AngelM
Senior Member
- Messages
- 150
- Location
- Oklahoma City
I hope it is not out of line for me to share the letter I received today from Dr. Charles Lapp of the Hunter-Hopkins Center in NC. I am flattered that this great CFS researcher and fine physician (at the behest of a mutual acquaintance) took time from his busy schedule to write and personally
address an issue I have struggled with for many years. He clarifies a great deal for me. I’m hoping forum members might help me better understand the tests he recommends. And, hopefully, his kind words and recommendations will be of help to others, as well.
Angela,
You ask a very good question: ‘when severe anxiety disorder is present, can you distinguish Chronic Fatigue Syndrome because the symptoms are so similar.’
The answer is, “It’s difficult.” However, there are characteristics that tend to differentiate the two:
Anxiety tends to be more of a lifelong disorder, whereas ME/CFS more frequently has a more distinct and recent onset.
Anxiety frequently responds modestly to medication such as benzodiazepines, while ME/CFS does not.
The severity of symptoms such a pain, fatigue, non-restorative sleep, upright intolerance are more severe in ME/CFS whereas “worry” tends to be more severe in anxiety.
Anxiety is not usually associated with the symptoms of recurrent fever, sore throat, and swollen glands.
Anxiety tends to paralyze the patient with symptoms, who may be withdrawn, whereas persons with ME/CFS are pro-active and even energized but exhausted.
From a biochemical standpoint, we would see low white cell and Natural Killer Cell counts, elevated LDL levels, low IgG, elevated CD8/CD38 cells, possibly a higher prevalence of DR3, DR4, DQ1 and DQ3 alleles, abnormal MRIs, and distinctive QEEGs or SPECT scans.
So you see, a careful history and examination can help discriminate the two. I hope this helps!
Charles W. Lapp, MD But
Hunter-Hopkins Center
7421 Carmel Executive Park, Ste 320
Charlotte, North Carolina 28226
Tel 704.543.9692 Fax 704.543.8547
Web: drlapp.com
…specializing in fibromyalgia, chronic fatigue syndrome, and related conditions.
Virus-free. www.avg.com
address an issue I have struggled with for many years. He clarifies a great deal for me. I’m hoping forum members might help me better understand the tests he recommends. And, hopefully, his kind words and recommendations will be of help to others, as well.
Angela,
You ask a very good question: ‘when severe anxiety disorder is present, can you distinguish Chronic Fatigue Syndrome because the symptoms are so similar.’
The answer is, “It’s difficult.” However, there are characteristics that tend to differentiate the two:
Anxiety tends to be more of a lifelong disorder, whereas ME/CFS more frequently has a more distinct and recent onset.
Anxiety frequently responds modestly to medication such as benzodiazepines, while ME/CFS does not.
The severity of symptoms such a pain, fatigue, non-restorative sleep, upright intolerance are more severe in ME/CFS whereas “worry” tends to be more severe in anxiety.
Anxiety is not usually associated with the symptoms of recurrent fever, sore throat, and swollen glands.
Anxiety tends to paralyze the patient with symptoms, who may be withdrawn, whereas persons with ME/CFS are pro-active and even energized but exhausted.
From a biochemical standpoint, we would see low white cell and Natural Killer Cell counts, elevated LDL levels, low IgG, elevated CD8/CD38 cells, possibly a higher prevalence of DR3, DR4, DQ1 and DQ3 alleles, abnormal MRIs, and distinctive QEEGs or SPECT scans.
So you see, a careful history and examination can help discriminate the two. I hope this helps!
Charles W. Lapp, MD But
Hunter-Hopkins Center
7421 Carmel Executive Park, Ste 320
Charlotte, North Carolina 28226
Tel 704.543.9692 Fax 704.543.8547
Web: drlapp.com
…specializing in fibromyalgia, chronic fatigue syndrome, and related conditions.
Virus-free. www.avg.com