The following article is my response to comments made on another article I published on the subject of stress-related disorders, including Chronic Fatigue Syndrome/Myalgic Encephalopathy (CFS/ME).

Someone commented in regard to my stating that CFS patients do not experience organ damage or loss of intellect as a direct cause of CFS and they took issue with this stating that there are severe cases in which organ damage and death have resulted. While I believe CFS patients with severe cases have experienced these type things I also believe there can be other factors involved, including co-morbid diseases, neurological disorders and chronic stress. In these cases, would the CFS be a result or a cause of the co-morbid disorders? So far, in my opinion, medical research has shown that CFS is a result, rather than a cause. The progression of the underlying disorders can cause disability and death in some cases but I do not believe CFS was the direct cause of these. CFS is actually a “syndrome” (symptom manifestations) and triggers can often be a number of different things. Once the onset of the illness does take place however, I do believe it becomes an illness-entity of itself.

It may be that singular articles or possibly my replies in particular posts on the CFS and fibromyalgia subjects have come-across as my not knowing that patients can have very severe cases of these illness. I'm not sure how that can be derived from these but for the sake of that possibility I'll add a bit more to my information-base on the subject, with the understanding that neither, myself nor any other person researching the subject, including medical groups has all of the answers. Could they eventually have all of the answers some day? We certainly hope so but in the mean time, for the sake of CFS patients we share what we know to the best of our abilities.

Not only do I believe CFS/ME cases can be severe, I do also believe it has contributed to lives being shortened in some cases although not commonly. With that said let me also add that "complications" that can occur co-morbid with CFS range a great deal, in fact the more serious disorders/diseases can be "triggers" or "underlying causes" for CFS/ME and fibromyalgia. You have to differentiate because of you don't, not only do patients not seek recovery from CFS they also will not seek to be thoroughly evaluated for co-morbid problems that can also be treated.

I have articles in which I cite the fact that Mitral Valve Prolapse is commonly found in CFS patients (among many other things) and may be one of many triggers for the syndrome. This common heart murmur can become severe enough to require corrective surgery and people have been, known to pass away from it (cardiac arrest from severe arrhythmias) but is rare. If I were to approach MVP from a standpoint that implies it is deadly in all cases when up to 20% of the population has the heart condition, I would be putting across the idea that huge numbers of people are going to drop dead from MVP and they might as well not even attempt to treat it or seek recovery.

Here's what is happening with many cases of CFS/ME & fibromyalgia:

Patients are not being evaluated for contributing and/or co-morbid disorders. Some medical sources believe that up to 75% of fibromyalgia patients for example, have thyroid hormone imbalances (usually underactive). If it is not tested-for and not treated, heart problems, myxedema and even coma or death can happen over time from progressive hypothyroidism.

The more severe cases of CFS are those with co-morbid problems but more than 15 years of ongoing CFS research cannot prove that these co-morbid disorders were caused by CFS. Most in fact conclude that the CFS was a result of them.

Why am I careful about what I claim to be facts about CFS? Because it is an extremely complicated illness and you absolutely cannot look at individual cases that are severe, even if they number in the 1,000s and claim these represent typical cases. Too many factors are involved, including the fact that we don't always know how much diagnostic testing in all areas a patient has had, how qualified or incompetent their doctors are in treating it specifically, what health conditions might have pre-existed their CFS, etc.....

Controlled medical studies usually contain the most accurate findings that exist. We therefore have to look at these studies as the most accurate info we have, even if it's still incomplete at this point. Also, claiming organ damage resulted from CFS would have to be substantiated with irrefutable proof and that is not an easy thing to do. No single article or book will ever be able to cover all aspects of CFS and if they claim they do, they are in serious need of re-thinking that claim. We do the best we can with all that we have and that's all we can do, period. In the mean time, we should not take away hope of recovery from patients, which might actually be the thing that keeps some of them hanging on.