Connection Between Fibromyalgia and Chronic Fatigue Syndrome

by M G Rana, MD.

Fibromyalgia and chronic fatigue syndrome (CFS) are both diseases characterized by severe exhaustion. In fact, the conditions seem to be so intertwined that the medical community continues to debate whether fibromyalgia fatigue is simply a different expression of the same disorder that causes CFS. Statistically, fibromyalgia fatigue occurs in more Americans than chronic fatigue syndrome.

The U.S. Centers for Disease Control and Prevention believes there are about 5 million people in the United States with fibromyalgia, compared with a little over 1 million people with chronic fatigue syndrome. Chronic Fatigue Syndrome or CFS is a medical condition with an unknown cause, presenting initially with constant or recurring fatigue for 6 months or more. Myalgic encephalitis or ME is the now the internationally accepted term for CFS. Fibromayalgia or FM is a medical condition with unexplained cause, often presenting with quadrant pain and multiple tender points for minimum of 6 months.

Along with several other common symptoms such as bowel problems, headaches, low mood etc fatigue and pain also seem to be present in both conditions. Both conditions are usually seen in women above the age of 40. Physiologically, both show reduced blood flow to the midbrain & cortex, symptomatic orthostatic tachycardia, non-refreshing sleep, suppressed hypothalamic pituitary axis, low levels of CSF serotonin & growth hormone, and genetic clustering of traits. Due to these similarities, they have been in the past suggested to be the same illness. Diagnosis would be based on whether a patient saw a Physician or a Rheumatologist.

These two disorders maybe connected due their parallel presentation. Widely clubbed as twins, experts now understand the differences between Chronic Fatigue Syndrome (CFS) and Fibromyalgia. CFS is frequently triggered by a flu-like or infectious illness whereas, FM is triggered by trauma. Still, study has found that the line connecting fibromyalgia fatigue and chronic fatigue syndrome is a very lean one. The Arthritis Foundation estimates that 50 to 70 percent of people with fibromyalgia also fit the criteria of chronic fatigue syndrome.

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Connection between fibromyalgia and chronic fatigue syndrome

Immune dysfunction syndrome (CFIDS) and myalgic encephalomyelitis (ME) are the few other names used for chronic fatigue syndrome.  CFS is another “invisible disease” that affects the body and the mind.  Like fibromyalgia, chronic fatigue syndrome is also an illness for which scientists are still attempting to determine the cause.  The leading theory is that CFS is an autoimmune disorder of the central nervous system.

Does this mean that some people could be suffering from both conditions? Possibly, but it would be difficult for most physicians to diagnose this with certainty. Nonetheless, there are important differences in the ways fibromyalgia fatigue and chronic fatigue syndrome present themselves. Rheumatologists and arthritis experts are mainly fibromyalgia researchers. Chronic fatigue syndrome researchers most often are immunologists and virus experts. Due to this reason, despite their similarities fibromyalgia has been thought of as a muscle disorder while chronic fatigue syndrome has been associated with viral infections.

Chronic fatigue is both a symptom coupled with many conditions and a syndrome on its own. Fibromyalgia is a condition that produces chronic fatigue as a primary symptom. It is possible that your symptoms of exhaustion, lack of energy, and an inability to sleep could stem from either of these two conditions. It is important to talk to a doctor or health professional for a proper diagnosis, because the symptoms of chronic fatigue syndrome (CFS) and Fibromyalgia (FM) look like those of other conditions.

Vitamin B12 deficiency in fibromyalgia and chronic fatigue syndrome

Other illnesses share similar symptoms with FM and CFS, causing yet more confusion in diagnosis and treatment.  Additionally, other conditions like pernicious anemia may occur at the same time as CFS, and may go undetected as a result. A high correlation exists between vitamin B12 deficiency and fibromyalgia.  Any condition that causes gastrointestinal problems will likely also result in poor digestion of vitamin B12.  Untreated, B12 deficiency can escalate into severe nerve damage.

Symptoms of B12 deficiency may include nerve pain (tingling, pins and needles) in the hands and feet, numbness in the hands and feet, decreased energy, loss of mental focus, fatigue, depression, anxiety, sore tongue, altered sense of taste, short-term memory loss, clumsiness, and difficulty walking, running or jumping without stumbling. Other disorders and illnesses linked with vitamin B12 deficiency are inflammatory bowel disease (IBD- Crohn’s disease and ulcerative colitis), lupus, heart disease, Alzheimer’s disease, autism, celiac disease, osteoporosis, and diabetes. Because vitamin B12 deficiency shares so many symptoms with chronic fatigue syndrome, it might go untreated.  For that reason, it is advisable for people suffering from CFS or FM to get their vitamin B12 blood levels checked routinely.

Differences between both conditions

People with chronic fatigue syndrome frequently nag of fever, inflamed glands, and other signs of swelling. Doctors find no evidence of inflammatory response in patients with fibromyalgia fatigue. Though chronic fatigue syndrome and fibromyalgia are both connected with disturbed REM sleep, a new study from Japan found key differences in other sleep disorder between people with CFS alone and those with CFS and fibromyalgia.

A lot of people diagnosed with fibromyalgia fatigue report that their symptoms followed some kind of trauma a bodily injury or a disturbing shock. While, viral infections like mononucleosis or influenza are the causes of chronic fatigue syndrome. If people feel tenderness or pain in at least 11 of 18 dissimilar sited on their bodies, then they are diagnosed with fibromyalgia fatigue. People with chronic fatigue syndrome do not have these pain sites. Common symptoms of both fibromyalgia and chronic fatigue syndrome include chronic pain and fatigue. The variation is that, in fibromyalgia, fatigue frequently takes a backseat to devastating muscle pain. People have a devastated lack of energy in chronic fatigue syndrome, but also can acknowledge some pain.

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References:

  • The Common Threads of Fibromyalgia and Chronic Fatigue Syndrome By Dennis Thompson Jr. via Everyday health
  • Is my Chronic Fatigue a Symptom of Fibromyalgia? via Dr. Honow

For support and Discussion join the group “Living with Fibromyalgia and Chronic Illness”

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