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Chronic Fatigue and Immune Dysfunction: Who Took the “ID” Out of CFIDS?

Ember

Senior Member
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2,115
Author: Erica VerrilloPublished: Mar 07, 2013 at 7:04 am

http://blogcritics.org/culture/article/chronic-fatigue-and-immune-dysfunction-who/
Does anyone remember CFIDS, aka Chronic Fatigue and Immune Dysfunction Syndrome? Back in the 1990s this was the accepted term for what is now called CFS, or, if you are so inclined, ME/CFS. The "ID" was quietly dropped by researchers and doctors about 10 years ago in favor of Steven Straus’s infamous legacy: chronic fatigue syndrome. Everyone agrees that CFS is a confusing, misleading and utterly dismissive name for the illness. Not only does it harm the people who have CFS, it harms the people who don’t. In a recent study of patients newly diagnosed with MS, nearly one-third had been diagnosed with CFS (or with the even more vague, “fatigue”) for one to two years prior to being diagnosed with MS.

Imagine how many other patients with incipient cancer, heart disease, liver disease, diabetes (to name a few “fatiguing” illnesses) have had the catch-all diagnosis of CFS slapped on them simply because they were tired. The term CFS has been just as much a curse to those patients, whose correct diagnoses and treatments have been delayed by years, as it has been to patients with CFIDS.

Who did this? Who managed to drop the all-important feature of immune dysfunction from the name? After all, it is obvious that people with CFIDS have an immune dysfunction. Chronicity is, in fact, the product of an altered immune system. With a fully functioning immune system, the host recovers. Immune dysfunction is not just a feature of chronic disease, it is its definition.

What's more, the furor over what to call the “Disease of a Thousand Names” has only intensified since the "ID" dropped out. Prior to its deletion, people who had been diagnosed with (depending on their geographic location) ME (myalgic encephalomyelitis) or CFIDS maintained a cordial relationship. Since the change, they are at each other’s throats. People with ME do not want to be diagnosed with an illness that not only reduces all their symptoms to the “f” word, but is doggedly lumped into some ill-defined category of mental illness....


Blame CFS on Dr. Natelson...
In summary, any further studies seeking to identify immunological abnormalities in CFS patients require careful attention to methodological issues. First, efforts should be made to reduce the heterogeneity of the patient sample; alternatively, large sample sizes are required in order to evaluate the importance of subgroups within the overall CFS population. Similarly, efforts must be made to reduce any potential major differences between patients and controls in areas such as the level of fitness and the presence of psychiatric disorders. Next, samples should be coded and, perhaps, provided as split samples to evaluate within-assay variability in a laboratory. Finally, appropriate statistical methods are required if differences between patients and controls are done on more than one immunological parameter. Our conclusion is that the available evidence does not support chronic fatigue syndrome as being due to any consistent immunological dysfunction. Until that evidence is better documented, we believe that the term “chronic fatigue syndrome” is preferable to the older “chronic fatigue and immune dysfunction syndrome" (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC120010/).