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Chronic fatigue syndrome and co-morbid and consequent conditions...

Sean

Senior Member
Messages
7,378
Worth repeating:

The high rates of affective disorders in our CFS subjects may reflect the severely disabling nature of the disorder, high symptom burden, lower quality of life, and biologic changes in the brain secondary to chronic illness.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Worth repeating:

The high rates of affective disorders in our CFS subjects may reflect the severely disabling nature of the disorder, high symptom burden, lower quality of life, and biologic changes in the brain secondary to chronic illness.

It may also reflect on these patients knowing that their doctors / the people asking completely understand me/cfs so they felt comfortable saying how they really feel. So often we have to hide our true feelings about having this illness. Or at least I have.
 

CBS

Senior Member
Messages
1,522
All of the above? Does the paper give more details?

@alex3619 - The question would have been worded as follows:

PART C: Comorbid and Consequent Conditions

15. Have you been diagnosed by a medical professional with any of the following conditions
since/after the onset of CFS:
...
j. Severe Spine Problem (lumbar or cervical disc disease, stenosis, radiculopathy, or DJD
requiring surgery, injections, physical therapy, steroids, or strong medications)?

ETA - The parenthetical description would have been read "Severe Spine Problem such as lumbar or cervical disc disease,..." If the response was affirmative for any condition, then the question would then have been followed up with the "check question:"

Was the severe spine problem (or other condition) diagnosis made before your CFS onset? No/Yes
 
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CBS

Senior Member
Messages
1,522
What about IBS? I struggled with that for most of my life and think it had a lot to do with my sudden ME onset 3 years ago...

@Thomas - IBS and GI issues were not specifically asked about as consequent conditions but interviewers had a list of conditions they were instructed to read as prompts when asking if there were "other issues." This list included the prompt "GI issues." I am not presently involved in the analysis but if there are a significant number of people who reported "GI issues," this may be included in a future publication.
 

CBS

Senior Member
Messages
1,522
Thanks. I would have been interested in any differences between sudden and gradual onset.
<snip>

This paper was intended as a more general review of this study. If there are significant differences between patients reporting gradual versus sudden onset, those differences may be included in a future paper.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
If the spine problems are related to osteoarthritis, also known as degenerative joint disease (DJD), the causal factors could be inflammation, mitochondrial dysfunction, and oxidative stress.

See http://www.lef.org/Protocols/Immune-Connective-Joint/Osteoarthritis/Page-03
Several interrelated metabolic factors also contribute to osteoarthritis onset and progression; chief among which are inflammation, mitochondrial dysfunction, and oxidative stress.
  • Inflammation – Osteoarthritis (OA), like many other age-related diseases, is tied to excessive inflammation (Goldring 2011).

    Over-indulgence in foods rich in pro-inflammatory omega-6 fatty acids and insufficient intake of foods rich in anti-inflammatory omega-3 fatty acids characterizes the dietary pattern of most modern, industrialized nations.

    Arachidonic acid (an omega-6 fatty acid) is the raw material used by the body to synthesize numerous inflammatory mediators, including leukotriene B4, prostaglandin E2, and thromboxane A2, all of which contribute to pain, swelling, and joint destruction (see figure 1) (Liagre 2002; Devillier 2001; Kawakami 2001).

  • Mitochondrial dysfunctionMitochondria are the power cores of our cells; they generate the energy that cells need to function. With age, mitochondrial function deteriorates, leading to a variety of negative consequences (Vaamonde-Garcia 2012; Cillero-Pastor 2008; Blanco 2004).

    In the case of OA, dysfunctional mitochondria conspire with inflammation to augment joint destruction. One study found that the inflammatory propensity of chondrocytes was amplified when their mitochondria were dysfunctional. Specifically, mitochondrial dysfunction in chondrocytes is associated with increased reactive oxygen species production and activation of the “master-regulator” of inflammation, nuclear factor-kappa B (Nf-kB) (Vaamonde-Garcia 2012).

    Fortunately, adhering to a plant-based diet rich in dietary antioxidants, reduced in saturated fat, and balanced in omega-6 and omega-3 fats, such as the Mediterranean diet (see Nutritional Interventions section below) may be an effective means of targeting several of the metabolic imbalances that affect OA.

  • Oxidative stress - Oxidative stress, which is caused by free radicals, is known to be a factor in cartilage destruction and inflammation. These reactive molecules are also involved in pain perception (Ziskoven 2010)
After the age of 50, more women are affected by osteoarthritis (OA) than men (Bijlsma 2011); this female preponderance suggests that hormone abnormalities may influence the progression and development of the disease (Tanamas 2011).
 

Hip

Senior Member
Messages
17,824
61% of ME/CFS patients also have fibromyalgia?

What does this mean, in terms of symptoms and labs tests, to have both fibromyalgia and ME/CFS? Most of the symptoms of fibromyalgia are the same as those of ME/CFS.

The Canadian Consensus definition document for fibromyalgia says (on page 11):
Differences Between Fibromyalgia Syndrome and Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) Pain is the most prominent feature of FMS and it is often triggered by a physical trauma. ME/CFS is often triggered by a viral infection and there is usually greater fatigue, post-exertional malaise and cognitive, cardiac, and immune dysfunction. Some patients meet the criteria of both FMS and ME/CFS.

So does this mean that if you have ME/CFS symptoms with no pain, then you just have ME/CFS? If you have pain as well, then you have ME/CFS + fibromyalgia? And if you have pain, but only mild fatigue, mild PEM, mild cognitive dysfunction, mild cardiac dysfunction, and mild immune dysfunction, then you have only fibromyalgia?
 
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Hip

Senior Member
Messages
17,824
36% of ME/CFS patients have low testosterone.

