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Some doctors believe that Fibromyalgia (FM) and Chronic Fatigue Syndrome/Myalgic
Encephalopathy (CFS/ME) are the same or are different forms of the same condition.
As researchers learn more about FM and CFS/ME, they're learning more and more about
the differences between them.
For instance, the immune systems of people with CFS/ME typically behave as though
they're actively fighting an infection, even though no infection is present. People with
FM don't have the same immune response going on.
Similarities Between FM & CFS/ME
FM and CFS/ME are known to have a host of symptoms in common. They include:
- Pain
- Fatigue
- Sleep disorders
- Irritable bowel syndrome symptoms
- Chronic headaches
- Association with Temporomandibular Joint Syndrome (TMJ)
- Cognitive or memory impairment
- Dizziness
- Impaired coordination
Differences Between FM & CFS/ME
One key difference, when it comes to a diagnosis, is which symptom is worst, pain or
fatigue. The diagnosis could also be influenced by whether your doctor is more familiar
with the American College of Rheumatology's criteria for FM or the CDC's guidelines
for CFS/ME.
However, experts have found some significant differences. CFS/ME tends to begin after
flu-like symptoms and may be linked to a virus. CFS/ME patients often have high levels
of a cellular antiviral enzyme called RNase L, while the level is normal in FM patients.
Also, CFS/ME diagnostic criteria include low-grade fever and sore throat, while FM criteria
do not.
Meanwhile, the onset of FM frequently is traced to a physical or emotional trauma. The
pain of FM gets better with heat and massage, while the pain of CFS/ME does not. Further,
people with FM have tender points and abnormal levels of a cellular chemical called
substance P (which transmits pain signals), and this level appears to be normal in those
with CFS/ME.
Conclusion
How can you tell whether you have FM or CFS/ME? Often people get one diagnosis but think
they might have the other one, or both. If you don't have tender points, you don't
have FM. If you don't experience exercise intolerance or post-exertional malaise, you
don't have CFS/ME. Usually it is not that simple, though.
Does it even matter which diagnosis you get? In most cases it doesn't. Both illnesses can
be treated with many of the same drugs and supplements, such as anticonvulsants. In
most countries it is equally difficult to get disability benefits with either diagnosis.
But if you do have CFS/ME, it is much more important to avoid excessive overexertion,
as recovery could take weeks, months or even years.
It is also important to avoid confusion with other illnesses. Hypothyroidism can
be misdiagnosed as both FM and CFS/ME, especially as most doctors do not realize that
low normal thyroid hormone levels may not be adequate for everyone. There are many
conditions that can cause pain and chronic fatigue, and some doctors may be too quick to
make the diagnosis before overruling other possibilities.
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