The CDC estimates that there are 500,000 people with ME/CFS in the U.S., which many feel is far too small a figure. Leonard Jason's recent study (published in October 1999 in the Archives of Internal Medicine) concludes that there are 836,000 people in the U.S. with CFS.

There are many illnesses that have chronic fatigue as a major symptom: depression, autoimmune disease, environmental illness and the classic reactivated viral type illness. All of these illnesses may have a similar basis for their development — molecular damage from oxidative stress or "rusting" of the cells. (This is a complicated concept which needs personal interpretation by someone knowledgeable in molecular medicine.)

The state of having ME/CFS cannot be understood through simplistic single-agent, single-disease models. What is required is a holistic study of the biochemistry of man and his environment including: invading organisms, chemical and heavy metal damage, digestion, nutritional (anti-oxidant, etc.) deficiencies, and stresses of modern life.

The recognition of the "flaws" or damaged areas from molecular injury and the elimination of those insults is the only way to solve the puzzle of ME/CFS. This can be done by a meticulous investigation into the human organism's "systems" from a functional molecular standpoint. In this way, the causes of the problem may be determined so that curative measures may be employed.

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