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Powerful Evidence That Chronic Fatigue Syndrome (CFS) And Fibromyalgia (FM) Are Real And Mainly Physical

  [ 42 votes ]   [ 4 Comments ]
By Richard Podell, M.D • • March 1, 2015

Powerful Evidence That Chronic Fatigue Syndrome (CFS) And Fibromyalgia (FM) Are Real And Mainly Physical
Key ArticleLight, A et. al. Gene expression alterations at baseline and following moderate exercise in patients with Chronic Fatigue Syndrome and Fibromyalgia Syndrome. J Intern Med. 2012 Jan;271(1):64-81*  Web address for complete paper is HERE
Alan Light, Ph.D, Lucinda Bateman, M.D. and colleagues from the University of Utah School of Medicine measured messenger RNA output from 13 selected genes both before and  over 48 hours after 25 minutes of exercise on a stationary bicycle.
The subjects included 48 patients with CFS-ME with or without co-occurring FM, 18 Patients who had FM but not CFS and 49 healthy controls. The 13 genes monitored relate to sensory nerve signaling, cytokine and immune function and the sympathetic nervous system.  Gene activity was inferred from the level of messenger RNA derived from each gene as expressed on the subjects’ white blood cells.
Results: CFS and FM patients reported increased symptoms of pain or fatigue throughout the 48 hours post exercise. In controls, there was no reported fatigue and no significant change in gene expression. In 71% of patients with CFS, whether with or without co-occurring FM, moderate exercise increased  messenger RNA output from 12 of the 13 genes. 
In the other 29% of CFS patients exercise caused decreased transcription of messenger RNA from an adrenalin related gene. Many of these patients had a clinical history of orthostatic intolerance. In contrast, the FM-only patients showed no post exercise changes in gene expression. However, their baseline level for several key genes were already abnormal at rest.
SignificanceThis is one of very few studies that identified an objective laboratory marker which closely correlates with the patients’ complaints of a prolonged increase symptoms after modest exertion. This is very important both politically and as a guide toward future research. Two different subgroups of CFS patients were identified. FM co-occurring with CFS may be mechanistically different from FM that occurs without major fatigue.
Personal Opinion: After considerable effort Dr. Light has obtained a modest research grant from NIH. If our goal is to make research money productive, I’d say that further support for Dr. Light’s work should be a priority.
Richard Podell, M.D
Clinical Professor
Dept of Family Medicine
Robert Wood Johnson Medical School

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Article Comments Post a Comment

CFS/FM Study WITH LAB Values
Posted by: Chiro22
Mar 1, 2015
Great article. It is rare to see a CFIDS/FM study that utilizes proper research methodology. The ones that do are often done without data that is as objective as solid lab values. I would enjoy seeing this study done along with the recording of other numbers: CreatinineKinase, myoglobin, and other inflammatory markers specific to muscular tissue.
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Objective testing
Posted by: Cayce75
Mar 12, 2015
This could result in the kind of objective testing that patients, like myself, who suffer with moderate to severe forms of FMS/CFS could use as evidence when applying for disability. It would be wonderful if there were some real scientific result that would confirm our complaints of post exertional fatigue, which is rarely taken into account during disability exams, where they continue to concentrate on what we can accomplish "right now". The explanation that my condition is fickle and inexplicable does not hold much weight with disability adjudicators. I have written whole papers, and cited sources, in an effort to get my point across that if I can manage a task today, it's quite likely that tomorrow and possibly the day after, I will need serious rest and recoup time (I.e. Grocery shopping, vacuuming one room of the house, playing outdoors with the dog for 30 minutes). Due to the erratic nature of these conditions, it is hard to find and keep and maintain gainful employment due to the strange and unpredictable nature of our pain, fatigue, and cognitive dysfunction. Any scientific test that would further prove that we are not just lazy malingers would be very helpful to further educating those who have to treat us, live with us, educate us, and make decisions about our entitlement benefits. It would also go a great way toward finding ways for us to learn to re-enter society as productive members, based on what we are actually able to accomplish and how we actually function, not just based on what society expects of us based on nothing but opinion. Hopefully, the funding for further controls and testing of this nature are granted and used successfully.
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interesting artcle
Posted by: AuntTammie
Jan 13, 2016
Interesting article, and I am very happy that good research is being done......however, I am SOOOOOOOOOO sick of research articles coming out with headings that proclaim that someone finally found proof that this is not in our heads (or something along those lines)..

...we have had a TON of objective research over the yrs that does show that this is a physical illness. It just gets suppressed, and the stupid theory that this is psychological gets pushed...

....and then every time there is something slightly new researched, we get another of these headlines......they are not doing us any favors, because they actually subtly reinforce the idea that this might be psychological - ie they tell people again that there are many who have long believed that this is in our heads, and in doing so, a lot of skeptics think that the new research isn't enough to discount all the long held beliefs ..

....believe me, I have read so many of these types of articles, and the comments made by people in the general public to know that this is what happens......the general public does not have reason to actually really look into the all the reasons why the psych beliefs are wrong, and all the previous physiological research that does show that this is a "real" physical illness.....they just see the stupid headlines again proclaiming that this is "real" and they don't buy it

and, yes, I know this is being published in a newsletter sent to patients, not the general public, but it is still available for anyone who happens to google this illness and articles also get shared with the general public themselves and also get quoted and used as reference for other this stuff does get out there
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re my last comment
Posted by: AuntTammie
Jan 13, 2016
I am all for this stuff getting published....I didn't mean for my last comment to sound like I am not.....I just wish that the headlines would simply say what the research is about; not proclaim yet another time that they have finally found proof that this is not a psych issue
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