Hi@sometexan84....I would say it depends on the individual. In some it could be #2, which could be fairly common in the age group this seems to start the most in or, in other cases, one of the other nos. It would be really, really nice to have an answer....I've been searching for approx. 34 yrs. now and I still don't have any answers. All of us have a lot of questions, but what we really need would be a large set of band-aids (at the very least) to cover the symptoms until the big day comes....when we know what causes what and why. Until then, we play the waiting game and try to stay as healthy as possible.
All of our cases are similar, yet different. Not so long ago, I'm talking my 34 years or so, we didn't have trained researchers who even knew what they were looking for. We also didn't have any money, and the govt. was trying to get over what the AIDS epidemic had cost us. Trust me, it wasn't looking for another virus of unknown etiology. So we languished and kept up with the latest theory. There have been a lot of them over the years, so perhaps that's why you'll find people less than anxious to fall over #1, #2 and #3. We get worn out after awhile; meanwhile research has never been better and answers are coming. And those band-aids I was talking about...trust me, they're going to be the bridges until the cure is found.
Personally, I also suffer from neurological diseases that came before my ME. Now that I look back on things, I realize that I had this since my 20's, but didn't know it because it takes time for symptoms to accumulate. Most of us have, for example, IBS (Irritable Bowel Syndrome), which then leads to something else, and on and on it seems to do.
A lot of body systems are affected, some are the same, but then there are generally differences in all of us. We're not carbon copies, which in itself makes it harder to study. We pick up so many secondary things, such as attacks of shingles (I've had 4 of them, 3 at one time all occurring one after the other). They were devastating because they become worse each time you have them. There are now antivirals which shorten the time limit of the illness itself, and the chances of post-herpetic infection, or bad pain that lasts and lasts for who knows how long afterwards And we don't know...in some people it's a few months, in others it never goes away. There is also a new immunization that's worth getting, but you have to be over 50 yrs. of age. Check with your Dr., there may be a way around that I'm not familiar with. You see all of these things further weaken the body and leave us open to infections and more illness. I'm a 73 yr. old female and not many have put in the years that I have. In the future they'll outlive me, but I was never able to return to work, to school, to my old life because illness became my life. Like MS this will stay stagnant in some fortunate people and they can get on with their lives. For the majority of us, that isn't the case. The younger ones make me especially sad as they haven't had time to make a life or family for themselves. This is hard to deal with and my best recommendation would be counseling to help you and/or loved one(s) learn how to handle it.
I'm also from Texas. I live in Dallas, where do you hail from? I'm not putting you off, I've tried to answer as truthfully as possible. I'm not up to the minute in the newest research b//c thus far none of it has borne too much in the way of difference than the old. The day will come though, and we'll all be excited about an answer. I'll be especially excited, not because it will do anything for me at this age, but because I've wanted one for so long and yet the years have flown. In my case I also have considerable pain because of the neurological conditions. When our first pain med came out, it was like bottles of champagne had exploded and yet by today's standards it was not much of anything....but the point is that it was something. It allowed many people to return to work and do some of their dreams. I don't know if it kept symptoms at bay for long, but it did dampen the intensity of them. Little by little we're getting there. As you'll find, there are some very intelligent people on this forum so questions are welcomed. It's just that no one can give definitive answers...trust me, we'd love to, but they're just not available.....yet. Donate for research, that's what will make the difference. If you want your dreams to come true, find a way to raise money for the all important research. I'm wishing you well, and hope you have improvement sooner rather than later. Yours, Lenora.