This is a high number, and suggests that many ME/CFS patients might improve their fatigue symptoms by taking testosterone replacement, or boosting their testosterone levels with stinging nettle herb or Tribulus terrestris, since low testosterone can cause fatigue.
 

Sean

Senior Member
Messages
7,378
The high rates of affective disorders in our CFS subjects may reflect the severely disabling nature of the disorder, high symptom burden, lower quality of life, and biologic changes in the brain secondary to chronic illness.

Not to mention the secondary, contingent, but often very high psychosocial burden due to misinterpretation and mistreatment by the medical profession and broader society.
 

Kati

Patient in training
Messages
5,497
36% of ME/CFS patients have low testosterone.

This is a high number, and suggests that many ME/CFS patients might improve their fatigue symptoms by taking testosterone replacement, or boosting their testosterone levels with stinging nettle herb or Tribulus terrestris, since low testosterone can cause fatigue.
Chicken or the egg, which came first? And could it be that many of us has hypothalamic dysfunction. Why? Could it be just another downstream effect of our illness?
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
My back feels quite weak, especially while sitting. I always thought it is caused by the weakness of the deep muscles, which stabelize the spine. Maybe poor blood perfusion or something else. I guess this could cause a lot of trouble over time. The deep muscles have three or four layers to give the spine more power.

That's interesting. My posture has tended to be pretty good, but when my excess fat decreased, and muscle strength and flexibility increased, following commencement of my leaky-gut regime, my back muscles were amongst those that I became more aware of again - in a good way, in that I can once again stretch them when I wake up, for example.

Another extraordinary consequence of the leaky-gut regime is that I now need walking sticks 2 inches longer, and can't imagine how I managed with them shorter! I don't seem to have grown taller (pity), but guess that improved musculature has raised my shoulders.

Incidentally, depression can be caused by high levels of interferon (which some of us appear to have), and anxiety can be significantly reduced by a leaky-gut diet and supplements, and many of us have leaky gut/IBS.

So these co-existing 'affective disorders'/'mental illnesses' are, I suggest, simply different manifestations of the same imbalances/physiological abnormalities as the ME/'CFS' itself. Maybe some of the other 'co-morbidities' are too.

Perhaps an example of the shortcomings of modern medicine's definitions of illnesses.
 

PNR2008

Senior Member
Messages
613
Location
OH USA
Five years after a serious back operation with complications both CFS doctors thought triggered the CFS/ME. I had a bone biopsy looking for TB which was never found but arachnoiditis was. Hypothyroidism came with the beginnings of CFS/ME and worse migraines then later very touchy FM. You better believe mental illness soon followed.
 

deleder2k

Senior Member
Messages
1,129
i would suggest that hypothyroid with low testosterone could mean HPA axis dysregulation as a consequence of having ME more than primary hypothyroid.
If patients mention hypothyroidism, chances are this is already being addressed medically.

My HPA axis tests are normal. Testosterone value was 18.5 nmol in 2010, 15 in 2012, and hit a record low this June with 7(!)..
 

Hip

Senior Member
Messages
17,824
Chicken or the egg, which came first?

That's always the case with comorbid conditions: they are statistical associations, but you don't necessarily know what the causal connection might be.

If statistically comorbid condition C is frequently found to occur with disease D, this might be because:
• C is caused by D
• D is caused by C
• Both C and D are caused by a third independent factor.
 
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Hip

Senior Member
Messages
17,824
So these co-existing 'affective disorders'/'mental illnesses' are, I suggest, simply different manifestations of the same imbalances/physiological abnormalities as the ME/'CFS' itself. Maybe some of the other 'co-morbidities' are too.

Yes, if would be very strange if the brain dysfunctions and abnormalities that we know exist in ME/CFS did not frequently lead to other mental symptoms or conditions such as anxiety, depression, etc.

When I first caught the virus that precipitated my ME/CFS, the first mental symptoms it produced were not ME/CFS symptoms, but rather were: generalized anxiety disorder, anhedonia and blunted affect. These mental symptoms appeared very soon after contracting my virus (and not only in me, but also in others who caught the same virus). My ME/CFS symptoms only arrived later.

So it was clear to me that my virus is capable of causing anxiety, anhedonia and blunted affect, as well as ME/CFS.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
To @Hip suggestions, I would like to add causal loops.

C might cause or contribute to E.
E might cause or contribute to D.
D might cause or contribute to F.
F might cause or contribute to C.

Or in some cases C might cause or contribute to D, D might cause or contribute to C.

Biology can be messy. These kinds of loops is why different people can look at the same data and pick their favourite point on the loops and say: it starts here.

In the immortal, simple and yet deep words of Isaac Asimov: A circle has no end.
 

Thomas

Senior Member
Messages
325
Location
Canada
Yes, if would be very strange if the brain dysfunctions and abnormalities that we know exist in ME/CFS did not frequently lead to other mental symptoms or conditions such as anxiety, depression, etc.

When I first caught the virus that precipitated my ME/CFS, the first mental symptoms it produced were not ME/CFS symptoms, but rather were: generalized anxiety disorder, anhedonia and blunted affect. These mental symptoms appeared very soon after contracting my virus (and not only in me, but also in others who caught the same virus). My ME/CFS symptoms only arrived later.

So it was clear to me that my virus is capable of causing anxiety, anhedonia and blunted affect, as well as ME/CFS.
Same on the anhedonia and blunted affect. Did you find anything to lessen those?
 

Hip

Senior Member
Messages
17,824
Same on the anhedonia and blunted affect. Did you find anything to lessen those?

I found some supplements that help a little bit: see this post. But I find you have to take several of these together in order to get a good effect.