The Biology of Chronic Fatigue Syndrome

3/26/14 – Medicine Grand Rounds – Stanford School of Medicine
Speaker: Anthony L. Komaroff, M.D.
Simcox-Clifford-Higby Professor of Medicine
Harvard Medical School Senior Physician
Brigham & Women’s Hospital
Start time: 6:38

22 Replies to “The Biology of Chronic Fatigue Syndrome”

  1. Most of the studies cited in this lecture seem to contain sample sizes of around 10-15 subjects. I'm no scientists but is that enough for the results to be significant?

    Be good if there were links to the actual studies.

  2. I have had this for over 25 years and glad to know now social security will accept the physical exertion exam results for disability (some kind of stress testing)

  3. AFTER YEARS OF ILLNESS WITH HIGH BLOOD PRESSURE AND LOW CORE TEMP.  ALONG WITH ALL OTHER SYMPTOMS ARE NOW NORMAL.  THIS IS AFTER FOUR YEARS. INOW STOPPED BP MED'S GO FIGURE.  I ALSO HAVE NEVER HAD A FLU OR COLD SINCE HAVING LATE CASE OF CHICKEN POX AT 34YEARS OLD.  ALL ILLNESS I EXPERIENCED WAS THE SYMPTOMS FOUND IN ME/CFS  THE LATEST ADDITIONS ARE BMS, NO TASTE BUDS, EAR PRESSURE, SLEEP ISSUES HAVE NEVER CEASED.  I HAVE LOST MY MUSSLE AND OPTIC NERVE WHERE MY EYES FILL WITH FLUID AND OVER THE PAST YEAR ALL FACIAL TISSUE AND EXPRESSION HAVE CHANGED WHERE I LOOK TEN YEARS OLDER.  MY BREATHING HAS GREATLY CHANGED LIKE A HUNGER FOR OXYGEN

  4. Anyone having CFS symptoms that came in gradually should check their dental health. My 4 months of CFS was caused by asymptomatic dead tooth with huge cavity on its side. It hurts when tapped with spoon. Rotten tooth, bad root canal, check them all! I strongly believe CFS is the exhaustion when you have continuos inflammation or infection, how localized it is.

  5. My girlfriend and I believe that she has CFS. Is there anywhere I can download these slides so we can show them to her doctor? 

  6. Having had Chronic Fatigue Syndrome for over 10 years now, I feel qualified to say this. The most important distinction to make in understanding this condition is that it is related to the RECOVER PROCESSES of the body rather than the immune system, which prevents disease and illness. The recovery process or to heal is something else entirely.

    Here are two simple examples from my own experience that explain this theory.

    1. In the summer of 2005, even before I was aware of having Chronic Fatigue, I noticed something strange. I have always kept cats and dogs as pets. When I was sitting at the kitchen table and they wanted my attention they would put a paw on my leg. This happened for years. In the warm weather, when I first switched to wearing shorts, invariably they would scratch my leg. Especially my dog, a chocolate Lab. It would only happen once or twice because I would always cry out. And, too, this happened in June of 2005. Except, in July or August, I realized I still had the same scratches they had left from early in the summer. Every year before this, those scratches disappeared within 7-10 days at most. It was enough that I commented on it to my son. I remember that very clearly. It wasn't until much later that I realized I already had CFS.

    2. As with many others, I have had periodontitis as a result of CFS. Prior to having CFS, I had perfectly healthy teeth. I always had. I brushed and flossed regularly. In fact, it took a while to realize (because I couldn't afford to see a dentist), that I had infections, not cavities. I would, without exception, develop these infections the day after over-exerting myself. It took some time (over a year) to realize these were infections and use Echinacea to combat them.

    Understand. I was a single mother with a dead-beat ex-husband who moved to another state to avoid paying his share. I had no insurance because I could only afford to support my children and myself by working in the restaurant business. It is a business that almost never offers benefits of any kind. But it pays. So when I got sick I did not go the doctor for some time. In fact, I hadn't gone for years.

    However, I was able to go on medicaid in 2010 and in 2011, I went to a dentist. They extracted 8 teeth altogether and had two partial (upper and lower) bridges made. They did this in a series of 4 visits. Each extraction was traumatic, even though most of the teeth were already quite loose. But after the first 3 sessions (which handled the loose teeth), it took at least 1-2 days of complete bed rest to recover. The fourth session, however, entailed removing two teeth that were still well rooted in the jaw. Removing these teeth caused a trauma so great I had a mild heart attack afterwards. It took me 12 weeks to recover from this.

    My point is, CFS will effect every person differently. Because it impacts the weakest part of the body; the systems that are most vulnerable. So some people may have flu-like symptoms while others have stomach disorders.

    As the condition progresses, it attacks more and more of the body. I now suffer from osteopenia, rheumatoid arthritis, a hiatal hernia, fibroid tumors and a cyst on my breast. The last 3 are potentially cancerous conditions. I also have a very low tolerance to medication so many treatments are difficult, if not impossible. Even simple procedures such as a colonoscopy or endoscopy have caused me to be completely exhausted for weeks.

    I am probably only alive because, A) when I first became ill I was in better-than-average condition for someone of my age (44) as I have always believed in exercise and was, in fact, running 5-8 miles a day only the year before I contracted this condition (and had been running since I was 14). I also walked my dog daily and bicycled regularly. And, of course, I was always on my feet in the restaurant business; and B) because, thanks to having grown up in an athletic family, I knew how to listen to my body and adjust my activity accordingly, yet keep trying. Throughout this condition, I have always tried to do all I can, walking as much as possible in the last years. But, in the first years, I had even continued running and bicycling after I became ill. However, these proved to be too problematic, as they would inevitably bring on symptoms no matter how carefully I trained. Even walking has now become difficult.

    My main point is CFS is a condition that effects the body's ability to recover, to heal. Recover is slow. This is the reason for the tiredness, which is really just a symptom of the larger problem.

  7. Griffith University Australia has made a lot of pathology on the disease, and there is now a test for it. Ditto with Fibromyalgia, the University of Chicago has a low cost urine test.

  8. You are depressed because you are sick and unable to live a productive, successful life. Guess what, you'd be be depressed too!

  9. I'm sure a lot of people approach you with odd suggestions. I am part of the "Mysterious Illness" group. My journey began a little over 5 years ago. I have been through a living hell! I would like to share what I have learned. there is a lot of info on the internet right now about a correlation between Epstein -Barr Virus recurrences being the cause! Also there is new info out there to support this. please search "medical medium.

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