There are regular reports in the media asserting that the cause of Chronic Fatigue Syndrome is unknown. In my humble but strong opinion, they’re wrong.
For example, National Public Radio asserted that …
Researchers still are not sure why people suffer pain, exhaustion, anxiety, insomnia and other symptoms, sometimes for years. They have suspected viruses, but have not proven which one.
Actually, Jacob Teitelbaum, M.D., has shown that a variety of physical and emotional triggers can lead to Chronic Fatigue Syndrome/Fibromyalgia Syndrome (CFS/FMS). I’m using a term he coined, because he has also demonstrated that Chronic Fatigue and Fibromyalgia are in fact the same underlying condition.
That underlying condition is hypothalamic dysfunction. When the body is sufficiently overwhelmed, this causes the hypothalamus in the brain to blow like a fuse. The body shuts down in an attempt to protect itself. This shutdown means that everything from hormone production (adrenal, thyroid, sexual and many more) to digestive function, immune function and cellular energy combustion, ceases to work properly.
This is tricky because the set of triggers that leads to hypothalamic dysfunction is unique in each case. Possible physical triggers include bacterial infection, viral infection, fungal infection; emotional triggers include grief, trauma and certain neural patterns. To add to the confusion, once triggered, the onset of the disease can be gradual or sudden. Also, the end result can be as unique as the triggers. Some patients experience just Chronic Fatigue, others just Fibromyalgia and most have some combination of both.
If a doctor tests for, say, thyroid function, it may look “normal.” As I understand it, this is because the problem isn’t just the thyroid. It is the total interplay of thyroid, adrenal and hypothalamus. So, while normal ranges are statistically determined from the population, this doesn’t mean normal for a particular person. Or, size 6 may be the average shoe size for a population but that doesn’t do you much good if your individual shoe size is 8. The test may not catch a small suppression in the thyroid function. But a small suppression in the thyroid, combined with similar suppressions in adrenal function and other parts of the system, can be catastrophic.
When news broke that XMRV may be the cause of CFS/FMS, I wrote here that this didn’t change my treatment protocol. Since the goal of treatment is to turn the fuse back on and get the overall system working, proper treatment shouldn’t really change with the addition of a new infectious agent to the list of potential triggers.
Sure enough, there have been reports as recently as this month, indicating that scientists have not been able to prove the XMRV CFS link. The main reason for my skepticism when I responded to the initial media reports, was that I understood that once CFS has been triggered, the body becomes more susceptible to infectious agents in general, given that the immune system is now compromised. In my mind, this suggests that you can expect to find more incidences of infectious microbes in CFS/FMS patients, as compared with the normal, healthy population.
It’s worth mentioning that another source of confusion is the fact that some patients get better faster than others. I suspect one of the factors here is early diagnosis. If you can catch this condition before it becomes entrenched then it’s easier to treat one aspect – say a viral or bacterial infection – and get a good response.
The problem is not whether we know the cause of CFS/FMS. Obviously, I believe we know the answer to that. The real problem, is that CFS/FMS does not fit the prevailing understanding of medical science nor does it fit the prevailing model of health care. There are indeed conditions that are specifically connected to particular microbes and your doctor can test for them, prescribe a pill and cure you. What we should be doing is expanding our understanding to benefit the resolution of Chronic Fatigue and Fibromyalgia, rather than trying to shoehorn a condition that is beyond our current understanding, into limited medical models. We need to remember that model means an approximation to help us understand reality. The model itself is not reality.
Before the advances of antibiotics, you had to go to a sanitarium to recover from tuberculosis. Since you couldn’t be treated with a pill or surgery, the idea was to go to a place where your overall system could be supported towards recovery. I have no idea whether one day Chronic Fatigue and Fibromyalgia could be cured by a simple pill. But even if we got to that point, it would still be beneficial to make use of the techniques of recovery that are currently known, so that patients don’t relapse. Maybe the idea of sanitariums needs to be revisited.