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Fibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivities – What do they have in common?

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Reproduced with permission from the July 2006 issue of HospitalNews.com.

FM, CFS and MCS: They are common poorly understood chronic multi-system illnesses that are newly recognized by the medical community and mainly affect women. Men and children can also be affected. They occur in 1.5 percent to 3.0 percent of people, according to the 2003 Canadian Community Health Survey. They cost the healthcare system millions of dollars in healthcare costs and the economy millions of dollars in lost wages. As a result of being chronic illnesses, this added burden often leads to family break-ups.

The following are summaries of the clinical definitions that describe these conditions.

Fibromyalgia (FM) is characterized by more than three months of pain on both sides of the body and at least 11 out of 18 positive tender points present on physical examination. Additional symptoms can also include:

  • Severe fatigue;
  • Sleep disturbance;
  • Neurocognitive problems including impaired concentration, reduced short-term memory, and difficulty multitasking;
  • Problems regulating blood pressure,
  • Irritable bowel symptoms;
  • Body temperature instability;
  • And loss of adaptability to stress with anxiety or reactive depression.

The criteria that define Chronic Fatigue Syndrome (CFS) include the following:

  • Severe disabling fatigue and post-exertional fatigue;
  • Sleep disorder; muscle pain and headaches;
  • Problems with mental functioning such as impaired concentration, reduced short-term memory and difficulty multitasking;
  • Symptoms related to the autonomic nervous system such as low blood pressure and irritable bowel syndrome;
  • Autonomic neuroendocrine symptoms such as low body temperature, weight change and worsening symptoms of stress with anxiety and reactive depression;
  • Immune symptoms including ongoing sore throat and swollen glands, flu-like symptoms and new sensitivities to food, medications and chemicals;
  • And persistence of the illness for at least six months in adults and three months in children.

All other causes of the above symptoms must be ruled out before the diagnosis of CFS is made.

Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by symptoms that are reproducible with repeated chemical exposure.

  • Very low levels of chemical exposure (lower than commonly tolerated), produce the patient's symptoms.
  • The symptoms improve when the patient is removed from the chemicals.
  • The patient responds to many chemically-unrelated substances.
  • Symptoms involve multiple body symptoms but the most common symptoms include feeling dull or groggy, having difficulty concentrating, feeling "spacey", and having a stronger sense of smell than most people.

As you can see, there is considerable overlap in these three conditions….

The exact causes of these conditions are not yet known.

  • Fibromyalgia is commonly seen after physical trauma such as car accidents.
  • Chronic Fatigue Syndrome is most commonly seen after a viral illness from which the patient does not recover.
  • Multiple Chemical Sensitivity is most commonly seen after chronic exposure to low levels of chemicals.

So how are these conditions treated? At the Environmental Health Clinic [part of The New Women's College Hospital in Ontario, Canada, where Dr. Bested practices, and created for patients with MCS as described below] we have developed the concept of "weed and seed." Weed out the bad habits of being sedentary, stressed out, eating junk food, drinking poor quality water, exposure to poor quality air and having poor sleep habits.

Replace these with the "SEEDS" of health, which is short for the following:

Support: medical support for the patient – physical, emotional & spiritual; family, plus work place accommodation

Environment: pesticide free food, water and better indoor & outdoor air quality.

Exercise: and Pacing of activities with appropriate rests

Diet/Drugs: as needed for symptomatic relief of sleep and pain etc.

Sleep Hygiene: for better sleep quality.

In the last few years medicine has developed clinical definitions for the above conditions, and research has begun to help unravel the mysteries of these illnesses. For example, preliminary genetic studies that were done through the Environmental Health Clinic Research Unit showed that patients with MCS were “different from the controls in genetic polymorphisms in drug-metabolizing enzymes.”

This is a fancy way of saying that patients with MCS metabolize chemicals through their livers differently than normal people. This might help to explain why they are more sensitive to chemicals than most people – perhaps the chemicals hang around longer.

More research is desperately needed in these areas.

