ME and CFS

Chronic Fatigue Syndrome (CFS) is long-term tiredness (fatigue) that does not go away with sleep, or rest, and affects everyday life.

CFS is also known as ME (myalgic encephalomyelitis). Myalgia is muscle pain, and encephalomyelitis is inflammation of the brain and spinal cord. ME is a commonly used term, although it can be thought to be too specific to cover all the symptoms.

CFS is the term that is often used to describe long-term tiredness by GPs and medical professionals. This is because in the majority of cases, the main symptom is chronic fatigue. This is usually the preferred term, rather than ME, as in CFS, there is little evidence that inflammation of the brain and spinal cord occurs.

ME is often the preferred term of people who have CFS. This is due to the fact that they feel fatigue is too general and does not reflect the severity, and different types of fatigue. Also, it is felt that even though fatigue may occur in most cases, it is not the main, or only, symptom people experience.

It is estimated that 150,000 people in the UK have CFS. Anyone can get CFS, although it is more common in women than in men. It usually develops in the early twenties to mid-forties. Children can also be affected, most commonly between the ages of 1315.

What's the Difference?

Some doctors treat fibromyalgia (FMS) and chronic fatigue syndrome (CFS) separately, while others think they are actually the same thing – or at least, variations of the same condition. According to the Arthritis Foundation, research shows that 50 to 70 percent of people with one diagnosis also fit the criteria for the other.
Similarities

FMS and CFS are known to have a host of symptoms in common. They include:
  • Pain
  • Fatigue
  • Sleep disorders
  • Irritable bowel syndrome symptoms
  • Chronic headaches
  • Association with Temporomandibular Joint Syndrome (TMJ)
  • Cognitive or memory impairment
  • Dizziness
  • Impaired coordination

Differences

One key difference, when it comes to a diagnosis, is which symptom is worst – pain or fatigue. The diagnosis could also be influenced by whether your doctor is more familiar with the American College of Rheumatology's criteria for FMS or the CDC's guidelines for CFS.

However, experts have found some significant differences. CFS tends to begin after flu-like symptoms and may be linked to a virus. CFS patients often have high levels of a cellular antiviral enzyme called RNase L, while the level is normal in FMS patients. Also, CFS diagnostic criteria include low-grade fever and sore throat, while FMS criteria do not. Meanwhile, the onset of FMS frequently is traced to a physical or emotional trauma. The pain of FMS gets better with heat and massage, while the pain of CFS does not. Further, people with FMS have tender points and abnormal levels of a cellular chemical called substance P (which transmits pain signals), and this level appears to be normal in those with CFS.

Why it Matters

In the end, does it really matter? Some used to say it didn't. Now, however, the drug Lyrica (pregabalin) is approved for fibromyalgia. The FDA also is considering New Drug Appliations for Cymbalta (duloxetine) and milnacipran as FMS treatments, as well as Ampligen (poly I: poly C12U) for CFS. Lyrica, Cymbalta and milnacipran all boost certain neurotransmitters, which may be normal or even already elevated in people with CFS. Ampligen modifies the immune system. It could be dangerous to take these drugs if you don't have the problems they're intended to correct.
The best course of action is to talk to your doctor about both conditions and make sure you've done all you can to solidify your diagnosis.

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