Understanding Chronic Fatigue Syndrome

First it is important to understand the meaning of the word ‘syndrome’. A syndrome is a group or set of symptoms that cluster together. A syndrome (e.g., pneumonia) can look the same clinically (with pneumonia, you cough, have a fever, produce sputum, have shortness of breath, fatigue and perhaps chest pain), but have different causes (pneumonia can be caused by tuberculosis, pneumococcal pneumonia, mycoplasma, fungal infections, toxic exposures, etc.) and therefore different treatments, depending on the cause. Additionally there are predisposing antecedents (vulnerability factors) for pneumonia, such as alcoholism, cystic fibrosis, or hypothyroidism. This means that people with these antecedents are at higher risk than the average person. Finally, there are chemical mediators of the pneumonia (the substances or factors that act as the medium of illness) such as white blood cells, hormones (e.g. adrenal steroids), and cytokines (the hormones of the immune system).

When one looks at a syndrome with this ‘Whole’ perspective, things are both more complicated, and more understandable and treatable. Thus, with CFS, we assume that there are a variety of antecedents, mediators, and triggers, which in combination can produce a syndrome we call CFS/CFIDS/ME. The attempt to find one cause for all people with CFS is a fruitless exercise, just as the attempt to find one cause of depression, pneumonia, diabetes, or cancer is fruitless. However, it is likely that there may be one or perhaps a few final common pathways (e.g., mitochondrial dysfunction-mitochondria being the energy factories of each cell, reduced capillary blood flow and oxygen delivery), yet to be indentified.

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