[About the Environmental Health Clinic for MCS patients]

…As a result of public pressure [in Canada], the Ontario government created the Ad Hoc Committee on Environmental Hypersensitivity Disorder chaired by Judge George Thomson. Their 1985 report stated that patients with Environmental Hypersensitivity (now called MCS) had significant health problems that required further research. The committee recommended that patients be treated with compassion and that a special clinic be funded as a bridge between patients, health professionals and researchers. The clinic opened in 1994 at Women's College Hospital and is now called the Environmental Health Clinic. When the clinic opened it also included an initial grant for a Research Unit connected to the clinic.

The clinic does not have a full time physician to service the province of Ontario. Time is divided by three part-time physicians who work at the Environmental Health Clinic one day a week. This out-patient clinic's mandate is to do a one time comprehensive patient assessment and a one time follow-up visit a few months later. The clinic is under funded and not able to service the whole province and has a lengthy waiting list. There is an ongoing healthcare access problem with patients who have severe MCS and need hospitalization, as there are no in-patient beds available for this patient population in Ontario.


* Alison C. Bested, MD FRCP, is a Staff Physician in the Environmental Health Clinic at The New Women's College Hospital in Ontario, Canada. She is a co-author of the book Hope and Help for Chronic Fatigue Syndrome and Fibromyalgia, published by Cumberland House and is available via Amazon at Hope and Help for Chronic Fatigue Syndrome and Fibromyalgia

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2 thoughts on “Fibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivities – What do they have in common?”

  1. loveme2 says:

    I suffer everyday. Last night i wrote a letter in regards to all the ways my body reacts on a daily basis but there just is not enought time and space to describe all, plus my hands gave up before i could finish. I needed to rest.

    I would like to contact the Womens College Hospital and try to obtain an appt. with Dr. A Bested.

    For all the Dr’s I have had over the last 20 yrs all have given up on me. I am in so much pain that some days i just cannot do anything , standing, sitting , resting all hurts and I weight only 100lbs. I really need help. because from where I am life is not so good and it scares me knowing that these Dr’s are recommending I take METHEDONE no way. I have heard some terrible things about this drug. What I take now is really no better. Please help. If there is which I know there are ppl out there like me can we talk and try to come up with some self care techniques that will help them and me. Please contact me at the e-mail attached.

    Thank you

    Clarisse mecg1@sympatico.ca

  2. p199y says:

    Hi all,
    Having been exposed to chemicals over my lifetime has given me Fibromyalgia,chronic Fatigue Syndrome and Multiple Chemical Sensitivities.

    In my opinion Fibromyalgia,chronic Fatigue Syndrome and Multiple Chemical Sensitivities is brain and nervous system damage caused by exposure to chemicals.

    Overload of chemicals brings on these dieases.

    Repeated exposure brings on nervous system damage which then progresses to brain damage.The order of conditions are first Multiple Chemical Sensitivities,then Fibromyalgia and ,chronic Fatigue Syndrome.

    Depending on what chemicals you have been exposed too and the length of time you have been exposed will depend on the overlaps of these conditions.

    I personally have been directly posioned by petro chemicals, primarly solvents.The effects of these chemicals cause damage sometime after exposure, anywhere from 2 years to 5 years.

    Ask yourself what chemicals have I exposed myself too.Right up a list think back as far as you can.Then look up the safety data sheets and look at the biologicals effects of these chemicals.

    Then ask yourself what would be the effects if I mixed up all these chemicals and exposed myself to these chemicals.What are the safety margins.They dont know.A rat cant tell you it has pain and fatigue.It just dies when it get too much.

    Dont forget the chemicals that you dont even know you have been exposed too.The pesticides on and in your nice healthy fruit.The chemicals they use on the animals you eat. The chemicals they put in your water.The chemicals you breath that pours out of your motor vechile.The chemicals that wash into the soil that they grow our food in,and where dose it go, into the big blue soup we call the ocean.

    We my dear friends we are the tip of the iceberg.The medical world dosnt want to accept the truth, we are all being posioned.Just some of us because of our work, because of our hobbys just have done it a bit sooner.

    All the information is there,just nobody wants to put it all together cause it would cause a public out cry a panic.Like I said this is my opinion.

    I would just like to say that Gulf War Syndrome,and cancer should be also added to the list.



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